Hello and Question

[SandyP]

Hi everyone, I've been lurking here for a couple of weeks now and wanted to take this opportunity to introduce myself and ask a question.

I'm 42 years old and am just over 3 weeks out from my surgery (surgery date was 2/6/17).

About 8 years ago I got a lap-band and while I eventually saw success (lost about 125 pounds of the 150 I was trying to lose) I started having problems after a couple of years. Long story short, I finally gave up a couple of years ago and had all the fluid removed because I was just suffering too greatly. Of course, I gained all the weight back.

My surgeon has hopes that I will see similar success with the sleeve.

However, I have some questions/issues and was hoping you guys could share your stories with me to help me figure out the best approach.

Surgery itself was fine, rough obviously, but successful. I barely ate for the first week or so. My hunger returned after about 10 days and I followed the diet they recommended (soft/pureed foods for the first 3 weeks). I have recently moved to the next stage where I'm slowly introducing new foods to see what works for me and what doesn't.

The issue is that I get quite hungry. I believe part of it is mental, but not all of it because as a writer, I tend to sit in front of the computer for hours at a time in "the zone." Before the surgery, I easily forgot to eat all day long. Now, despite being busy and preoccupied, I'm feeling hungry more often.

The dietician wants me to eat 3 meals a day with about 1 to 1 1/2 ounces of protein per meal. I can add some veggies but very little (like a couple of broccoli florets). She wants me to try to do the shakes also, mostly because I'm struggling to get fluids in (again, when I'm writing, I'm in the zone so I forget to take sips so it's hard for me to get my water in).

Before I had my most recent follow up with the dietician, I was eating probably 3 ounces of protein (for example, 2 eggs or an entire container of yogurt). I was and am feeling hungry just a few hours later. I was, however, getting my protein for the day in by just eating actual food and not supplementing with shakes.

After meeting with her, I am now trying to cut back to 1 1/2 ounces and up my water (I'm currently drinking about 40 ounces a day so I have some work to do here.)

I'll be honest, and please don't rip into me with lectures about how I need to follow the protocol, I struggle with some of the food choices I've been given. Like the shakes - I hate them with a passion and while I'm going to try and find some recipes I like, I'm not certain these will be something I can stick to. I've cut out lots of sugar, but when I do get a craving, I will have a small piece of chocolate or I will have a banana with a teaspoon of chocolate sauce. Considering how bad my habits were prior to all this, I'm quite proud of myself for not giving in to the need to eat things like ice cream and sweets. However, my dietician did not seem thrilled about the banana and the chocolate sauce.

Which ultimately leads to my question (and sorry for the long spiel).

How many of you followed the food program your doctor's office gave you to the letter vs how many tweaked it to something you could live with and ideally start to improve over time as the cravings and bad habits started to fall away? I have seen many people talk about not "dieting" which gives me a lot of hope because I really want to get to a point where I figure out what works for me and hopefully it will include foods that I can enjoy in small quantities and that will make it easier not to go crazy and eat anything and everything.

For those of you who "tweaked" when did you start this? Did you stick to the diet you were given for a certain number of months or did you start adjusting right away? With the band, the restriction was so tight, I felt like I was literally starving. With the sleeve, I'm not feeling anywhere near that restriction which on the one hand I feel will make this process more difficult, but on the other, more sustainable because I'm not suffering like I was before.

BTW, I'm down about 16 pounds from what I weight on surgery day (I have 150 pounds total to lose). It's been a frustrating thing because the scale will literally not change for 10 days despite the drastic change in my diet, but I understand that's pretty normal this early on. I'm going to take my doctor's suggestion and weigh myself only once a month (he said to put the scale in the garage which I thought was a great idea).

Any insight would be appreciated. Thanks so much!!

Sandy

[Christie13]

I followed pretty closely but I do have things occasionally. Usually a bite of something when I need to. If you are eating solid proteins first you should fill up pretty quickly. If you are getting hungry again or what you think is hunger it could potentially be acid reflux. A lot of people are on either a H2 blocker or PPI for this. I had it something fierce in the beginning. It has gone away now. I still occasionally need a tums.
A typical day for me at 20 weeks post op is as follows:
a venti nonfat latte from Starbucks with 2 Splenda
for lunch and dinner I will have meat and veggies (I do not measure anything)
2 sugar free popsicles
if I feel any hunger...I will eat some beef jerky or maybe a few nuts during the day.

