Stuck! Do Surgeries Mess Up Metabolism?

Dazzling_Debbie

I've logged on MFP for 720 days. I've lost 64 lbs. Need to lose more weight but I'm stuck.

MFP now tells me to only eat 1200 calories if I want to lose two pounds/week, but that's not sustainable. I get too hungry. I'm not eating junk though. I have coffee with half n half in the morning only, and I'm finally drinking at least 84 oz of water daily. No sodas. The occasional glass of herbal tea with sugar for dessert. No dessert. Lots of fruit, veggies, black beans, some chicken, etc. Peanut butter, yes. I think I need to eat smaller portion sizes there. I need a food scale for better accuracy.

Question: does surgery affect metabolism? I think it does.

I was losing weight easily, starting May 2015. I had knee surgery (torn meniscus) late Jan 2016. Weight loss slowed dramatically even after I could start exercising again (and I always kept up with PT).

Weight started coming off around November. Then I had shoulder surgery (full thickness rotator cuff tear) in early Jan 2017. Gained 9 lbs in ten days immediately afterwards. I did not pig out that much! That would be impossible. Some of that was fluid retention, of course. And I wasn't allowed to move around for about six weeks.

I've lost about 5 lbs of that initial weight gain, but that's it. I go to PT and am finally starting to use 2 lb. weights. Range of motion is good, but strength isn't. I've been going to the gym but still am not cleared for upper body work. I use the machines for core and lower body and use the stationary bike. My knee is still not working well—I have bone-on-bone arthritis there.

I'm still going to PT. I'm swimming but am not cleared for freestyle or backstroke. I do some water aerobic exercises, kicking, sidestroke, dog paddling (sounds stupid but it's one way for me to work my triceps), etc. I wouldn't say my heart rate is madly elevated, but I'm working my core and am continuously moving for over 35 minutes. Plus I have to work against the water's natural resistance and it helps guard against stressing my joints. I'm building up my biceps by swimming, so I am building some muscle.

Before the surgeries, I was losing weight. Now it seems practically impossible. Do I have to wait until November to see any weight loss again and just pray I don't need any more surgeries?

Also, my ortho wants me to get a cortisone shot for my knee. (It also needs draining, I think... and my ankles too—just love OA.) But I've read that a cortisone shot can slow down metabolism. If that's true, I don't want the shot.

I was diagnosed as pre-diabetic in May 2015 and completely reversed it in six months. It's been normal ever since, so that's telling me I'm doing the right things.

I should be losing weight, even if it's just a couple of pounds per month, but nothing is happening. I'm stuck. Any ideas?

middlehaitch

You didn't give any stats so it is hard to say if 1200 and a 2 lbs loss a week is appropriate.
You are not using a food scale, but know you should get one.

Go get the scale, have your stats so you are losing at an appropriate rate, if under 50 lbs to lose that is 1lbs a week, over 100, 2lbs a week.

Weight all your food for a month and monitor your loss.

Cheers, h.

HippySkoppy

Your first port of call would be get that food scale and use it for everything, without it you are flying blind. You don't say how close you are to goal but losses will slow down and deficits require much more attention the closer you get.

Surgery does play havoc on our bodies. There is a lot going on under the surface as you heal and even under perfect circumstances weight loss is never linear so I would think that there would be some freaky stalls and gains happening when you are healing.

It's great you are getting back into safe movement and continuing with exercise but accurately knowing your CI verses CO is going to get you back into losing weight.

Just a thought too about the steroid injection for your knee it sounds like it's incredibly painful and impacting your life getting from A to B many find the positives of pain relief and increased mobility worth having the injection. It's worth being mindful that not everyone will experience the side effects attributed to meds. I myself have steroids daily and had several injections and I haven't gained weight nor seen any reduction in my metabolic rate.

All the best.

AnnPT77

Laparoscopic gall bladder surgery added enough water weight that I didn't see a drop for 5 days when I was in about a 750 calorie daily deficit, which was unusual. That's it, though. Things went back to normal after that, and i was only activity-limited for 3-4 weeks, much shorter than you were.

I will say that I decided staying in a deficit after surgery is a fool's game - I paid for it in weakness & fatigue. In a similar scenario in future, I'd go to maintenance for 2 weeks to a month. Thank heaven my body prioritized healing high enough that that went OK.

I'm speculating wildly, but is there any possibility that multiple things are conspiring to create an apparent slowdown for you, none of which is huge in itself, but they're adding up?

I'm thinking maybe a little slowdown from your body prioritizing healing so down-regulating other functions a bit; a little less daily activity (NEAT) because of movement limitations; a little muscle loss from less activity; etc. You mention your strength recovery not being optimal.

You don't say what weight you're at now, whether & how much you adjusted calorie goals downward as you lost weight, what weight you're at now, how much you have left to lose - any of which could suggest something.

I'm not sure of your age, either, but I do see my recovery from anything getting slower, and my detraining from reduced inactivity getting faster, as I age (I'm 61).

I'm not really suggesting much here, I know . . . just kind if riffing on my own surgery experience and thinking out loud (or the forum equivalent ).

I hope your recovery course is smooth from here, though, and you find a good path to your weight-loss goals!

TimothyFish

You are likely to burn more calories than normal after surgery because the body needs the energy to heal itself.

