Ketogenic Diet and Duodenal Switch ( DS ) weight loss journey

Miss_Hattie · May 2017

I thought I read and heard that it is very difficult to gain any weight with a DS. So perhaps that is not really true?

toastedink · June 2017

Hello!

DS patient 2.5 years out here. I actually just switched to a keto meal plan as well after a small gain due to a medical emergency and could not work out on a regular basis.

I'm already down 5 lbs after a couple of days. I'm just so happy to not be bloated anymore. The stools aren't that loose either.

yadda78 · August 2017

Okay, I never reached out to anyone online so this will be my first post ever! I had the duodenal switch ten years ago and lost 130 lbs. My lowest weight was 183 pounds and I was “good” with that number. Then, life ills began to happen in which I was losing family members and friends back to back.
In addition, last year I experienced ds hell! My vitamins ADEK was extremely low and I could barely move. I had my DS in California so I had to fly there to get help since the doc’s in NC was not getting my issue. The doc gave me a shot, put me on a strict regimen of eating fatty meats, no sugar or carbs, and drinking plenty of water, I felt better within a month time. However, when the smoked cleared I weighed 225 pounds. Somehow, I managed to lose 14 pounds without thinking about it but I am still in the uncomfortable, I do not want to be here again range.
I would like to know how you all are “key toeing” How are you setting up your macros using my fitness pal. Do you all have any issues (runny stool and bad gas) after consuming veggies and fats? Recently, I discovered Dr. Eric Burg and I am thinking about taking his supplement for Gaul bladder and electrolytes. Have any of you heard of him? Have any of you tried his supplements?
Any assistance would be great at this time. I am so tired of battling my issues with weight.

garber6th · August 2017

Some of the people in this WLS group have adopted a keto diet, I think they could give you helpful information:

http://community.myfitnesspal.com/en/group/637-gastric-bypass-vsg-lapband

alabaaster · August 2017

Hi all, I would like this forum to continue because it's exactly what I'm looking for. I had the DS 17 years ago. I'm now 45 and am struggling to lose 35 lbs. I weigh about 155, but would like to get to 135 as that's where I'm most comfortable. The extra weight started at about age 40. I'm doing the keto diet, which I love. I have weened myself off of carbs over the years and don't miss them at all. I've been in Nutritional Ketosis (test thru my blood) and I'm in the 'sweet spot' for best weight loss. How much have I lost? Nothing. I will go down 5 lbs, then back up 5 lbs. Very frustrating. I'm also doing the 16:8 intermittent fasting (fast for 16 hours, eat during an 8 hour window, only eat when hungry).

My question is the fat absorption piece. It dawned on me this morning that since we don't absorb fat as normal people, could that be throwing me off? I ate 4 fat bombs yesterday and it was not a good thing at 3am...I'm sure u know what I'm talking about. I normally only have 2 fat bombs on any given day. I do eat avacados, olive oil, salmon...I get all the good fats in my system, but could our malabsorption screw up the benefits of eating all that fat?

Anybody have anything to add or have any insights let me know. I'm not giving up, but would like to see some progress given I'm in a good keto state and I don't miss carbs whatsoever.

msjen15 · August 2017

Hi! I had the DS in Jan 2004, weight was pretty stable for most of that time (after the losing phase, my high was 335 lbs.), but I recently gained about 35 pounds in the past two years (15 in the past 6 months alone!!). I'm 5'3", 43 next week, so I've had that post-40 slow-down of the metabolism, but also have been much less active and more carbs, more snacking. I'm at 183 today, would like to get down to about 145 (ideally).

I can eat totally normal amounts and feel like I probably don't have as much malaborbtion. I've been actually considering doing WW or even Jenny Craig since I wonder if I am more like a "normie" now. But maybe I just need to buckle down to the low-carb, kept thing. Ugh. Hate being this heavy.

alabaaster · August 2017

msjen15 I too believe my body has adapted to the surgery. I can tell a difference when I eat more fat than normal, but everything else seems pretty normal.

The high fat/low carb diet for me is great. I love heavy whipping cream, hamburgers, and butter. Give it a try and see how you do! Carbs are really the devil in our diets.

nvmomketo · August 2017

alabaaster wrote: »

Hi all, I would like this forum to continue because it's exactly what I'm looking for. I had the DS 17 years ago. I'm now 45 and am struggling to lose 35 lbs. I weigh about 155, but would like to get to 135 as that's where I'm most comfortable. The extra weight started at about age 40. I'm doing the keto diet, which I love. I have weened myself off of carbs over the years and don't miss them at all. I've been in Nutritional Ketosis (test thru my blood) and I'm in the 'sweet spot' for best weight loss. How much have I lost? Nothing. I will go down 5 lbs, then back up 5 lbs. Very frustrating. I'm also doing the 16:8 intermittent fasting (fast for 16 hours, eat during an 8 hour window, only eat when hungry).