When I really crave something sweet I will have a bite of chocolate or whatever. I will not deprive myself but I focus on making good choices MOST of the time. I feel like my weight loss has been good and steady. I have lost 49 lbs post op (in 19 weeks and 6 days) and 69 total in.
Good luck Sandy!

[Ann2]

I was a WLS Nazi while I was losing weight!

But having said that, I was true to MY program, not necessarily anyone else's. You can read everything (and more) about how I lost 100 pounds in these two threads:

First Surgiversary

Second Surgiversary

BTW, for the last year and three months I've maintained my 100 pound weight loss (fluctuating only two pounds plus or minus).

[Kindle]

Like Ann, I followed MY plan to a tee until I was at goal weight and even several months past that. But again, it was my plan, no one else's. Key points for me were 80+g protein, 64-100+oz fluids and no white carbs (sugar, pasta, rice, bread, alcohol). Did not give in to head hunger until below goal. Believe me, if you are caving to cravings this soon, maintenance is gonna be a bitch. I tried several dozen protein shakes to find 6-8 that I liked and then used Torani syrups to invent new flavors. You can get samples at nashuanutrition.com. I ended up liking most of the Syntrax nectars. I also Put unflavored protein powder in every kind of soup I could find.

As for your hunger, it could be thirst (your body sends similar signals for both) so really try and get a minimum of 64 ounces in. But ideally you should be drinking 1/2 your body weight in ounces every day. Treat both your protein and fluid intake like life saving prescription medications....non negotiable. The other thing it could be is acid. Try taking Rolaids or maalox when you are feeling hungry. If you aren't already, you should be on a PPI (Prilosec, nexium) or H2 blocker (Zantac, Pepcid).

[Shirl]

I am going to be completely honest; I had thought about the sleeve many years before actually going through it. I did about 8 months of research before undergoing WLS last May. For years I have followed a low simple sugar/carb and 80% vegetarian diet. Always nearly feeling starved to maintain or to lose regained weight. Not anymore. I am pretty much eating now the same way I was before surgery, except this time I do not feel deprived or starved and I am losing weight slowly, but steadily.

I started going to therapy to deal with my food and weight related issues, and while we didn't address those issues straight on initially. I found that I lacked stress management skills and used food as a comfort and as punishment. The few months I saw my therapist, my relationship and view about food have changed. I am not getting as triggered by certain foods, but I am vigilant of the foods that have triggered me in the past which led me to go down a downward whirlwind slippery slope.

I used to eat out a lot, now I cook or prepare all my meals except once or twice a week. I feel that is a way I can control what goes into my meals.

MY plan is a variation of what worked for me in the past, and a culmination of what I have learned here from veteran sleevers. I eat nutrient dense diet, which includes a variety of foods. Most of the time I stick to that diet plan, but I can always improve. Look for key anchors or pillars that can sustain a healthy lifestyle for you.

I am work in progress. I don't beat myself up anymore if I mess up, I just try to make better food choices.

I think the worst combination for WLS failure is grazing on low nutrient foods, and that is the one thing I don't do.

[Donald G]

OK I'm curious here and the ladies who have responded to you in my opinion are some of the best this site has to offer. With that being said you mentioned that your dietician wants you to eat 3 meals a day of about 1 -1 1/2 ounces of protein each meal with the average protein delivering 7 grams per ounce that means you are consuming roughly 32g of protein from actual foods plus the low amount any veggie gives you. I find that amount to be very low from al the post I have read on here about how many grams of protein most women need to take daily. Maybe one of the ladies on here can respond to this but based off that number it seems to me that she should be getting roughly double that amount of protein and if she is not I can see why she is getting hungry.

[sraebaer]

Unlike Ann and Kindle, I never was perfect, but always very careful. I have never counted anything except liquid and protein. I also lost all my weight and have been maintaining for almost 3 years. Most of the time I eat how I should, but that doesn't mean I won't have a piece of pizza, a taco, a tiny burger, a glass of wine, etc. occasionally. I don't look at this as a diet, and don't deprive myself of anything.

That being said, I weigh myself daily to be sure I am keeping on track. (I will NOT regain my weight.) I also really enjoy exercising, which I'm sure helps. I have totally changed my tastes from carbs (which is how I got fat) to protein. Every time we eat out I look for the protein choice. And we do eat out a lot! Not to mention my husband is a gourmet cook, and always follows our "rule of two," a protein and veggie. I've gotten to love foods I had never even tried before like scallops, ahi tuna, etc. I would say I eat more seafood than meat. I still take my bariatric vitamins and don't drink with or after meals. I still attend my hospital support group monthly.

