Any DS'ers here doing LCHF / Keto?
Tonya_me
Posts: 28 Member
I've had a DS (Duodenal Switch wt loss surgery). Is there anybody else here that's doing LCHF / keto who has had a DS? I'd love to share and hear your experiences.
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I'm not a Duodenal Switch but I am a Roux en Y pt. I've had great success with Keto. I posted something very similar to this when I first came here too, looking for others "like me". Not many of us, but there are a few. I also don't have my Gall Bladder by the way. I didn't go through the Keto Flu and I think that was because of the copious amounts of vitamins I have to take because of the surgery. I have no trouble eating high fat even with the missing GB. I feel like I was a successful surgical pt - went from 363 lbs to 194. Then bounced up to 260 this last year. My surgery was in 2003. The 260 brought me here and LCHF. I'm down 34 lbs now and I'm aiming for 190.2
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I had gastric bypass in 2004. All was going well until health issues rendered me inactive & I regained weight. I also don't have a gall bladder. I've not been doing keto quite a month yet & I seem to be doing well. I did have keto flu for a couple days. Right now my biggest issue is no appetite & not being able to finish my food. I'm told it's probably because I'm in ketosis.2
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When I am approving new people for this group, WLS is not an uncommon mention in their messages. It's not a huge number of members, but there are many people here who have had some form of it or are trying this as a last-ditch effort before considering that.
They are here. They might not be posting about their surgery a lot or calling attention to it, but you're not alone.5 -
I have had a VSG (Sleeve), and I am a regular lurker in here
There are specific groups for WLS (I belong to a VSG group too) and I assume RNY or DS as well? Search the groups. I get a lot from both groups - VSG and LCHF! They go together pretty well. 1 -
My bestie had WLS surgery and her doc put her on a very low carb diet before and after, she was my biggest inspiration for going VLC after trying to eat around 100 g carbs a day for years with minimal weight loss success. She has lost a bit faster than me, but she's also had to work a lot harder having had surgery as she has a lot more challenges to cope with.1
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Thank you all for you feedback. I had my DS in 2011 (end of 2010). I lost from 298 to my lowest stable wt of 183. But, after that, the wt slowly crept on, a lb here and there, and now I'm up to about 225.
One of the challenges I'm facing as a DS wls pt is that according to the data I've been able to find, I absorb about only 20% of the fat that I take in. Because of this, I've been wondering how other DS'ers handle going LCHF. I did manage to go low carb at one point but when I realized how few calories I was getting in due to the malabsorption of my DS, I really started pushing fat to compensate. I had learned that eating too much protein could cause issues (raising glucose, and I think it bothered my kidneys), so I pushed fat as hard as I could. I eventually did go into ketosis but my breath was SO BAD that I quickly ate myself out of it. I was mortified and didn't want to put my coworkers through that. It was BAD. But, I work from home now and am going to try low carb again.
As I move back in the LCHF (keto) lifestyle, I've been curious as to how other DS'ers handle it with absorbing so little fat. But, even if there aren't any other DS'ers who can chime in, I'll gladly enjoy sharing info and stories with everyone else. (I will check the DS board as well.)0 -
@Toyna_me - with the fat - I'm the same way with my RnY. I am missing the part of my intestine that absorbs stuff which is why I take sooooo many vitamins. I haven't noticed any breath effects or other negative effects like expelling excess fat in the bathroom. Maybe building up to keto slowly would help your DS body adapt?1
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@RowdysLady , that's what I'm hoping. I'll just transition slowly. One, if I try to force it, cravings will win and I'll fail. And second, I do want to give my body a chance to transition into it slowly. I've just been making it my focus to buy and use more and more foods that are low carb -- cucumbers, avocados, cabbage, mushrooms, etc, and let achieving lower carb #'s happen naturally via the things I'm putting on my plate. Today, I've managed to get my fat up over 200 grams, and I've managed to keep my carbs well below 100 (around 60 at the moment, but the night's not over). This is by far the most successful day I've had yet since returning to low carb!
Do you have a fat goal that you strive for to ensure you're getting enough cals in?1 -
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.0
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@Tonya_me I am usually low on fat actually. I was just looking at that today. But I want to be at 70 to 75%. I fill up fast these days and recently dropped my calories because I was way under most nights.0
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@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.)0 -
Well, my carbs are still far from low, but I do appear to have started the wt loss process! I'm surprised that it has started even though I got in more than 100 carbs yesterday (ended the night with a big glass of milk and some prunes--was craving those carbs!). Overall, depending on where I started from, there's a chance I'm down about 6 lbs. I didn't weigh myself right away, but I'd been bouncing below and above 225 for quite some time.0
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@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.)
