The Nutritionist is WRONG! Please please help me.

Charismasme2

Ok, so I don't agree with the nutritionist in that your body can't survive on 600 calories a day. And am wondering why she want's you to keep your protein so low??? I would use the internet, and research protein consumption for patients of gastric bypass. There my be a good reason, but I don't know it. So I would start there. But definately, try to get those cals up to at least 1000 a day. I agree with the above poster...give up cardio and go with strength training. That way you'll still continue to lose inches while keeping the muscles strong. Take what she said, and then use the internet to find out things for yourself. She might have gone to school, but you are an intelligent person and can use it to research these things for yourself. When my husband came down with Cardiomyopathy, that was the first thing I did, was to teach myself everything I could about the disease. You can to!!! Keep your chin up and work towards YOUR GOALS, not hers. Friend me if you'd like and I'd be happy to work with you. I'm still learning too, but two heads are better than one!!!

mrykyldy2

Like another member posted here, go to a dietitian, a REGISTERED DIETITIAN.

For the person that you went to to tell you not to exercise portion control is pure B.S. Any person that I have spoken to has said that portion control is key. Even my hubby who is a Registered Nurse will tell you to exercise portion control. You don't have to stop any portion of your exercise program if you don't feel it necessary.

Now with that being said, my hubby has had the lap band surgery. He didn't succeed at his own hands. The dietitician we saw in the begining recommended portion control, low fat food, a variety of food but a bit higher in proteins. Now with that being said, the biggest part of portion control is to weigh and measure your food. If I were you, I would continue to weigh and measure my food and find a couple of registered Dieticians that are EXTREMELY familiar with weight loss surgeries and visit with them. Nutritionalists many times have their heart in the right place, but do not have the extensive training that an RD has.

roachhaley

Why did you go to her if you already knew what you were doing was right?

The fact is that she has training and you have "internet training". Its fine if you don't want to listen to her, but don't act like she's some idiot because you and her dont agree.

bcattoes

Honestly, the nutritionist doesn't sound wrong to me. I realize she didn't say what you wanted to hear, but that's not her job. Why do you think she was wrong?

devil_in_a_blue_dress

I'm sorry if you already answered this, but how tall are you?

I do not want to give any nutrition advice because I am not an expert. But what I can tell you is this: At 5'3, I weigh 150 pounds. I m technically overweight, but I wear a size 8 and my body fat is normal and I'm actually moving toward the mid point of normal the range (the next category is athlete, not under). BMI does not take into account body composition (muscle/fat ratios -- all that good stuff), it is a general tool and shouldn't be used as the sole indicator of things like obesity because, well more factors than weight play into obesity.

It is VERY possible that 140 isn't realistic. I can't say for sure though -- I think seeing a nutritionist or dietician who has a LOT of experience with surgery patients is the best idea.

Shayrubine

Like many others, my comment might not fit someone who has had surgery, but I was kind of shocked by the 600-900 net calories a day. I've often read that no matter what, you are not supposed to eat less than 1200 net calories a day (except if told so by a doctor). Eat less than 1200 calories a day and your body will go into 'starvation' mode, meaning it will hold on to (and reatin!) any gram of fat you have to be able to function. This leads to being unable to loose weight even if you don't eat much.

I haven't looked at your diary, but your calorie intake should come from the least possible processed foods (aka fresh fruits and vegetables, pieces of [lean] meat), and you should avoid highly processed foods at all cost (they are full of calories and wrong fats) like minced meat, sausages, etc. I see you leave in the US, I suggest you try Shakeology from Beachbody (I don't know if we're not supposed to advertise for brands?) as a daily meal replacement, it is absolutely delicious and incredible!

Exercising is good, but what kind of exercise are you doing exactly? The same routine everyday isn't gonna make you loose any weight, because after some time your body gets accustomed to the exercises you do. Also, cardio is the "only" workout that makes you loose weight (compared to weight lifting or aerobic-like exercises that are useful for toning up and shape your body).

