The dirty little secret of RNY...(long)

I don’t know about your surgery program, but my program often emphasizes the importance of avoiding overeating. Which is good. We didn’t get to where we were by starving ourselves obviously. However, I have found in my experience that not enough emphasis is given to the topic of undereating. I feel like this is equally important for many reasons.

 

I see a lot of post-ops who undereat for several reasons. First, being that with the operation they lost their appetite or get full so quickly that they have trouble getting in enough calories. Add to that the fact that we are constantly being told “don’t eat if you’re not hungry" and that can be a quickie recipe for disaster.

 

Secondly, and I fall among this number, are the people who are out-and-out afraid of food post-WLS. I was scared to death of the stuff! Yes, I experienced the loss of appetite and all that jazz but after a time I was purposely starving myself (and when I say starving I mean it. At my 3 mos. appointment I brought in a 3 day food log where my cumulative calories did not even add up to 1,000 for a three day period). And all the advice about not overeating did not help in this situation. Nor did the scale. It was a vicious cycle. I didn’t eat, which meant I didn’t lose, which made me feel like I was eating too much, which made me eat less, which made me not lose…and on and on.

 

This is not something I think is so much a problem for new-new post-ops as most of their attention is directed at trying to comply with their program and figuring out what the hell they did to themselves. I think issues of undereating begin to become a bigger part of our lives at…about the 3 month mark or so. When we should be eating more but maybe are not. Where we should integrate carbs to support activity but we don’t. When we think we should have more energy but don’t.

 

I mention this because at 19 mos., I still struggle with this. Anyone *****ads the WAYET threads knows I eat a substantial amount of peanut butter. If you look at my overall calories, they are not that high. Just a side note, any daily eating plan that can sustain eating 3-4 tbsp of peanut butter a day is probably too low in overall calories. Because if you take away the 2-300 calories of peanut butter I ate (and I have cut down…my system has trouble handling all that fat) what do you have left? But I digress…

 

Let’s open up a discussion about undereating. Do you feel like you take in enough calories? Do you struggle? Why? I know we all have “big pouch days" where it seems we can eat everything not nailed down but in the end if you feel like you don’t get enough calories to support your activity, and especially if this has caused you to stall, let’s talk about it. Perhaps we can get some strategies together to combat it. Lord knows I’ve tried getting my surgeon’s office to include this in its guidelines because some of what they tell us is downright confusing.

 

(I’m getting to the end I promise…) for example the eating until satisfied/full and not eating when you are not hungry. If I only ate when I was hungry not only would I only eat like 2 times a day, I would probably get in only about 6-700 calories a day. My appetite is more habit than it is physical but I learned very early on that to be successful I have to eat. Even when I’m not particularly hungry.

 

So anyway, I am opening this up. Share your thoughts, your strategies, your successes, your challenges.

I struggle but differently i guess
I do get enough calories but I struggle to make them good ones, quality high fiber, protien etc.
I feel like I am in a constant battle with food demons. It is exhausting at times. I am feeling hungry how and do also battle that reactive hypoglycemia. Even sometimes after eating healthy appropriate meals. I am frightened becasue i read an article melting mama posted about it and that low blood sugar camn make you feel ravenous and want to eat.  And can be a cause for rnyers to gain back weight. I haven't gained any back, other than a 2 or 3 pound fluctuation but i am petrified.

Nik , I realize in working with my NUT that was my long time problem .Not eating enough. Once she added 2 meals per day I started to lose.

That is why I think I will have this problem post op. I don't eat when I am not hungry but then when i get hungry , don't be holding a plate cuz i may eat ur hand too !!

I cant wait to hear what strategies are posted cause I will darn sure be takin' notes...........

I cant wait to hear what strategies are posted cause I will darn sure be takin' notes...........

I think eating on a schedule is the key here.  I still use the same basic schedule for my day as I was given in my pre-op nutrition class.  If we don't have a plan, we'll end up short (or over) at the end of the day.  So even if I'm not "hungry", I still eat because I think of meals as nourishment (delicious nourishment, of course) -- and know my body needs to be fed at regular intervals in order to function at its best.  Here's my current schedule:

7:15am -- protein drink
10am - breakfast
1pm - lunch
4:30 - snack
8pm - dinner
11pm - late night snack

I try to eat at least every 3 to 4 hours.