[Kindle]

OK I'm curious here and the ladies who have responded to you in my opinion are some of the best this site has to offer. With that being said you mentioned that your dietician wants you to eat 3 meals a day of about 1 -1 1/2 ounces of protein each meal with the average protein delivering 7 grams per ounce that means you are consuming roughly 32g of protein from actual foods plus the low amount any veggie gives you. I find that amount to be very low from al the post I have read on here about how many grams of protein most women need to take daily. Maybe one of the ladies on here can respond to this but based off that number it seems to me that she should be getting roughly double that amount of protein and if she is not I can see why she is getting hungry.

You're right, the math doesn't add up. There is no way I could get enough protein in only 3 meals/day. I would also be starving and probably make bad food choices. I get hungry and I eat every 2-3 hours, resulting in 6-8 meals/snacks every day.....in addition to at least one protein shake, even 3 1/2 years out. Again, this was part of MY plan. I did not have a dietician micromanaging my every bite. I had simple guidelines which I structured my new eating habits around.

And like Shirl, I finally started seeing a therapist in order to develop coping skills that did not involve food and alcohol. This has helped me maintain my weight loss as much, if not more than surgery itself. So note to OP, if you aren't already, getting professional psychiatric help could be very beneficial to long term success this time around.

[peasantme]

Hi,
First, thank you sraebaer, for mentioning the Rule of Two. I never heard of that term before, I just googled it and found it online.

To SandyP, I am 10 weeks out. I came home and followed the teams plan pristinely. I initially lost a chunk in the first 10 days and then stopped. I understood stalling but I also felt like crap and the feeling like crap was getting worse. I stalled for a long time which was worrisome. So I saw my Endo and she felt that since I have lived bouncing between vegan/vegatarian, (mostly depending on whether I am eating eggs)... switching me to a mostly meat diet wasn't a good idea. So she inverted my diet, meaning I eat 4-6 meals a day not 3, mostly unprocessed veggies and fruit. And my protein goal is now 46 grams. I use egg whites to achieve that, especially egg white veggie omelets, plus I have soymilk and then theres protein in veggies. This i how I ate before when I lost 60 pounds and started running. She pointed out that I did terrible on Atkins before that, I gained 20+ pounds and my labs went way up, so we know that mostly protein doesnt work for me. I can say that eating protein leaves me feeling hungry and its not my head, I have a therapist. Eating a cup of steamed veggies keeps me happy for hours, especially the buiky ones and root veggies. Now that I am a week out from my Endos plan, I have lost 4 pounds, I am never hungry and more importantly the sluggish ucky feeling has gone away. I dont do shakes or anything with fake sugars and I don't eat processed food. And I also do the bite of banana with chocolate sauce. When I am totally wanting a yummy dessert, a bite of fruit with a teaspoon of chocolate sauce is my go-to as it is just a fruit, and only a taste of sauce. It gived me a moment of yumminess. And for me, I get used to that so I never crave a bowl of dessert.You think in terms of itty bitty..(.. I never want to lose my way, I just want a taste... so I make that one taste awesome and worthy. A single strawberry dipped in sauce or a teeny blurb of whiped cream works well too. This does not work for everyone, for some its a trigger so you have to know what works for you.

I know the Bariatric teams have a plan for their patients but I also think that we all bring our own indiviual metabolisms and lifestyles, ways and wants to the table. I hope that helps.

[Shirl]

OK I'm curious here and the ladies who have responded to you in my opinion are some of the best this site has to offer. With that being said you mentioned that your dietician wants you to eat 3 meals a day of about 1 -1 1/2 ounces of protein each meal with the average protein delivering 7 grams per ounce that means you are consuming roughly 32g of protein from actual foods plus the low amount any veggie gives you. I find that amount to be very low from al the post I have read on here about how many grams of protein most women need to take daily. Maybe one of the ladies on here can respond to this but based off that number it seems to me that she should be getting roughly double that amount of protein and if she is not I can see why she is getting hungry.

There is someone else here who mentioned their surgeon only recommends 50g or so grams of protein a day, or maybe I read her wrong. I gotta look for it to confirm! But my understanding and working with a nutritionist pre/post op, and reading my surgeon's post op recommendations 58g of protein is a minimum.

According to authority nutrition blog "The DRI (Dietary Reference Intake) is 0.8 grams of protein per kilogram of body weight or 0.36 grams per pound.

This amounts to:
- 56 grams per day for the average sedentary man.
- 46 grams per day for the average sedentary woman."

This amount is a deficiency for anyone who does more than just breath which most of us!