I think you should ask a second opinion, from a dietetician, like others have suggested.

Josie_lifting_cats

I just glanced at your food diary for yesterday (didn't go past that, sorry) and my first comment is: your sodium intake seems higher than it needs to be. You are eating a lot of processed foods (i.e. store-bought) and not enough fresh fruits and vegetables. Calories are not the only important things to be counting. Too much sodium means water bloat and ushers in a whole host of health problems, not the least of which is high blood pressure. You may be feeling good right now, but that is not an indication of what is going on inside your veins. I agree with everyone else: go see more health care professionals. We are not in a good position to advise you specifically because of the bypass surgery. By all means continue exercising: cardio for your heart, strength training for your muscles. But my only advice would be: CUT THE JUNK FOOD; EAT NATURALLY!

Meh. They've proved with loads of studies that in normal people sodium does not affect BP.

Again, different things work for different people, but I have high sodium too often for some people's opinions, and it hasn't hindered my weight loss at all. Plus sodium is important for muscle growth, synthesis and regeneration.

only1chelle2012

sometime the nutritionist can be wrong. I saw one about a 3 years ago and she told me to cut back on my eating even though I told her how much i ate. Well guess what! that was my problem i wasn't eating much, I eat one to two small meals a day, I just was not hungry however, the meals were not all that healthy since it was mostly protein and sweets. since I started eating more times a day i have lost weight. I think you should get a second opinion.

JacksMom12

See a REGISTERED DIETITIAN! Especially one that specializes in post bariatric surgery.

becoming_a_new_me

This was information from the nutritionist at the surgeons office and she's great at recommending nutrition 101 and that's about it. I don't think what I'm doing is right and that's why I'm looking for advice. And yes, I basically lost 21 pounds the first three weeks on MFP with very limited caloric intake (which IS NOT healthy). And finally in reply, she basically said 600 net calories is ok if I'm representing all the foods groups!

Finally, I'm not condemning all doctors and nutritionists, just my primary doc and the bariatic nutritionist. The bariatric surgeon was fantastic, but I don't see him anymore as he concentrates his time on upcoming surgical cases.

I get much better advice here from people in weight training and that have weight issues than from the so-called professionals.

Please only respond if you're willing to give helpful advice and please don't criticize my looking to you for help. Thanks!

^lol
you asked a PROFESSIONAL for advice, but didnt like it .. so you asked strangers for advice but didnt like it ..
you dont want to get advice u want to be told you are right ...

you need to listed to the doctor you are not trained in nutrition PLUS all the information u are getting on MFP is for normal people not people who have had surgery ... u really need to just listen to your doctor...

BUT at the end of the day u arnt looking for what u need to do u are just looking to be told u are right and keep doing what u want .. SOOOOOOO

YOU ARE RIGHT FORGET THAT SILLY DOCTOR! doctors want you to be fat and unhealthy so they can keep making money off you!

how dare they tell you how to be healthy! they have never been nearly as unhealthy as you so how would they possibly know how to get healthy from that point!

instead of taking advise from an educated & healthy doctor take it from other obese people wthl access to google ..

and dr oz ... u strike me as somebody who could get a lot of help from google and dr oz

There's no need to get snarky...I get what you are saying, but sometimes there are better ways to say it

tlonie

Because you've had surgery, I wouldn't want to give any suggestions. Maybe a second opinion from a professional would be a better idea. Preferably someone who is an expert in working with people that have had the surgery that you had.

I agree. You should definitely get a second opinion from a doctor who specializes in patients who have had weight loss surgery.

cburky911

I had bariatric surgery in 2006 and am in a similar situation as far as losing a lot of weight, then gaining some back, then working through MFP to get back to where I want to be.

I will agree that you should speak to a registered dietician because I'm a little confused by some of the information that the nutritionist is giving you. One of the first things the dietician at my surgeon's office tells us is to start keeping a food diary so that she can look to see what and how much we're eating, etc. etc.

