Congratulations marallewis! I'm curious how you and the others avoid the desire to eat/snack while on the replacements? Is it easier/harder than you thought it would be?

Hi! I'm not new either. I started the New Direction program last July and had great success losing 70 pounds. A change in my insurance prompted me to move into the Outlook program (2 shakes/day and 1 meal). I've lost another 10 pounds on that program. Yesterday, I switched to what my center calls the "Individual Plan" where I no longer attend weekly meetings, but I do meet monthly with a nutritionist and get more attention. My plan still includes 2 shakes and 1 meal. With thirty more pounds to lose in order to achieve my goal weight and having hovered around the same 3 pound range for a couple of months, I am approaching this new phase in my weight loss journey with renewed vigor, but an open mind also.

I go in tomorrow for my big consult and to get my "shopping" done. I was really impressed with my first meeting last week, which ended up being a one on one with me, a PA and the bariatric doc (all women). Julie, are you in the Lincoln area? (Im a Husker too) My doc was pushing big for exercize starting week two- once ketosis is achieved- so I can gain and maintain muscle mass and not lose valuable muscle that helps to burn fat. She also said she likes to introduce 1 meal as soon as possible so we can start learning healthy eating habits ASAP while still under regular supervision. Tomorrow we'll discuss my 20 page questionaire, weight loss goals and our approach to them. We'll discuss the results of my initial blood tests and we'll customize the program for me. Then I'll "officially" start the replacements on Thursday. Im so excited and scared. I'm ready to get this show on the road!

Thanks for reaching out Lisa! I live in Omaha.

Your clinic is run so much different from mine. I have never seen a bariatric doctor, just the PA in my meetings but I would like to! They seem to be for those patients doing the bariatric surgeries. I don't feel the PA I see really gets all the science behind ketosis, just restates the basics and yet I'm very interested in the science part as I am an RN!

The registered dietician who leads our class is super sweet and supportive but gets her science facts wrong sometimes! I have done lots of research on ketogenic diets since starting, it's all VERY fascinating. I had always been a die hard Weight Watcher devotee and never researched any other kind of diets before so I was unfamiliar with the concept of ketosis. I've learned that many people continue ketogenic diets even after losing weight due to the other side health benefits. I asked our RD about modifying the New Direction maintenance portion when I get to that point and eating a low carb/high fat diet with no sugars/starches so I could stay in ketosis and she said I couldn't do it, that I would eat too much fat, that it was unhealthy, that it was not realistic and not sustainable. Hmmm...I just said okay. Still I know of many people have lived on LC/HF or Paleo-Keto diets and stayed in ketosis for years and decades with great success (even children with epilepsy and people with diabetes) so I was a little taken back that she couldn't say anything positive about it. Being in ketosis has REALLY helped my painful joints so much due to it's anti-inflammatory properties and my acid reflux is gone now too, I have no swelling in my feet or hands! I don't have sugar cravings and don't miss the peaks and valleys of hypoglycemia before and after my meals! I have learned so much about what makes us fat by Gary Taubes (author of Good Calories, Bad Calories and this video https://youtu.be/lDneyrETR2o , and how the food industry is so tied up into money and poor nutrition, see this video by Tom Naughton https://youtu.be/DIt80PxvKn8.

A couple weeks ago we were going over the topic of fats in class. Now for a long time saturated fats have got a bad rap but the science is coming around more this past decade that it's inflammation that causes heart disease and that we don't have to fear fat like we have been told for years. Our RD said "eating saturated fats is like pouring fat down your sink and clogging up the plumbing."
It's just not so. Read here: http://thebigfatsurprise.com

I attended another day for class one week and before class I was sharing how I prefer to use a blender and ice with extra water than the shaker container and another lady said that the RD told their class that they could not use a blender because it would destroy the protein!! What??!! I do appreciate the behavior portions of the education because that is my weakness.

Rather than eating one meal sooner, we TALK a lot about meals so we know how to eat when we are done and she follows the diabetic exchange program. She is all about tracking but really feels strongly that we can't rely on using MyFitnessPal and that we need to learn the exchange program as a foundation. I know it's part of the New Direction program but seems a little outdated to me when we now have such easy apps on our phones like MFP! I just keep my mouth shut so as not to be negative around others in the class.

