Is anyone else seriously paranoid about their calorie intake? I'm seven weeks out, down 44 pounds, and eat between 450-575 calories a day. I constantly worry that I'm eating too much. Like, obsessively worry. I also eat the exact same thing pretty much every day because the prospect of eating new foods freaks me out. I need to know the nutrition content of every bite that goes into my mouth. When I feel like I've eaten too much -- which at this point is every day -- I feel horribly, immensely guilty.  I went to a dinner party the other night where, due to a last minute menu change, we were served pasta instead of fish. Like an idiot I ate 6 pieces of ravioli. I had a panic attack at the table, tried to make myself throw it up (unsuccessfully), and cried all the way home. Though I know I've lost a decent amount of weight and am almost at onederland, I constantly battle the feeling that I eat too much, have not lost enough, and am failing this surgery. I know intellectually that this probably isn't the case, but emotionally it feels very real. I know that this is my last chance and I am terrified to screw it up.

Does anyone else feel this way? Any advice for changing my thinking? (Yes, I am seeing a therapist.) 

 You must be reading my mind tonight.. which is exactly why I was surfing the forum.  I am 4 months out and lost 64 lbs preop and 42 post op and drive myself crazy worrying if I'm eating too much or not enough.  Yes, I'm loosing but it's at about 2 pounds/wk which is very similar to how I was loosing preop so where are the surgery results??? I'm getting in about 1200 calories and 100g protein (I have a pretty hefty exercise routine).  Sending my NUT an email because we actually discussed that maybe I wasn't eating enough -- OMG seriously????

My only words of advice are... PLEASE do not try to force yourself to throw up- that's going to lead you down another path which is no better than the overeating path.

Good idea on the therapist -- hang in there.   I actually think we are our biggest (no pun attended) roadblocks... we are so very impatient 

Thank you so much for responding!! I sometimes wish my NUT could move in with me and just tell me what to eat at every meal. It's exhausting to be so stressed all the time. My weight loss has slowed down BIG time, way more than I expected it to so early out, so that's definitely a contributing factor. I totally get the reaction to being told you're not eating enough -- honestly, the thought of upping my calorie intake makes me so panicked! :-/

I totally agree that we're our own biggest (heh) roadblocks. The mental part of this has been so, so much more challenging than I ever expected.

While many people lose crazy amounts with WLS, the ultimate goal (as I see it) is not the rapid weight loss but the chance to actually maintain it!   I don't know about you but I have lost weight many times in my life just to promptly put it right back on.  I have reached the point where I don't even want to try anymore since I knew my odds of true success where slim (pun intented!)

You have already lost over 100lb!  I know over 60lb was pre-op but it is still a staggering amount of weight.  Losing 2lb/wk is healthy.  You WILL lose the weight, but hopefully you are saying goodbye to it forever!

Andrea.

First of all, please remember that your body no longer absorbs all the calories you ingest. So if you eat 500 calories a day, you're not actually getting that many.

That being said, 250-400 calories a day is NOT a healthy diet. Especially since you're not newly post-op, your body can't live on that. It's basically a starvation diet, which would account for why your loss has slowed so drastically. And on so few calories, how are you getting your protein? With a post-op recommendation of 60-80g of protein, you should be eating at LEAST 240-320 calories a day in lean protein alone, and that doesn't include dairy for calcium and vegetables for vitamins, minerals, and fiber.

If you're worried about anything at all, I'd be worried your calories are too low. It's important and necessary to be cautious about what you eat, but getting to the point of obsession over keeping your calories down at an unhealthily low level is a really good way to develop a transfer addiction and end up with a serious eating disorder. What does your nutritionist think about your calorie level?

I usually reach my protein goal or I'm in the ballpark, but it's definitely a concern. I have a hard time convincing myself to eat vegetables and fruit (which I love) because I feel like they're too many calories for not enough protein. I am really wary of increasing my calorie intake (the thought actually makes me feel really panicked) because I am terrified of gaining. I'm scared it will slow my weight loss if I eat more. I already feel like I'm slowing my weight loss by eating this much. I do worry that this obsessing isn't healthy and that I am on the road to developing a transfer addiction, but at the same time with RNY it's not like I can STOP being really careful about what I eat. I am seeing a NUT, but her guidelines were extremely vague. I was basically given a packet of information and told to come back in six months.

Well, think of it this way.

You're already having a little trouble getting all your protein.
You love fruit but are afraid to eat it.
Your weight loss has already prematurely slowed.

So try an experiment. Try adding 100 calories more of protein and 300 calories of fruit and veggies and see what happens. If your weight goes up (which I very seriously doubt it will), stop. If you start to lose again, then you know what the problem was--you were starving and your body was clinging to every last calorie it could get.

You have -nothing- to lose by adding healthy calories to your diet. Except perhaps sone more weight.

Also something to think about, when you lose weight because of starvation as opposed to healthy calorie deficit, you also lose essential nutrients and muscle mass. You might be losing pounds, but you'll end up weak and malnourished.

I'm not a doctor, and obviously, my advice can't and shouldn't be considered professional. I do have my Masters in rehabilitative therapy, which required a year of study in nutrition and I do know how the body's systems work. It's worth a try.

Yeah you should listen.. you are probably in starvation mode..do you know what this means?  it means your body is eating away at important muscles to stay alive...like your heart and brain..etc.  if you keep starving your body of proper nutrients then you will hurt your heart..If you eat something wrong chalk it up and move on.  Nothing is really wrong to eat though and anything is good in moderation.  Try to stay away from white food...white rice, white pasta, white breads and buns..and eat multgrain or whole grain foods and brown rice.  What IS your diet at this point in time?  I was on soft foods at 7 weeks out i do believe.  And at 450 calories there is no way your getting your protein in unless your drinking two 30 gram protein shakes?  You kind of gotta get over this obsession and i would strongly encourage you to seek some counseling as you seem to be on the road to another horrible eating issue..good luck and keep us up to date.

HOney I know what you are feeling. I lost just as quickly on the pre-diet as I am after surgery.  If you are only eating 450-575 I don't think you are eating enough.  I was barely losing when I was eating 600 cals a day the first few weeks of the liquid diet.  I figured that since I wasn't losing not eating I might as well eat something. Then the scale started moving.   I still don't get all the food in a day that the nut says I'm supposed to eat but I too am worried about too many calories.  I have accepted the fact I'm going to be a slow loser.

P.S. a few pieces of ravoli won't doom you!  Hang in there!

I suffer terribly from it.  I am constantly worried to the point that I feel as if I sabotage myself at times.  hang in there.  try not to worry.