Another thing that I was told was to "go back to the basics" with regards to using the tool of the surgery. Don't drink 1/2 hour - 1 hour before and after eating, chewing food enough, etc. One thing that your nutritionist and my surgeon have in common are that they are both opposed to protein shakes to get calories. My surgeon was very opposed to taking in liquid calories.

Also, have you tried to get in to see your surgeon and talk to him/her? If he is so focused on his upcoming cases that he's ignoring his other patients you may want to consider shopping for a different bariatric provider.

Kimsied

Congratulations on your loss so far. If you have doubts about this advice or feel the nutritionist wasn't taking your concerns seriously, a second opinion from a RD is always a good idea. I think it is important to consider what is recommended for you might be different than for someone who has not had the surgery--at least in the short to medium term. So I guess I would consider the advice of someone who specializes in that area even if it sounds different to advice you see online or in other sources. I am guessing your nutritionist is actually trying to get you to eat a controlled amount just using a different approach than counting calories as you mention she suggested weighing your portions. And it sounds like she is trying to encourage a balanced diet. And to encourage you to stop worrying so much about the number on the scale...

. She suggested I eat low fat yogurt and I told her I wouldn't do that because the low fat yogurt is usually full of sugar. I eat very low sugar, extremely low artificial sugars, high fat and high protein for the calorie boost. She also said NO MORE protein shakes.

It depends on the yogurt. Flavored yogurt i.e. vanilla tends to be sweetened. I use to eat an unflavored, plain nonfat yogurt that had similar sugar count to other plain, unflavored yogurt--just the sugars naturally in milk. True, some lowfat processed foods have more sugar to make it taste good, but not always. Is there actually a difference in added sugar for flavored lowfat yogurt vs flavored full fat yogurt? Depending on the sweetener used, both would contain added sugars. You sound like someone savvy enough to compare food labels, so you most likely could find a healthy yogurt that is lower in fat.

If it is an option, a second opinion might be a great idea or even a follow-up with the same person to clarify the reasoning behind her suggestions. Are some of them specific to people with your surgery, for example. Does a high fat or high protein diet somehow cause a problem for people recovering from your surgery?

JenMull44

I thought that after the surgery you were only supposed to maintain a diet of about 900-1200 cals/day? I would listen to the dietician, because she had to go through school and become certified to teach you a dieting plan. Yes you may like our advice better, which is usually to exercise and eat more, but that advice is for people that do not have the bypass, that changes the circumstances and advice dramatically.

You lost the weight initially from "very limited caloric intake" which isn't healthy, but is it healthy for someone with the bypass to eat more than what is suggested? I don't think that we can help you because we are not specialized in bariatric surgery, and follow up, like your nutritionist is.

You may not like what the nutritionist told you, and what we are telling you, but it is our honest opinions from seeing the situation objectively. Listen to your nutritionist, or try a new one.

The "number on the scale" isn't important, as long as you are feeling good and making progress your body will change.

I agree. I have a VERY good friend who also had this surgery and she has never been the same. When you lose weight so fast and it such drastic numbers you metablolism becomes unmanageable. You definitley need to seek the advice of a professional.
Also understand that the message boards are not going to tell you what you want to hear, every time you ask for advice.

krisiepoo

I did a quick google search of diets after bariatric surgery and now I fully agree with the nutritionist you saw.

She is wanting you to focus on food groups and not calories becuase many pre- & post- op bariatric patients don't get the nutrients they need. Because your stomach is so much smaller now, the calories aren't as important as the macros. the articles ALL say that portion control is best and rarely mention caloric intake because you're supposed to be focusing on the right foods.

They all also mention 65-70g of protein being optimal. My guess is that becuase you're supposed to be focusing on portions and not calories, that this is a good amount to aspire towards.

