4 month long stall - frustrated. Could use advice, encouragement, etc.

Hello everyone. I am a long-time reader, but have only posted a couple times. This may be a little long, but I could use some advice and maybe some encouragement, so I appreciate anyone who takes the time to read it all.

I had my RNY on May 15, 2012, so I am 13 months out. Three months after my surgery I moved to a new city to start a PhD. Due to the insurance changes, I no longer have access to a nutritionist and can't afford to pay out of pocket with my measly stipend. Things progressed pretty normally the first nine months: pretty rapid weight lost in months 1-6 then a slowing down. However, in month 9 my weight loss essentially stopped. I lost 107 pounds, but am still thirty pounds shy of my goal (125-130 range since I am 5'2). Since February I have been bouncing between 150-155. I'm about to turn 31, if that matters.

Until last week, I exercised 6 days a week. I was just diagnosed with a torn meniscus in my knee so I have to wait to see what my workout schedule can be like once I meet with my physical therapist this week. But up until now, I would run for 40 minutes and then do an hour of weights four days a week, and then I would swim for an hour twice a week (usually 90 laps). The only day I took off was Sunday. However, none of this has been enough to break my stall and I am starting to get very frustrated.

I typically eat between 800-1000 calories a day. I try to get between 80-100 grams of protein, and stay under 50 grams of carbs per day. I eat a Chobani yogurt for breakfast every morning (0% Apple Cinnamon) and then alternate with my protein meals for lunch and dinner. Typically each lunch and dinner meal has 200 calories and 30 grams of protein (less than 20 grams of carbs). I don't eat bread, rice, or potatoes. I do eat a lot of peppers, zucchini, and onions which I know tend to be higher carb. I don't snack (I was never much of a snacker, just an overeater). I drin****asionally, but not too frequently. I feel hungry pretty often, but I never eat more than my pre-determined portion. One of the great things I have discovered with the RNY is that being hungry doesn't mean I will die or have other dire consequences. I know that it's ok to be hungry.

Anyways, I am finding it harder and harder not to fall back into old eating habits given my frustration with this stall. I can tolerate pretty much any food (I don't dump), although if I eat too many carbs/sugar I will feel really dizzy and sick about an hour later so I try to avoid those as much as possible. I just feel like I am doing everything right, but nothing is working. I'm so frustrated and feel very lost and discouraged. I am worried I will never reach my goal and could use some encouragement. If anyone has any suggestions, I would be very appreciative.  Thank you for taking the time to read all this. I'm just in a bit of a funk right now.

You're are not getting enough calories, especially when you were working out almost every day.

If you're going to eat 800 calories a day, you need to be closely supervised by a doctor and a dietician.  It can be dangerous to get so few calories for very long.

Thank you, Kelly! Without access to a nutritionist I feel a little lost. My primary care physician tells me to keep going with what I am doing, but my surgeon's office told me I need more calories. It makes me very confused. But I must admit that I am terrified to increase my calories since I am not at goal weight. I am just so desperate to hit a "normal" BMI. It is probably not something I should be shooting for, but I can't seem to help but strive for it.

Since your surgeon is supposed to be an expert in weight loss and your PCP is not, I'd follow the surgeon's advice and increase your calories.

Ditto!

Lora

As Kelly said, 800-1000 calories per day is not enough for someone who is over a year out and exercising regularly.  You need that much without all that exercise!  I had a nine week stall in my 9th month and the weight loss was MUCH slower when it broke, and then it slowed down yet again after a year out when I, too, still had 30-40 pounds to lose, so I understand the frustration.  

If you are burning, say, 300 calories a day exercising, you are leaving only 500-700 calories a day for your body to use as fuel just to keep you breathing, your heart beating, your digestive system functioning, etc. Your body needs about 10 calories per pound each day for basic functioning and normal activity without losing any weight, and it is recommended that you only have a 500 calorie per day deficit to keep your body from dropping your metabolism.  If you are at 150 pounds, that means you will burn roughly 1500 calories per day without exercise (individual metabolism variations not taken into consideration, of course).  If you are only eating 1000, you are already at that point, but if you are burning an extra 300 calories (a pure guess on my part since I have no idea how many actual calories you are burning), you are "short" about 300 calories.  Your body has likely lowered your metabolism because it is not getting enough and is trying to make the most of the calories it IS getting.  At this point, exercising more is not going to help (and may, in fact, make things worse). Try increasing your caloric intake by 200 calories or so. I know that sounds counterintuitive for people who have been so focused on "eat less" to lose weight their entire lives, but your body's number one directive is to stay alive and it has a lot of metabolic mechanisms to help it weather times of limited food availability.

