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  1. #1
    Gastric Sleeve Member
    Surgery date
    09/01/2020
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    Dr Pirrello
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    Nov 2019
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    Default how to eat in final phase/maintenance

    So I am having surgery this late Summer
    I am a bit unclear on how I will be eating in what my Dr / nutritionist is calling "phase 5" or maintenance..or "the rest of my life!"

    I am a 54 yo male currently about 370 lbs.
    I was 168 just about 5 yrs ago !
    I had a bod pod done and know my lean body mass at that weight,..which is my goal, ideal weight.
    I had another reading done at 368 LBS this past fall and I have actually gained muscle mass. I am told this is due to lugging round extra weight.
    so even though I have been sedentary w the weight gain (not going to gym/lifting or "working out" / cardio) that I actually am doing weight lifting by virtue of lugging around an extra few hundred pounds and the extra muscle mass is in my legs and rear end etc

    Anyway, nutritionist says at minimum my protein requirements are 60-80 grams.
    That is only 240 - 320 calories. that is what I will be eating first to sustain muscle and hopefully minimize muscle loss post op.

    Also, I know from experience, when I was 165-170 and based on her formulas, she estimates that my ideal weight (also 165-170 for her) maintenance calories is around 1,800 - 1,900.
    This is an accurate #.
    So, my question is...
    If my stomach capacity is going to be 1 cup of VOLUME...how on Earth am I going to get in 1,800 calories a day?
    If I prioritize proteins and she wants fats limited and also starchy carbs limited..what else is there?

    I guess she means low glycemic index carbs..oats& sweet potato and brown rice vs white rice and white potato, pasta and enriched flour products etc

    No fatty condiments she said citing mayo, creams, dairy etc
    So, does that mean stick w fatty protein like salmon & things like avocado and olives?

    So those fats would make my small meals more calorically dense?

    Bottom line...how do people "eat enough"

    I have a friend who did sleeve who looks terrible...looks malnourished and "deflated"...not thin..just emaciated & unhealthy !

    MORE meals or calorically dense meals??
    As an over eater, I am hesitant to want to eat MORE times a day...like asking an alcoholic..oh drink a bunch of times a a day..w more frequency..just take small sips !

    confused !



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  3. #2
    Gastric Sleeve Member kenson's Avatar
    I have had a gastric sleeve.
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    01/13/2014
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    Dr. Karl Strom
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    Default Re: how to eat in final phase/maintenance

    I think that once you have surgery, it will all make sense. The important thing is for you to eat your protein first. Your bariatric team will give you a list of acceptable proteins, and what you will be eating as you move into each phase of eating. Don't worry about the numbers in the beginning, just worry about listening to your body and doing whatever your bariatric team recommends. There is no set answer to give you. We have all been told different guidelines by our doctors. As for me, I do eat every few hours. Another thing to remember, in the beginning, you will not have any desire to eat at all, so have no fear. Just get your mindset ready that you will do whatever your bariatric team tells you and you will be fine.



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  5. #3
    Gastric Sleeve Member
    Surgery date
    09/01/2020
    Surgeon
    Dr Pirrello
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    Default Re: how to eat in final phase/maintenance

    thanks Kenson

    not trying to overthink things
    I used to be very fit & have seen some friends look "deflated"
    skinny/fat and am afraid of "not eating" and looking "weird" or "un naturally thin" or strange how Oprah looked weird when she was thin for 5 minutes!
    lol...
    I'm just nervous about the whole thing !
    Attachment 28582
    that's me @ 165ish about 5-6 yrs ago before I quit smoking, broke up w my long time girlfriend, experienced $$ hardship etc etc



  6. #4
    Gastric Sleeve Member Tonerman40's Avatar
    Surgery date
    06/03/2014
    Surgeon
    Dr. DiBenedetto
    Join Date
    May 2020
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    Default Re: how to eat in final phase/maintenance

    I usually consume 1200-1500 a day max, but that is me. I'm 59 and work out like a madman and I still gain muscle mass. I try not to consume more because I gain fat if I do. My body fat is around 8-9% at this time and feel its perfect for me. You will find your grove when the time comes.

    Follow the plan they give you to the T!! That is important. I would also recommend using a food/fitness tracker like My Fitness Pal to keep you accountable when you get going. I call it my bible!!

    Good luck you WILL succeed!!



