Loosing Lucy

What guidelines has everyone been given or do you follow?

Recommended Posts

So my dietitian hasn't gone into specific guidelines for long term eating yet,  only the initial post surgery phase. She has said that I will essentially be able to eat any healthy whole foods,  not to worry about fat or carb content as long as I'm getting my protein in as I won't be able to eat enough of anything to cause an issue or slow weight loss anyway. 

I'm just wondering what sort of guidelines everyone has followed re: calories/ food types/ frequency of meals etc?

Share this post


Link to post
Share on other sites

There's not much focus on calories usually because of the small quantities we're able to eat, but most of us are given protein and fluid guidelines as priorities.  My directions long-term were pretty simple...protein first, then veggies to comfortably "full" with daily minimal protein goal of 60gm, preferably 80gm.  At maintenance added in fruits, and whole grains, and limited "treats'.  Fluid is important because we're not getting as much fluid from our food (because we're not eating as much) so it becomes very important to make sure you're getting at least 64 oz per day.  My guidelines recommend breakfast, lunch and dinner with 2 snacks as needed. 

Four years out I eat pretty much what everyone else does, at least others who eat healthy.  I try to stick to unprocessed foods whenever possible and spring for the highest quality I can.  I try and savor each bite and make it more about quality than quantity.

Life is glorious on the healthy side, good luck to you on this new path!!

Share this post


Link to post
Share on other sites
6 hours ago, msmarymac said:

There's not much focus on calories usually because of the small quantities we're able to eat, but most of us are given protein and fluid guidelines as priorities.  My directions long-term were pretty simple...protein first, then veggies to comfortably "full" with daily minimal protein goal of 60gm, preferably 80gm.  At maintenance added in fruits, and whole grains, and limited "treats'.  Fluid is important because we're not getting as much fluid from our food (because we're not eating as much) so it becomes very important to make sure you're getting at least 64 oz per day.  My guidelines recommend breakfast, lunch and dinner with 2 snacks as needed. 

Four years out I eat pretty much what everyone else does, at least others who eat healthy.  I try to stick to unprocessed foods whenever possible and spring for the highest quality I can.  I try and savor each bite and make it more about quality than quantity.

Life is glorious on the healthy side, good luck to you on this new path!!

This.....with bells on!!!!!!

I get very concerned when I hear the advice given by dieticians in Australia. They tend to all say the same thing and in my experience set their patients up for mediocre results, and down the track, to regain and feelings of failure. What they are saying is in essence true in that you can usually eat anything you want just in smaller quantities.  With this advice in their heads, every single WLS patient I've come across, has not hit their long term goals and has suffered through significant regain if not full regain long term. I've heard and read on Australian dieticians' blogs that achieving a "normal BMI" after WLS is unrealistic. I just want to yell at them and tell them its only unrealistic because of the poor advice patients get given by them. To achieve 100% excess weightloss and maintain it requires a complete mindset change with regard to diet and exercise and by far the easiest way to lose all that excess weight is to do so during the first 12-18 months. It happens by being focussed on diet first. To be successful long term we do need to "diet" for the rest of our lives. By "diet" I mean adopting  healthy eating habits. Fresh is always best, sugary treats including drinks need to be moderated, and processed foods should only very rarely make their way into the shopping trolley. Sure I eat anything I want to now, but I do it in a seriously modified way. Treats for me are definitely only for special occasions, and once that occasion is over....it's over. It's very easy to let treat foods make their way back in to daily habits, and that guarantees weight gain longer term....and I really do mean guaratees. I've had dieticians tell me I shouldn't still be weighing myself because it's unhealthy and obsessive. It isn't. With regular weighing I can see immediately when my weight creeps back up and address is before it all becomes too hard again. Once the honeymoon is over its really hard to drop any extra kgs that get regained. I'm not obsessive about weighing food and I haven't tracked consumption since my surgery. I weighed portions early on until I was comfortable that I had portion sizes right, and only occasionally do I weigh things now just to check I've still got my eye in and not gradually increased the size of my portions. I've had dieticians and medical specialists tell me I'm an outlier, but I'm only an outlier because I read widely on forums etc the advice of others I saw as successful long term WLS patients. The thing they all had in common was they "dieted" almost religiously to goal, they weighed regularly to maintain weightloss addressing even small regains immediately,  and they never forgot where they started from. They were the people I wanted to emulate. No need for me to go into my diet plan as msmarymac has said it perfectly. She was indeed one of those successful people whose footsteps I wanted to follow in.

