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  1. #1
    Gastric Sleeve Member TheRealJen's Avatar
    I have had a gastric sleeve.
    Name
    Jennifer
    Surgery date
    02/16/2018
    Surgeon
    Dr. Dirk Rodriguez
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    Jan 2018
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    04-18-2019 04:40 PM
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    Question Tell Me Your Maintenance Menu

    I am posting this again, as I think something went wrong. If it posts twice, so sorry!

    For the veterans who are 1+ years post surgery, show me what your maintenance nutrition menu looks like. I am trying to figure out if my carbs/calories are too low, protein too high, or if my intake is too low for how much I am working myself. My surgeon retired, and I have no one else to bounce ideas off. I am 14 months post-op, and reached my goal of 160 pounds at the end of last month. So, I extended my goal to get down to 150 pounds for maintenance and a small buffer. The doctor shows my ideal weight at 146, but I'm not sure that is healthily attainable. I have hit a stall, which is not my first in this journey. But I want to lose these last 10 pounds and enter maintenance. Here are my stats:
    * Age:41
    * Current weight: 161 lbs (some water weight)
    * Activity Level: Gym rat 6 days a week (45 mins weight training, 1 mile run on treadmill 11:30 mins, and 60 mins of 4.0mph walking with random incline from 9% to 14%)
    * Macros averaged over the last day:
    -Protein: 95g (~30 from protein shake/powder, the rest from whole food sources)
    -Carbs: 60g
    -Fat: 32g
    -Calories: ~900/day
    -Exercise: ~800-900 burned during gym time, then I do house and outside chores daily

    I always start my day with a toasted slice of Dave's Killer Bread that is 60 cal/12g carbs/6g protein, topped with PB Fit mixed with MCT oil, fat free Fairlife milk, and half scoop of protein powder. I eat light cheese, fat free low carb Greek yogurt (Dannon light & fit). I have my Gummy Worm preworkout (no cals/no carbs) before I workout, then a MuscleMilk protein shake for recovery. I always start my meals with protein, and then pretty much nothing else because I just dont have room. I dont drink while I'm eating, I wait an hour in between drinking and eating, and I usually am feeding myself every other hour, with fluid in between. I get 64oz fluid every day. I basically follow sleeve law to the letter. I track everything I eat. I dont count calories, just protein, carbs, and fluid. I have a calorie count because it is a byproduct of tracking everything in My Fitness Pal. I dont really make bad eating choices. I tackled this weightloss journey like my life depends on it, because it does. I dont ever want to be that 306lb girl again. I'm looking for some advice to see what you guys are doing in maintenance. Total weightloss is 146lbs in 14 months.

    What does your nutrition look like for those who have been around this proverbial block?


    SW 306
    1YR 173
    CW 161

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  3. #2
    Gastric Sleeve Member Christie13's Avatar
    I have had a gastric sleeve.
    Name
    Christie
    Surgery date
    11/03/2016
    Surgeon
    Dr. Wright
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    Default Re: Tell Me Your Maintenance Menu

    To me it seems like your intake may be too low with your amount of activity. As long as you up your calories with healthy proteins and maybe add some veggies. It doesn't seem, from your description, that you are eating any veggies? I could be wrong. I am almost 2 1/2 years post op and pretty much eat what I want because I also am an avid exerciser. Weight training with some cardio sprinkled in between sets. I do focus on my protein and veggies first but I will eat pretty much anything. I just try to eat healthy most of the time. And I weigh myself daily so I can cut back when I need to.



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  5. #3
    Gastric Sleeve Member TheRealJen's Avatar
    I have had a gastric sleeve.
    Name
    Jennifer
    Surgery date
    02/16/2018
    Surgeon
    Dr. Dirk Rodriguez
    Join Date
    Jan 2018
    Last Activity
    04-18-2019 04:40 PM
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    Default Re: Tell Me Your Maintenance Menu

    I dont eat much on the veggie side - I forgot to include in my original post that I am getting most of those veggie nutrients through vitamins. Blood work is fine, doc said that if I dont have room, no need to worry about it. I think i am low, too, but i am scared to start upping the calories/protein/carbs for fear of weight gain. Carbs and me, well, we have a love hate relationship. It's like a bag of potato chips - I cant eat just one!


    SW 306
    1YR 173
    CW 161

  6. #4
    Gastric Sleeve Member Dutchie's Avatar
    Name
    Simonne
    Surgery date
    01/03/2017
    Surgeon
    Dr. Pablo Enriquez Valens
    Join Date
    Dec 2016
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    Default Re: Tell Me Your Maintenance Menu

    A couple of things comes to my mind, when reading this.

    In the first (but not unimportant) your body is still taking over and may continue to do this until your honeymoon period is over.
    That period can last up to two years post op.
    All you can do right now is make the most of that period.

