Haven't lost a POUND nor an INCH doing this! WTF?

[Dan_Dan]

Whitney said

I don’t wanna hear someone say Eat MORE!!

I was trying to use her own words to tell her to Eat MORE! and give it time

Sometimes the best advice is to listen to yourself and ask am I being reasonable

[jilliangordona]

I did not stay losing until I started supplementing with vitamins D was Daisy mentioned, might be worth getting checked out! Mine was low.

[Donna]

I cannot stress this enough…I see it both in patients and in myself: WLS patients are different with fasting. We cannot do it quite the same as non-WLS patients without some modifications. Even IF is a bit different. The permanent boosts surgery gives us which are different from fasting concurrently making fasting more difficult. Conversely, you should not fast unless you can ensure that you are able to eat at least 70 (preferably 90g) of protein a day, and quite a bit of fat as well. This is because it is imperative you can consume this in your IF window.

If you cannot tolerate fat and are eating less, you are getting less of the fat soluble vitamins. Make sure the vitamin D you take is either the water miscable/dry form, or that you are taking D3. Also, make sure you are taking your calcium and magnesium with the vitamin D, and take them separate from iron supplements or iron food. Most RNY patients though seem to do alright with fat some time out from surgery. It may be you have reactive hypoglycemia, actually, and is possibly not the fat at all.

What was your ferritin last when it was checked? RNY patients have chronically low ferritin and not everyone tests for it. You must get ferritin checked at least 1-2x a year, even if the doctor doesn’t mention it. This can cause fatigue, a lack of weight loss, and alternatively worse complications. Most in-the-know RNY patients proactively do this and regularly get the iron infusions many require after surgery. This is because with the RNY, the duodenum is entirely bypassed, and thus your iron absorption is basically nil (depending on where the surgeon places the anastamosis after this part).

Also, 50 grams of protein is far too low for someone with a gastric bypass. In fact I would say that with malabsorption it’s borderline dangerously low. It is possible to not lose weight if you are even minimally protein deficient, as the body will cling to fluid in this case. You malabsorb a small amount due to the bypass procedure. I’d not have less than 70+. 90 is waaaay better, preferable, even. You do not have enough protein by far. I work with many gastric bypass patients and they follow ketogenic meat-forward diets and easily get in 60-90 grams minimum. Often they exceed what I eat.

An example of an RNY keto peep’s day of meals:

Meal 1: 1/4 cup low carb protein shake, two eggs fried, 1-2 tbsp salsa
Meal 2: 3 slices salami, 1oz fatty cheese
Meal 3: 2 oz beef stick
Meal 4: 4 oz fatty beef

All that is around ~90g protein, good iron, good fat, ~1000 calories.

If you cannot eat more fat or protein it is possibly one of two things: 1) possible gastroparesis, or 2) you must simply eat every 90 minutes during the IF window. It may also be that you did not refeed well and must slowly and gradually increase your tolerance to food.

I have a 40F sleeve (not much larger than the RNY pouch most have) and I can easily eat 90g of protein in 6 hours even without protein supplements.

Lastly, we are different when we have been very obese than the slimmer overweight/thin people fasting. I used to weigh 750+ and I absolutely have to follow a different protocol. Extended fasting that is not IF is even more valuable for us, but with the RNY you must be exceptionally careful leading up to this.

The unfortunate side effect to that is it may take several months to lose 20 pounds if you are close to goal and have lower body fat. That is the truth for all of us, WLS patients or no, because it took many years to gain the weight. The less we weigh and the further out from the initial weight loss, the longer it may take to lose it.

My suggestion is to treat it like refeeding post-op - slowly and gradually increase protein daily and fat. Introduce one new food at a time. Start only eating meat, lean at first, and then gradually increase fat content. The body will adapt.

We absolutely can do IF post-op, however I’d say your priority is to get adequate protein, fat, and hydration first. The fasting is great, but if you cannot meet your nutritional needs, the fasting will harm you in the long run.

[Donna]

Forgot to add, that if you continue to have issues eating and it prevents you from getting proper nutrition, you absolutely must see a doctor or your surgeon and ask if it could possibly be anything else. The RNY in particular has unique anatomy with the surgical connections (anastamoses) it has, and if you are malnourished there could be other issues at play. Might even be a hiatal hernia or something else.

[WV-Chef]

THANK YOU so very much for this. I get so tired of people saying, “Just eat more protein” or “Eat more Fat”…thats simply not do-able for me. Hopefully, soon…I will find what works but as of right now…I haven’t lost a pound nor inch in weeks.
Again, Thank you so much for your replies.