covevendor wrote: »
The weight loss procedure was done years ago and the removal of likely an adjustable gastric band is a very minor procedure and would not need increased protein to allow for healing from the surgery as some people have stated. I agree that half of 1350 kcal per day would be way too little, but our experience is that most people are very bad about estimating calories without help or very carefully logging things. It is not uncommon in the first week or two to be consume little and this calorie estimate may be right. Agree with the comments above regarding "starvation mode"...what you are referring to are changes in the non-exercise activity thermogenesis (NEAT) which is not likely to be a factor here (a long technical side discussion if people are interested).
1. Continue to follow a diet. The one you mention sounds reasonable. Multiple studies have shown that following a diet is useful especially in the long term. It does not seem to matter so much which diet you do since trials comparing different diets have usually found weight loss to be similar but better than people who were just counseled regarding weight loss but not given a specific plan.
2. It is important to set realistic goals and think of this as a long term process. I find it really frustrating that I can only lose 1.5 to 2 pounds per week but I have to remind myself that the weight came on slowly and your body will only allow you to remove it safely at limited rate. Trying to push weight loss beyond about 2 pounds per week is just not sustainable in my experience, and we worry about the long-term health effects.
3. Consider cutting out highly processed foods (sodas [including diet], fast food, chips, etc). This was a study out of Stanford University last year where people did that and either followed a low carb or low fat diet, and they achieved good weight loss without counting calories (I think it was on the order of 12 pounds over the study).
4. I personally think it is best to weigh yourself frequently - every day or at least once per week and put the result in one of may programs online that will show you a trend line (or you can do it in Excel). There is considerable daily variation in weight based on fluid retention alone and this is especially true in your case where you have some leg swelling. This can result in several pounds of weight swing up or down and can be very discouraging if you are retaining more fluid than usual or lead to unrealistic expectations of weight loss achieved if you are on the lower end. I find it useful to keep a careful track of calories consumed and activity (easy with a Fitbit or Apple Watch). Taking this along with my basal metabolic rate (estimated through a number online calculators) I graph out in Excel what my weight actually is predicted to be. What I have noticed is and my weight will swing up and down around the true weight. This difference can be several pounds. It is quite common for people to it have a very dramatic weight loss in the first week or 2 and unfortunately this is primarily due to changes in fluid retention (due to a number factors including the decrease in glycogen in muscle which is only temporary). However, real weight loss is occurring so hang in there.
5. Keep a log of what you eat. I find keeping a log of what I eat easy to do with phone apps or online programs, and I think it is helpful. For me it helps me make better food choices.
6. Medically supervised weight loss is not all the same. In this case it sounds like your physician has given you a diet, but he or a dietician is not meeting with you frequently, tracking your progress carefully, and adjusting your diet as can be done. I think this later approach is more effective, but insurance does not pay for this usually and few people can afford it out of pocket.
7. The procedure I suspect you had is years ago was a laparoscopic adjustable band or less likely a vertical banded gastroplasty or other similar procedure. These just reduce the stomach size, and weight loss has been very disappointing from such procedures especially long term. There are multiple reasons for this, but the biggest is that they do not impact the hormones that signal hunger and feeling full. If your obesity is bad enough (class II or III) then a Roux-en-Y gastric bypass (the most common procedure) may be something to think about especially if you have health problems related to obesity. This surgery makes a smaller stomach that is connected to the esophagus (swallowing tube) and intestines. It also rearranges the intestines so you can absorb less of the calories from the food you eat. The gastric pouch can stretch out over time (as it likely did with your gastric band), but with a Roux-en-Y the intestinal bypass is still there (the "malabsorptive component") that will help lose weight.
8. There are a number of medications that can assist in weight loss such as Contrave or topiramate. Talk with your doctor about these if you have not lost weight after a couple more months. They are not miracle drugs, but they will help cut your appetite.
9. Your edema is a bit concerning. I'm assuming that you have been checked for obstructive sleep apnea or are already on treatment with CPAP.
covevendor wrote: »
I really doubt from her description that she has hypoalbuminemia. In addition, I have not noticed waxing and waning edema to be commonly due to low protein since it more typically causes persistent swelling. This is a minor laparoscopic procedure to remove it and it would be uncommon to be bed ridden from complications from the removal.
covevendor wrote: »
Well thanks for all the disagrees folks. Not sure on what aspect. Very motivating to spend time trying to help people and get the negative feedback (0 likes and 7 disagrees), but whatever. With my schedule think this will the last post I do since I really don't have time for all the flames and was just trying to help.
A few comments on your reply:
1. Not sure what your topiramate dose is. Find for some that increasing it further to twice per day or 2 in the morning and 1 in the evening helps.
2. Phentermine should be cycled on and off. Typically 3 months on and 3 months off since it loses effectiveness after a couple of months.
3. The diet choices you made after your lap band are unfortunately quite common with that procedure. Due to the narrowing of the stomach from the band is common for people to make those choices since they are the only things that stay down. This (and the lack of weight loss) are why the band has fallen out of favor. With the gastric balloons that are used now we find that pretty intense counseling before and after the procedure is very important to help people find a diet they can tolerate.
4. I would consider switching to an alternative sandwich to the Whopper or at least getting it without cheese, mayo, and ketchup.
Rowdib wrote: »
Wow, didn’t realize I’d cause such a commotion. I kind of resent being told I’m not keeping an accurate food log, because I am. I do all the cooking in my house and I log the recipes in this app so my nutrition is accurate. And I have not eaten fast food, ice cream, chips, dip, or nachos since my lapband came out. Thank you to the respondent who also had their band out and wanted broccoli first thing! I wanted grilled chicken. When I got my band I was 221 lbs and when I got it out I was 271 lbs. When I had my one month post op check up, I had not lost nor gained weight since removal. My doctor was very encouraged. This was before I was put on medication or my special diet. I was just generally eating healthier and keeping my portions small. He said most patients a month after removal have gained ten to fifteen pounds already. I felt pretty good about that. So now I just want to lose the weight and get on with my life again.
snowflake954 wrote: »
I'm sure your nutrition is fine and dandy. The question was "are you using a digital food scale?"
Rowdib wrote: »
Wow. I’m an educated woman, and in my way of thinking, if I’m cooking my own food at home, at least I know what is going into it and how it is cooked. And so from what I’m gathering here, if I open a can of black beans to use in a recipe, the nutritional information in the side of the can is not to be trusted?? That just doesn’t seem right to me. And if you can’t trust the nutritional information on the packages, then where do you get it? The nutrition fairy?? If I go to a restaurant I have no reassurance of exactly what is in my food, how much exactly is there, or how it was cooked. Or am I supposed to trust their handy nutritional guides? Come on. And btw, by not eating nachos, I know damn well I haven’t consumed a days worth of empty calories in one setting. And that my friend, is all the accuracy I need when it comes to nachos. I think these boards could use a little more positivity and a little less criticism. I know I asked for advice, but good grief, I never thought people would be this negative. It’s hard enough to do what we’re doing, a little encouragement goes a long way.
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