As an aside, I have a sister who had lapband surgery a few years ago. The only weight she lost was on her pre-op diet. Four weeks ago she had a revision to RNY. She told me she was jealous of my weightloss so was going to try again by having the same surgery I did. I went to one of her dieticians appointments plus a couple of her bariatric doctor consults, and heard the same information you seem to have been given. Once again I was labelled an "outlier" with regard to my weightloss. They even went so far as to tell my sister not to aim so high because my % of excess weightloss was an unrealistic goal to set for herself. Yesterday I happened to be with my sister at lunch. She had a deep fried crumbed fish and chips! It wasn't even a real fish fillet inside the crumbing, instead it was one of those pieces filled with fish flesh formed with a floury paste. She did make a point of not eating the crumbs and declared how "good" she was. This was on day 29 after her surgery! That's quite acceptable in light of her dieticians' advice, although most of us here would be cringeing at just the thought of it. Her dieticians' advice is setting her up for failure. I couldn't say anything because of the company we were with at the time, and it's unlikely I will unless I'm specifically asked to. Nobody really wants food police watching them eat.  I'm maintaining my weightloss yet still wouldn't have touched that meal. In fact there was nothing on that menu I would have chosen. I opted instead to have a large glass of low fat milk, I had two chips which I took off her plate (ha ha! That's a sister thing in the house I grew up in where someone always stole another's chips), had a single serve cheese and crackers in the car as I was driving away, and stopped at a fruit and veg shop on the way home and bought a banana. While not ideal, it was a one off way to deal with an unsuitable menu, but more to the point it was an example of how I think about food now. My losing weight phase set me up to automatically go for the healthiest option for me. I got my protien from the milk and cheese, I got nutrients and the all important fibre from my banana, and no sugar rush to deal with later from hi GI carbohydrates. By far I would have consumed a far more nourishing lunch than she did. The point Im trying to get across here is that it is how we look at food in the early stages when weightloss is easy,  that really will determine our long term success. I could have physically eaten anything on that menu for lunch yesterday, I just chose not to because there was nothing on it that I felt worthwhile putting into my precious body.

Share this post


Link to post
Share on other sites

Thank you both, that's very helpful . I actually found that guide a few days ago Res Ipsa but didn't read far enough down to see the Stage 5 guidelines and example plans, helps when you read the whole thing!  

Can someone please tell me what Chili is? My assumption was a mince beef meal with spices etc but there seem to be a lot of other variations that people talk about so I'm guessing it's more a type of meal rather than a specific meal itself? and I'm sure I've seen people suggest it for the earlier stages before soft food is allowed... or is my memory loss coming into play again there?!

Aussie Bear, you are right about the Australian dieticians.. and the surgeon. He was actually more skeptical people's ability to lose 100% of their excess weight and certainly of their ability to keep it off. His comment was that for whatever reason you got to this weight in the first place so why would all those reasons just stop now.

The dietician advised me to set a goal at about 90-95% of my excess weight but her reasoning was more about not wanting me to feel like I had failed if I only get to 85kg and focus on the 5-7kg I haven't lost as opposed to the 45kg that I have. She did also emphasize protein and fluids first and encouraged whole foods (fruit, veg, whole grains) etc with treats as an occasional. I don't know what her usual approach or level of information is though... she asked a lot of questions about my current eating habits and got a pretty good understanding of my current level of knowledge about healthy eating before we started talking. I do have a decent understanding of healthy eating guidelines.. I just can't seem to follow them even though I know what they are!

I can understand you not wanting to say anything about the dietician's advice in the appointment but did you tell her bollocks to that when you got out? or doesn't she take kindly to information from family? 

Aussie Bear, you mentioned that you ate a banana, I would have thought that that would be too high on the GI index (not that I've done that much investigation into GI value of most foods) if you have RH... or can you still eat fruits? you are giving me high hopes right now that even if I do get RH that I will still be able to eat a wider range of food than I thought - I have been picturing protein and green veg only type diet, similar to what I'm doing now with the optifast - but if I can still have some fruits and a wider variety of veg I am happy with that!

Share this post


Link to post
Share on other sites

Chili is usually (not always) tomato based.  Hamburger, chili powder, beans (kidney, pinto or black beans usually), tomatoes, maybe jalapeños, there’s probably as many recipes as there are people on earth!  Can be topped with cheese, avocado, sour cream, or not.  Kinda like a thick soup.  

Im a bit different.  I can eat the same thing for months til I get tired of it.  I hate veggies (tomatoes and corn on the cob are about the only thing I eat.  Oh and asparagus in the spring).  I could live off fruit.  I love berries in season with Greek yogurt.  Apple dipped in Greek yogurt is my lunch at the moment.  I snack on string cheese.  I do well with chicken.  I’ve only counted protein and liquid and calories.  Early post op I survived on cottage cheese, Greek yogurt, egg,  and refried beans with taco sauce.  I’m thinking week 3 or 4 was meatloaf.  I am a picky eater.  Dont keep junk around.

i went to 2 support meetings and quit when someone wondered why he wasn’t losing weight.  He was eating a box of twinkies a day!  My husband works with someone whose wife has gained her wls weight back by drinking a fifth of vodka a day!  

Temptation will always be there.  It’s up to you how you handle it.  Many times I tell myself I don’t need something!  Or I ask what nutrition is in it for me.  Are the protein to calorie ratio good enough?  

