Jay W

Interesting Conundrum

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Good morning TT folks!

As most of us have figured out, life and our ways of thinking change dramatically after WLS.

Here is my most recent conundrum and I would like to put it out there to see if anyone else has found themselves in the same situation.

I have read post after post of people who say they can still only eat very small amounts (1/4 cup to 1/2) of food even though they are quite a few weeks post op. I have also read of people who have trouble eating a lot of different kinds of food.

I read the posts and feel good that I have none of those issues. I do not have trouble eating anything. I have tried a lot of different kinds of food, besides sugar and foods high in fat. It seems I can eat quite a bit (in comparison) to what a lot of people can eat (1 and sometimes 2 cups worth of food) without even feeling like my pouch is full.

On the surface this looks like a blessing. But then I realize that it may be a curse. Part of the reason for the surgery is forced behavior modifications. If I don't have these I am worried my surgery will not be a success.

Does that make sense?

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So what is your rate of weight loss now?

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I understand. I do struggle with some foods ( gets better everyday though) but I am able to eat things I know I shouldnt such as french fries and chips. Some days I am thnkaful that even though I can eat much less, I can still eat. It does worry me but I think as long as you are aware of it and can keep an handle on it, it will be ok. As far as portions go, mine are still pretty small. I do read some people say they can only do 3 oz of yogart when I can do the whole 5 plus a 1/4 of Kashi cereal but if there is one thing I have learned, I can not compare my progress or set backs to others. Its my journey and as long as my doctor says I am ok, then I am happy.

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Aviator:

I lost 52 pounds between May 2 and June 2, but have lost only 1 pound since.

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Jay  it means that you have to USE your surgery as a TOOL and put some self-control into the mix.  I have a 1/ 4 to 1/2 capicity,  but that small portion can also be made up as Ben and Jerry's,  I am glad that you have no issues, isn't it nice??   Just incorporate more exercise and good choices.  stop before you feel full and plan your meals.    k

Edited by KarensTurn

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I also feel that way, Jay.  I can probably eat a 1/2 cup of meat and veggies in one sitting.  I usually make my lunch and dinner about 1 cup and split into two smaller meals to get more protein in (I eat about 5 times a day).  I keep thinking to myself that it is WAY too much!  However,  I still religiously measure everything out, and by using My Fitness Pal to track my food I know I am getting usually less than 1/3 of the calories I used to.  I have to remember that even this 1/2 cup leaves me very full, where before it was 2 or 3 full plates, or even 2 or 3 fast food hamburgers.  I think that I equate this feeling of being very full after eating to before my surgery when I had the same feeling, albeit after eating much more food.  I work out quite a bit so I make sure I eat about 700-800 calories a day.  I also have the sleeve with a bigger bougie size (40 french) than a lot of other sleevers so that may have something to do with it. 

 

I think my biggest problem is that I can tolerate literally ANY type of food, with the exception of bread which just feels too heavy in my pouch.  I eat steak and pork with almost no problem, and I tolerate a few bites of tortillas and brown rice with no issues (although I don't make those a regular choice).  I also have admittedly had a few bites of things that are too fatty, for instance fried orange chicken from a Chinese place, and have no issues.  So I know that I have to keep that WAY in check as my biggest problem before surgery was eating really fatty foods.

 

It looks like you have lost a lot of weight since your surgery so you're clearly doing something right!  For me, it's not how much I eat but what I eat.  As long as it is very healthy, so high in protein and nutrients, I know I am doing way better for myself than I used to.

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The food I eat is healthy, it just seems like I can eat more than I should. Of course, eating a tilapia filet and a 1/2 cup of green beens in the past would have been a major accomplishment. But now it seems like that is a lot more than I should be able to eat.

I also exercise, cardio and weights. So at this point I am not worried.

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For us sleevesters, bougie size is what the doctors talk about. It's the round gage they use to size the stomach. I have no idea what they use for Gastric Bypass to size the pouch. Your pouch can stretch so make certain you don't overfill it.

My current situation is in the last few pages of my Log Book, if you care to look, but I felt my sleeve was oversized too. My bougie size was a 40. The revision that I will be having soon, he will be using a 36.

I would definitely log the calories you consume in Lose It! Or something like that. You are likely just in a stall and the weight loss will continue downward soon. But the easiest most definitive thing you can do is log your food and exercise. That will give you some diagnostic data in case you need to see your surgeon about this.

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If you feel like you're putting in too much, start filling up on veggies. I'd be all over broccoli, green beans, carrots, etc.

Get your 3-4 oz protein in for a good 21-28g serving of protein per meal, but then LOAD on veggies.

You can also try water loading half an hour before you eat. It helps cut down on hunger, since part of your ghrelin is made in the small intestine and part in the brain (not a lot, but some). In other words, fool your brain into thinking you're overloading.

I don't know how often you're eating either, but have you considered more frequent meals? If you never feel hungry, you won't be so tempted to overload.

Hope that helps. There are plenty of things to consider. Don't despair!