My question is the fat absorption piece. It dawned on me this morning that since we don't absorb fat as normal people, could that be throwing me off? I ate 4 fat bombs yesterday and it was not a good thing at 3am...I'm sure u know what I'm talking about. I normally only have 2 fat bombs on any given day. I do eat avacados, olive oil, salmon...I get all the good fats in my system, but could our malabsorption screw up the benefits of eating all that fat?

Anybody have anything to add or have any insights let me know. I'm not giving up, but would like to see some progress given I'm in a good keto state and I don't miss carbs whatsoever.

A safe way to approach keto for weight loss is to think of it as low carb rather than extra fat. You want to stay below your upper carb limit, hit or exceed your protein goal and then fill in the rest with fat - less if trying to lose weight since you will want to use your own fat stores instead of dietary fat.

For example, when I was losing I ate under 20 g carbs, between 80-90 g protein, and about 100-110 g fat. When maintaining my carbs are about the same, protein is 80-95 g, but fat is often over 120g... And I still rarely fit in fat bombs.

Fats can cause the runs in many people, especially coconut oil. Cutting back on coconut oil might help.

Good luck.

aylajane · August 2017

I know you are thinking you have to increase the fat by huge amounts to make up for the malabsorption, but I think you might be thinking about it wrong...

In keto, there are no fat "goals" to hit. There is a carb "limit" to not go over, and a protein "target" you want to hit (maybe higher for you due to malabsoption). Then you use fats to fill out the rest of your eating to "satisfaction". I.e. You dont eat fat to hit a target, its just what is left. The idea of keto is that your body will learn to use fat for fuel, and it doesnt know the difference between the fat you eat and the fat on your body. So if you dont eat "enough" fat (i.e. calories), it will burn the fat from your body to make up the difference in energy output. So you lose weight.

Anyone who eats keto still has to eat fewer calories than they burn to lose weight. You seriously cannot eat all the bacon you want all day and lose weight. People say that because generally you fill up pretty fast with fats and it keeps you full longer, so some people do not need to COUNT calories because their hunger cues will be suppressed and they will naturally eat less.

So dont force fat - keep under your carb limit and make sure you eat enough protein. Fill in with fat up to your daily calorie limit - but only if you are actually still hungry!

That means your malabsorption is basically irrelevant... The only thing it might mean is that you can eat over your calorie limit (energy out) and still lose weight - because you dont absorb all the calories you are taking in. So in theory, you could eat more than ever and still lose weight (i wouldnt do that personally

).

BreakonThru68 · December 2017

Howdy, I had DS in 2004. I gained some weight back after hitting 165. (at that weight I looked anorexic and was wearing a size 8...people thought I was really sick.) I have gained up to 195. Every bariatric doc I have talked to (a few because I am followed by someone who did not do my original surgery -for annual labs, etc) says I have kept off 75-80% of my weight loss, which is phenomenal compared to other WL surgeries....

I wear a size 12 and would like to weight 175. I could use some liposuction on my legs and hips, but that's another story....that fat doesn't respond to diet or exercise.

As far as KETO is concerned, I have not been able to lose more than 10 lbs, yet...(if I go over my macros for protein (over 100) or over about 1650 calories.....I also developed Hypothyroidism about 4 years ago.

I was also counseled before DS that years Post Op, the "honeymoon period" of weight loss in DS would subside after a while. It did for me, yet I'm content not being perfect.

KETO WISE:

I feel better going 25 net carbs or less....I'm looking at KETO as a Way of Life rather than a Diet...I have more energy and I'm not having the energy slumps I did when I ate more carbs.

People are asking what I am doing differently, have I lost weight?

The weight seems to be redistributing itself....AND my fat mass has gone down a few percentages.

SO the scale fluctuates, I was worried.

There is a saying in the Keto Community: KCKO (Keep Calm and KETO On) I choose to continue.

Hope that helps someone in the DS weight loss/ Keto Lifestyle community.

spacedog1111 · December 2017

I had the DS in 2009. As a 5'10" female, the DS helped me go from 325lbs to 150lbs and I felt great. I was working out, running, eating well, active, happy. In the last two years my weight has been creeping up, simply because I stopped working out and have been eating lots of sugar and carbs. I have gained about 40 lbs and need to lose it because it is making me miserable. I have no doubt that I am a sugar addict and that sugar triggers me, and in the past when I have gone paleo I have felt better, lost weight, and my sugar cravings were gone. Since Keto shares more similarities to paleo than not, I am going to give it a shot. I am hopeful that it will help me feel more satiated and help me to lose the weight more quickly. Very thankful to have found this forum.

flamewerks · December 2018

I know this is an old thread, but I'm hoping some DS/Keto folks are still out there.