I do have malabsorbtion with fats. I Don't compensate. I eat fats for satiety. I rarely hey them all in each day. What matters most to me is that my carbs stay low enough that I'm in ketosis. I add butter to my foods. I drink BPC. I eat higher fat meats. I don't have to absorb the fats to feel full. I just need em to keep me full and not crave carbs0 -
RowdysLady wrote: »I do have malabsorbtion with fats. I Don't compensate. I eat fats for satiety. I rarely hey them all in each day. What matters most to me is that my carbs stay low enough that I'm in ketosis. I add butter to my foods. I drink BPC. I eat higher fat meats. I don't have to absorb the fats to feel full. I just need em to keep me full and not crave carbs
For me, if I'm not getting in many carbs, it's hard to get in enough calories for the day. Here's the absorption #'s I've seen online: 60% absorption of protein, 20% absorption of fat, and 60-100% absorption of carbs (simple carbs being closer to 100%). So, when I cut out carbs, it's hard for me to get in enough calories. I don't know how much healing the gut does after surgery, so my absorption #'s might be different than those. But, it's why I worry so much about getting in enough fat. If my protein is moderate and my carbs are low, my calorie intake becomes too low without wagon loads of fat. Still trying to find the sweet spot in terms of feeling like I've given myself sufficient calories while keeping carbs down.
Right now I'm out of avocados. Miss those avocados! Those seem to be such a perfect balance!0 -
I'm a weight loss surgery patient too. I found that returning to my old way of eating was a huge mistake! I learned that I had to change what I eat to keep the weight off. No surgery was ever going to do this for me! LCHF seems to agree with me in every way! I haven't had any problems nutritionally, so far. But I take all, and then some, supplements that are recommended!1
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@Karlottap Which surgery did you have? Yep, me too on the eating. Dipping my hand into the carbs is what has been putting the lbs on me.0
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I had a sleeve, but refluxed bile terribly and had a conversion to RNY. Carbs are far too easy to eat, and cause weight gain! I haven't been successful with weight loss until eliminating then from my diet! They will be gone, for good!2
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Just a question, since I have zero experience with bariatric surgery and don't personally know anyone who's had it...
Is there a real need to worry about getting your dietary fat levels up so high if you want your body to use the stored fat?
Seriously interested.... not being snarky.2 -
canadjineh wrote: »Just a question, since I have zero experience with bariatric surgery and don't personally know anyone who's had it...
Is there a real need to worry about getting your dietary fat levels up so high if you want your body to use the stored fat?
Seriously interested.... not being snarky.
I was thinking that too - I would think just eating fat to satiety as you would want to use the stored fat on your body as an energy source?? I would also wonder if there is a need to compensate with more food to get more calories? After the surgery were you given a higher calorie diet to compensate for the malabsorption or told to just eat normal amount? Might be done more research needed? As above I have no experience but it just would seem counter-productive to just eat more to replace what's lost if the point of the surgery was to create that deficit in the first place?0 -
I believe there was a transition to become fat adapted. In the beginning I needed more fat to create the satiety needed to sustain LCHF. Then, once the habits of eating this way became instilled it took less fat to maintain the woe. This is when I really noticed the loss of my own fat stores.
Imo the weight loss from surgery is mostly from muscle wasting, not from fat burning. Hence the odd shape of many weight loss surgery patients. Not to be mean at all! But, they do! Remain heavy in the hips, usually. I believe this is because many continue to eat the way they did before surgery (I did after the sleeve), and justify it because they can't eat much of it. These are the people who usually regain after they stop losing from the surgery.
I decided that I had to change what I eat to see different results! LCHF to the rescue! It has been what's made the difference!! I won't ever believe any differently!
How can we continue doing the same thing and expect different results? Not going to happen!1 -
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.
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Above, I said I've lost 17 lbs. That was a total math brain fart. It's more like 12 lbs. Sorry! (I think that the time allowed to be able to edit the post above expired.)0
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Thank you all for you feedback. I had my DS in 2011 (end of 2010). I lost from 298 to my lowest stable wt of 183. But, after that, the wt slowly crept on, a lb here and there, and now I'm up to about 225.
One of the challenges I'm facing as a DS wls pt is that according to the data I've been able to find, I absorb about only 20% of the fat that I take in. Because of this, I've been wondering how other DS'ers handle going LCHF. I did manage to go low carb at one point but when I realized how few calories I was getting in due to the malabsorption of my DS, I really started pushing fat to compensate. I had learned that eating too much protein could cause issues (raising glucose, and I think it bothered my kidneys), so I pushed fat as hard as I could. I eventually did go into ketosis but my breath was SO BAD that I quickly ate myself out of it. I was mortified and didn't want to put my coworkers through that. It was BAD. But, I work from home now and am going to try low carb again.
As I move back in the LCHF (keto) lifestyle, I've been curious as to how other DS'ers handle it with absorbing so little fat. But, even if there aren't any other DS'ers who can chime in, I'll gladly enjoy sharing info and stories with everyone else. (I will check the DS board as well.)
