Weight Loss Surgery - What is the "lifeplan" after surgery?

05-10-2003, 09:53 PM
I have friends and one sister who have had the surgery. I am interested in having a "virtual WLS" and adopting the diet and exercise that I would use if I had the surgery.

I know that I can get involved in work and forget to eat for 3 days, and as long as I have coffee I'm fine. but on that 4th day, I am ready to eat, and I'll be looking for fruit and veggies. I would do lovely on this if I was absolutely certain what the docs prescribe as a good eating plan for someone post-surgery.

I find people won't tell me what they should eat, maybe because they don't want to have to answer for the realities of what they DO eat. lol.

I know the stomach capacity is reduced to something like 2 oz per sitting. I can do that, I'm sure, but I need details :)

How many "meals" are suggested during the day?
What supplements are needed to work with a diet so quantiy restricted?

I slipped into the mens forum to see if there was anything from males with sig. others struggling with weight issues, but what I found was a thread where a fellow was considering this same virtual surgery idea. I'll keep up with that thread as well.

Also, feel free to let me know if this should be taken to a different section, so this area is reserved for those who have truly undergone the medical process, I don't want to step in and muddy your waters here. :)

I'd also like to ask if there are any appropriate areas to discuss weight issues and sexuality. I didn't find anything. I'll start one if needed, but it would be good for me to lurk a bit more beofre hoping in with new ground.

266 lbs, and only 120 to go! gawd.

05-10-2003, 11:48 PM
well, hi there dian... interesting questions. and i'm not sure the eating plan will actually work for you, but it's worth a try. i've seen the person on the men's forum who's doing this lifestyle change, and it's working for him. the only thing is that we'll have to wait and see if he gets the weight off and keeps it off.

the re-wiring we've had with the bypass impairs calorie and nutrient absorption.

now, the next step is the 'what to eat' and one of the big problems is that docs don't all give the same advice. some docs recommend high protein. others want patients on carnation instant breakfast and say they can eat mashed potatoes.

all i know for sure is that the docs whose patients have good to excellent long term outcomes recommend something along the lines of this: for the first week after surgery, clear liquids and protein shakes [two 20-gram shakes a day]. the next week starts a soft diet, but you have to get 80-100 grams of protein in a day. that means that you're doing 2 shakes and several tiny meals.

and you have to eat by the clock, not by hunger, because you're not hungry.

for the next 6 months, 80-100 grams of protein, gradually adding items. it's experimental. some days one thing works and the next day it doesn't. vegs are worked in after the first month, and start off being soft cooked and peeled.

fruit can be added after about 3 months, but should not form a major part of the diet,. not more than 1 piece per day. peeled.

tiny [and we do mean tiny!!!!! like a teaspoon or so] amounts of potato, rice, pasta can be added after the first month.. not more than a teaspoon at a time.

no juice, no crunchy snacks. we are not supposed to drink our calories, no sugar. as little fat as possible.

the first month's calories run about 500-600 a day. after that, we gradually work up to about 1000 within about a year. maybe a little more.

how does all this work out during a day? bottom line: do what you have to do to get your 80 grams a day in. if that means that you eat several snacks during the day, then that's what happens. if you can do it with three meals and a snack, go for it. but remember, a rule of thumb is that there's7 grams of protein per oz of meat or fish [not exact, but close enough] so if you eat 3 oz of meat or fish at each meal, you're at about 63 grams. you still need a protein snack or two. after more than a year, i can tell you that i can only rarely eat 3 oz of meat or fish at a meal. others have been doing it for awhile.

as for the fruit and veg, they get worked in as there's room.
and we must drink at least 64 oz water a day. and that really is a bare minimum.

exercise, yes, has to happen. aerobic and weight training. as tolerated., remember, many of us have been wheelchair bound and completely debilitated.

sex. yes. it happens. reports are that it's a little painful for the first couple of weeks, until everything heals. but reports are also that it gets better. those people who have said that sex isn't as good or better tend to have ISSUES in their relationships that were buried with food.

supplements. a good multivitamin. i use centrum rugrats chewables,. they taste better than the adult centrum chewables. and 100% of the RDA in calcium. and we get our B complex vitamins tested regularly, along with iron. i take extra B12 because my levels dropped really fast.

now. about your not eating for three days. hmmm. not good. your body goes into starvation mode and holds onto every ounce of fat you have. you really and truly need to eat regularly. and if you adopt the wls woe, you MUST eat about every 3-4 hours.

let us know what happens.

05-11-2003, 08:45 PM
now. about your not eating for three days. hmmm. not good. your body goes into starvation mode

Oh, I know! my point wasn't that that was a preferred mode :) I just get so into work I forget to eat and sleep. That's how I have added the lbs I'm sure. My body is always preparing for my next accidental famine.

Thanks so much for your valuable info. I understand there are physical changes that I won't experience and I expect that will affect my program for sure. I just figure I qualify to have this surgery done, but if I can possibly do it without, I owe it to myself to try.

