After the RNY: When did your patterns normalize?

PAV8888 wrote: »

msalicia07 wrote: »

I'm sorry, I'm confused. Will you clarify what you mean when you say you couldn't lose weight on less calories, but when you increased them you lost weight? How does this physiology work? Genuinely interested. Thanks in advance.

Your weight loss or gain is based on your caloric balance.

There are two sides to a balance.

We often concentrate on the calories in side.

Nothing stops someone from increasing both calories in and increasing calories out by more than the increase to their calories in.

Not to mention that a follow up post also disclosed that in aiming for really low calories in, the result was not always the right amount of calories in on average. A very common issue often referred to as a restrict-binge cycle

Quasita wrote: »

msalicia07 wrote: »

Okay, so she was saying she was practicing CICO by increasing her exercise. That's what I wanted clarification on. Thank you.

Yes and no. I mean, technically it was still CICO, but there are a lot of nuances behind it.

I was technically in a severe caloric deficit to start with. I averaged at 900 calories a day with "binge" days getting to about 1500-1800 calories. At high weight, I was 535lbs. The math didn't compute from a pure CICO approach, so we did some testing. In discovery, we had found that my extended complex anorexia/bulimia had altered my thermogenic burn to such a degree that if I did not eat, I did not burn anything except was was absolutely necessary. My adapted basal metabolic rate was significantly lower than other people my height and size.

When I increased my calories to be closer to my "maintenance" as determined by average scales, which at the time was over 3k, things changed significantly. I made a cognitive promise to my doctor that I wouldn't drop my calories in under 1800 calories in order to accommodate bare minimum nutritional needs.
I slowly increased this amount to 2300, then to 2800, and that's when significant changes started to occur, primarily in the fact that I felt hungry for the first time in years, and voraciously so. We're talking, painfully hungry, wake up in the middle of the night, have to eat every hour kind of hungry. This continued as I increased my exercise, and in order to keep up with the significant amount of training I was doing at the time, I couldn't eat less than a typical 4k day, with many going up to 6k when I did aquatics. This being because while my base metabolic rate was much lower, my average burn per minute was significantly higher than average, due to having a much above average muscle tissue % and pure lethargy and pain preventing me from exercising prior to that.

My caloric deficit didn't actually change that much in the sense that the number attached to the deficit was the same. The difference was that my lower number, the calories in, was at a level that was high enough to not trigger survival responses. Before this gets jumped on, please again note above, this was medically documented... Prior to blood work and hormone therapy to correct it, I had been refused care for my pervasive complex EDNOS because everyone likes to say "there are no fat anorexics" and turn you away.

ANYWAY. I lost over 100lbs working on that and tracking every number very specifically, but then I hit a wall that I could not get past, not with medical help or professional assistance. We eventually agreed to do the RNY because it removes a portion of your digestive tract and literally alters your ability to absorb certain parts of your food, most importantly the fats, which then, in theory, forces your body to remove its needed fats from your stores. I originally wanted a sleeve but was deemed a poor candidate since I was prone to restrictive problems, and I had to have a certification of 3+ years clear of any anorexia/bulimia relapses before I could be considered a candidate. Very few people with my history, no matter their weight, are allowed to do this, because most cannot go that long without relapse but I have worked extremely hard to battle my demons and make progress.

To date, I'm a little over 250lbs down and it's been extremely rewarding yet one of the most medically dangerous things I've ever done. It cost me my ability to have my own children, nearly cost me my life even, and there are people here on MFP who have heard the story, read my posts and respect where I come from with it... So I guess sometimes I forget what it's like to come into the public without much other direction. MFP has been an incredibly vital part of being this person I am now... from helping me track my changes to giving me friends who sent me flowers during my many hospital stays since I targeted 210 as my find number all those years ago.

I know this is a long response, but I felt it was important to explain that CICO works, but where you set those numbers is important from a medical perspective. I would never, ever give the advice I see some give those very large people, which is "you can handle a much larger deficit than most, you have more weight to lose." It is always, always better to figure out what those numbers should look like, and not fall to the temptation that is chronic under nourishment. I promise you, it's not a fun recovery.

Not to mention that clinically speaking, those who have recovered from anorexia tend to have to eat MORE to maintain after achieving a healthy weight because their metabolism has been permanently hyped up. There's no study about people like me to say what the experience did to permanently change things chemically... but I don't doubt that it did. My surgeon believed it did too, which is why RNY was done, so we could reverse if necessary and allow me to eat 2400 calories a day if I have to. I'm just trying to do it in a smarter way before we start having conversations like that.

Sooooo there's the long answer to your short question. Sorry to ramble, but maybe this will help people understand. If they bother with it anyway. My goal is information, not instructions. It always worked best for me when I figured out what special combination was the best fit for me as an individual.

Good luck! Let me know if I can help.