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I think its a blessing - easier to get your protein and vitamins in naturally :)  as long as you are eating healthy and in moderation and losing then what's to complain about :) whoop whoop :)

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I will give an example from today as reference.

Last night my wife and I got a Grilled Chicken Market Fresh Salad from Chick-Fil-A (daughter works there so we get 50% discount). I ate 2/3 of it. That in itself is pretty big.

Today for lunch, I finished the other 1/3 of the salad. This consisted of probably a cup of lettuce and 2oz. of grilled chicken, among other healthy toppings. On top of that I ate a tilapia filet, probably 4oz.

I did not feel full until the last two bites. I don't even feel real full, just satisfied.

This just seems like a lot of food only being 7 weeks out.

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I'm not post-op, so know nothing. But it seems if you stop losing weight you might want to cut back. And get rid of salad and other greens and eat proteins and see when you fill up. Proteins fill you up (satisfy your body's "full" meter) faster than greens and way faster than carbs.

 

But what do I know. ;)

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At every meal, I always prioritize my food intake as:

1. Protein

2. Vegetables

3. Carbs

Even with the tilapia and salad, I ate the fish first, then the chicken, and then the leafy stuff.

I always get the full serving of protein in before anything else at every meal.

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That does seem like a lot.  Are you weighing out your food or just eyeballing it?  I feel as if it would be very difficult to eat 6 oz of meat.  Granted, I can eat more fish and chicken than I can steak or pork, but 3oz of chicken (normal thickness) should approximately cover the size of your palm.  I recently found this website and it's really helpful:  http://blog.photocalorie.com/portion-sizes/  I was freaked out that I was eating too much for a while as well, but when I found out what 3oz really looks like I felt much better.  Now I serve myself 3 oz of meat and then measure out about 1/4 to 1/2 a cup of veggies, depending on the type.  I consider that a cup of food, but it may be more or less.  I used to measure the meat by volume with my veggies but I found that different ways of cutting it lead to different measurements.  I don't have a food scale, but I find other ways to make sure I am not eating too much.  For example, from my meat counter I generally get half a pound and know that there are two servings.  Since meat weighs less after cooking (my program recommends weighing after cooking) I know it will be about 3oz when I'm ready to eat it.  Just my 2 cents, but if it is concerning you I would talk to your NUT or surgeon.

 

eta:  When I measure out the "cup" as I call it, I split it into two meals.  I eat the 1.5 oz of protein first and then eat as many veggies as I can.  Round 2, I do the same.  I probably couldn't get all 3 oz down otherwise and I know I need that protein. 

Edited by hayleyca

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Agree with Hayley, it seems like a lot.  But then again, we are all so different.  I weigh everything on my kitchen scale (well, all protein) and can't ever finish the 3 oz of fish I give myself for dinner.  Usually can get down 2 oz plus a few pieces of broccoli, cauli, or asparagus.  A restaurant meal becomes 3-4 work lunches usually.

 

I think we all have very different satiety levels, and unique ways of dealing with emotional/head hunger.  I don't allow myself to entertain the idea of emotional eating or cravings, it just isn't an option here.  I eat by a plan, and faithfully stick to it.

 

Perhaps you can plan your days in advance, so there will be no disruptions and see how it goes?

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Thats seems like a lot for RNY, but they say it can take a few months for the nerves to heal in the pouch and give you a true "full" feeling. it took me about 3 months. I was told to weigh and measure everything untill I had good feedback from my pouch, and to continue this practice "until further notice" - this was my Docs advice.

 

Looks like you have dropped a lot and are doing great! you might want to reach out to your NUT and see what they have to say :)

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I weigh out my food or use special portion size utensils we have at home, if the food is prepared at home.

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Wow, that's a lot of pounds for one month.  Its not surprising you have slowed down.  As entertaining as it might seem, that rapid a weight loss probably wouldnt be good for your system.

 

The surgeon gave us a Nutrition guide when I went through the process -- the long term goal in the guide said 6 ounces of meat a day.  Vegetables and Fruits were added "long term"

 

They used the same guide for sleeves as for roux en y, so it would seem that maybe you are eating more than normal - especially a month or so out.

 

I would like to be able to eat chicken, period - but my system just doesnt like it.

 

I can see how it would be harder if you dont have the restrictions you expected, but I think we both know from experience that just because you Can do something doesnt mean you Should.

 

I'm sure you will find your way in this, good luck!

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Jay,  I am like you.  I feel that I can definitely eat a lot more than I thought I would.  I may be overestimating, but I can easily eat 5 oz of poached salmon along with 1/2 - 1 cup veggies.  I am moving in a couple of weeks, but my kitchen scale has been packed for months, so I have been eyeballing everything. I have never dumped and very recently tried out that theory on a few bites of my daughter's birthday cake.  After doing that and not dumping...I dumped the cake itself - into the garbage!  Too tempting.  Like one  of the posters said above, this is the time to use my tool, and my motivation for having the surgery in the first place.

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I just talked with my nutritionist earlier this week (first meeting post-surgery).

