I guess I'm an outlier

[Rhondajs]

So I had a vsg revision this last April to a full DS. I was really successful with my VSG and lost 114 lbs (100% of my excess weight). Over 6 years, all that weight came back. Enter DS.

I have not had a honeymoon phase yet. I watch my carbs, eat high protein/high fat and go to the gym 3x week (elliptical, running, spin classes).

I have only lost 17 lbs since surgery and I'm 24 weeks out. I've lost 11 inches overall since surgery. I can't begin to tell you how frustrated I am. I see my surgical team in a few weeks and I know they are going to be disappointed.

Any advice?

 

[southernlady]

How many macros of protein, fat, and carbs? Not calories but macros?

Post a day or so of average eating, listing even things like condiments, sweeteners, etc.

 

[DianaCox]

Reminder: if you eat more protein than you need, your body will convert most of the excess into fat, plus give your kidneys more work to do to get rid of the excess nitrogen. You're better off padding your diet with fat and fibrous veggies (salad, broccoli with cheese sauce) than too much protein.

 

[Clematis]

Also did you have a proper DS addition to your VSG with two anastomoses and a common channel of about 100?

 

[Rhondajs]

How much protein do we need in a day?

 

[Rhondajs]

Yes, I have a true DS. I read the OR notes. My cc is 120cm. My surgeon wouldn't do any shorter.

 

[southernlady]

How much protein do we need in a day?

That depends. The minimum is around 90 grams after you are 3 plus months out. But depending on your protein labs, you could need 90 grams up to 200 plus. You check your own lab report for protein values. It needs to be a 7 at least. Range is typically 6 to 8.3.

 

[Munchkin]

Revisions often lose slower. I wasn't a revision and my CC is supposedly 75 but I was right there in the boat with you. I can tell you what worked for me. I cut my carbs down to 20 or less per day and start walking and eventually running. Not all of us need 100 or 150 gr protein per day. I don't need anything close to that.

When what you are doing isn't working, change something. Another strategy that works for me is a simple cheat weekend reset. One weekend a month I can eat anything I darn well please. I think this works for me because I always know I don't have to give up everything all the time!

 

[Rhondajs]

Munchkin,
Thanks so much for your words and being you. It is really great to know that I'm not the only one who has struggled. Honeymoon my ass.
I have been weary of going too strict with exercise and too strict with following a high protein (well, I basically lived on protein shakes for 6 months). I was so successful doing this with my VSG, but I was putting in 2+ hours a day on the treadmill to achieve my goal. It was completely unsustainable. I was having to train for half marathons year round to keep regaining. With that said though, I do eat a lot of fat now (bacon, cheese, avocado) because I can and I do put in my hours at the gym.

I will do as you said- drop my carbs down to 20g/day and see if that does the trick. Would you mind PMing me and giving me a typical menu for the day?

 

[southernlady]

Munchkin,
Thanks so much for your words and being you. It is really great to know that I'm not the only one who has struggled. Honeymoon my ass.
I have been weary of going too strict with exercise and too strict with following a high protein (well, I basically lived on protein shakes for 6 months). I was so successful doing this with my VSG, but I was putting in 2+ hours a day on the treadmill to achieve my goal. It was completely unsustainable. I was having to train for half marathons year round to keep regaining. With that said though, I do eat a lot of fat now (bacon, cheese, avocado) because I can and I do put in my hours at the gym.

I will do as you said- drop my carbs down to 20g/day and see if that does the trick. Would you mind PMing me and giving me a typical menu for the day?

If you eat 30 grams of protein before even touching a carb and making the carbs you do eat either dairy or leafy green veggies, you can go that low.

 

[Duckman]

Hold tight @Rhondajs you'll work it out

 

[DSRIGGS]

Yes, I have a true DS. I read the OR notes. My cc is 120cm. My surgeon wouldn't do any shorter.

The CC is not the only relevant part of your DS. Do you know your total small bowel length and the your Alimentary limb length? I was told that I was given a 100 cm CC with my virgin DS, when Dr K revised because I had significant protein malnutrition that I could not overcome, he actually measure it at 125 CM. If the CC was the only determinant of weight loss and nutritional status that 125 CM CC should have resulted in insufficient weight loss and good nutrition. It obviously didn't for me, so people really need to understand that the ratio of your absorbing path (CC + AL) to total Small Bowel length is crucial to weight loss and nutrition with a DS. Dr Hess says the optimal ratio of post DS small bowel make up is 40% absorbing/60% non absorbing.