    I agree with Christie, I think you are not eating enough.
    And unless you are doing keto, good carbs are not the enemy.
    I am very carb sensitive, I still don't eat many carbs (around 70 grams per day), but I do eat whole grains, veggies and fruit.
    But good carbs are key here.
    Not the simple carbs, like potatoes, white rice, white flour (products) and white pasta.
    Those are poison to me.

    About all the light products you are eating: when you continue to do this, you will have no leverage in the future.
    Meaning: you don't have something to swap out, when, in case of some regain, you want to lower your cal intake.
    I did not do the "light" products, not until I was in maintenance.
    And I still don't care for them much, full fat tastes much better to me.

    Is this the way you want to continue to eat for the rest of your life or do you see this as a way to loose as much as possible?
    Because this really sounds like a "diet" to me.

    My maintenance is around 1400 cals per day, sometimes a bit more, most of the times less.
    B: Greek yoghurt with oats, nuts and seeds.
    S: protein coffee shake
    L: whole grain rye crackers with cheese
    S: fruit and some sort of protein (cottage cheese, or left over protein)
    D: lean protein and veggies, legumes and goods carbs if room. Half an orange as dessert.
    S: raw almonds

    With your level of exercise I would raise my cal intake to 1200, if not more.
    I am sure you will start loosing again.
    English is not my first language, so I may and do make mistakes in my spelling, or say things oddly. Please ask me, if you want any clarifications.



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  8. #5
    Gastric Sleeve Member Sandra3's Avatar
    I have had a gastric sleeve.
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    Sandra
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    01/20/2016
    Surgeon
    Dr W
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    Default Re: Tell Me Your Maintenance Menu

    Hi Jennifer,

    First congrats on your weight loss, but congrats especially on your commitment! that will be the key of your success on the long run.

    I completely second what Christie and DutchSleeve told you. For two main reasons : I did study nutrition at uni (since 2014, and still do) and also because "been there done that". If for some reason something happen to you at some point (you break your leg for ex and can't exercise for months) , you will regain on 900 cal a day.

    Here is my own personal example so you will understand what I mean.
    I was also doing a "medium low carb" because like many I can't lose if too much carb intake, even with cal under my BMR.
    So I was around 1000 cal at 6 months out, then around 1500 cal at 18 months etc because at the same time I was increasing my "workout" but also because staying too much under your BMR is never a good idea.

    At 2 years, you can eat more, that's the same story for everyone. I've been tested at 3 years out, my stomach capacity is 210ml, my doc was really happy because it does prove I didn't eat too much.

    But here is what happened anyway. I do have several health issues, and long story short, I had to take 4 months of prednisone, did gain 30+ pounds, just had surgery last months, two days in hospital for my surgery +12 pounds = grand total 42 pounds!! since I did stop the prednisone before the surgery, during the last six weeks I was able to lose most of the last pounds (10 pounds). Because my main issue here, I can't exercise since October!! not at all!! And will be able to start tomorrow a light exercise program but only until my next surgery in May, and then again 6 weeks with no exercise!

    Regarding my BMR : I'm always eating "under". My BMR today is 1800 cal. When I was active, I always made sure to eat 1700/1800 per day. Today I'm eating around max 1500/1600 since I'm sick because I can't move ...and did regain anyway . The weight loss will only show up if I can exercise a little. And I did regain only with meds, eating under my BMR. So on paper I should have lost weight right? but no.

    My multiple health issues have also hormonal links, and prednisone does mess up my hormones each time. But I'm grateful that at least, with the sleeve, and eating a moderate low carb diet, I "only gained" 30 pounds. If I had been able to exercise that would probably have been less...before the sleeve, eating a "normal balanced diet" with carbs around 120gr a day, I could gain with only one week of prednisone: up to 35 pounds!!!

    Anyway : here are my two cents:

    First if I was you I would do a DEXA scan (my friend found a cheap one on Groupon) to know exactly what it my real BMR and also what weight loss is realistic. I did several of those at the hospital and it's a big help to have an accurate idea. Using only the BMI is not giving you an accurate picture.

    Second, don't listen to your doctor regarding nutrition, most doctor have no background in nutrition, they don't learn it at uni, and even if they did, depending on the year, they probably did learn only about the pyramid or other obsolete things.
    We are all different, and each diet has to follow our real needs.

    At the hospital post-sleeve I was told to eat at least 100gr carbs a day, I had surgery in Asia because I worked there at the time, and my metabolism doesn't fuel on carbs like Asians. But I had to really explain in details why their guideline didn't work for me being a westerner, at the end after two meetings the nutritionist told me I knew more than her about nutrition and I didn't need to come to the other "compulsory appointments", and my surgeon asked me if I agreed to share my notes/textbooks with the nutritionist so they could learn more...and be prepared for other westerners! for ex most Asians are lactose intolerant so they never included cheese or yogurt in their guidelines etc..