150poundsofme

Gallbladder surgery - in hospital 8 days, only allowed to eat hospital food last 2 days = gained 18 lbs.
One week later - in hospital for 4 days, remove renegade gallstones = gained 8 lbs.
One month later - back in hospital 1 day to remove metal or whatever they put to hold me together = gained 4 lbs. Previously to the surgery I lost about 50 lbs. So very difficult to lose that IV/? weight.

Machka9

Surgeries make you gain a bit of water weight.

They also reduce the amount of exercise you can do during your recovery period.

jennifer_417

You're right, 1200 calories isn't sustainable. Change your goal to lose 1 lb per week.

Sandcastles61

If you are taking pain meds, even something like over the counter Aleve, that can also lead to water retention.

chelllsea124

Soooooo.... what are your stats? Why haven't you tried weighing your food? You can eliminate a lot of inaccuracies by simply weighing food.

chelllsea124

Also, I eat 1200 calories a day and it works just fine for me. That's why I'm asking about your stats.

Dazzling_Debbie

I'm 61. I still have quite a lot of weight to lose. I'd like to lose 60 more lbs minimum. There's no way I can eat 1200 calories. I tried it and I felt so deprived, I ate more. I need that food scale... my budget is very tight so can't buy one until next month. Any recommendations on a good, easy to use digital scale?

I've upped my exercise this past week. 6 days/7. It cause my hip bursitis to flare up but, oh well. I ice.

I'm on celecoxib (Celebrex) daily. It's an NSAIDs for my arthritis. That could contribute to retaining water.

I've been wanting to eat more at night. That's the most difficult time for me.

Today, I upped my activity level to lightly active. Weight loss goal: 1.5 lbs/wk. Because of my limitations, I don't get my heart rate up as high as I did when I was younger, but I move as fast and as strong as I'm able. It takes effort!

My carbs were pretty low this week, and protein was high, so I went down from 50% to 40%. If that doesn't quite work, I'll change carbs to 45%.

lucypstacy

I just had massive hernia repair on Thursday and spent 3 days in the hospital. While I'm still swollen (and have drain tubes for the time being), my weight actually stayed the same. Sadly I won't be doing much in the way of exercise besides walking through the house for quite a bit.

middlehaitch

If your bursitis is flaring at 6x a week exercise cut back to a reasonable, non flaring activity x3 a week, alternating days.
It is not useful long term continuously agrevating an injury.

It is your calorie intake that is the important thing.

A good digital scale costs between $10-20 in the USA. Any make is good, but make sure it measures in both grams, the better weight to use, and ounces, as well as having a tarre function- where you can put your plate on the scale and reset it to 0 each time you add a different food.

If you are lightly active during the day, without exercise, keep it there.
If you are sedentary during the day, without exercise, switch to that and add in your exercise calories.

If 1480 cals isn't enough food, change to 1lbs a week, and on days where you are satisfied on 250 cals less, eat that amount.

If evenings are hard, put aside calories specifically for that time.

Play with food timing as well as your macros so you find a way of eating that suits you.

You are half way to your goal, hooray.

Cheers, h.

DamieBird

So, I had 5 knee surgeries within 20 months (3 open, 2 laproscopic and 2 of them replaced tissue), the last one just under a year ago. I also have recurring bursitis in my hip (currently treated with steroid injections) and I've had prior foot surgery. I say all that to let you know that I know exactly how frustrating it is to try to lose weight after surgeries! I couldn't lose anything, and ended up gaining more than 20 pounds over that period.
Others have addressed your calories in, so I won't repeat the good advice you've already gotten about accuracy and the like. I will say that it's tough lose weight after surgery (especially knee surgery IMO) because the overall amount of how much you move on a daily basis is significantly reduced and you don't even realize it. For instance, I personally took to carrying tote bags around the house with random items in them that I might need, because I didn't want to get up off the couch to go get something. I made sure that all of my chores were done as efficiently as possible to limit the time that I was on my feet and putting pressure on my knee. I'd avoid making trips up or down stairs unless it was ABSOLUTELY necessary. I did physical therapy through the whole process, but I went from working out and breaking a sweat several hours a week and walking everywhere I could to working (and hurting!) but barely breaking a sweat at all in pt for months and months and hardly walking anywhere. Cumulatively, all that decreased my NEAT so much that my TDEE dropped like a rock, so I was eating way more than I needed. I also found that pain medication made me care much less about healthy food choices. Recovering from surgeries makes it really, really hard to lose weight! You may want to consider that you just need a break from heavy dieting for a while as you heal. Not to say that you should give up on it, but perhaps consider a less aggressive deficit. The additional stress right now probably just isn't worth it in the long-term. I do know how tough it is physically and psychologically to get better and I'm hoping the best for You! Be gentle with yourself and be nice to your knee and hip. Readjust your goals to something more manageable, eat delicious healthy foods that you enjoy, take your time and let your body heal before you start pushing it too hard. You can do this!

MoyMG

I agree totally with @DamieBird. With your current healing, and knee issue, it's time to eat maintenance calories and give your body a chance to heal fully. I'm 64, and had a knee replaced Aug 2015 and hip replaced Dec 2016, and started trying to lose weight again in August 2016. And it was slow. It is only now, 1.5 years past that hip replacement, that I am fully mobile and exercising again, and starting to lose significant weight. Go ahead and get the cortisone shot so you'll be comfortable.