I think my NUT is a nut!

I keep getting in trouble with my NUT when I go and see her. The aftercare program that I am a part of insists on a 1200 calorie per day plan that includes about 75 grams of protein, 125 grams of carbs and at least 9 cups of water per day. There is no way that I can eat 1200 calories and not feel physically ill at this point. The idea of 125 grams of carbs goes against everything that I have done in the last 6 months. I do average between 40 and 60 grams and am seriously considering lowering that to get to 20-40 grams per day as I have been stalled for a couple of weeks and it is starting to drive me crazy.

I am curious about why people have chosen the low carb route (I really like to know the theory behind the choices people make). Is there a specific reason that you choose to eat low carb? Are you concerned about long term health effects? (My NUT tells me that long term the low carb diet will not work and I will regain the weight that I lose, but I don't believe her!) 

Any and all thoughts and opinions welcome!

125 grams of carbs sounds like a nut.

I should start with the obvious declaration that you should do whatever you think is right and I am not a medical professional.  Having said this, I think your best bet is to go low carb, low calorie and high protein.  As far as you gaining your weight back on a low carb diet, that's just silly and really makes me question your NUT.  I am almost four months out and my ticker has hardly moved (up and down about 2-4 pounds) in the past 3.5 years.  Of course I am not the only one, there are many others with similar long term results.

As far as a more scientific explanation for the low carb diet goes, I would PM Ruggie and ask him.  He is a true scientist and a researcher as well as being one of the most level headed people around here.  If you still can't get what you want from him, PM me and I will get the information to you.  It would be more thorough coming from him.

Thanks. I agree. Have you found that you need additional vitamins and minerals to maintain your levels? I have switched back to the low carb, low cal, high protein approach and feel much better than I did when I was trying to follow the "rules". This surgery is still very new here in Calgary and I don't believe that people really know what they are doing with the after care programing yet.

My vitamin levels have been excellent every single time.  The only thing that I am a bit low in is iron, and that was the case before the VSG too.  For me, this is just part of my genetic makeup.  I need to supplement iron, but other than this, I am good to go.

Also, just so you feel better, there are plenty of NUTs and even doctors here who in my opinion have very little clue.  Ever since the VSG started being approved by insurance, a whole lot of new surgeons started doing it, many of them have very little background in bariatric nutrition and prescribe the usual 1200 calories diet that is recommended for non bariatric patients.  It is a bit disheartening to watch.

You make a very valid point here. In Alberta surgeons only started doing the sleeve last March I believe. They have been doing the band for a few years but in general are not satisfied with the results that people are having with that option. We so not have the option of self pay in this province so if people want "other" surgeries they must go out of province or country to have it done so there is no surprise that there would be limited knowledge with our support health care providers. 

It is time for me to do some serious research on nutrition for bariatric patients, I have done a lot already but need to look at it with a different lens. 

Wow!! You would think that the doctors who do these types of surgeries would know more about aftercare & good tips that help with maintaining the WL. I would think the nuts & the docs would know & recommend what works best. Shame on them if they don't know & aren't trying to figure it out.

I do believe & I'm not pointing fingers at anyone's surgeon but I believe that at least 5% of surgeons want to see their patients fail because if you fail with the sleeve than most likely you'll be back in their office shopping for something else, like GB... I'm just saying... Most doctors see us for who & what we are (people that really need help) but there are some that could give 2 ****s about you or I & we're just really big walking & talking dollar bills. Tens of thousands of dollar bills. I say that with distaste in my mouth & an overwhelming feeling of fear for those doctors next victims. I've worked as an Office Manager for a few different large healthcare organizations & I've seen it with my own 2 eyes. It's disgusting. Surgeons, doctors, dentists, ARNP's just waiting for people to fail or doing less than quality work in hopes that the desperate person who once came to see them for help will return again, for their second time hopeless & beaten down with poor results looking for a better option. A new & improved option, an option that will FINALLY work. It's disheartening & it's the truth. That's why it's so important to do your research & study a few doctors before you make your final decision.

I'd go low carb & high protein myself. 1200 calories is almost double of what I've heard & read that we're supposed to have. Do what feels right to you first & foremost.

Best of luck to all of you,
Hilary

My bariatric team is on the same page as your Nut, and I am just one of many, many examples here that the plan works.  My only question that I would probably ask your Nut is at what point does she think you should be at 1200 calories?  My plan called for a gradual increase, not 1200 right out of the gate.  600 was what I was eating at the first follow-up post op, and they did say they wanted me a little closer to 800 at that point.  By 2 months 800.  By 4 months 1000-1000, and by 5 months 1200.  I shot for net carbs at about 100 (similar to your 125, I just subtract out fiber).  I did exercise regularly. 

For the first 2 months I went low carb (50 and under) and felt like complete crap.  I was light headed all the time, hypoglycemic, and terribly constipated from that approach.  I made a mistake listening to the well-intentioned people here who will basically tell you to go low carb, but follow up with some version of "I am not a medical professional and not trying to undo what you are being told by them"- but really they are.  There is a lot of pressure on this board to follow the low carb, under 800 calories approach.  

It absolutely does not need to be that way.  Your body, your health.  My 2 cents is use the support team that you just paid a gajillion dollars for.  Everybody stalls out- don't let that trap you into thinking you have to not meet your nutritional needs in order to lose weight. 

 

 

My NUT is following the Canada Food Guide. Yes it makes sense and yes it is a very balanced approach and I see the value in it. I have discovered that I have some real issues when it comes to eating potatoes, breads, pastas, and rice. At this point I am working with my psychologist to get a handle on it because I know I need to add these into my diet. In my head carbs are a bad thing, I gained my weight eating these things and at this point truly believe I will not lose the weight I need to to get healthy if I eat them. Balancing these thoughts and feelings with making myself healthy in the long term is why I am asking the questions and doing the research!

I do believe that both approaches are valid and work. The low carb approach might be "faster" but the higher carb version just might be more sustainable. Time will tell.

I should add that not all carbs are equal.  Skip refined, white flour, rice, etc.  Make it whole grain, fruit, veggie type carb.  Also, in order to avoid the carbs triggering cravings and hunger I would alternate 15 net carbs at one meal and 30 net carbs at the next.  Too much  carb at one sitting can flood your system with insulin, which in turn causes to store fat, trigger hunger, and trigger cravings.  If I behave and do that no problem with cravings.  If I fall off the wagon, the cravings come back quickly-- but it is possible to detox from it so to speak.  Just clean up the carbs again and after a few days back to normal.