I am scared shitless of muscle wasting! Isn't anyone else?

I understand that protein overload can turn to fat stores, but I think most post sleeved patients will not have that problem the first couple of years. No?

[Trastan]

Hello, I am currently not quite three weeks out and just can't seem to get my protein shakes down. I am at the soft food stage and am really struggling too as I hate eggs and can't figure out how to get my needed protein in as the shakes make me gag now. I liked them prior to surgery but I can't stand them anymore. Liquids are a real struggle for me too. I am not quite where I am supposed to be. I have no idea how to get my needed protein in at this stage without the shakes and eggs. My weight seems to be at a stall now that I am not getting the needed protein. Does anyone have any suggestions on what I could do at the soft food stage to get more protein in? I had my surgery done in Mexico so I have never been to a nutritionist and am strictly going by what I have read.

[Donald G]

Hello, I am currently not quite three weeks out and just can't seem to get my protein shakes down. I am at the soft food stage and am really struggling too as I hate eggs and can't figure out how to get my needed protein in as the shakes make me gag now. I liked them prior to surgery but I can't stand them anymore. Liquids are a real struggle for me too. I am not quite where I am supposed to be. I have no idea how to get my needed protein in at this stage without the shakes and eggs. My weight seems to be at a stall now that I am not getting the needed protein. Does anyone have any suggestions on what I could do at the soft food stage to get more protein in? I had my surgery done in Mexico so I have never been to a nutritionist and am strictly going by what I have read.

I would suggest 3 things to try the first is a different brand of shakes, the second is yoplait greek high protein yogurt each one has between 14 and 15 grams of protein and finally fair life milk it has 13 grams of protein per 8 ounces.

[Shirl]

Hello, I am currently not quite three weeks out and just can't seem to get my protein shakes down. I am at the soft food stage and am really struggling too as I hate eggs and can't figure out how to get my needed protein in as the shakes make me gag now. I liked them prior to surgery but I can't stand them anymore. Liquids are a real struggle for me too. I am not quite where I am supposed to be. I have no idea how to get my needed protein in at this stage without the shakes and eggs. My weight seems to be at a stall now that I am not getting the needed protein. Does anyone have any suggestions on what I could do at the soft food stage to get more protein in? I had my surgery done in Mexico so I have never been to a nutritionist and am strictly going by what I have read.

First couple of weeks I survived on bone marrow broths, grab and go Premier Protein Chocolate shakes, i hated the Vanilla! But later used as coffee creamer heehee! The other was blended Miso and tofu soup, yogurt, cottage cheese and dahl! I tried broccoli cheese soup at about two weeks and nearly gagged!

I've heard other add protein powder to their milk base soups.

[Emmeraldas]

Trastan,
I had a problem pre and post op with Artificial sweeteners. Particularly, sucralose (Splenda). I get stomach pain and severe nausea. So I had to do some protein supplement shopping. FOR ME..... I take Genepro in my tea or coffee or soup. I find it has no taste and mixes well in 140 degrees or less hot foods. It is also 30 grams of protein per tablespoon. I could never do the protein shakes in any quantity to keep up my daily requirements. I would be very ill. While I love eggs. They can become boring. You may have to test out different brands of supplements to get one that agrees with you.

Thinking back to my soft diet days... I ate, and still do eat, Greek yogurt and cottage cheese. Fish, baked or pan fried in scant amount of oil is soft, as well as canned tuna which comes in some tasty flavors these days. Meats braised until fork tender was also allowed. Think...pulled pork. I also remember putting the protein powder into black bean soup; even added a dab of sour cream....lol. Sometimes you have to be imaginative.

One tool I found extremely helpful was www.myfitnesspal.com. The food journal helped me to see where I was on the minimum protein in take as well as documenting my fluid intake. My husband logs his food religiously but I am now a little slack. it is a great help.

You may find that it takes a bit of creativity and planning to find foods that work as opposed to consuming on a whim. But then, that behavior may have contributed to our original problem in the first place.(it did mine and my husband's for sure!) I mean... I doubt any of us who have gone through WLS had perfect eating habits prior to surgery. At some point I think we all have to face our eating demons as we adapt to a better health plan for the future. It is a small price to pay for the ability to finally lose weight and keep it off.

[sraebaer]

[QUOTE=peasantme;570496]Hi,
First, thank you sraebaer, for mentioning the Rule of Two. I never heard of that term before, I just googled it and found it online.

Huh, I thought I just invented the "rule of two!" I had never heard it used before!