My doctor wants me to give up shakes but only eat 3 times a day.

I think he's being unreasonable!

I'm 3 months out and have very tight restriction (which is great, right?). I can eat 2-3 ounces of dense protein if I'm lucky. 2 ounces feels just right, 3 is pushing it and I don't want to pu**** I can eat more if it's yogurt or ricotta. I asked him how, exactly, I'm supposed to do this. And why.

The why: I mean, honestly, he didn't make a lot of sense to me. I told him that I really liked it because it fit into my routine well and was easy. He said he doesn't want me doing something that's "easy" because it's a slippery slope to bad habits. He said that a time would come when I would not be satisfied by my protein shake and therefore would overeat at other meals. I mean, my feeling is that I will cross that bridge if and when I come to it. 

I said I would happily add a fourth meal of real food but that wouldn't satisfy him. He insists on 3 meals a day. He wants me to add protein powder to yogurt or oatmeal (which I definitely do not eat). Hm, adding protein powder to yogurt is sounding suspiciously similar to a protein shake. 

I just feel like these are unreasonable demands and wanted to vent about them.

Also he did not congratulate me on my awesome weight loss (didn't even mention it!) or normal A1c. I'm off to have a good sulk about that! 

My doctor told me at my 6 week check up that he didn't want me drinking protein shakes. I have never drank them, I can't tolerate the taste and my body doesn't like them. He did tell me to be cautious with yogurt because it was a snack and not a meal. I think it has to do with learning new eating habits and not relying on a shake to get the protein requirements in. If we are going to maintain the weight loss, we have to develop healthy and sustainable habits or we are in danger of falling back into bad habits and re-gaining the weight.

Congrats on your weight loss!!!  

The thing is, I cannot eat enough protein in only three meals with no snacking to meet my protein requirements. He's insisting that I eat only three meals, no snacks, and no protein shake. It's like, pick two. 

I understand the frustration. My doc was really strict on pre op guidelines and then after I have asked what my protein goals should be and he says, just eat. I ask what should I aim for on calories and I am told eat. I am thinking, it's not good to tell a fat girl to just eat. I have to be accountable to myself so I read and researched and set my own guidelines and they seem to be working fine. The dr staff is happy with my weight loss ( will not set a goal, said it was up to me, but be realistic) That kind of stuff drives me nuts. I like a hard line to be set so that I know when I am too close to it, I can adjust.

I would probably do what works for me, if I were you. But that's me. ;)

I am almost 5 weeks post op and I am right there with you.  I have a Premier Protein shake in the morning to start my day and 2 small healthy meals - I can not eat much and I have to get lean protein in first to even come close to my protein goals.  I do supplement an afternoon snack of low-fat cheese - to ad protein - but if you are eating healthy meals and that one shake - well I am like you - that's the best I can do.  I have made a lot of life changes - but I also have to maintain my job, my house, my kids, and can't really make anymore drastic changes now. Who knows in the future?

Congrats on the weight loss! Keep your head up and keep up the good work!

You're going to have to look at your doc's advice, look at what you know you can/can't do, and make an informed decision.  Given your restriction right now, I can't imagine how you're suppose to hit your protein goal in 3 meals.  So, you either plan more mini-meals, or you stick to your shakes, or a combination of both.  I understand why some docs are opposed to more than 3 meals - they believe it leads to grazing.  I've found that, as long as it's planned eating, it doesn't really matter how many times a day I eat.

And, 4 years out, I still use protein shakes on occasion just because.  I prefer to chew real food, but when the stars aren't aligning, a protein drink guarantees that I get my daily nutrition. 

Yeah, I told him then and there I'm gonna keep doing what I'm doing and that I will reevaluate if satiety becomes an issue. 

I am not sure what your surgeon's original plan was but - mine is to have me back on eating meals by 6 weeks.  Your shakes are a supplement to lose weight quickly prior to surgery for your liver and for getting enough nutrients post surgery because your tummy is healing.

you can put protein powder in anything, gravy, casseroles, if you have breakfast cereal add it to the milk.
The only time you should have trouble getting in enough protein is when you are restricted to liquids because you are not able to eat solid food for healing reasons.

Your weight loss is fantastic, but right now, you have got there by essentially following a shake diet for 4 months (depending on how long your pre-surgery diet was). What your sleeve facilitates is a dramatic weight loss to start with and then a long time to acclimatise to a new lifestyle of eating smaller amounts and being more active.  You have "lost" 6 weeks of learning these habits, because you are not actually doing it. You are supposed to be learning how much solid food is enough for satiety without getting full or overfull and how to manage that long term.

When your pouch starts to relax to normal size and your body starts to get more hunger hormones, a shake will not satisfy your hunger and you could end up doing a lot of things that are not very constructive - 1 having multiple shakes to fill yourself - which can amount to way higher calories, 2 - substituting high caloric drinks with the shakes, 3 - Because shakes are generally not savoury having a very high desire for sweet stuff, etc

there is about 10g of protein in 3ounces of yoghurt, but there is 25g in chicken or tuna. It's quite easy to get enough protein when you are not limited to liquids and you choose the right food.

In summary, you should be proud of your dedication and determination in following your lifestyle choice. You should take your doctor's advice and start to learn the new behaviours you need to succeed long term, because the assistance you are getting from your pouch now, is going to decrease over time.  

It does seem harsh not congratulating you, but congratulating you for behaviour that is not sustainable long term would re-inforce the behaviour and it is also understandable that he didn't. The ends do not always justify the means.

Take Care of Yourself and Good Luck with the  rest of your journey

Perhaps I should have clarified. I currently eat 3 meals of real food a day and supplement with one protein shake so that I get 60-80 g of protein. I have been following this routine since I was 4 weeks post op. I'm not on a shake diet. 

Erm... just ignore my message then. I totally misinterpreted what you were saying. (sorrY!)

I actually then totally agree that your surgeon may be being a little unreasonable, and the silence on your fantastic progress is totally weird. And I will join in the sulking with you!

Hopefully others can help on upping the protein and offer other alternatives for the shakes (if possible).