Dietician makes me feel like it's a "one size fits all" solution

YaYasMom12
YaYasMom12 Posts: 6 Member
edited November 17 in Health and Weight Loss
History: Previous gastric bypass patient so metabolism likely screwed, however its been 13 years.
Weight Mid December was 270, current weight 250. Calories set at 1200 per day, I do *not* eat back my calories. First few weeks using MFP I averaged about 1400 calories a day. Then went to the doctor. Dietician says I should stick to 1200 calories every day - I try to follow higher protein, lower carb, lower fat as a post wls patient. I drink a lot of water, usually over 100oz a day. I go to the gym 3-5 times a week, and work with a personal trainer at least once a week. Feeling like 3 months to drop 20lbs is a little slow based on my current weight and BMI. MFP average is 1200 calories to 1250 calories for 8 of the last 9 weeks, and one week average 1400/day. (and 1400 for the 4 weeks before the dietician) so 14 weeks, 20lbs. I know that a good healthy maintenance weight loss is 1-2lbs a week, I was hoping to be closer to starting at 2lbs a week average because of how much I need to lose.

Replies

  • pinuplove
    pinuplove Posts: 12,871 Member
    edited April 2017
    Nothing is one size fits all. I'd even say no two MFPers are following the exact same path. 20 pounds in 14 weeks really is fantastic. I know it's tempting to get impatient and want to lose it all NOW but sadly that just isn't how it works. Keep it up, you're doing great!

    ETA don't get married to the idea that you HAVE to eat 1200 to lose weight. I'm guessing as a former WLS patient you've eaten a vlcd at some point but even 1200 is pretty limiting.
  • qweck3
    qweck3 Posts: 346 Member
    edited April 2017
    There is no one size fits all for sure since everyone is different yet the one standard is creating a negative balance on the calorie end from what the body is accustom to. 20 pounds is great progress! Keep going at it! There could always be underlying issues affecting the weight as well. Are there any blood sugar or thyroid issues? High blood sugars cause some people to not lose weight. You seem to have everything else under control.
  • richardgavel
    richardgavel Posts: 1,001 Member
    Be careful about wanting to lose too fast. I did and it partly contributed to losing a lot of lean body mass. And believe me, it's a LOT slower to build that back up than it is to lose it.
  • YaYasMom12
    YaYasMom12 Posts: 6 Member
    What I mean by one size fits all is this: I'm under the impression that the heavier you are, the more calories you need to stay alive. That's why weight watchers for example the more you weigh the more points you have, and as you lose weight, you lose points. So if I weighed 180 and wanted to lose 10lbs, I'd still be told to stick to 1200 calories a day- I guess I'm wondering if that's too low for my current weight, and causing me to have issues losing if my body is in starvation mode - how do you know? What if I was a long distance runner and ran 50 miles a week, would it make a difference? Men get more calories than women, what if i was a bodybuilder? I get that CICO is a mathematical fact, but 1200 in minus the difference between where i'm at now and a long distance runner/body builder is a BIG difference. That's what I mean by one size fits all.

    Yes I'm weighing solids and measuring liquids. I use the best information I have available to me which is databases, nutrition labels, and then my scale and measuring cups. I am highly anemic, so I get blood drawn every 6 months, and no other underlying issues with blood sugar or thyroid.
  • annacole94
    annacole94 Posts: 994 Member
    1200 is the "one size fits all" approach for people who want to lose as fast as possible and don't want to put the work in to figure out a more personalized approach. If you ran long distances or wanted to gain muscle, it would be a very bad fit. Just like every one size fits all product.

    If you want to eat more, you'll lose more slowly. That's a totally valid plan. Most of us are planning to lose less than 1.5-2 lb/week.
  • YaYasMom12
    YaYasMom12 Posts: 6 Member
    annacole94 wrote: »
    1200 is the "one size fits all" approach for people who want to lose as fast as possible and don't want to put the work in to figure out a more personalized approach.

    Okay that makes sense because if I go to some of the other sites that Ive seen mentioned on these boards, I get much different results. for example scoobysworkshop's calculator has me at eating like 2000 calories a day I would still lose weight. no way is that possible (probably because of my screwed up metabolism) so maybe a more accurate question is how do I accurately determine what is my BMR?
  • MoiAussi93
    MoiAussi93 Posts: 1,948 Member
    edited April 2017
    YaYasMom12 wrote: »
    annacole94 wrote: »
    1200 is the "one size fits all" approach for people who want to lose as fast as possible and don't want to put the work in to figure out a more personalized approach.

    Okay that makes sense because if I go to some of the other sites that Ive seen mentioned on these boards, I get much different results. for example scoobysworkshop's calculator has me at eating like 2000 calories a day I would still lose weight. no way is that possible (probably because of my screwed up metabolism) so maybe a more accurate question is how do I accurately determine what is my BMR?