I haven't finished reading all the responses after your message, @Tonya_me, but have you asked your doctor about using supplements to increase your stomach acid and levels of digestive enzymes? I've seen a huge increase in my digestion efficiency with using these items (since I'm without a gallbladder). I know you're missing part of your system, but breaking things down *should* to my uneducated mind make sense to help maximize what absorption chances you do have.
@RowdysLady - Do you use any stomach acid/digestive enzyme products to help?0 -
@KnitOrMiss I do not use anything, for a while I did but found it didn't really change anything.
To those with the questions - @Tonya_me did a great job of talking us through - but to add a little more; the whole point of the RNY surgery was to stop me from in taking as many calories so I don't gain weight back. It cut my stomach down to the size of a chicken egg so I could only take in so much at one time and removed the first 5 ft of my small intestine to help create malabsorbtion.
Of note, my stomach is so much smaller than someone else's that I couldn't intake more calories unless I did eat very calorie dense foods - I can't eat a burger, fries and a shake like most people. I can't eat a whole chicken breast and a baked potato. It's too much food and will cause horrible pain. I can eat a burger no bun, a couple of fries and forget shakes - that'd kill me. Now that I'm Keto, I'll have my burger no bun, no fries, and butter or cheese to go with. Carbs are the worst. I can't eat a lot of them in one sitting but when you are stuffing candy, cookies and cake in your mouth all day it doesn't matter how small your stomach is or how much you don't absorb, you are getting the wrong things....all day long. That's where I was before Keto. I'd snack on junk all day. When dinner came and we had bread and rice, I'd eat both....slowly...so I'd wind up with a "normal portion" it just took me longer to get it down. Totally circumventing the reason for the surgery.
I can tell you that I intake 1600 calories a day but the truth is, I really don't know what I absorb of that. I may only really absorb 1200 for all I know. I guess for me what I think of today is am I doing better than I was? Am I ailment free? Am I satisfied? If that is all answered yes, then I'm happy with whatever is happening inside me.
I eat the fat to fill up and feel satisfied. To stop me from eating the carbs. I am at a place I no longer crave all the carbs and I'm thankful for that. I rarely hit my "fat mark" each day and I'm ok with that.
Before I found Keto and you guys I was eating anything and everything - I may have eaten 5 Little Debbie cakes a day because they are small and I could and I liked the taste. Today they sit in the cabinet and I want nothing to do with them. I had a snack earlier of salami and cheese and never even considered carbs.
Did I answer the questions?2 -
@Tonya_me since you haven't been doing low carb for very long, is it also possible you are feeling weak due to electrolyte imbalance? I would think with all the absorption issues you have, that may come into play as well, no? I know a few people who have lost over 100 lbs ( & kept it off for a few years now) doing mod protein, low carb & low fat 750-900 calories in their weight loss phase and then at goal weight they eased into typical low carb with higher fat. Balancing supplements and electrolytes is vital for that though. And they are not unhealthy now, a couple of them are into multiple 10K races, and triathlons. They even trained C25K while on the last 1/3rd of the weight loss phase of their WOE (with a bit extra protein though).0
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@RowdysLady - I have recently discovered that not all digestive things are created equally. i was taking an Rx - Questran - that is bile salts, and it did absolutely nothing for me - except to give me even looser stools than I already had. I didn't feel better, it didn't improve absorption - at all... I stopped it completely, and never noticed any change...
Then I was doing liquid ACV, which helped some, and added a basic digestive enzyme, which also helped some - but I didn't feel great with - not as I expected. I have since switched up to a pill ACV at the recommendation of my PCP who does the same (I was having concerns with the acid on my teeth, etc., due to taking it with each meal), and I was struggling to find balance with the ACV and digestive enzymes, so more research I did (how much of each, together or alone, max in a day, etc.).
Nearly everything I found suggested a combination pill... I was taking only Betaine HCl with Pepsin before...and it was hard on me...my poor bottom and the toilet nearly became mortal enemies! The one I take now has Ox Bile, lower doses of Betaine and Pepsi, but also has an enzyme blend that helps on the intestinal side, too. I take one pill of that and one of ACV with each meal... I can tell when I forget!! If it gets bad (this weekend I had a spot of indigestion due to poor food choice, and I added in one of the stronger enzyme pills - did me up good.
I can tell a better efficiency in my digestion, and in nutrient absorption - I just feel ... MORE? I don't know how to explain, but I feel more nourished... If it is something you can afford to take for a test drive, just to see if it helps, I definitely would. Really, I don't see how it could hurt, particularly if you start with only one meal, and progress if you tolerate it... Everything seems to come back to poor digestion for me these days. Literally EVERYTHING. 2
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