Eating below BMR, not losing?

catecholamine

I'm a bit at a loss. I had a weight loss surgery in January (Duodenal Switch) - the general rule is that we don't absorb about 40% protein 40% complex carbs and 80% of the fat we eat. I think I absorb more than this, a little bit more, maybe closer to 50% fat, but how can one tell? Anyway, the general style of eating is to avoid simple carbs (we absorb 100% of those) and eat high protein (100g+) and moderate fat (or we stop pooping, skin begins to flake, lips crack open, hair gets brittle, it's not pleasant). So take that in mind when looking at my diary.
- Most days, I eat well below my BMR which is around 2100. Plus I go to the gym and do an hour of cardio 4-6 days a week. I don't log that most of the time and I never eat back calories. So even if I HADN'T had my guts rearranged, I still should be losing. But I'm not. I dropped down to 256, then popped back up to 258-259 and that's were I've stayed for a bit. The past 2 days has been 1300 calories. No change. If anything, I've gained a pound. I'm at a loss here.

Nutritionist at surgeon's office is no help.
My body is amazing and can run on air, apparently, because I'm using more than I'm taking in and not losing weight.
P.S. I measure and weight my food. I'm not overeating and not logging.

What the hell should I do? I still need to lose 100lbs and my total loss for the past 3 months has been about 5lbs.

arditarose

I didn't read all this but you mean you eat below TDEE not BMR, right? How many calories are you eating?

catecholamine

Nope, just BMR. Obviously my TDEE would be higher. How much I eat varies from 1200 to 2000 (rarely) calories a day, but most of that is fat, which I don't absorb at least half of (refer to OP)...so I'm not really absorbing nearly as much as I'm eating.

catecholamine

Just checked my TDEE, looks like my BMR is actually 1960. TDEE is 2781.

gmallan

Keep in mind those calculators only give you an estimate so they could be a bit off. I guess the next thing is to look at your tracking methods. Can you be certain that you are accurately tracking (food scale)?

catecholamine

Yep. I am. I weigh/measure everything, and my food scale is accurate.

gmallan

Maybe a second opinion from a different nutritionist/dietician. I feel like the professional should be able to help you

catecholamine

To overeat enough to make up for the fat I'm not absorbing, I'd have to eat way more than an ounce here and there. I'd have to eat and not log whole meals. And I'm 100% positive I'm not absorbing at least a portion of the fat I'm eating....you don't wanna know how, lol.

catecholamine

They told me to do what I'm doing and keep doing it, and I have been, and I'm not losing. Even when I should be losing even if I hadn't had surgery at all. All I can think to do at this point is see my surgeon and find out if it's possible to shorten my common channel (making me absorb less) and making my stomach smaller than it is. I don't know what else to do besides starving myself. Which hurts. If I go 8+ hours without eating, my stomach starts burning and I want to curl up and cry it's so painful. Sigh.

MKEgal

Congrat's on your success so far!! That's amazing.

I only looked back about 10 days in your diary, but it looks like other than the last 2 days you've been eating very near your BMR.
So all you have to help you lose weight is exercise.

Most weight loss occurs because of decreased caloric intake. However, evidence shows the only way to maintain weight loss is to be engaged in regular physical activity.

http://www.cdc.gov/healthyweight/physical_activity/index.html

From your ticker, it looks like you're about to the point where you could be eating 1400 cal / day, in order to lose 2 lb / week.

The 2 methods my doctor told me are:
1 - Multiply your current weight x 10, then subtract 1000 cal to lose 2 lb per week.
2 - Multiply your healthy goal weight x 10.
Don't go below 1200 unless your doctor says it's OK.
And ignore exercise/net calories. Most people underestimate what they eat (though it sounds like you're doing very well at being accurate) and most machines (including MFP) overestimate calories burned. My doctor says to treat it as a bonus toward weight loss.

When I started this effort in JAN, my BMR was 1958 & my goal calories were 1700.
Currently, my BMR is 1695 & my goal calories are 1550.
My doctors are all quite happy with my health, my progress in losing weight, my blood work, etc., so consistently eating below your BMR shouldn't harm you.
http://www.myfitnesspal.com/tools/bmr-calculator

catecholamine

The only thing is I shouldn't be absorbing most of those calories, and I'm not, at least some, because I can see that I'm not absorbing fat when I go to the bathroom (I know, TMI)...so one can assume I am also malabsorbing protein and complex carbs as well. So even on days where I eat 1900 calories a day, I'm only absorbing 500-900 calories depending on how much was fat/protein/carbs. If I cut back on the fat (which is the only thing I CAN cut back on), I have the problems listed in the OP because of having so little fat absorbed.

The only thing I can really think to do at this point is to try what some people who had the DS claim I should do, which is eat lots more protein/fat to up my calories so I'm absorbing more than 600 calories a day. But I don't really see how that could work.

MKEgal

catecholamine wrote:

All I can think to do at this point is see my surgeon and find out if it's possible to shorten my common channel (making me absorb less) and making my stomach smaller than it is. I don't know what else to do besides starving myself.

Whoa!
You're only 25 and you already have to spend the rest of your life with screwed-up eating patterns & malabsorption (not just of food, but of medicine, vitamins...) because of the damage the surgeon did (deliberately).
Don't make it worse.

- Talk with another dietician.
- Talk with the doctor. Take documentation of your (lack of) weight loss, and your food diary.
- Give the 1400 cal several weeks, see if that helps.
- Talk with another doctor, both a bariatric specialist and maybe an endocrinologist.