Question:
I worry that I can eat too much

I am almost 6 weeks post op and I worry that I can eat too much. I never feel full. I am hungry all the time. I cab eat 3-4 oz of protein at a time. I calles my nutritionist last week and she told me that I am not eating enough. I limit the amount I eat at one time but I still try to eat 6 small meals a day like my surgeon and nutritionist say to. I usually get in around 500 - 600 calories a day. I just feel so guilty all the time for eating. I try not to eat any carbs. My nutritionist told me when I called her to stop counting carbs and calories. I only need to count sugar and fat, that we need carbs just not the bad ones. She also said that I should be ating 1000 calories a day, to make sure I don't skip any meals. I am so scared that I will never lose all my weight. So far I am only down 27 pounds. I had so hoped to have lost at least 50 pounds by now. I walk 30 minutes a day and drink at leat 64 oz of water and usually reach my protein goal of 74 grams. I feel like such a failure....    — Stacie B. (posted on August 10, 2003)

August 10, 2003
You're nowhere near a failure, Honey. Calm down, take a deep breath, and listen to your dietitian. It's very hard to eat 1000 calories a day this early. Do the best you can, but don't sweat it if you don't make it every day. Make healthy food choices, and don't skip meals. You must eat more than just protein. Carbs from veggies and fruits are absolutely necessary to your health, so be sure to eat them every day. You are wise to avoid processed carbs (most of the white foods: flour, sugar, bread, pasta, rice, potatoes, crackers, etc.), but please do not try to live on protein alone. Eat a variety of healthy foods and you will lose the weight, but most importantly, you will develop healthy eating habits for the rest of your life. It's great that you're being so conscientious, but don't make yourself crazy counting everything. Your dietitian sounds like she knows what she's talking about. She's a trained professional. Accept her guidance. And calm down. You're doing fabulously.
   — Vespa R.

August 10, 2003
Some classic issues here:<P>You're hungry, and you're disappointed with your weight loss (though 27 pounds in six weeks is very successful -- I know you won't hear that, nobody does, but it is), and you're being told to eat MORE. In fact, eating more may help you lose better, as your body is less likely to shut down into starvation mode if it's fed better. Give it a try, especially if you're never full and always hungry. You can't last like that forever.<P>I agree that counting calories and carbs may be unnecessary if you're only intaking 500-600 calories, *but* it prepares you for counting calories down the when you DO get to 1000 or more, so count 'em if it helps you. I disagree with your nutritionist about not counting carbs. I think it's pretty clear many of us do better on a high protein, low-carb diet, especially in terms of controlling the "head hunger" that can undo the benefits of this surgery in the long run. How "low" low-carb actually is, is something to negotiate with your doc and nutritionist (and your metabolism). I just kept my protein grams ahead of my carb grams every day, and didn't limit carbs beyond that, but lots of people limit them pretty severely.<P>I also disagree with your nutritionist on counting your fats and sugars instead of carbs. It makes sense to count sugars -- they trigger intense cravings for more sugars, they can make you dump, and we absorb the heck out of those. But, our absorption of fat IS affected by the RNY, so while it's wise to keep an eye generally on fats (especially if they also make you dump), I'll chose a sugar-free product over fat-free every time (as you know, sugar-free is usually compensated for by adding extra fat, and vice versa). And of course, we don't malabsorb carbs, either. I'm for counting the stuff that's fully absorbed (sugar and carbs) if it makes us fat and gives us uncontrollable cravings and head hunger, and for supplementing the "good" stuff we malabsorb (protein), and for basically keeping a much looser eye on "bad" stuff we malabsorb (fats) than on the other stuff. JMHO.<P>I also suggest staying off the scale and concentrating on changing your eating and exercise habits. Set goals there, not by the scale. Scale-watching is dieter behavior, which is the same old behavior that didn't work before. It's so hard NOT to measure our feelings by the scale, but it's a trap into your old failed-diet lifestyle to let the scale rule your emotions. If you truly change your lifestyle, the scale WILL follow along. Hang in there!
   — Suzy C.

August 10, 2003
Sometimes it just shocks me how different post-op plans are. I can't believe you are supposed to be getting in 1000 calories from food at 6 weeks PO! I'm a little over 6 moonths and NEVER hit 1000 calories and most days am at 600 with the occassional 700-800. At 6 weeks I was eating 2-3 oz per meal for 3 meals, about 300-400 calories a day. However, my post-op plan used ketosis to the max back then - as close to zero carbs as possible. Because your plan is not limiting carbs is why you need more calories but even still 1000 is an awful lot in my opinion. <p>The fact that you have lost 27 lbs don't fret about as it likely has very little or nothing to do with the amount of calories you are eating at this stage. I was eating very little and only lost 22 lbs the first month. Now at 6 months I am down 150 lbs, so things change. Your body is also recovering and adjusting to it's new plumbing. Lots of healing going on yet too. I would follow what they tell you for a while here and give it a chance. If it isn't working you can always adjust. Personally I have no ideal how one is to get 1000 calories, strictly from food, at 6 weeks PO. I'm guessing the only way you can get there is with protein drinks. <p>I also have a problem with telling someone to eat when they are not truly hungry. How does that set us up for long-term success. JMO Good Luck! Chris D.
   — zoedogcbr

August 11, 2003
Stacie, how funny was it that I read YOUR post and related before I even knew it was you. :) (My surgery roomie) I'm down 35lbs but can't get in the 79G of protien to save my life. I can't even get 6 meals in, I have to force myself to eat, and even then it seems like not very much before I am full. I can't stomach the whey protien anymore, seriously can't stomach it. (with what little stomach I guess I have) Do you eat lots of fish? What things make you "sick" or does anything? I was really bumming last week thinking "Only 35 lbs in 5 weeks?" but then something my hubby said may help you out also.. he said "Missie, you didn't have this surgery to lose 100 lbs in a month, it's going to happen, you need to keep doing what you are doing and one day you will look in the mirror and be amazed because not only are you still beautiful.. but you are beautiful and thin." So, hang in there, don't over do the protien and for SURE don't you get down on yourself ok? We are women, hear us roar! I am so proud of you still, and this time next year we will be looking back and wondering why we were getting so worked up, right? xoxoxox, Missie
   — MissieBird

August 11, 2003
Why is it that new post-ops persist in comparing their early weight losses with others and then when they don't lose 40 or 50 pounds in a month (an unrealistic goal), they lament that they feel like they are failing??!! Hellooo? Please eliminate the words "only lost X number of pounds" from your vocabulary immediately. And stop comparing your loss to others, or expecting too much-it just sets you up to feel like a failure when you are far, far from it. We all lose at our own rates, and all lose differently, so try to enjoy this wonderful journey and not fret so much. I think your nutritionist is not far off the mark-striving for 1000 calories a day is a good thing eventually, but at 6 weeks post, you won't get there, so don't be upset by that. I'd like to ask, you say that you never feel full-have you ever felt full at all? If not, try eating 4,5,6, or more oz of protein-dense food-to see if you do get full. If you still don't feel full, then ask the surgeon to check out the mechanics of the surgery. Not to alarm you, but a staple line disruption or an enlarged stoma would cause you never to get full. If you do achieve "fullness", then eat when you are hungry. Make sure you are actually hungry though-early on as a post-op sometimes it is actually head hunger but if it is real hunger-EAT. Small frequent meals is a good thing and will serve you well. I'm also a believer in good carbs and my nutritionist recommended them as an essential part of our daily diets.
   — Cindy R.

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