I am going to apologize in advance if what I am going to say offends you... but I think if any of us that had surgery were experts in nutrition, we wouldn't have gotten to the point where we chose to have surgery. Our experiences clearly got us to where we were. I am not saying that at some point some amount of fat can't be included in our diets, but two weeks out and you want to deviate from the plan? From what I have seen, those that are the most successful are those that listen to their surgical team and do what they are supposed to do. They are the subject matter experts.You aren't following the plan to please them, you are following it because it's best for you and your success. My fear is that when someone deviates from the plan, it could be the start of a slippery slope.

Take a minute and read this post from the other day for a little insight -

http://www.myfitnesspal.com/topics/show/1389664-beware-tough-love

This surgery is an amazing tool and it gives us the chance to give ourselves awesome gifts - health and quality of life - but we have to use this tool properly. I wish you all the best and much success.

I agree with the original poster. I use real butter and full fat cheeses. I do no fat greek yogurt and lowfat milk and cottage cheese. Overall, my rule is natural over chemicals. I do choose low fat proteins for the most part and I use low fat dressings, but only the ones with yogurt that are natural. Sugar and excess fats will be bad, but I would rater have a half ounce of a fabulous cheese than an ounce of fat free nasty.

I'm not sure I'm reading your post right. Are you pre-op?

I agree regarding the fake fats. You have the choice to just not eat them. I haven't had any in years and years. Regarding no fat dairy products, read the labels. Daisy brand doesn't have any added ingredients. You want no-fat without added starch to make up for the fat. That's why greek yogurt is so popular. It's strained more, so more milk solids to thicken it up. Kroger carbmaster milk, non-fat, is very high protein and low-carb.

I understand what you're saying about the fats, I feel the same way. Too many 'healthy' foods have junk added to them to replace the fat that's been removed. Here's the deal, you're not required to eat them if you don't like them. You still have plenty of choices to help you meet your protein goals - beans, fish, lean meats, none of which require the addition of any kind of fat, fake or not.Fruit and veggies are fat free. There's no requirement to add anything to them.

Rather than focus on the stuff your nutritionist requires that are upsetting you, choose to leave those out of your diet and instead, concentrate on those foods she recommends that do not upset you.

I understand where you are coming from. I do NOT like to eat processed or artificial foods. Like another poster said, I prefer real foods over processed foods. I understand, though, why my doctor wants me on low fat right now (I am 1.5 weeks post-op). That doesn't mean I have to eat processed crap. It takes more effort to find foods that aren't processed but it's not impossible. For example, I had to really look to find a fat free greek yogurt that didn't have artificial flavors and colors. But I found one. I also know that this stage is temporary so I follow my doc's orders. I understand you not wanting to eat "low fat spreads" and fake foods. But why not have chicken breast instead of thighs for a little while? Why not get the low fat greek yogurt instead of the full fat or the 2% cottage cheese instead of full fat? The lower fat versions don't always mean fake foods. So why not opt for those?

Also, I'm surprised that you don't have a calorie goal. I am only in the full liquids phase but my doc wants me between 600-800 calories. That goes up as I progress through the stages, but never higher than 1200. Eating full fat foods means you don't get to eat as much and it will make it harder to meet your protein goals and stay within your calorie range. What's the point of the surgery if you plan to go back to eating high calorie?

