Question:
My PCP says 600-800 cals a day is a starvation diet!!!!
My pcp said that eating 600-800 cals a day was too little and that is what an aneroxic person would eat. She also said that she does not see anyting wrong with me being on a 1200 cal diet, since I have been complaining about being tired and having headaches, she says she think it is from taking in too little cals-has anyone else's PCP suggest that they talk to a nutritionists to up their calorie intake. She said that when your body thinks it is starving it will try and protect itself-which is the reason for many plateaus-She said eating more through out the day has actually been proven to help people lose more weight, she said she is saying stick with suggested portion servings, but up my calorie intake, and that even 1200 was a pretty strict caloric intake — TotallyTori (posted on May 3, 2003)
May 3, 2003
Tori - do what your doctor and surgeon tell you to do, but just to let you
know that I was taking in between 600 and 800 calories as late as 6 months.
My nutritionist told me to up it to 1000 calories a day, but I haven't
even gotten to 1000 yet - my top has been 999. I keep track of my calorie
consumption on Fitday as well as in an Excel spreadsheet and my average
daily calorie consumption for April (where I was 8 1/2 to 9 1/2 months
post-op) was 793 calories a day. Considering that I just got my 9-month
labs back and everything looks great (including a fantastic 5.0 HgA1C for a
diabetic), I must be doing something right with the 172 pound weight loss
to date...JR
— John Rushton
May 3, 2003
Like John says, your doc's advice is the most important, but ... you're
only two months post-op. I think 600-800 calories a day is probably typical
for many RNY patients at two months out, when the pouch is still healing
and not able to take in much, or much variety. I wonder how many WLS
patients your pcp has seen, that she would recommend 1200 calories a day to
someone just two months out from surgery (I'd ask her). Personally, I
didn't go up to 1200 calories a day until I was about seven months out or
so. I just couldn't have taken in 1200 calories a day at two months out.
On the other hand, your pcp is right that too few calories can help stall
weight loss. Maybe there's a compromise, and you could bump yourself up to
800-1000 calories a day and see how you do. JMHO.
— Suzy C.
May 3, 2003
I'm down 50 pounds at 5 months. Last month I started counting calories and
found my days running from 900 to 2000 calories a day. Definitely, needed
some guidance. I figured out what my normal calorie input would be at my
goal weight and have been holding myself to that calorie count. I eat a
little something every 2 or 3 hours. I thought I was doing well but the PA
at my surgeon's office said I also was starving myself. He said I should
be eating between 2,000 and 3,000 a day, which I feel is impossible without
adding a lot of unneeded sugar. I think the important thing is small
frequent meals, variety, and eating what you want in large or small
portions depending on it's caloric value. My blood tests are perfect and
no horrible protein shakes.
— Sher R.
May 3, 2003
I don't want to say this for you to think I have a bad opinion of your doc,
but I think a lot of PCP's are uneducated when it comes to this particular
surgery. I live in a small town and I have to say it's a little scary at
how little the docs here know about it. Anyway, in the beginning I got on
fitday.com just to see what kind of calories I was taking in and it was
only about 400 a day. And I have done just fine. I am now 9 months out and
down 106 pounds! You have to remember you have a lot of "reserve"
your body can use in the beginning. And by the time those reserves are
depleted, you definately will be taking in more calories by then. I
wouldn't be that concerned. Also, I would be reluctant to see a
nutritionist unless it is one that specializes in gastric bypass patients.
I think there would be a huge difference between a regular nutritionist vs.
a nutritionist that specializes in gastric bypass. Just an opinion though.
I hope that helps. Good luck!
— Laurel C.
May 3, 2003
There are very few dieticians that understand what this post-op life is
like much less a PCP or in many cases the surgeon who did the surgery.
What your PCP says is correct for the average person who has not had WLS
and has a normal sized stomach. I lost 200 lbs in 13 months on 1200
calories and lots of exercise. 1200 well chosen calories is actually quite
a bit of food. However, I did it with the old pyramid thinking - around
50% carbs.
<p>According to your profile you are a few days short of 2 months PO.