Lora

Thank you, Lora! I think you and Kelly are right that I need to increase my calories. It just seems so counterintuitive. I am in such fear of going over my daily caloric intake, but I have actually managed to lose a pound this week since I have been unable to work out due to my knee. Any suggestions for how to increase my calories in a healthy way?

My personal approach would be to increase your calories by making your diet a bit more well-balanced than it probably has been for the past year (with a healthier amount of carbs and fat), and something you can maintain long-term. 

I would add a little bit of fruit if you have been eating a limited amount of it (with only 50 carbs per day, I am guessing that is the case). If you have been really limiting your fat intake, I would suggest adding a little bit  of extra fat... perhaps a serving of cheese or half a serving of nuts (which have both protein and some extra calories due to the fat content; with the nuts is a healthy fat).  Alternatively, if you have been "settling" for a fat free or reduced fat version of something that would taste better in a higher fat version (cheese, yogurt, PB), you could simply substitute the higher fat version.  

Since you indicated that you are sometimes still hungry after eating your measured portion, though, I would suggest that most of the calorie increase just come from increasing your portion sizes.  At a year out, your pouch is larger than it has been (by design and necessity so you don't starve to death after all the fat is gone!) so your portion sizes can (and should) also be larger.

Lora

Thank you, Lora. These are all great suggestions. I think adding some peanut butter, nuts, and cheese will be easy to do. Hopefully that will help break this stall. I've actually never eaten to fullness, so I don't know how much I can hold, but I've wondered if I should be increasing my portions given that I am usually still hungry shortly after I eat.

Our stories are very similar right now! I am in the middle of a pretty long stall and I've been bouncing between 150-156 since the middle of April. I had my surgery May 10, 2012 and I've got about 15-20 to go to goal (I'm 5'3" and I would love to be below 140, but I will take below 150 at this point)! I exercise 5-6 days a week, too, for 2-3 hours a day at a pretty good intensity. I eat between 1500-2000 calories a day, though. So I'm not sure if this is a stall, which I hope it is and the scale moves again, or if I'm eating the amount of calories and doing the amount of exercise that balances itself out and I can maintain here. It is insanely frustrating, I agree, because I will up my exercise intensity and the scale does.not.move. Or it goes UP! 

And...then I read the stories of the folks who don't exercise at all or do very little and they are losing at a steady clip or maintaining with little effort. So I'm wondering if I should cut back on exercise and calories and see what happens. My dietician says that I need to be thinking about my nutrition like an athlete and that my carbs and protein will be about the same and that if we are going to exercise a lot, that carbs are necessary for energy and performance. Not to go crazy adding extra carbs, but make sure that we are getting whole grains, nuts and seeds, beans, etc. in our diets and to plan meals so that we have enough energy for exercising and recovery. She said that 1800-2000 calories a day would be a good zone for long runs and days over 2 hours of exercise. But...I'm doing that and NOT losing! 

So here is what I'm going to do and this might be helpful for you, too: I'm getting my RMR tested (resting metabolic rate) to find out how many calories my body burns doing normal daily functions so I can know my baseline calories for functioning and maintenance. Then it is easier to know how much to eat for heavy exercise days and recovery days. 

I'm hungry all the time, too, and I have to tell myself that it isn't the end of the world. I struggle with eating too much at each meal and I'm constantly working on that (I will take those extra bites when I shouldn't even when I can feel I'm full). 

I'm also eliminating protein shakes and bars (after I eat the stuff I've got) because I can eat enough protein now in regular food and my shakes and bars are adding an extra 400 cals a day that I don't need. My shake doesn't keep me full enough anymore.

But this scale stuff is messing with my head and I *totally* understand your frustration. The exercise is beneficial in so many ways and at 150 -155 lbs I can wear size 4 dresses and jeans so I know it is helping tighten and shape my figure and has shaved off inches everywhere, but I want the scale to go down too!! It is effecting my moods and then that makes me upset - why am I letting this number get me so worked up?

I am overjoyed about what my body can do and I'm signed up for 2 half marathons in September and training for those and I'm trying to live in a space of abundance and joy and be grateful for my new life (I mean, I was 275 lbs this time last year - ONE month out of surgery!!) but DANG IT! I want these pounds outta here! For my mental health, they need to go!
 

Keep me posted on your progress!! Thanks for posting and giving voice to exactly how I'm feeling right now, too!!!