Excited&Scared
Member
Hi, new to group. Preop appt 4/27, gastric sleeve scheduled for 5/17
Hi
- Thread starter Excited&Scared
- Start date
missyinacage
Member
Hello and welcome. That's less than 3 weeks. Are you excited or nervous? I was both. This site has lots of info and great people, so I hope you find what you need. Good luck on your surgery!
sharontx
Member
I am also struggling with my upcoming maintenance phase.
How do I know how many calories to eat?
I definitely feel some hunger now at 7 months that I did not feel earlier. I did fall off the wagon after recovering from some viral illness I had and now I have gotten it back under control. I had lost weight from being sick and it did come back fairly quickly, I was eating more calories to "feel better" after losing 15lbs too fast.
I am not afraid of keeping losing, I think it will stop around my lower goal weight, just afraid of gaining instead of maintaining.
Finally figuring out what foods really don't work for me now, mostly anything heavy or complicated like casseroles.
How do we do maintenance?
Do we magically stop at the goal weight the doctor said I would reach? (based on who knows what)
Also the "bariatric team" isn't great and I haven't gotten the support I expected from them so no resource for me there.
How do I know how many calories to eat?
I definitely feel some hunger now at 7 months that I did not feel earlier. I did fall off the wagon after recovering from some viral illness I had and now I have gotten it back under control. I had lost weight from being sick and it did come back fairly quickly, I was eating more calories to "feel better" after losing 15lbs too fast.
I am not afraid of keeping losing, I think it will stop around my lower goal weight, just afraid of gaining instead of maintaining.
Finally figuring out what foods really don't work for me now, mostly anything heavy or complicated like casseroles.
How do we do maintenance?
Do we magically stop at the goal weight the doctor said I would reach? (based on who knows what)
Also the "bariatric team" isn't great and I haven't gotten the support I expected from them so no resource for me there.
missyinacage
Member
I have read and heard from others, that for women maintenance should be 1,000 to 1.200 calories. That seems low to me or at least for me. I probably get between 1,300 and 1.500 depending on the day. And I'm still losing, albeit more slowly. I think you'll have to find what works for you individually. It's hard not having a concrete guide. But your body and metabolism will be different from mine. I am 11 months out and spent about 7 weeks within a pound, so I assumed that was my stop point. I have since lost another few but I'm pretty sure I'm getting close to maintenance. At least, that's all I'm trying to do anyway. I'm comfortable with my intake, meaning I'm not hungry nor do I feel deprived, and I'm pretty happy with my activity level. So, I'm going to keep going with what I'm doing and any more weight loss would be gravy.
JudyNY
Member
Great questions, I need advice on this too.
JudyNY
Member
WazzuCoug
Member
The most reliable way to determine how many calories you need is to get your Basal Metabolic Rate or Resting Metabolic Rate (RMR) measured using indirect calorimetry when you've hit your nadir weight. It might be hard to find a place that does that unless you live in a larger city, but you can usually find them at some advanced Physical Therapy clinics. The cost for RMR is usually somewhere between $100-$200. The cost for evaluating BMR is usually a lot more expensive because it takes significantly more time, but the difference between the two is usually 10% or less. Using online Basal Metabolic Rate calculators online can get you in a reasonable ballpark, the thing to keep in mind however is that if you use whatever weight you are right now, you'll want to consume less than your basal metabolic rate + activity to burn fat. It's not all that easy, which is where choosing the right foods and getting in tune with intuitive eating can help, but knowing how efficiently your body is burning calories might be helpful to plan around as you learn what to eat to maintain your weight when you reach your maximum weight loss.
Many factors affect a person’s metabolic rate: weight, age, body composition, hormone levels, and gender making it a highly unique number. There is no one intake calorie level that will work for everyone.
The food you eat matters a great deal. Nutrition is a very individual thing. There is no perfect diet that works for absolutely everyone, so diversity in what you eat can help determine what your body metabolizes well. Although a calorie is a constant value, it is incredibly hard to accurately track them coming in or going out. Food labels are notoriously inaccurate and calories in a particular food can vary significantly depending on how it is prepared and what foods are combined together. Even more important than calories is how what you eat affects insulin in your body.