I had a banana with supper tonight.  

Edited by Cheesehead

Share this post


Link to post
Share on other sites
1 hour ago, Loosing Lucy said:

 

I can understand you not wanting to say anything about the dietician's advice in the appointment but did you tell her bollocks to that when you got out? or doesn't she take kindly to information from family? 

Aussie Bear, you mentioned that you ate a banana, I would have thought that that would be too high on the GI index (not that I've done that much investigation into GI value of most foods) if you have RH... or can you still eat fruits? you are giving me high hopes right now that even if I do get RH that I will still be able to eat a wider range of food than I thought - I have been picturing protein and green veg only type diet, similar to what I'm doing now with the optifast - but if I can still have some fruits and a wider variety of veg I am happy with that!

She wasn't my dietician, I was just sitting in on the appointment,  so not really my place to say anything. That said I've now seen 4 different dieticians that have all told me to eat more carbs. They actually all wanted my carb intake at 180g daily!!!!  What's worse is that this was one I was sent after the RH diagnosis specifically to teach me how to manage it. She even told me off because I try to substitute lower carb things for higher ones. For example I make lots of mini quiches for easy lunches, the kind you do in muffin tins. They're easy and can be frozen and reheated easily. Instead of pastry I generally use a wonton wrapper to hold it all in so there an easy on the run lunch alternative.  This particular dietician was almost stomping her feet that I was missing an opportunity to add extra carbs into my diet and that they are crucial for a balanced diet. I'm not a low carb freak by any means and in fact haven't been in ketosis since my surgery 18 months ago. I just like to chose what to eat and when to eat it. When I told the endocrinologist that is treating my RH he said " what does she want you to stack the weight back on?" My bariatric surgeon after telling me three times to change dieticians, which I did but each one clearly believed the same stuff, then said to forget even seeing any because they are "just wrong"!!!

As for the banana, the surgeon told me not long after my surgery to eat them if possible to lift my blood sugar after a crash. This was well before the RH diagnosis. According to him they contain both hi and low GI carbohydrates, so won't result in a  further round of high and subsequent crash. Glucose tablets aren't an option for me because the Glucobay (acarbose) I have been prescribed to try to control the RH act to stop the body absorbing glucose. So far I've been able to handle fresh fruits without the sugar high and subsequent crashes but I've really not tried a variety of fruits yet. I'm slowly working my way through different ones as they come into season to see what's okay and what's not, and I do limit the amount I have at the time. Generally I'll only have half a banana (i just freeze the other half and use it in a smoothie later) or one kiwi, or about 6 strawberries or cherries. I don't touch the really high sugar fruits like grapes. I have yet to come across a vegetable that I can't eat, and I love my veggies and eat a wide range of many different colours. I really don't feel deprived because of the RH. I still eat what I want, including the very occasional donut or slice of cake, I just make sure to take the acarbose before I eat it.

I've personally found that eating well most of the time has changed my taste buds. The snacks I used to love (like cheese twisties) really don't taste as nice to me anymore. It's not about the fact that they cause an RH episode,  the reality is that they just don't taste as good as they used to, and I've always been a very picky eater. I think when we eat clean for the active weightloss period, that come maintenance time when we can afford the extra calories, we realise that our taste buds just don't appreciate the things they used to. Then when opportunities come later to have those foods again, the interest just isn't there like it was in pre-surgery days. I love now to eat the higher end protiens etc and I can afford to because my serving sizes are so small. I'm developing very discerning taste buds. Other than quite high end pizza, I haven't had fast food in over two years and the desire to do so just isn't there. When we eat so little, we want what we do eat to be worth the pouch room it takes up. It's a bit akin to appreciating a glass of fine wine as we get older compared to chugging flagon or cask wines at university. Haha....surely it's not just me that did that!!!!!

Share this post


Link to post
Share on other sites
3 hours ago, Aussie Bear said:

It's a bit akin to appreciating a glass of fine wine as we get older compared to chugging flagon or cask wines at university. Haha....surely it's not just me that did that!!!!

Hahaha I believe Nikov was my poison of choice... do you remember Nikov?cask vodka and orange... if you don't let me tell you,  IT. WAS. BAD!!!!!!!

Share this post


Link to post
Share on other sites
1 hour ago, Loosing Lucy said:

Hahaha I believe Nikov was my poison of choice... do you remember Nikov?cask vodka and orange... if you don't let me tell you,  IT. WAS. BAD!!!!!!!

Nope, never had it. I lived in great wine growing regions, so it tended to the fermented juice of grapes that I was guzzling....not good ones either. In winter we'd make mulled wines by the flagon....it went down so easily and quickly that we didn't even know we drinking alcohol until we couldn't get up from the floor after collapsing on it. Those were the days!!!!

Edited by Aussie Bear

Share this post


Link to post
Share on other sites

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...