 

She asked me how many calories I'm eating and when I told her 500-800, she said that was on the edge of being too low. I asked her for what I should be aiming for (in the losing phase) and she said 1200 calories/day, 30 grams of protein per 100 pounds of body weight and a fat % < = 30%. Obviously carbs are to come from healthy sources, not the "5 whites" (rice, potatoes, bread, pasta, and sugar).

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That does seem a lot to me, but I have a size 36 bougie ( I thought it was 40 until I looked at the post-op report the other day.)  So I am lucky to eat 2 oz of protein (usually chicken, fish, or ground beef) in one meal.  I can barely get to the carbs and feel like I have to force them down some days. 

 

Talk to your dietitian if you think there is going to be an issue so that you can catch it now instead of later.

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It seems like a lot to me also. But you have to consider like with salad, that lettuce collapses into almost nothing once it has hit the acid in your stomach. So it's not very filling, and I can easily see being able to fit in what looks like a lot.  If you go with a denser vegetable, it might be less that you can eat at one time, I'm thinking.

 

Additionally, someone mentioned that you're still numb.  And that is true.  I recall this from my own surgery.  

 

Nowadays, at 4 months post op, I can eat about 3 oz of meat and 1-2 bites of veg & potato in a single sitting.  I'm about as healed as I'm going to get, I think, so there isn't any more swelling to go down and give me more room.  It's usually about 1/2 cup of food if it's solid food.  Maybe a tiny bit more or less, not much.  

 

In any case, you are a GUY, so you have lots of muscle.  And even though you think this is more than what you should be able to eat, it's still a tiny portion.  If you're doing cardio while you're eating like this, it's going to come off... I wouldn't be super concerned about revisions and such until you were quite a ways farther out, if it were me.  If it really bothers you though, talk to your doctor and make sure he isn't concerned.

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That does seem like a bit much for our tools to work with. You may be on a long stall, but I would guess you are eating a bit too much. With food consumption, I don't estimate. I use a food scale and measuring cups and spoons, along with amounts listed on labels, on websites and even on the sites of restaurants (most will have nutritional values of their menu items online). What may be happening is that you have stretched the pouch a little. But on the other hand, it may be a new kind of normal for you. Definitely keep a diary for a while, so you know for sure how much you are eating. I find that tracking my food, even at almost a year out, has been the greatest of help for me. I believe I was deceived about portion sizes before the surgery... self deceived I should say. You are doing well - keep working at it. Glad you asked this question.

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You are early out. Your nerves are not fully healed, therefore you do not have full senstation of true fullness. I would't trust what you can put in your stomach. Go by the guide of weight and measurement.

My first month my pouch would not have been able to consume the quanity you are. But I had so much inflammation that month. Your pouch is unique to you:) I still feel strongly you aren't fully healed though. Don't worry that you can eat more. Just go by the rules of because " I can, doesn't mean you should." Speak with your doctor's team and get good advice on measure and weight. You will do well!

At two+ years out I can certainly eat a good amount of food. A healthy cup of chili, yogurt with a few TB of cereal on top is a piece of cake. But those are slider foods. Easy in and easy out.

1/2 of peanut buter and jelly isn't completely easy to finish, but doable.

If If we were talking about something more solid like a hamburger, it would look like a piece of lettuce with a 2 oz patty and that would leave me very satisfied.

Now lets get even firmer. A piece of chicken is a toughy. Lots of chewing to be careful and easy fullness.

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I'm nearly 3 years postop, and I'm in the same boat as you are in.  In fact, I recall thinking the same thing a few months postop.  I remember telling my surgeon at my one-year postop visit that I was fairly certain I had broken my tool because I never felt full.  He tried to reassure me that I had apparently not tested the limits, but I was fairly confident I had. 

 

I religiously measure and weigh my food, but it would be nothing for me to eat a 6-8 ounce steak with side salad, a 6-8 ounce grilled chicken breast with vegetable, or something of similar size or consistency without any ill effect or ever feeling full.  I might even be able to eat more than that, but I physically stop myself. 

 

When I saw a new surgeon for my two-year postop visit (my original surgeon retired), he told me that it could be that my stoma had stretched but that my insurance wouldn't pay for a revision until my BMI had increased significantly (I think he mentioned 35 or so).  I'm not about to allow that to happen, so I continue to be diligent about watching what I eat and staying within my dietary parameters given to me by my dietitian (1200-1400 calories, <30 g fat, 80-100 g protein, <1500 mg sodium, <135 g carbs) and exercising on a daily basis.  I find this incredibly frustrating because my "tool" really isn't a tool.  I swear all my original surgeon did was cut me open and then sew me back up immediately. 

 

I do feel blessed that I can eat anything and everything without ill effect; however, I truly wish I had a sense of restriction.  I'm not saying I expected this to be easy or that restriction would make it easy, but it likely would have done wonders for my brain to begin to associate small amounts of food as "enough."  It's something I still struggle with to this day. 

 

Follow your surgeon's / dietitian's guidelines...and expect good things!    

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