Weight Loss Surgery - Straying From Post-Op Guide

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05-20-2013, 10:21 PM
I am curious to know if there are other's out there that strayed from your post-op guidelines and what kind of success you had.

Personally, I am 10 weeks post VSG, and have lost a total of 75 lbs since pre-op. I lost rapidly over 3 months, and am happy about that, but as someone with an educational background in both nutrition and human physiology, I really felt like I was doing my body no favours by following a VLCD (very low calorie diet) that was high in protein and low in everything else.

By week 8, I switched my focus from rapid weight loss to eating a balanced, nutritious diet and my weight loss hasn't slowed. I have WAY more energy, enough to workout 6 days a week, including cardio and strength training. And best of all, my blood sugars are finally stable after struggling with near constant hypoglycemia for months.

05-21-2013, 10:12 AM
This is something that's best discussed with your surgeon, your primary care, and perhaps the dietician/nutritionist [although they vary widely in ability]. Because of the VLCD, you MUST take your vitamins - and while we can get into the weeds discussing formulations, absorption, combinations, timing, dosing and all those other details, bottom line, TAKE YOUR VITAMINS. You don't have the malabsorption issues, so you will get the nutrition from whatever you eat. But you have to avoid grazing, and that's the risk with being able to eat only limited amounts of food and trying to get in more calories.

As for the rapid weight loss, again, discuss it with your surgeon and primary. i lost 100 pounds in the 3 months before my RNY, and after surgery, i lost 1.5 pounds PER DAY for 6 weeks, and then 1 pound per day for the next month or so. So that's about 200 pounds in roughly 6 months. [long story]. that was in 2001-2002. I'm still around and everything's OK. And i DID NOT deviate from the post-op guide. There was literally too much at stake for me [life and death - truly] that I couldn't do that.

Please be honest with your surgeon and your primary - not only will they respect your views and obvious intelligence, but they'll also be better able to advise you and monitor you.

05-21-2013, 10:44 AM
That's the problem with having your surgery done in another country...you can't just discuss things with your surgeon. Lol.

My primary care physician, however, agreed completely with my nutritionist and personal trainer that I needed more calories, and definitely more carbs. My blood sugars were so low so often, my primary did tests just to make sure I didn't have a pancreatic tumour or anything else causing the hypoglycemia. She has had several patients that have had WLS, and she has never seen such a 360 when it comes to blood sugars.

Now that I am eating more (though still not enough) and getting in more complex carbs, my sugars are pretty darn stable, so I am very happy with that.

My issue with bariatric surgeons and professionals is that they don't explain to their patients (generally) that VLCDs are meant to be used in the short-term, and that there are risks for following them long-term. To me, it suggests that they care less about the patient's overall health and more about results.

05-21-2013, 12:20 PM
Yeah, Vivid - that IS an issue - and something that everyone should consider when going out of the country - there are good reasons for taking that route, and some downsides that might go along with it.

If your primary agrees with this strategy, then go for it! seems to me - as someone who doesn't know you AT ALL [but I'm glad you're here!], that making sure your blood sugar is stable seems to be a good strategy, no matter how many calories you're eating.

The key to ANY WLS is to not overfill the surgery - whether it's a lapband, RNY, VSG, DS, whatever. eat until you're satisfied, and then STOP, no matter how many calories that ends up being. Maybe you could eat a few higher-calorie items!

obviously, this is something that you're going to have to fiddle with [and we ALL have to fiddle with it - way back in my early postop days, if i didn't consume 15 grams of protein every 3 hours, i'd get dizzy] to get the balance of nutrients, weight loss, blood sugar stability, and whatever else, that suits you the best.

And i hear you loud and clear about weight loss being the only goal. I've lost about 50 pounds [maybe more] over the past year or so [having had an 80-ish pound regain]. And one of the ways that it happened, besides not being very hungry, was that i had a lot of trouble with food getting stuck, so it would come back up. When i talked to the docs about this [because I KNOW throwing up several times a day, day in and day out IS NOT GOOD], their universal reaction is ALWAYS: but you're losing weight, right?

and when i tell them that the way this is happening isn't good or healthy, they literally shrug. Frankly, as long as my lab values are OK, i'm not going to worry... but the risk of dehydration is very real, and something i HAVE TO keep an eye on, especially since summer heat is here.

I'm really glad you've been thinking this through and making choices that work for you - some people deviate from 'the plan' because they want a donut or to eat like they didn't have surgery. One woman posted on here [a few years ago] that she was having a revision from her RNY because she kept burping up whole french fries after she'd eaten at Wendy's!!! DUH!!!!

05-21-2013, 07:21 PM
Personally, I am 10 weeks post VSG, and have lost a total of 75 lbs since pre-op. I lost rapidly over 3 months, and am happy about that, but as someone with an educational background in both nutrition and human physiology, I really felt like I was doing my body no favours by following a VLCD (very low calorie diet) that was high in protein and low in everything else.

I don't think most post-WLS diets are supposed to be VLCD for long. At first, one needs to give the stomach time to heal, so foods are limited. Then, the reduced capacity prevents most from eating a lot, so the diet is low calorie. But, in the long-term, I've never heard of a reputable nutritionist that recommends VLCD. If you were to follow me around for the day, for example, you would not know I had WLS. My portions are not huge, but they do not scream abnormal either. I don't count calories, but if I were to guess, I'd say I eat 1500 calories a day. And the postop people that I know are the same. Heck, if you follow any of the well-known bariatric patients in the blogworld, one would also see that they eat healthy, average-sized meals as well.

So, I guess I don't agree with your assertion that bariatric professionals are not honest or are promoting VLCDs. That hasn't been my experience, nor have I found that the case in the WLS online world as well.

05-21-2013, 10:35 PM
good point, jen. i remember the surgeon told me that most people end up on somewhere between 1600 and 2000 calories per day, depending on their activity levels and body makeup and so on. i have no idea how many calories i eat. i focus on getting in protein, veggies, a little fruit, and good quality grains [in that order]. and i don't always succeed, but i'm still plugging away!

oh. and one dietician said that meals should be around 350 calories [times 3 = 1050 calories] and snacks should not exceed 200 or so [times 2 = 400-450 or so], so that comes in at 1400 and maybe a little more. but she said so many bizarre things that i coudln't trust anything that she said [like RNY patients should be eating 150 grams of carbs a day after the first month]