You could get to those high calorie ranges using higher calorie protein
drinks but not through only eating food, unless you have quite a large
pouch. Otherwise you would stretch your pouch significantly affecting the
long term benefit of getting max weight loss. The big question here is how
much carbs are you allowed to eat? If your carbs are greatly restricted,
as mine are, then your plan is using maximum ketosis and min. 600 calories
is not even an issue because starvation mode does not enter in. The whole
process of ketosis forces your body to use the fat on your body for energy
and not go after protein in your body. I have not noticed any loss of
strength nor being weak, tired etc. other than if I had a crappy nights
sleep or forget to take my daytime sleep disorder meds. I am working out
with a trainer 3 days a week and also doing my walking those days, so
afterwards I am pretty spent but it's because I have burned enough calories
to cover 2 meals. Those days I usually end up eating a 4th small meal. If
your plan allows more than 30 grams of carbs a day then it is not really
using ketosis and then starvation mode does kick into play. So look at
your plan and figure out which way it is driven. I am 12 weeks PO and I've
lost 87 lbs in 14 weeks, 66 since surgery and 21 before. I can't even
begin to believe that I might hit 100 lbs in 4 months. It's just
impossible to fathom.
<p>Personally I would not follow what your PCP is saying unles she
agrees to call and discuss it with your surgeon. She needs to fully
understand your plan before advising you how much to eat. Also this early
on you need to be eating very high percentages of protein and I really
doubt you can get in like 1000 calories of stickly protein without using
drinks. My pouch would explode. Most days I am in the 450-600 range. 450
calories is the norm and lately probably more like 300 because I've been
throwing up a meal again a lot of days. It has to be how I am eating, too
fast, as the food will be fine one meal and then another meal I cannot keep
it down.
<p>Talk to your surgeon and/or his nutritionist and work with them.
They have the best possibility of understanding how your particular post-op
eating plan is supposed to work.
— zoedogcbr
May 3, 2003
The surgery didn't alter the laws of physics for us. If we burn what we
consume, we maintain; if we burn more than we consume, we lose; if we
consume more than we burn, we gain. Depending upon your activity
level--that you're leading a somewhat sedentary lifestyle--I guess it's
possible that 800 calories is too little. However, I have to agree with the
previous writers: most PCPs haven't a clue about nutrition in general; and
when it comes to our needs, their ignorance approaches the infinite. Check
in with a real nutritionist who knows what you need. Hang in there.
— Chuck O.
May 4, 2003
At 10 weeks post-op. my surgeon got really upset with me because I was only
getting between 500 - 600 calories a day. He told me I had to up it to
between 1000 and 1400. Well I did and in a year, I had lost 160 pounds. I
am at his goal now and he told me that I had to get between 1200 and 1600 a
day now. When we are new post-ops, we only absorb half of the calories we
take in, so if you are less than a year post-op, and you are getting 800
calories a day, you are only absorbing about 400. Your body will think
it's starving. After a year, the intestines adapt and you start absorbing
more.
— Patty_Butler
May 5, 2003
The laws of Phyics always remain constant. The variable in the equation is
ones metabolism As you starve yourself your body slows down. That is why
you use less calories to maintain your weight in a starvation mode. One
needs to raise thier metabolism thru activity. Good Lux
— Robert L.
May 5, 2003
I think you have a very wise PCP, however, her advice applies when you are
further out. At only 2 months post-op, your right on track with 600-800.
As the months go by, you will be able to eat more. I agree with the poster
that suggested the PCP consult with the surgeon or a nutritionist that
specializes in gastric bypass. Its a learning process for her too. Her
advice on not taking in enough calories, the body thinking it is starving
and trying to protect itself, plateaus, eating more thruout the day is all
correct, just applies to you when you are further out.
— Cindy R.
May 5, 2003
Another thing everyone seems to be overlooking about metabolism is that not
everyone's is the same! Most of us have surgery because we have a food
problem not a true metabolic problem. So, to say that the same
"caloric intake formula" will work for everyone is absurd. Sure,
there are going to be general guidelines, but YOU need to listen to YOUR
body and then make appropriate changes. I was a bit concerned because at
13 weeks, I only eat 400-500 calories a day, (and exercise 45 min, 5 days a
week and do weights 3 days a week) including my protein drinks. When I
talked to my PCP (internal medicine), last week, he said that I must just
have a very slow metabolism and that as long as I am still losing 3-5
pounds a week, not to worry, and NOT to try to force myself to eat more
because the increase will come in time and that forcing it may end up
slowing things down now, and ultimately lead to less weight loss in the
end. On the other hand, IF my weight loss comes to a complete stand still,
it could indicate that my body has gone into the starvation mode and ONLY
then should I purposly try to up my intake. Finally, I was told that I may
NEVER be able to eat more than 1000-1200 calories a day in the maintenace
phase...but that is just me and my slow metabolism. You may find that if
you are plateauing, that some increase will help...as will exercise,
protein and water, but again, you need to get to know your body (and your
tool) and make adjustments according to how your body reacts, regardless of
what the general consensu is. Also, remember that the goal is to use your
tool (surgery) to the max now while the going is easy, but also to be
making permanent lifestyle choices and changes that will carry you when
things slow down.
— eaamc
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