Increasing fats, lowering protein...how to not be hungry?

catecholamine

I have a weird question here, looking for some tips. But first you have to take into account one thing to explain the weird diet I'm asking about, so sorry for the wall o text. I've had a weight loss surgery about 3 years ago, called Duodenal Switch. The average amount that a DS patient absorbs is: 20% fat (yes, the average malabsorption is 80%), 60% protein, 60% complex carbs, 100% simple carbs.

So in order to maximize my diet, I eat a lower carb, higher protein, higher fat diet. I dropped below 50g fat/day for a month at one point and had serious complications (depression, severe cognitive problems so bad my doc did a CT scan of my brain, lips cracking open and bleeding, skin flaking off). Lately I've been eating around 1400 calories most day, with a day here and there when I'm super hungry and closer to 1650. I'm 5'3" female, 200lbs. The past almost month, I've been fluctuating back and forth between 198 and 202. Back and forth, even with weighing food and logging religiously. Someone on one of my WLS FB groups suggested up up my fat (currently 80g-110g most days), lower my protein just a smidge (usually 90g-120g) and mostly keep my carbs about the same, but stop having those one or two days a week where I'm 10g-15g over or so. I do net carbs, so total carb minus fiber. I try to stick to 25g net a day.

But what I'm at a loss here for is how I can eat more fat and less protein and not be hungry. I don't add a lot of fat to my stuff beyond what I'd consider normal. Going for 150g+ fat a day (which would mean 30g absorbed if I was "average", but I'm pretty sure I absorb more) every day seems ridiculous and frankly, a bit disgusting...I'm not sure how to accomplish this, as I'm the kind of person who cuts fat off a ribeye or chicken and feeds it to the dog.

Before anyone loses their mind over the level of fat or my cholesterol, remember - if you don't absorb it, it doesn't affect you. My total cholesterol is 91 and my doc actually wants me to raise it, if you can believe that.
So, just looking for ways to dial back protein and add fat without adding carbs, in a way that is actually satiating. Obviously more ground beef is a way, though I'm not a huge fan of it compared to chicken.

Sued0nim

What does the dietician attached to your medical team advise?

30g fat absorbed daily is extremely low IMO

catecholamine

Sued0nim wrote: »

What does the dietician attached to your medical team advise?

30g fat absorbed daily is extremely low IMO

I don't see my surgeon or anyone at his office anymore because he's several hours away. There's no one near that is familiar with my surgery. There are literally only 2 surgeons in my whole state who do the DS, and they work at the same office.
So there really isn't anyone. Even if I drove out there, their nutritionist is not covered on insurance, and charges $250/visit, which I don't have.
I personally think I must absorb more than 20% or else I wouldn't be 200lbs when I'll be 3yrs out from surgery in Jan. I've lost about 160lbs total. I want to believe in CICO, but I should be losing, and I'm not. I have no idea. But I do know I'm not absorbing some fat - the gross truth is that it makes your poo stinky, makes it float and soft, you see an oily sheen on the water, and sometimes you get a glimpse of food - especially veggies. I saw a fully intact piece of bok choy leaf yesterday, fully identifiable. Disturbing.
So there's something going on there. My also entire length of small intestines that food travels through is 350cm, and only the last 100cm is it mixing with the digestive juices. The normal small intestine length is a little over 600cm.

It comes down to that there's no real way to know exactly how much I'm absorbing. 150g+ fat may make me gain weight. I don't know. But I'll try and see. If I can figure out how.
Maybe lots of coffee with ridiculous amounts of heavy cream?

Gisel2015

I agree with Sue that this is a question that you need to ask your doctor since your situation is different and especial.

I will just drop these suggestions but please ask your medical team if these choices will be appropriate for you: Avocado, eggs, full fat milk, cheeses, ice cream, yogurt; olive oil, canola oil and coconut oil (for cooking your food and/or adding to the salads), tuna and sardines packed in oil instead of water, butter and mayonnaise, peanut butter, etc.

Good luck and I hope that your situation improves.

catecholamine

Gisel2015 wrote: »

I agree with Sue that this is a question that you need to ask your doctor since your situation is different and especial.

I will just drop these suggestions but please ask your medical team if these choices will be appropriate for you: Avocado, eggs, full fat milk, cheeses, ice cream, yogurt; olive oil, canola oil and coconut oil (for cooking your food and/or adding to the salads), tuna and sardines packed in oil instead of water, butter and mayonnaise, peanut butter, etc.

Good luck and I hope that your situation improves.

Thanks. Sadly, there's no one around who is familiar with my surgery. My own primary care doctor keeps calling it "gastric bypass" even though it's not even close to gastric bypass.
The problem is adding fats without adding carbohydrates. That means no regular milk, no ice cream, limited peanut butter. It mostly leaves almost pure sources of fat - like oils, mayo, etc...but what do you do with them? I already add reasonable amounts for cooking, and I'm not even getting close to 150g. I'm not normally a fat guzzler so drinking even coconut oil in coffee is gag-inducing.

capaul42

You could switch some chicken thighs in for breasts here and there. Not sure why they're considered fattier as I rarely have to trim thighs but always have to trim breasts, but they do have slightly higher fat and slightly lower protein. I usually batch cook and shred for wraps and such.

Arizona_C

Get more fibers?

I'm sure sure to have understood your situation completely, but generally a higher increase of fibers fills you up for longer and you dont feel hungry except from what you really need

sammyliftsandeats

I see that you're a person who does not necessarily like too much fat (taking fat off the ribeye, etc) so you can have your lean meats (pork tenderloin, boneless skinless chicken breast, etc) and then just cook it in olive oil or butter or make a fatty sauce to go with it.

Do you like bacon? Try wrapping a strip of bacon around a boneless skinless chicken breast stuffed with cheese.