I expect I'll be trying to keep calories to 600 daily, and force myself to remember to eat small + frequently.

I have had a good measure of success on a low fat diet years ago, and overall it's kept me from getting bigger, but I think my body is so used to that by now that I needed to change something to triger loss again. So I was convinced to give Atkins a shot. Oh, how horrible. I'm not a yo-yo dieter, in that I never really "diet"..so this was first experience with a list of "evil foods". I'll never do that again. I got fixated on things I couldn't have, which was funny because I usually don't think about what to eat when.

Welp...here's my plan: tonight in my sleep I'll have my virtual surgery and speed-heal and skip the fluids only stage. <grin>

Then I'll start tomorrow with a One a Day vitamin. I'll be doing 6 "meals" which will be in these little 3 oz. finger bowls I call happy bowls. I'll fill the fruit and veggie bowls in the morning so I'll have my stuff on hand and won't forget to eat it. I'll also 'fridge my 64 Oz of water.

1 serving of Total corn cereal split into 2 bowls morning/night
2 bowls of veggies
1 bowl of fruit
1 bowl of other entre type foods mix-- meat, fish or potatoes/ rice, cottage cheese? whatever "plate" I make at families dinner time. (this last bowl will also be where those odd treats will go, If they can fit after I've met dietary needs.)

I'll check into some Carnation Instant Breakfast, and look for some good protien sources as well.

I'll report back on how it works or if I change that basic outline. If nothing else, it'll be a good experiment. Wish me luck!

(Next week-- How to lap beer out of a bowl)

05-11-2003, 09:50 PM

and dian... on a 600 calorie diet, with a body that's used to not eating.. do you REALLY think this is a good idea? and the diet you're proposing minimizes the ESSENTIAL protein needs brought on by this kind of diet. i cannot urge you strongly enough: talk to your doc. if you are THIS desperate, perhaps one of the commercial fasts might be a decent idea. with your doc looking over your shoulder.

instead of making protein an afterthought, you might want to consider getting a good quality protein drink. something like designer whey or isopure or gnc's pro performance whey or even atkins. good quality protein, low cal, low carb.

05-12-2003, 12:42 AM
Didn't mean to alarm you, sorry. I wasn't very clear about what I meant by looking for some good protein sources.

I was thinking about liquid proteins, along the lines of those fasting diets used in the late 70's. I know those are not a good complete diet, so I would be using the fruit, veggies and total cereal to keep my body working and digestion processes healthy. I'm not one for those herbal remedies or strange new "diet compounds" and fad stuff. In fact, the Atkins thing was something I tried only for one week, after making sure there had been no adverse blood presure reactions for people using it short term. (Although the high fat went completely against my grain!)

I figured it would be easiest to get my protien with some form of supplement, because I can't see any other way to sustain a 600 calorie diet while getting your protein through meats and other sources, plus be able to take in the fruit and veggies that I believe we were intended to eat.

I checked into carnation instant breakfast at their website, and it only has 5 grams of protein per serving plus 8 grams in the milk, but at a total calorie cost of 210 including the milk. Not a very good source if you're trying to get 80+ grams a day. (you said some doctors reccomend that, so I had to look into why they might. I don't think my doctor would. And if she did, I'd be looking for another doctor. ;) But you're right, it doesn't make sense as a food source!

As for the commercial fasts, I really think that is a more extreme choice than actually having the surgery. I need a way to drastically cut calories while keeping my body working at processing food normally. Small portions won't kill me, they don't kill post-operative patients if supplemented properly. The corn Total cereal does provide a clean source of 100% RDA for everything except Vits A,D , magnesium and phosphorus, but those can be picked up in the daily vitamin.

I'll be keeping up with my doctor, especially if I note changes in my blood pressure or swelling. I sort of have to: I have sleep apnea, high blood pressure, congestive heart failure, and diabetes runs heavily in my family. The idea is to back away from these health problems, not exacerbate them. :)

I would consider seeing the doctor here that performs most of these surgeries in my area, see if he'd oversee my nutrition plan like a follow-up patient, but I know he'll just tell me to have the surgery. I'm not planning to do that. I'll have to do it the other way.

05-12-2003, 01:28 PM
whew!!!! you have indeed set my mind more at rest about this plan. but i'm still concerned that you're planning to do this kind of by the seat of your pants.

there are a few dieticians who specialize in post-op diets. the center where i go for my support groups has a terrific one who is also a certified diabetes educator. maybe there's one in your area? or affiliated with the local bariatric surgery program? i know vanderbilt has a program...

these dieticians might be able to help you with this.

i understand your concern with the weight issues and family history, but please take every possible care to make sure you don't damage yourself in other ways..

05-12-2003, 06:10 PM
Being on such a low calorie diet for any length of time is risky unless you are under the direct care of a physician and your food choices are not that good...mainly carbs. You should see a nutritionist and get a healthy plan. At 600 calories you are going to be in trouble fast.