True, the fat digestion happens further down the gut but it does delay gastric emptying which is why it satisfies so well. However, sleeve surgery is well known for causing as well as exacerbating reflux and a low fat diet is recommended while the stomach heals. That is just standard practice for prevention and treatment of reflux. As for the nutritionist, if you were a marathoner she would probably be throwing peanut butter, olive oil and coconut oil in your lap. But she treats morbidly obese pts every day who have become accustomed to a high carb high fat diet. You are correct that it is more the carbs (specifically fried carbs) that are usually the problem, not just random fat. And since morbidly obese people are usually crap at portion control the Nuts tend to focus on low fat to keep volume high and calories low for better outcomes. This is why the low fat spiel works for the vast majority of pts. Very few pts are as committed early on as you are to a ketogenic lifestyle. I applaud you for choosing the tougher path of low volume full fat. It is more natural to limit the high glycemic carbs that have become an unnaturally large portion of our diet. I suspect that your Nut and surgeon will come around as your excellent wt loss will show your commitment to high protein and calorie deficit. I eat bacon for breakfast most days, I cook with ghee, coconut oil and olive oil. I do not own or plan to own Pam spray. My Nut thought I was kidding when I quit eating wheat,rice,potato and processed corn. She thought I was a bit odd for making my own chick pea wraps and mung bean flat breads, parsnip and kabocha chips. She never expected me to go lower than 180 lbs and orient my life around a normal BMI instead of overwt. But, here I am 263 days later and within 1 lb of a normal BMI for ht. unlike you some of my full fat favs had to go. I just couldn't portion control peanut butter or flavored full fat yogurt so hello pb2 and light fit vanilla Greek. Based on your past significant wt loss I suspect you have found a workable solution. Once you have your 3 month visit and you are down 50+lbs I doubt they will say much. My nut was more of a fanatic about weighing and measuring to train us to really understand our actual calorie intake and our base calorie burn. At the end of the day it is all about achieving deficit. Good luck.

First, I will say that I hated the first nutritionist that I met with. Ahhh, Katrina. She was blonde, adorable, sneered during our entire first appointment, and couldn't have weighed more than 100 lbs soaking wet. I got the impression that she thought fat people were lazy and stupid - when I am anything but. She, herself, was not a rocket scientist.

For example: she gave me a photocopy of the USDA "my plate", and said to me "this is a 9" plate - what you should be using to serve your food on". When I asked, "how can a 9" plate fit on 8.5x11 paper?", it didn't go over well. My second appointment was just as bad. I felt condescended to, and it made me intolerant to the whole idea of nutritional counseling.

I ended up requesting a third visit go go through things again, and asked for different nutritionist. I had to go to another office location to accomplish that. When the office manager asked me why I did that, I ratted out Katrina for being the judgmental B**** that she was, and the office manager told me it was not the first complaint that she had received. I felt better and the second nutritionist was an improvement. So, I get it - nutritionists can be judgmental idiots.

Second, before I had WLS, I had practiced a strict LCHF, ketogenic diet for 2 years, with a 40 lb weight loss. I plateaued for more than a year. Then, I got pregnant, my OB said I couldn't be low carb and pregnant safely, I had the baby and gained all the weight back, then could never manage to get back on LCHF again because I had opened the door to bread and sweets and was thoroughly addicted.

When I made the decision to pursue WLS, I was THOROUGHLY indoctrinated in the LCHF mentality. Carbs are evil. Fats are good and necessary and go face-first into them. The WLS-office nutritionists were okay with my "carbs are evil" mentality, but could not get behind the "eat fat freely" part of LCHF. I had SUCH a hard time with this piece of the diet. I was up front with them about my mental struggle. I think that the second nutritionist appreciated this, and she took the time to sit down with me and educate me about why the office made the dietary recommendations that they did, and credited me with knowing a good deal about nutrition.

I felt empowered. I knew I was standing in between two different nutritional theories, and I had a decision to make - would I stubbornly insist that I - a 228 lb T2 diabetic with HBP, PCOS - knew better, or would I just suck it up and make the best by following their dietary plan, complete with fat restrictions?

I followed the dietary advice from the office. It was a good decision.

Look, a big part of why WLS works is because we eat extremely low calorie diets. If you are getting 3-4 x 2 oz portions of meat per day, with some veggie sides and maybe a protein shake, you are going to get between 700-1000 calories. Unless you are eating fish at every meal, your protein is going to be tied up with some fat. My average meal is 200-250 calories, and snacks are about 100 calories. I try to make each meal and snack protein heavy.

Every time you add on a pat of butter, you are adding 100 calories. Every time you add on a tbsp of mayo, you are adding 70-80 calories. Every time you add a tsp of olive oil, you are adding 100 calories. If you do that with every meal, that can add up to an additional 300 or more calories per day. Also, because fats like butter, mayo and oil are low-volume, slippery and coat what you are already eating, the calories that you get from them aren't going to make you any fuller.

