I'm on my way to a second day of lower carb eating. I'm at 47 grams so far for the day, and my carb-head is really talking to me. I'm so glad I decided to take this slow. I know I'll eat more carbs before the end of the day, and if I do, I will just take it in stride. I know that this will take me some time. I've been such a heavy carb eater, especially sugar.

@rowdyslady Do you have any fat malabsorption? And, do you compensate in the amount of fat you take in to compensate for it?

I'm getting closer to 100 grams of carbs for the day and I feel better than I did earlier. Like I've said, I'm game to take this really slow and to let my body get used to the lower and lower carb #.

As for me and fat, I am way way way low from what I figure it will need to be when I actually start achieving low carb #'s. I'm thinking that I'll need to get in between 500 and 700 grams of fat a day, and I'm just not sure how to make that happen (I presumably malabsorb about 80% of my fat intake.)

After I had wt loss surgery, the surgeon's office gave me a diet plan that was a modified RNY diet plan and not one specifically designed for someone with a DS. It was essentially low carb and low fat. And, after accounting for malabsorption, I think it only provided 200-300 calories for the day. In addition to that, when I did try to eat low fat, my hands started hurting. My body was not getting enough fat.

Fast forward a little to now. I'm going to assume the 60% absorption of protein, 20% absorption of fat, and 60%-100% absorption for carbs (100% simple carbs, but let's call it 90% absorption for ease of calculations and the assumption of some complex carbs) as I've seen reported. My absorption rates might be better now that I'm 5.5 yrs out from surgery, but I haven't been able to find literature that explores that.

So,

100g protein x 60% = intake of 60g protein = 240 calories
50g net carbs x 90% = intake of 45g carbs = 180 calories

Total without fat = 420 calories

As for fat, lets assume 100g fat x 20% = 20g fat intake = 180 calories

That only gets us up to a total of 600 calories. And, that's just not enough calories for a healthy metabolism.

But, for whatever reason, adjusting calories via carbs doesn't lead to the same kind of wt loss results as when adjusting calories via fat or protein and keeping carbs low. And, of course, protein can be converted to glucose if you eat too much of it and it can be hard on the kidneys. That once again brings me back to fat and the need to up calories through fat. But, with the scenario above, it would take 322 grams of fat just to get me up to 1,000 calories for the day.

Now when you take into account the push to go for lower than 50 carbs for the sake of trying to get into a fat adapted / ketogenic state, it puts even more emphasis on getting in lots more fat.

So, what happens when my carbs are low, my protein is moderate and my fat is moderate? I feel starved. I don't mean that I feel hungry. I mean that I start to feel weak. My body notices the lack of calories. It might take a few days, but it catches up to me.

Now, I do suspect that my absorption figures are different than the 60% protein, 20% fat, and 60-100% carbs that I've listed. My gut has had time to heal, and I'm sure that I absorb more than what I did during the first 6 to 9 months after surgery. Having said that, I know that my absorption isn't (and will likely never be) at my pre-surgery absorption rate. So, I just have to listen to my body and see what's working for the moment.

Right now, I'm failing to get in lots and lots and lots of fat. My #'s yesterday were 49 net carbs, 121 fat, and 81 protein. I haven't been spot on with measuring my food, so these are estimates. But, the wt has been dropping fast -- which I currently attribute to water weight. However, I do think that I am right at the point where the future wt that I'll be losing will be more fat than water. I have had a day here or there where I felt weak in the way that I've grown to recognize as lack of calories, but in those moments I've made it a point to eat and get more calories in and that has translated into that weak feeling going away.

All in all, I've shed about 17 lbs of water wt. This morning was the first morning in several that I didn't have a pretty big drop. In fact, I had a very slight gain, which I attribute to variations in morning bathroom moments.

I'm excited to see how the wt loss continues from here.

*Ah! Just realized I forgot to include in my food log a bit of a treat I made yesterday that would have driven up both carbs and fats. I'm going to add that into my food diary, but I'll leave the information I've listed above as is.