People often assume that all simple carbs will spike glucose and raise insulin, but it isn't that way for everyone. Some people's insulin will rise eating certain proteins. Even if you do not have diabetes, it can be helpful to spend a week or two frequently measuring blood glucose after meals to see how your body responds to certain foods. When glucose and insulin increase, we often get hungrier and tend to gravitate toward higher calorie foods, which is obviously counter-productive.
There are some simplified Basal Metabolic Rate calculators that can get you in the ballpark of what your RMR would be, but the only way to truly know how many calories you are burning is to get it tested. Although I've heard anecdotally that BMR for WLS patients is different than a person of equal weight who didn't have the surgery, some clinical studies I've recently reviewed showed no significant difference in BMR or RMR in WLS patients vs non-patients 2-3 years after surgery.
Many factors affect a person’s metabolic rate: weight, age, body composition, hormone levels, and gender making it a highly unique number. There is no one intake calorie level that will work for everyone.
The food you eat matters a great deal. Nutrition is a very individual thing. There is no perfect diet that works for absolutely everyone, so diversity in what you eat can help determine what your body metabolizes well. Although a calorie is a constant value, it is incredibly hard to accurately track them coming in or going out. Food labels are notoriously inaccurate and calories in a particular food can vary significantly depending on how it is prepared and what foods are combined together. Even more important than calories is how what you eat affects insulin in your body.
People often assume that all simple carbs will spike glucose and raise insulin, but it isn't that way for everyone. Some people's insulin will rise eating certain proteins. Even if you do not have diabetes, it can be helpful to spend a week or two frequently measuring blood glucose after meals to see how your body responds to certain foods. When glucose and insulin increase, we often get hungrier and tend to gravitate toward higher calorie foods, which is obviously counter-productive.
There are some simplified Basal Metabolic Rate calculators that can get you in the ballpark of what your RMR would be, but the only way to truly know how many calories you are burning is to get it tested. Although I've heard anecdotally that BMR for WLS patients is different than a person of equal weight who didn't have the surgery, some clinical studies I've recently reviewed showed no significant difference in BMR or RMR in WLS patients vs non-patients 2-3 years after surgery.
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missyinacage
Member
My point, exactly. I think that maintenance calories are going to be something we all have to figure out individually. As Ryan pointed out, even if you were to get tested to determine your exact calorie expenditure, there's a big difference in quality and types of calories out there. Some function best on a higher (healthy) fat diet, others love low carb, others need more high quality carbs. Add in personal preference and you can see why science has never been able to give us a one size fits all perfect diet recommendation.Wow, that sounds awfully low for maintenance. I am doing that now easily.
Once you are ready to begin maintenance, my best advice would be to begin tracking everything you eat for a few weeks to determine how many calories you are averaging and what types of nutrients you are getting. Then you can tweak it from there if you feel you are missing/low on certain nutrients. I am assuming that your nutritionists did give a suggestion for macros for protein, carbs and fats. My nutritionist suggested 35/35/30. I'm closer to 35/40/25 but it varies day to day.
sharontx
Member
Thank you all for the input. Unfortunately there was no nutritionist involved at my surgeon's clinic. Something I didn't realize would be an issue when I went with him. Pre-op it is all rainbows and butterflies until post op support is needed. My sister in law experiences the same thing with the surgeons office. I have given up on them. I can't afford to hire a nutritionist on my own.
Feeling a little mortified about how this will all play out, but will push through it.
Missy I love that you are 4lbs BELOW your target, incredible work! Your new pic is beautiful too. And Ryan your before and after's were great, you look fantastic. I reread your great post on goal weights today since I had some time. So interesting and useful.
Feeling a little mortified about how this will all play out, but will push through it.
Missy I love that you are 4lbs BELOW your target, incredible work! Your new pic is beautiful too. And Ryan your before and after's were great, you look fantastic. I reread your great post on goal weights today since I had some time. So interesting and useful.
Pink Julie
Member
I’m about the same as you missy and I’m 2 years out. My weight has been stable for 18 months and I don’t want to lose any more.
WazzuCoug
Member
Thanks, and I'm glad you got some value from what I shared. Post op life is complicated with many possible paths. You can definitely find yours with some patience and a little experimentation.