Calories, Carbs & RNY - help long timers!

Hey Ya'll:

I had my six month follow-up appointment yesterday. I'm down 93 pounds since surgery - woot woot.

Anyway, I'm super frustrated with the nutritionist/dietician they have. She said, "you're sabotaging your success by not eating at least 30 carbs per meal, snacking, and hitting 1,200 calories per day." Her ideas of snacks to get up to 1200 calories a day was a sweet potato or baked potato, cheeses, yogurts, etc.

Number One: I have diabetes - when I eat over 20 carbs per day; my numbers suck. They're stupid guidelines are what keep people diabetic.
Number Two: 1,200 calories a day?!?! After RNY? I'm six months! I feel blessed that I get 800 to 1000 calories per day. (daily average is about 800). Maybe that seems appropriate guidelines for later down the road; but, I remember a class where they cautioned against eating all the time. This quack would have me eating 6 times a day. If you're following the 30/30/30 rule then there's very little time to hit liquid goals if you're always stuffing your face.
Number Three: I do hit my protein goals most days, getting 60 to 80 - using protein drinks.

I feel like if I follow their dated guidelines my diabetes numbers will suffer and I'll gain weight. I think 93 pounds in six months is phenomenal but she said I should have lost more!

Will you-all please chime in on your thoughts?

My personal opinion is that you are doing great, and I think 800-1000 calories a day at this point is adequate if you feel well. I just went back and checked my logs and at 6 months out I was also eating 800-1000 calories a day, and my average looks to be about 850/day.

I believe that patients are best served losing as much weight as fast as possible after surgery as this is the easiest time to do it. If you consume more calories than you need/want to eat just because someone told you too, it will unnecessarily slow down your weight loss.

I always recommend you listen to you doctors and follow your programs guidance, but you also have to think for yourself and listen to your body. I am not aware in any of my reading or research of any evidence that you need to eat any more than a minimal amount of carbs.

Personally, I eat a ton more carbs than the average bariatric patient, but that's because it is part of my plan and it works for ME. I do not eat refined carbs (I eat no sugar, no bread, no pasta, no rice, no crackers, etc). All of my carbs come from fruits and veggies (and I do eat steel cut oats for breakfast, but did not add those in until maintenance). So, even back when I was eating 800-1000 calories a day, I was consuming about 120g of carbs a day on average; however, I do not think it is in any way necessary. I eat a lot of carbs, because I find fruits and vegetables to be delicious, filling and chock full of important phytonutrients. I don't eat them for the carbs themselves.

Now that I'm in maintenance I tend to eat between 1700-2100 calories a day (probably average about 1850) and I average about 200g of carbs - still from the same sources as before.

She wants you to increase carbs and calories but thinks you should have lost more weight?

Something does not compute there.

There is a LOT of variation in the quality of information you'll find from nutritionists. Some really know what they're doing, others are clueless about bariatric nutrition. Sounds like you've got one of the latter.

The most successful people on the boards seem to do 600 - 800 calories per day, 60 - 80g protein, under 25g carbs. Many folks maintain on 1,200 calories!

I agree that 93lb in 6 months is fabulous. Keep doing what you're doing and ignore this misguided advice.

I just had my 4 month follow-up appointment Wednesday and am down 60lbs, which is half way to my goal!

I just heard the same crap from my NUT. She said I should be at a minimum of 1,000 calories and try to hit 1,200 a day...then at 6 months I should be at 1,500, SMH. Thanks to what I've learned here, I know better and just smiled and nodded.

She said my center considers the surgery a success if you lose 70% and maintain 50% of your excess weight. Since I am already at 50% she tells me to "slow down, its not a race." I told her that I read that most RNYs weight loss slows way down between 12-18 months, so shouldn't I try to do as much as possible as soon as possible? She agreed to the slowdown, but went on about starvation and losing muscle...nod and smile. And started wondering if the stats she is quoting about her successful patients is from others that totally ignored her suggestions but didn't tell her.

I told her that I gained a pound while on a girls weekend, but I attributed it to not getting enough protein, since we walked at least 15,000 steps and climbed 15 sets of stairs each day. She asked if I felt deprived, and I said a little while they were drinking and eating oreos. She actually said, "why didn't you drink? At this center we consider alcohol a clear liquid!" I almost fell on the floor! Then she said, "life is too short, have an occasional oreo. We just expect you to make good decisions 85% of the day" This skinny women has no idea what is inside our heads...1 orea is like 1 lays potato chip, you have to finish the bag, right?

RANT OVER...Thanks to all for your advice and support!

And then they wonder why the success rate for the surgery is what it is.

Keep them low as long as you can.

It sounds like you're doing great. Keep doing what you are doing.

Unreal!! First of all congrats you have done great. I am 14 years this Sept post op and actually below goal. No one will agree with me but I never drank a protein shake but that's just my dr. I eat my food. Even at this stage I am mindful of what I put in my mouth. My pouch is the same size it was after surgery . I physically can't eat a lot so protein is my main concern. I am blessed that I don't feel hunger. The first year I told myself if I felt hunger I needed fluids. Became habit. I am 67 and very very active. Again congrats on the loss and IMHO I would toss the nutrtionalist

I'm never hungry. And if I feel hungry, I know I need to drink more.

Your post makes me want to bang my head against a concrete wall because of all the uninformed Nuts & Dietitians out there! UGH!!!

You are doing awesome, 93 lbs down in six months is awesome and don't let her tell you different.

Lets see if this even sounds rational... "you want to lose weight so why don't you eat more!!!" When in gods name did eating more food, more calories, more carbs ever get any MO/SMO/SSMO person to lose MORE weight. NOPE do not eat more, plain and simple. Its Weight LOSS surgery people not weight MORE surgery! Sorry I am not coming down on you, I am so frustrated with all the bad advice out there from Nuts/Dietitians!!

I am 3.6 yrs post op, I eat 850-900 calories a day, 20-30 carbs and 100+ protein. I am super carb sensitive and can't even look at bread or crackers or cookies without gaining weight, so for me, low calorie, low carb and high protein is what keeps me maintaining.

Don't stop what you are doing, keep it lower calorie as long as you can until you get to goal, keep that protein high and carbs low. You got this, I think you are doing amazing and so glad you posted!

Keep up the great work!