    The only way to accurately determine your BMR (short of going to a lab where they hook you up to equipment to measure how much oxygen you use, which I assume is expensive and certainly is not covered by insurance) is to very accurately track everything you eat and exactly how much exercise you do for several weeks...I would say at least a month to make sure weight isn't impacted by monthly cycle, water weight retention due to higher sodium, or other temporary fluctuations that can "hide" weight loss week to week.

    Then you look at what you SHOULD have lost, based on what mfp or any other site you used told you was your bmr. You compare that to your actual loss and adjust BMR up or down based on the difference (assume 3500 calories per pound).
  • jemhh
    jemhh Posts: 14,261 Member
    Your BMR doesn't matter as far as weight loss goes. What matters is how much you eat and how much you lose.

    How active are you outside of exercise?
  • YaYasMom12
    YaYasMom12 Posts: 6 Member
    jemhh wrote: »
    Your BMR doesn't matter as far as weight loss goes. What matters is how much you eat and how much you lose.

    How active are you outside of exercise?

    Outside of exercise, I'm stuck at my desk M-F - I coach kids swimming on saturdays so a little more active then, but the M-F I'm riding a desk all day every day.
  • ent3rsandman
    ent3rsandman Posts: 170 Member
    YaYasMom12 wrote: »
    So if I weighed 180 and wanted to lose 10lbs, I'd still be told to stick to 1200 calories a day- I guess I'm wondering if that's too low for my current weight, and causing me to have issues losing if my body is in starvation mode - how do you know?

    That's not a thing. You can't make energy out of nothing, otherwise kids starving in third-world countries would be huge. Plenty of people do zero-calorie fasting for weeks at a time and lose weight like crazy, not that I'm advocating it.

    Find your TDEE and put yourself at a 1000 calorie deficit if you're trying to lose 2 lbs a week. Make sure the factors are the same when weighing yourself so that you can get an accurate estimate for how much weight in fat you've lost. For example: I do a full-day fast on Fridays, so I weigh myself on Saturday morning before I've eaten, before I've had anything to drink, and after I've used the restroom. This keeps the water weight fluctuations as low as possible so that I can see how many pounds I've lost in a week in just fat/possibly LBM.
  • jemhh
    jemhh Posts: 14,261 Member
    YaYasMom12 wrote: »
    jemhh wrote: »
    Your BMR doesn't matter as far as weight loss goes. What matters is how much you eat and how much you lose.

    How active are you outside of exercise?

    Outside of exercise, I'm stuck at my desk M-F - I coach kids swimming on saturdays so a little more active then, but the M-F I'm riding a desk all day every day.

    Based on your weight loss, your TDEE does seem low. A big factor in that could be low NEAT expenditure. What do you do when not working or at the gym? Are you running around taking care of household stuff or walking to the store or walking your dog, etc? Or are you vegging on the couch?
  • barn1223
    barn1223 Posts: 2 Member
    I also had gastric bypass surgery (11 years ago). After many series of events and years my weight in January had hit an all-time high at 315. I also went back to my nutritionist as I didn't know how many calories I should be eating, if I still should be following a wls nutrition lifestyle still or not. My nutritionist has me eating about 1050-1100 calories a day. I exercise 4-5 days a week and have lost 58 pounds in the last 90 days. My point in writing this is I would follow what the nutritionist says, they are experienced in working with wls patients and will tweak things accordingly for you along the way. I have been going back to the nutritionist every month, which also helps me personally because I feel like it holds me accountable. The second time I went back, she noticed that I was not getting enough protein. So now I drink a protein shake every day in order to get my protein up to 90 grams a day. Ultimately you have to do what works for you, good luck in your journey!!!
  • Francl27
    Francl27 Posts: 26,371 Member
    barn1223 wrote: »
    I also had gastric bypass surgery (11 years ago). After many series of events and years my weight in January had hit an all-time high at 315. I also went back to my nutritionist as I didn't know how many calories I should be eating, if I still should be following a wls nutrition lifestyle still or not. My nutritionist has me eating about 1050-1100 calories a day. I exercise 4-5 days a week and have lost 58 pounds in the last 90 days. My point in writing this is I would follow what the nutritionist says, they are experienced in working with wls patients and will tweak things accordingly for you along the way. I have been going back to the nutritionist every month, which also helps me personally because I feel like it holds me accountable. The second time I went back, she noticed that I was not getting enough protein. So now I drink a protein shake every day in order to get my protein up to 90 grams a day. Ultimately you have to do what works for you, good luck in your journey!!!