If it wasn't for my supplementing with protein powder 3 times a day, I would definately not get enough calories.  I am sipping my morning protein (hot) drink now and about 1/2 done with it and I feel so full that I don't want to drink the rest - but I will because I need the protein and calories.  It will take me 2 hours to get over this fullness to where I can eat lunch.

 My nut has me at 600-800 cal right now.  I usually am at 750-850 daily.  When I go in for my 6 mo post op check - I will ask to raise it.

My weight loss is slow and I sometimes wonder if I do need to eat more calories.  I eat healthy and according to my plan.  I dump - so I don't eat sweets, no bread yet and only snacks are whole wheat crackers or protein or soy chips, protein ice cream, fruit or vegetables.

Love your threads, Nik.

I have had the mind set from the beginning that this was a lifestyle change. To that end as soon as I could comforatably eat a thousand calories or more per day I have been.  Rarely do I ever go below a thousand calories and some days I eat as much as sixteen hundred, yes SIXTEEN HUNDRED!  Imagine it!?!

Guess what, I have lost almost 100 pounds in four and a half months.  A normal weighted person that eats 1800-2000 calories of good, healthy food every day will not be overweight as long as they get some exercise. If you get a lot of exercise, you should eat more. 

I don't want to starve and I don't want to be on a diet, they don't work.  So for me, this is a lifestyle change and I eat, plenty.  But I eat VERY differently than I used to and I truly believe that good calories are used by your body much easier than bad calories.  A low carb pita with peanut butter is going to do your body a whole lot more good than a cheeseburger, even without the bun.  And the protein is almost the same. 

Great thoughts Kelly.

I would like to comment on one thing you said though. To me it was a lifestyle change too. I was just confused about HOW my lifestyle was supposed to change. In the beginning I thought the point was to not eat much. My surgeon had to break it down for me. He said "at the 2 year mark I'd like it for your plate to look like that of a normal adult who eats healthy portion sizes." That was profound to me. I was like "so I'm NOT on the two-bite plan forever????" Scared me sh*tless...

Yep, I get that thinking.  But I had reasearched this for more than seven years and have read everything about weight loss/maintenance. Just couldn't practice it!  I do believe a lot of people think they have to live on five or six hundred calories a day like you say. That either scares them to death, or sometimes I think they do it until they can't take it anymore and go back to old eating habits. I sure hope this tool keeps me thinking all the time.  I never want to feel that way again.

So glad I found OH and you!  It's great!

I sturggle, bur definitely NOT with eating too little.  I *am* at 2 years out, and my plate looks like about half of what a normal adult who eats healthy portions would look like (depending on the density of the protein involved, of course).  I make sure I get my protein in, and I do try to eat on a schedule for both my meals and snacks, but sometimes I end up having to eat later than I would like (too clsoe to bedtime), and I still really struggle with not snacking and with the fact that it takes a lot of sugar to make me dump.  I am more sensitive to fat content than sugar content (too much fat = diarhhea) but, even so, I have to REALLY focus on eating the right things.  I honestly wish that I could NOT eat as much as I can. 

For me, the dirty little secret is that, because I almost never feel physically hungry, with a little willpower and a lot of mental distractions, I could eat VERY little on a daily basis (as long as I ate enough to keep me conscious and not shaking when my blood sugar plummets when I don't eat).  I would still like to lose 5-10 pounds and it is very hard for me to fight off the idea that I should just all but stop eating for a couple of weeks to drop those last few pounds...

Lora

I had my surgery 06/01/09 and since then have only lost 47 lbs. I stuck to my doctors plan--60 gr protein and  no more than 30 carbs. I have steadily tried to increase my walking. Then one day I started tracking my food on the daily plate and realized that I was only eating 450-500 calories on most days. Then I  wondered if that was the issue...Not enough calories. I have tried to increase my calories but I am having such a problem trying to eat more...I would love to have an example of a daily menu to see how you can manage to eat enough this early to get 1000 calories.