Ketogenic Diet and Duodenal Switch ( DS ) weight loss journey

Thanks guys! I did a search but had trouble finding people who both had the DS and were trying keto. I know that my fat push will be HUGE compared to yours because of my malabsorption of fat, but please do drop in and let me know how things are going for you.

I am still doing very, very badly with regard to carbs. I only started tracking myself a couple of days ago, and my macros are surprising me. I eat a lot more than I thought I did! lol My biggest carb downfall is my coffee, that I load up with sugar and milk. I've got some erythritol ordered, though, and I'm going to give that a try. I'm a major, serious carb addict, so I'm going to take this transition slow and just whittle my carb load down. I'll identify a spot and figure out how to address it and then move onto the next adjustment.

I am very, very, very new to exploring keto in terms of just moving in that direction right now. I only started tracking my food again a few days ago. It's been a bit of an eye opener!

I'd like to have my protein intake at about 100 grams. Because of my DS, I really need to not go less than 100. I am surprised to find out that I am exceeding that 100 grams rather handily! So, not overdoing protein will actually need to be on my radar. I wasn't expecting that.

As I get my carb load down, I'm going to have to increase my fat -- a lot. Because of the DS, I think it will need to be between 600 and 700 grams a day. DS'ers (theoretically) absorb about only 21% of the fat they take in. When I did this once before, I didn't know about keto. But, I had figured out that if I were dropping carbs for the sake of going low carb, then I needed to push fat super duper hard or else my calorie intake for the day was WAY below 1000 cals. So, as I move forward, other than managing my addiction to carbs, how to get in enough fat is the thing I see as my biggest hurdle.

Erfw7471 wrote: »

I used to work with a woman who had the DS and had terrible side effects from higher fat & refined carb intake, and apparently those were to be life-long issues. Have you checked for advice on WLS forums?

*edited to add: she had terrible diarrhea with higher fat and had extreme gas with the refined carbs, but this may just have been her reaction.
**edited again: still asleep, not enough coffee, lol

If I eat bread, especially whole wheat bread, be careful. The stink of my gas can clear a room! It's BAD!!! But, I don't do much in the way of bread. If I were to eat crackers, I suspect I'd struggle. And, I notice a gut-gas reaction when I eat potato chips. But, I tend to be able to eat fruits without much issue. And, I could eat sugar all day long without it producing stinky gas.

As for fat and diarrhea, eating too much fat can trigger diarrhea for me, but it's short lived diarrhea as the fat is passing through. Other than that, I struggle quite a bit with constipation. Occasionally, I'll eat something besides fat that triggers some diarrhea for me, but more than anything else, it's constipation that's my problem. It really makes me taking iron (and I take heme iron which tends to be easier to pass) and calcium a real struggle. I take far, far less than what I should. But, wow, I like to be able to poop! (DS'ers are famous for talking about poop -- my apologies). I do take Miralax and it does help, but when I take my calcium and/or iron, constipation becomes an issue even with the Miralax.

But, with regard to the prospect of eventually having to get in possibly as much as 600+ grams of fat (because of the presumed 80% malabsorption of fats) as I lower my carbs, I'll take it a day at a time and slowly increase my amounts. I'll take it slow in figuring out what my limits are and what things work and what things don't.

For the lady you worked with, I hope her situation got better. I've got a friend with DS who had similar issues and she slowly increased the amount of fiber she eats by making beans a staple in her diet. It helped a lot. Now about 7 years out from surgery, she doesn't have the issues she did early on. The gut tends to heal itself and adjust over time.

I got the erythritol I'd ordered in. I haven't done well with alternative sweeteners in the past, so I'm taking it slow by cutting it half with sugar and half with erythritol while I get used to it. But, I'm super excited to see how it impacts lowering my daily carbs. Sweet coffee is a huge habit for me, but I'm eager to see how this helps. One step at a time.

I haven't been able to find much activity by DS'ers, and I haven't found anything DS specific to going LCHF, so I'll continue to post here in case someone goes looking to read about a DS'ers experience going low carb.

Yesterday I went for a long, slow walk (with a slow walking companion) for about a little over an hour. I got in 55 net carbs, 100 fat, but only 43 grams protein. And, the scale dropped another 1.6 lbs today, taking me to 217.4.

I'm going to assume my wt loss is mostly water wt until it either slows down or gets to 210 or below.

I don't feel that I got in enough calories yesterday. I definitely didn't get in enough protein. I'll try to do better today -- but I also know from what's in my fridge that it might be just a so-so day on protein.

Also, I didn't have much of an apatite yesterday. I felt a little shaky at time during the second half of the day, but I attribute that to the low calories. I got some more to eat and felt a bit renewed.

For any non-DS'ers reading this, the figures I've seen on absorption for a DS'er is 60% protein, 21% fat, and 60-100% carbs (simple carbs at 100%). I don't know what my absorption rates are, but I keep these #'s in mind as a guideline regarding how many calories I'm potentially taking in.