    Ok 58 pounds in 90 days is insane.
  • HeliumIsNoble
    HeliumIsNoble Posts: 1,213 Member
    edited April 2017
    Francl27 wrote: »
    barn1223 wrote: »
    I also had gastric bypass surgery (11 years ago). After many series of events and years my weight in January had hit an all-time high at 315. I also went back to my nutritionist as I didn't know how many calories I should be eating, if I still should be following a wls nutrition lifestyle still or not. My nutritionist has me eating about 1050-1100 calories a day. I exercise 4-5 days a week and have lost 58 pounds in the last 90 days. My point in writing this is I would follow what the nutritionist says, they are experienced in working with wls patients and will tweak things accordingly for you along the way. I have been going back to the nutritionist every month, which also helps me personally because I feel like it holds me accountable. The second time I went back, she noticed that I was not getting enough protein. So now I drink a protein shake every day in order to get my protein up to 90 grams a day. Ultimately you have to do what works for you, good luck in your journey!!!

    Ok 58 pounds in 90 days is insane.
    Live in this thread: starvation mode as popularly misunderstood has been conclusively disproved.

    1050-1100 calories a day + 4-5 days purposeful exercise = humungous weight loss
  • nevadavis1
    nevadavis1 Posts: 331 Member
    TimothyFish wrote: »
    Personally, I'm still on convinced that gastric bypass does anything other than give the patient an incentive to follow a very low calorie diet. It would be interesting to see what would happen if they told patients they had done surgery but they didn't actually do the gastric bypass.

    But don't gatric bypass patients have issues with malabsorption and dumping syndrome, indications that they aren't digesting everything they eat after surgery? I mean, they bypass part of the small intestine, where most digestion happens... Right?

  • fbchick51
    fbchick51 Posts: 240 Member
    TimothyFish wrote: »
    Yes, it is insane, but very low calorie diets are used with gastric bypass patients to reduce the risk of complications associated with the surgery.

    No, it's not to reduce the risk of complications, rather it's an actual requirement by design. The smaller stomach pouch is designed to only allow the person to eat a very tiny amount (2 ounce protien shake or 2 grapes for example). This is why the surgery is so successful at weightloss. If the patient eats more then the stomach will hold, they generally feel sick to the stomach and often throw up the excess.
    TimothyFish wrote: »
    My understanding is that the meal plans are very specific to make sure the patient is getting the required nutrients.

    Partially true. The meal plans are also specific to help reduce the risk of complications as well. Usually the first few weeks are completely liquid based (usually a vitamin solution, protein liquid and broth) to allow the new digestive track to heal without causing undue stress/stretching. The next few months begins a reintroduction to solids, but with tight restrictions on what can be eaten early on due to heighten sensitivity to sugars and acidics. After that, it simple becomes a process of slowly increasing they caloric intake back to a healthy level.
    TimothyFish wrote: »
    Personally, I'm still on convinced that gastric bypass does anything other than give the patient an incentive to follow a very low calorie diet. It would be interesting to see what would happen if they told patients they had done surgery but they didn't actually do the gastric bypass.

    From what I've seen from friends and family that went through the process, it's far more then an incentive. For at least the first 6 months or so, when ever they would try and over eat, the result was them throwing up in the bathroom and horrible stomach cramps that could last up to an hour or more. It basically created a Pavlov style conditioning situation that forced them to severely moderate their intake. Though it isn't permanent. Which is why it is still possible to slowly restretch the new stomach pouch and begin gaining weight again. Close to 50% of Gastric bypass patients do regain some weight within 5 years. 15% will regain a significant amount because they still manage to fall back to old habits that got them fat in the first place.

    nevadavis1 wrote: »
    But don't gatric bypass patients have issues with malabsorption and dumping syndrome, indications that they aren't digesting everything they eat after surgery? I mean, they bypass part of the small intestine, where most digestion happens... Right?

    No. The purpose of the gastric bypass is to create a smaller stomach pouch (about the size of a walnut). But depending on which procedure is used, the process of reattaching the small intestines to the new pouch can drastically shorten the length of the small intestines which causes the malabsorption and dumping syndrome. Though, for most patients... this too corrects itself over time.
  • cbelc2
    cbelc2 Posts: 762 Member
    Do you exercise outside the gym? If you go to the gym 3 hours a week and sit for 165 hours a week, re-evaluate. You've done well to lose that 20 lbs. congrats!
  • VintageFeline
    VintageFeline Posts: 6,771 Member
    It's also worth noting that MFP uses a different method to other calculators like Scoobys. MFP uses NEAT so the 1200 would be BEFORE purposeful exercise which would be logged separately and at least eating some of those calories back. It also assumes you pick the correct activity level when setting it up for your baseline calories before exercise.

    Scoobys is a number including exercise and daily activity and thus wouldn't change day to day.

    There is also the issue of logging accuracy. You can get all the numbers you want and tweak as necessary, the most accurate approach is to log meticulously and accurately. Depends how you want to approach it and accuracy becomes more important the closer to goal you are.
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