If you have a 120 CM CC and a 200 CM AL with a 600 CM total SBL for a ratio of 53%/47% then I can see why weight loss would not be great because you wouldn't be malabsorbing enough. The AL does absorb contrary to what some believe. More carbs than protein but some protein absorption as well.

That being said, it is possible that your ratio is fine and as some have said, revisions do tend to lose at a slower pace but do still lose. Best wishes and I would suggest you look at your Op report to see if you can find the AL length as well as total SBL.

 

[Munchkin]

Munchkin,
Thanks so much for your words and being you. It is really great to know that I'm not the only one who has struggled. Honeymoon my ass.
I have been weary of going too strict with exercise and too strict with following a high protein (well, I basically lived on protein shakes for 6 months). I was so successful doing this with my VSG, but I was putting in 2+ hours a day on the treadmill to achieve my goal. It was completely unsustainable. I was having to train for half marathons year round to keep regaining. With that said though, I do eat a lot of fat now (bacon, cheese, avocado) because I can and I do put in my hours at the gym.

I will do as you said- drop my carbs down to 20g/day and see if that does the trick. Would you mind PMing me and giving me a typical menu for the day?

Done!

 

[LindaDarnell]

So I had a vsg revision this last April to a full DS. I was really successful with my VSG and lost 114 lbs (100% of my excess weight). Over 6 years, all that weight came back. Enter DS.

I have not had a honeymoon phase yet. I watch my carbs, eat high protein/high fat and go to the gym 3x week (elliptical, running, spin classes).

I have only lost 17 lbs since surgery and I'm 24 weeks out. I've lost 11 inches overall since surgery. I can't begin to tell you how frustrated I am. I see my surgical team in a few weeks and I know they are going to be disappointed.

Any advice?

Im right there with you on the time table of the revision. I will say this, what we learned with VSG does NOT apply to DS..so you have to un do that thinking. Which I know is HARD.but fat is our friend..so is higher calories. Of course, carbs are the enemy. But carb cycling has helped me tremendously...it helps with the feeling of deprivation and to shake up my body. I will also say this, you may want to back off exercising for a while. Ive had both RDs and trainers tell me over tge years that when ur trying to jumpstart weightloss through diet, hold off on exercise until u get going. Otherwise ur body tries to hold on to every calorie bc uve cut ur sustenance while increasing ur burn. Maybe just a week without exercise...and try carb cycling. I too am not losing as fast as I'd hoped..but im losing. Definitely understand your frustration..revision is sooo much slower..and harder!!

 

[Rhondajs]

The CC is not the only relevant part of your DS. Do you know your total small bowel length and the your Alimentary limb length? I was told that I was given a 100 cm CC with my virgin DS, when Dr K revised because I had significant protein malnutrition that I could not overcome, he actually measure it at 125 CM. If the CC was the only determinant of weight loss and nutritional status that 125 CM CC should have resulted in insufficient weight loss and good nutrition. It obviously didn't for me, so people really need to understand that the ratio of your absorbing path (CC + AL) to total Small Bowel length is crucial to weight loss and nutrition with a DS. Dr Hess says the optimal ratio of post DS small bowel make up is 40% absorbing/60% non absorbing.

If you have a 120 CM CC and a 200 CM AL with a 600 CM total SBL for a ratio of 53%/47% then I can see why weight loss would not be great because you wouldn't be malabsorbing enough. The AL does absorb contrary to what some believe. More carbs than protein but some protein absorption as well.

That being said, it is possible that your ratio is fine and as some have said, revisions do tend to lose at a slower pace but do still lose. Best wishes and I would suggest you look at your Op report to see if you can find the AL length as well as total SBL.

Thank you for responding! I'm not sure what my other lengths are but when I see the NP this month, I will ask her if she knows. I'm really worried about seeing them again as I have not lost much weight. That is all they truly care about...not all that I care about, but this is such a sensitive subject....I don't want the added stress of their opinions.