One more weird thing she said and then I'll quit my "rant". We had a lady doing VLCD so no meals and she was going on a vacation with her family and wanted to switch to the LCD just for her vacation (where you eat a meal but they eat carbs so they are not in ketosis). The RD said she couldn't do it, that she had to stick with the meal replacements. I suggested she do a modified LCD during her vacation and just eat protein and very low carb veggies, etc and stay under 50gms like they tell us to do with the meal replacements) so she would stay in ketosis and the RD said no, that even if she did that it would knock her out of ketosis. That was just flat out incorrect but I kept my mouth shut.

I can't say for sure what I will do when I reach maintenance but I have learned a lot by watching LOTS of YouTube videos and joining the Keto-Adaptation Facebook group. I appreciate NOT having to cook and grocery shop during all my research so I will continue with New Direction for my weight reducing portion, after that I may not continue with my RD for the 2 year after losing portion.

I am also curious what other people have been told about exercise but will start a new thread. This is LONG already!

Is that bit about the blender ruining the protein true? I always use a blender to mix water, ice, hot cocoa mix and powdered peanut butter. Our nutritionist even used a blender in a recipe session.

I don't want to give up using my blender.

Well, I had my physical and my EKG and everything else today. No big surprises, other than my vitamin D deficiency for which I'll need suppliments. I got all of my first weeks product. Tomorrow I officially begin my journey.

So, I reached my initial weight goal and the PA moved me from VLCD to LCD. Eating 1 meal and 1 snack a day. It is hard! I'm really struggling with making decisions about what to eat. My Dr. said I should do LCD for about 6 weeks and get my metabolism back up and then maybe do another round of shakes.... has anyone done that?! It was news to me that I would go off, and then back on again. I'm just under 200, and at my skinniest adult weight (training half marathon - running 5-8 miles a day) I was 175lbs.

Kate: I had trouble going down to 3 replacements a day -- so I would do a couple days at 3, then have a 4 day, and then get back on 3. I was misunderstanding thirst for hunger - so keep drinking, and I was allowed to eat calorie free dill pickles and a diet soda, which would substitute as a snack when I was dying around 4pm every day. I'm not a soda drinker, but a diet cream soda felt like a treat! Good luck!

Welcome Michell! I hope you've had a good start!

Wow! Michell, Kate, Maraal and Lisa all have said you are supposed to go down to 3 shakes. I asked about going down to 3 because some days I'd sleep later in the mornings on my days off or get busy in the afternoon doing errands or I wasn't that hungry. The dietician said "If it happens that's fine but don't let it happen often. It's very important that you get 4 shakes a day."

I have been tracking my body fat at home on a monitor I bought on Amazon and was concerned because I was losing lean body weight on the weeks I had more "3 shake days" than "4 shake days". I was worried about that. If I exercise and don't have enough calories it will go after muscle but I need to exercise to keep the muscle!

I didn't "go down" to three shakes. That how I was started: 3 shakes and 1 bar. I didn't realize so many of the clinics do things differently. I was told if I felt I needed more than the 3/1 I can have celery, cucumbers or a few pickles. Boullion broth if I feel salt depleted. So far I've not had to do any of those. I've been tempted with the celery and I have pre cut celery "snack packs" in my fridge waiting if I need them. I realize though that my temptation to have them comes more from the desire to snack and munch than from any hunger. So far I've resisted because I want to break my habit of wanting to snack. I'm sure I'll break down at some point, but right now while my will is strong, I'm trying to resist. I feel like I'm detoxing, in a way, so I hope to throw those old habits out the window as well.

Julie, you're right. I went in for my 2nd check up a few days ago. I was told I pushed myself too hard with the exercise. Even though I physically CAN do those heavier exercises, I wasn't taking my caloric intake and bodily changes into account- thus being wiped out of energy. I was told to slow it down to a more relaxed level and build up slowly. So instead of trying to do a full areobics video and 2 miles on a treadmill followed by 50 laps in the pool, I went with my adult daughter to the park and took a nice stroll on the trail, a mile and a half, but we did it leisurely. Even with that I had to sit down towards the end because I got dizzy. It's weird to be so limited, but it's temporary, right?

You've done so great with your weight loss, Julie! I hope I can get similar results. I was down 10lbs at my Tuesday appointment. I'm down 2 more since then. I had to go to the goodwill and buy 2 pair of jeans in a smaller size. It had to be a thrift store because I know I won't be wearing them long, right? I was so happy! I had lost about 10 pounds last spring before I went to Europe, so my jeans were already saggy. This recent -10 made it a necessity in order to avoid a wardrobe malfunction, ha ha! It was such a great feeling and a wonderful motivator. This is a lovely RESULT! I carry most of my weight in my upper body, so I'll be extra happy when I start shrinking shirt sizes!