    Third : eating a healthy diet is looking at eating real whole food. Low fat is processed food. Every processed food has more preservatives, additives and at the end for sure, a lot less nutriments! And you pay more for it!! The food industry really knows how to make more money!!! Nobody should eat low fat, it send the wrong signals to the brain. Your brain do need real good fat (avocado, olive oil, nuts, full fat cheese etc) but you also need fat to stop the hunger!

    A good diet does include veggies because you need real vitamins, real fibers because fibers also clean our body.
    But at this stage, it's ok not to include many veggies if you don't have room, it's only temporary.
    You will very soon have more room, and that will be a good way to avoid regain. Veggies are low calories.

    So when you know what your BMR is, slowly introduce like 100 or 200 more calories per week. Until may be 1400cal and waitt like two weeks to see what happen. Switching for real food will do the trick, you don't need to eat more in quantity, just in quality.
    You should be fine!!

    Regarding your protein intake, it is too high for a woman. You should target around 60gr per day only (too much protein is bad for your kidney on the long run) and that will also give you more room to add for ex more fat, olives, avocado, nuts which are good for your brain, skin etc.

    Take care


    HW : 150 kgs
    09/02/2014 : 142 /1st apt
    01/20/2016 : 134 /surgery
    01/30/2016 : 130 /1st post-op
    02/27/2016 : 126 /2nd
    04/23/2016 : 118 /3rd
    07/16/2016 : 109 / 4th
    10/01/2016 : 103 /5th
    01/21/2017 : 98 /1 year post-op
    February 2017 : 100 lbs lost
    07/22/2017 : 96
    10/21/2017 : 93
    12/22/2017 : 91
    01/02/2018 : 96!! regain (medication)

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  11. #6
    Gastric Sleeve Member sraebaer's Avatar
    I have had a gastric sleeve.
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    10/07/2013
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    Default Re: Tell Me Your Maintenance Menu

    900 calories a day and working out like that? Sounds crazy to me. You need to eat my friend! Healthy lean protein, veggies, fruit, and good carbs like whole grains, etc. Good luck.



  12. #7
    Gastric Sleeve Member TheRealJen's Avatar
    I have had a gastric sleeve.
    Name
    Jennifer
    Surgery date
    02/16/2018
    Surgeon
    Dr. Dirk Rodriguez
    Join Date
    Jan 2018
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    Default Re: Tell Me Your Maintenance Menu

    I'm not doing it on purpose. I just really dont have room, and I am literally eating every other hour. I just got back from the grocery store. Last night, I sat down and looked at exactly what I am eating, and it's all great stuff. I'm just really fighting flavor fatigue. So I researched and made notes of things that other VSGers in maintenance are eating, and got some ideas. I found a great food group/servings per day worksheet on another forum, and took some ideas from that. I keep smoked lean meats in the fridge (see my profile pic with the smoker in the background!), healthy choices of yogurts, cheeses, nuts, berries, and raw veggies, etc. So I am going to up my complex carb game. I picked up sweet potatoes, pasta made out of red lentils, whole grain oats, avocados, just to name a few. I spent probably 2 hours at the grocery store, armed with my list, looking at different options and nutritional data. I just needed some people, similar to my situation, who could give me some ideas as to where they are at so that I could have a jumping off point. it's hard when my surgeon retired and I have no feedback. He is a great surgeon and totally knows what he is talking about, which makes it even harder. I am now armed with some data, so hopefully I can break this stall and get to my goal. I will give my body a couple of weeks to get used to a higher/more nutritional and varied diet and see how it responds before I make any more changes. I am all about the metrics/data.


    SW 306
    1YR 173
    CW 161

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  14. #8
    Gastric Sleeve Member KiwiGal's Avatar
    I have had a gastric sleeve.
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    Lisa
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    09/04/2017
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    Stephanie Ulmer
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    Default Re: Tell Me Your Maintenance Menu

    Wow, you are doing great - and well done on the exercise routine!
    I'm not going to comment on your food intake because I'm no expert. Perhaps a visit to a real expert would be beneficial? A nutritionist?
    They might be able to give you some guidelines.



  15. #9
    Gastric Sleeve Member Dutchie's Avatar
    Name
    Simonne
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    01/03/2017
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    Dr. Pablo Enriquez Valens
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    Default Re: Tell Me Your Maintenance Menu

    I love the lentil pasta.
    It sounds like you have a plan!
    Work that plan, own the results, make changes where necessary.
    You will get there!
    English is not my first language, so I may and do make mistakes in my spelling, or say things oddly. Please ask me, if you want any clarifications.



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