Finally, my guess is she was saying to ditch the protein powder becuase MOST (read, not ALL) have high sugar content and with the malabsorption and bypass issues, it can lead to dumping syndrome.

so, I'm not a registered anything (YET- working on my RN ) however a quick search led me to exactly what your nutritionist told you

LinaBo

Get an opinion from a DIETICIAN. Nutritionist's don't need to be licensed.

Ditto, on this. Laurie1267, you say you saw a nutritionist, so I have to wonder if you actually mean that you saw a qualified dietician, because anyone can call themselves a "nutritionist" without having gone through specific training and licensing.

I would speak with a specialist doctor about your weight. One thing you may want to take a look at is extra skin; do you still have a lot of it? Because if you do, this could count for several of the lbs you are carrying. Minus the weight of extra skin, the rest of you could be at the high end of the healthy range. If you dip down to 140 lbs and still have extra skin, your body composition could be more like someone who is several pounds lighter (and therefore, you would actually be underweight).

I do also agree that you should do strength training. Muscle will help support any loose skin, giving a better overall appearance to someone who has lost as much weight as you have. Aside from that, I really can't give you any more advice. Like others have already said, there are special concerns with your diet given that you've had gastric bypass, for which people on this board aren't really knowledgeable enough to firmly state what you should and shouldn't do.

StarkLark

Here's my advice...

Stop worrying about "the number". I'm not sure where I'll stop, because I'm not sure at what number I'll like the way I look. Stop when YOU feel you look good, not because you reached some arbitrary number that is tied to a ancient and bogus formula. And speaking of bogus formulas...

F#&% BMI. Seriously. If I get to the rough range of where I think I might want to be (180 - 225) I will still be either "overweight" or "obese". BMI does not take into account your body type or overall build.

To this point, keep in mind that many fit people are considered "obese" according to BMI because of their lean muscle mass.

In terms of logging, I can't recommend it enough. Either you KNOW your calorie intake, or you are guessing. If knowledge is power, then guessing is not being in control.

Anyway, congrats on your great progress so far and whatever plan you figure out stick with it!

kiminikimkim

Because your body no longer absorbes nutrients as efficiently as it did pre-surgery, I would opt to ADD ONE multi-vitamin packed shake once a day. I am not a believer in shakes but in your case, nutrients are more easily absorbed in groups. For example:

Calcium intake alone = body can't absorb.

But

Calcium +. Magnesium intake = body CAN absorb.

Set your caloric intake as per your body size and weight for safe weight loss for now, as you wait to get a second opinion.

PS: I am also not a believer in taking pills: vitamin, diet, herb etc. They are not regulated and 80% of them don't have the exact ingredients as specified. Studies have shown that people who take VITAMIN PILLS everyday live shorter lives than those who don't: http://www.huffingtonpost.com/dr-mark-hyman/vitamin-dangers_b_1018430.html

Quasita

Seeing as you acknowledge her as being good at the basics, and you seem to have not been able to maintain a loss when working on your own, I would try her recommendations.

Bariatric patients are usually advised to take on low caloric intake with supplementation that far exceeds a "normal" person's needs. That is, shots, infusions, and capsules, used to make up for the deficits.

She's likely tellin you that you need to cut your protein because you aren't getting in enough good calories and you're not allowing your body room for nutrient rich foods. Protein is going to stick with you a long time and as a bariatric patient, you need to be able to eat more than 3x's a day to do what you gotta do.

I know the intention is 6-8 meals a day, and that should be plenty enough to get 200 calories per meal to reach a 1200 intake. However, I'm pretty sure that from what you're saying, you are getting practically no plant based nutrients, which I would presume is another reason for the low intake. They want you to make sure you get good foods, and not worry about the scale, because you could get very sick and DIE if you don't take better care of yourself.

Springfield_Rocks

Get an opinion from a DIETICIAN. Nutritionist's don't need to be licensed.

A.C.E. Certified Personal/Group FitnessTrainer
IDEA Fitness member
Kickboxing Certified Instructor
Been in fitness for 28+ years and have studied kinesiology and nutrition

^^^^^^ This!!