I am not going to say that I won't put a little bit of butter, sour cream or mayo on some foods. Tuna or egg salad - hello??!! I just make sure that I count it, and that I only have it once in a while.

I have learned to cook without fat, or with very little added fat. It is a transition, and it is hard. I have always been an excellent cook, but this change really challenged me to figure out how I could brown foods properly, make sauces and soups taste rich, etc. Now, I start a sautee with a little Pam, add more low or no calorie seasonings, and add a couple of tablespoons of water to the sautee to get things softened before they brown. Think about how you make taco meat, according to their directions. That technique works for so many things.

TODAY: I am two months post-op. I weight 191 lbs and have dropped just about 40 lbs since late May (about 2 months ago). I continue to lose and lose. Monumentally, my lowest weight on LCHF/ketogenic was 196 lbs (about 2 years ago), and I still had diabetes, low blood pressure, PCOS, and several other symptoms of metabolic disorder. When I again hit 196 just a week or two ago, post-WLS, I had no diabetes and took no diabetes meds, my BP is good, and I am physically smaller at 196 than I was 2 years ago (I fit into smaller clothes).

So, it has been good for me. It could be good for you. You are an adult and you can make your own decisions. So, you have to decide who knows better - you or your medical team. But, you are ultimately the one who lives with the consequences of those decisions. People who go off the diet develop bad habits and get fat again. It happens all the time. Don't let that be you.

Also - I just posted a comment today that I think is also relevant - do you want to be an "eat to live" person, or a "live to eat" person. These are two distinct roads, and I think that people who are particularly successful with WLS end up being the former, rather than the latter, because "live to eat" is dangerous, especially for those of us with food addictions and all kinds of triggers to delicious stuff.

My program only required a NUT eval pre-op. All post op care comes from medical appointments and support groups lead by the bariatric nurse coordinator. While well "educated" up front, and since via avenues mentioned above, I've kind of been on my own through this process. While I was in my losing phase, I chose lower fat options, not ALWAYS, but most of the time. Less butter, more olive oil, etc. Now that I've reached goal, and gone a bit below, I'm working in some full-fat cheese, real eggs and higher calorie options. I exercise 5 days per week and most days I have to work to hit my calorie goals for maintenance without eating complete crap. I had to quit the nutritional program I'd signed up for at work, (for the insurance rate bonus) because my Bariatric diet has NEVER looked like the typical USDA recommendations. How many servicng of veggies do I get per day? Sometimes nada. My instructions have been to finish my protein and IF there's room, have a bite of veggie. I take copious supplements on a schedule and will for the rest of my life to compensate. My blood chemistry has been perfect and my medical team is pleased with my progress. Even the NUT who evaluated me 1 year ago gave me those instructions... Protein above all else and take your vitamins. Sounds like you need a NUT trained in the bariatric diet, (and with a better chairside manner).

Low fat does not always equal processed. It's totally possible to eat low fat without eating overly processed foods, and full fat is not necessarily the only option. I still believe tweaking the plan two weeks out is risky. Once someone is back on solid foods, if full fat foods agree with you and you can fit them into your calorie goals, it's a completely different story, but while your stomach is still healing, I would go with the plan given to me by actual medical professionals. I see a lot of posts from people who want to change things early on and honestly it surprises me. If we knew what we were doing prior to surgery, if we knew better than our surgeons and their teams, we probably wouldn't even be in this group.

I was obsessed with fat after my op. I averaged 10-15grams of fat every day. My skin suffered and lots of my hair fell out. My nails even started splitting. My nut told me to up my fat but 'good' fats. Olive oil, salmon, avocado. I was told to use natural fats but to weigh it all and try not to go over 25 grams. I am now 2 years out and average 35 grams of fat. My skin, hair and nails thank me. Keep as low fat as you can but own and record the fat you eat.

I eat normally and watch my weight normally, I own my good days and my bad days. I am not perfect. Food got me into a mess, surgery and hard work got me out of it. I still enjoy food but I also love the fact that I control food. Food does not control me.