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  8. #5
    Gastric Sleeve Member
    Surgery date
    09/01/2020
    Surgeon
    Dr Pirrello
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    Nov 2019
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    Default Re: how to eat in final phase/maintenance

    Thanks !
    We are basically same ballpark then..well my BEFORE and my goals anyway !
    ...I am 54..so I will be 55-56 when done/at goal.
    I am 9-10% bf in the above pic. I ate 1,500-1,800 and also worked out quite a bit. heavy total body lifting m-w-f
    and 45-60 minutes of cardio w hiit/intervals..walking at a good pace w sprints



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  10. #6
    Gastric Sleeve Member
    Surgery date
    09/01/2020
    Surgeon
    Dr Pirrello
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    Default Re: how to eat in final phase/maintenance

    Tonerman

    you look great

    what was your starting and current weight if I may ask?



  11. #7
    Gastric Sleeve Member Tonerman40's Avatar
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    06/03/2014
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    Dr. DiBenedetto
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    Default Re: how to eat in final phase/maintenance

    291 lbs give or take at 5’8” now I’m at 158 lbs.



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  13. #8
    Gastric Sleeve Member
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    09/01/2020
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    Dr Pirrello
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    Default Re: how to eat in final phase/maintenance

    Thanks
    can you tell me what a typical day of eating looks like?

    And did you need any skin removal?
    158 is very light?
    I anticipate 15-20 lbs of skin, so not sure I can get to 165 from 370



  14. #9
    sraebaer
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    Default Re: how to eat in final phase/maintenance

    No worries. I don't think I eat any differently than any one else, just less. No one who sees me eat (at a restaurant - remember those - or a dinner party) would know I had gastric surgery. I definitely eat more than 1 cup of "volume" but I'm over 6 years out. Early on I could hardly eat 2 bites of chicken. I still concentrate on protein first, then veggies, then whatever else if I'm still hungry. I have to be super cognizant to stop eating when I am full. Early on full hurt, now it doesn't.

    You're overthinking this. Just follow the rules and enjoy the ride! It is amazing. Your life is about to change.

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  16. #10
    Gastric Sleeve Member Tonerman40's Avatar
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    06/03/2014
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    Dr. DiBenedetto
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    Default Re: how to eat in final phase/maintenance

    If you look at my profile, take a look at the before and after photos. The before was about 1 week before surgery 6 years ago. The after is about a week or so ago. As you can see I do have loose skin around, not a ton but enough to piss me off, lol. I have not had it removed because I can't afford that at this time.

    A typical day for me now since I am retired is get up whenever. I drink some pre-workout and write some thoughts while drinking it.
    Workout out for 60-90 minutes. Lucky for me I have a gym set up in my basement and garage!!

    Any meal I eat now I limit to 300 calories or so.
    I log everything and I weigh everything I eat.
    Portion control is important, a kitchen scale is essential.

    After I workout I usually consume a protein drink with 250-300 calories.
    We meal prep a couple of times a week, in that we cook up a bunch of meat however, chicken breast, steak, pork, or whatever. Always lean as possible.
    For me, it is 4 oz of meat, a serving or more of vegetables and 2 oz of rice (my wife is Puerto Rican-I love rice)
    This usually works out to 250-300 calories per meal.
    I have 4 meals a day usually, so I consume 1000-1200 typically unless I get hungry and grab a snack.
    If I do snack I always have hard-boiled eggs around or beef jerky.

    Don't beat yourself up now. Don't worry in the beginning you will barely be able to eat much of anything and the weight will literally fall off.
    Don't worry about loose skin now, just stay healthy, and follow directions.
    After that it's on you, and I know you will succeed, just go back to working out consistently, that is key!!

    I hope this helps.

    Tony



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  18. #11
    Gastric Sleeve Member AnnieG's Avatar
    I have had a gastric sleeve.
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    Annie
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    10/05/2017
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    Dr. Ryan Heider
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    Default Re: how to eat in final phase/maintenance

    I'm 5'4 and started way up, and stay between 135-140.
    Like Kenson, I track. The good, the bad and the ugly. Yes, once in a while I do have something that is not "best" nutritionally. But I don't overeat, ever.
    I eat slowly (new thing post sleeve -raising 6 kids, meals were always a crazy time for mom).

    I get about 50 grams of protein a day, but use a chocolate protein shake as my "creamer" in coffee (decaf). I like the flavor and the ritual.

    Almost always have a wonderful salad for lunch - with tuna or chicken, or a low fat cheese and light dressing.

    I am also turning 68, so way older than you guys

    Yes, loose skin. Sigh. But I would not have elective surgery at this point in life -- I've had many emergent ones and just don't want to go there.

    You'll do great. And kudos on exercise.
    [I]HW: 240 lbs SW: 199 lbs GW: 140 lbs

    1 MO = 167.0 2 MO = 156.4 3 MO = 148.4 4 MO = 140.6
    5 M) = 136.0 6 MO = 130.0
    1 YR = 122.0 2 YR = 140.00 2.5 YR = 139
    Happy with my weight; happy with my size; over-the-moon with my health!

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