VSG Patient Question!

Mikkimeow

Hi everyone, I am hoping to get some help. I am struggling with finding medical journals or peer reviewed work that can get me some answers on this. My apologies for the length, I have been thinking about this issue for some time now and could really use some help.

Stats: 248lbs, highest weight 335lbs
Height: 5'6"
Activity Level: Stronglifts 5x5 three times per week, upper/lower split accessory work 1-2x per week, cardio 3x per week. Currently on week 2 of C25K. I usually do SL and C25K on the same day, so I would say I work out 3-4x per week for at least an hour.


I am post op 4 months vertical sleeve gastrectomy. I have lost 87lbs total, 53lbs since surgery.

I am struggling with calorie intake and macros. When I was strictly hitting a protein goal and eating low-no carb, I struggled to eat 900 calories a day. I am about four months out and noticed I am able to eat more than have previously (close to 4-5oz per meal) and once I started adding carbs in, I am struggling to stay under 1200 calories per day. That is the generic guideline I see almost every bariatric hospital, program, surgeon give. My surgeon's book they gave me post op stated that long term I should not go over 1200 calories the first year and 1400 calories when in maintenance.

When I calculated my macros, everything says that with me having an office job but working out 4x a week lifting for an hour and cardio 3x for 30mins I should be between 1600-1700 calories. I can feasibly probably eat 1300-1500 comfortably without restricting much, but I have a severe fear of going over 1200 calories. Which, everything I ever learned about food was that 1200 calories is the lowest possible amount an adult female should eat. But it seems that the guidelines for bariatric patients are different, and I don't have many people that are four months out with the same activity level that I can speak to about this. I meet with my surgeon next month, but I am having some pretty severe anxiety related to food, and was hoping you could provide some insight. I guess to condense all of this:

1) Should I be sticking under 1200 calories, or should I eat bariatric portions and meet my goals with a closer to "normal" non surgical patient calories/macros?

2) Do bariatric patients have to stick to 1200 calories for fear of regain, or is this psuedoscience?

3) If I take away my surgery, I should still be at a significant deficit (that is with my goals set to lose 2lbs per week) at 1600 calories per day. But I notice when i do eat higher calorie, I don't lose. Which is crazy that for me, anything over 1200 calories is higher calories. I mean, the mind *kitten* of vsg is serious.

Aerohead21

Unless you are at your target weight you should be sticking to your plan

TheMuse

I agree. The biggest mistake people make is not getting to their initial goal. Also you’ll want to make sure that you’re also following the low carb/sugar restrictions. VSG really is only a tool. Every VSG person I know has gained a significant amount back after they “go off plan” the biggest reason the surgery works is because the pre-surgery guidelines force you to detox from carbs and sugars. Helping the addiction portion. I personally did fabulous for the first 8 months. Lost 120 lbs. it only got me down to 175. I’d gotten to where I no longer was driven by food. No cravings. No head related or addiction related pulls to eat. I became one of those people who others had to remind to eat. Never did I imagine I’d ever be like that. Pre surgery I thought about food every waking second. But then I added a few sugary items and carbs back. At first the sugars made me instantly sick. I should have heeded that reaction as a clue but I added small stuff here and there. I slowly started the regain. I got cravings back. I’ve gained back around 40 and highly regretted not following through. Because it’s hard to find the motivation again. Luckily for me I’ve only gained 40 back in 3 years but the friends that talked me into getting it done have gained everything back. Plus some. They fell off plan early. Never got as far. Lost about 1/4 of their goal and allowed their food addiction to take over. Please see it through. Don’t follow their path.

88olds

These are questions for your Dr. Can you move your appointment up? Can you get a referral to a nutritionist?

Post op I wouldn’t go looking for answers outside of my medical team.

I understand that you’re anxious. But I find myself wondering if before the surgery you pursued weight loss by jumping from diet plan to diet plan a lot. Are you starting up an old pattern? Be careful.

We’re it me, I’d try to get an earlier appointment. Tell the Dr about all of your issues including the anxiety. If you find yourself dissatisfied with your medical people, find other qualified medical people.