I had a DS in 2008 at 300 lbs. Lost 140 pounds and maintained that until a year or so ago because, ya know, life. I started the keto WOE in mid-October this year and have lost 18 of the 30 regained pounds I want to lose.

Because I had already cut most grains and processed foods from my diet due to adverse gut reactions, I found it to be a relatively simple process to convert to keto. Sugar wasn't quite as easy to eliminate, but eventually I was able to cut it from my diet completely. I can't stand the taste of most non-sugar alternatives so "sweet" things are a very small part of my life now.

If anyone is still out there reading this, how are you doing today?

jnlwright37 · January 2019

I'm loving low carb (but not necessarily keto). I had the DS in 2005 at 280 lbs. Got down to 160 by the two year mark, and my body likes to hover around 175 when all is well. After having kids it has become harder to for me to keep the weight off (health/fitness has taken a backseat to family and work). My highest in the last year was 190 and my lowest 150. I've done keto numerous times in my life. It works great to get my weight down, but I personally find it hard to sustain. I DO maintain a very similar eating style though. I avoid processed sugar and breads, so many days I naturally eat 20-30 net carbs. Here's my personal pros/cons list for keto:

Pros:
- fat loss (duh)
- doesn't take long to not miss carbs
- I love meat!
- Heavy cream in coffee and cheese are amazing (now a Con for me... thanks lactose intolerance, ugh)
- the Keto community is fantastic! I loved the /r/keto subreddit (and even still read it semi-regularly).

Cons:
- On strict keto I struggle to find a good balance with fiber, potassium, and magnesium
- as mentioned above, I love dairy but my body doesn't, so if I do dairy (which is some of the best parts of keto) I have digestive issues
- I no longer consider myself a carb addict, so occasionally I want to be able to eat a quinoa salad, or plate of pasta without feeling godawful the next day. And I enjoy being able to be social and not worry quite as much if a social situation involves non-keto-friendly activities.
- if you try specifically to add more fat (like fat bombs), it can make bathroom life unpleasant.
- I think sometimes its hard to get enough calories in with malabsorption. I worried about that a lot. And my husband noticed a large difference on days I ate "lots" vs days I was very sub (what I estimate with absorption) 1,000 calories. Not necessarily in energy, just in things like snappiness, old injuries more prone to act up, and even things like my sleep.

On strict keto I find I'm constantly overthinking my macros and minerals (and who has time for that?!). Some people don't naturally overthink it, but I'm not one of them.

I'm finally finding a happy balance with an eating style that focuses on whole foods. I do keep it low carb (sub 100ish), and when I add carbs I try to keep them to "healthier" carbs (sweet potatoes, flaxseed, quinoa). It is not uncommon for me to eat 20-30 net carbs, which some people would consider keto... but I think ketosis is often offset for me by an overabundance of protein, and also all the fiberous carbs (which I think can still kick you out of ketosis if you eat enough of em). Plus, many days I eat closer to 90g carbs, so I can say bye bye to maintained ketosis and true fat adaptation, which is the goal of keto. Long story short, I love keto but I personally have a hard time not overthinking it, which makes it difficult to sustain. I find a meat n veggie with a little fruit diet to be more intuitive for me (and personally keeps me feeling full longer). I also ended up having to cut out diary, which sucked a lot of the fun out of keto... but many people don't have dairy issues, so I can see why that would also be a plus for sustaining keto! In the end, its more than what you eat. Its lifestyle, time, how your body reacts to things, and your own personal taste. Keto is awesome! Healthy eating is awesome! I'm happy to report I've found something that works for me and where I'm at in my life

I hope others can report similar!

one last note: keto DSers... keep posting! When I was doing keto I searched high and low for info and people's experiences specific to DS and keto. Threads like this were super helpful. KCKO!

Pugluver73 · March 2019

DS done May 2017. I lost 130lbs but have gained back 30lbs. I'm on long term disability. Looking to start keto fht am not sure about what my macros would be. Can anyone help me?

sarahep85 · March 2019

I'm on keto and would love to be friend some of you guys who are still doing keto! Definitely need the motivation

lleeann2001 · March 2019

Pugluver73 wrote: »

DS done May 2017. I lost 130lbs but have gained back 30lbs. I'm on long term disability. Looking to start keto fht am not sure about what my macros would be. Can anyone help me?

Honey, I would like to know myself. MFP puts my carb macros high

lleeann2001 · March 2019

Pugluver73 wrote: »

DS done May 2017. I lost 130lbs but have gained back 30lbs. I'm on long term disability. Looking to start keto fht am not sure about what my macros would be. Can anyone help me?

hello. what exactly is the duodenal switch?. I am so uneducated on that. I has gastric bypass on December 20th 2017. I want to lose 57 more pounds. I have lost 73. I absolutely wasted half of last year because I wasnt doing my duty by my pouch. But I am back on track. It truly is a tool and it works if you work IT.