[ChristineR]

Last time I saw my nutritionist, she told me that 12-18 months post-op, my body will adapt to the malabsorption and I will gain weight easier. The example she gave was that me getting a latte every morning on my way to work will add 2lbs a month. I thought the milk in the latte was a good source of protein... she says I'm drinking my calories.

So what I'm asking is if I continue to avoid sugar, minimize carbs, and exercise, will I have a harder time maintaining my weight when I'm a year or more post-op?

[Perfesser]

The magic window for "easy" weight loss lasts until sometime around 18 months or so, then good sense and self-discipline are required to make maintenance work. By then you've learned to eat healthy and in moderation and are able to adjust intake and exercise to hold where you are.

We've had a number of long-termers recently who lost focus and were unable to maintain due to their decision to stop following the rules. We are never free of those!!

The malabsorption lasts as long as you have your plumbing re-routed to bypass the stomach. It's not the major force in weight loss, though, so don't rely on it to cover for you if you stray.

In other words, we have to relearn how to relate to food and NEVER EVER go back to the way we once were.

CT

[DocSanae]

The human body is remarkable in that it will find ways to recompense for the abilities it lost--not all, but but enough to the extent that life can be maintained without much extra effort. Yes, it will regain a lot of the abosrbtive abliity after a year or two, especially the part that was dependent on the amount of absorbtive *area* lost due to the shortened route. The per inch absorbtion will increase to recompense for the distance lost. However, there are some specific enzymes and factors excreted from specific sections of the digestive route, and these may not be regained in full, which is why you have to keep up with life long vitamins and minerals supplementation.

Drinking your calories is not a good idea. Especially if it is loaded in fat, even if it has a lot of protein in it. Where protein is concerned, it is best to get in the solid form--this helps your body by 1) spending the energy needed to process, absorb, and utilize the protein, and 2) in making your body adapt to excreting more enzymes that you need to absorb the necessary nutrients for your body, that was temporarily decreased due to surgery.

With any processed products, make sure that you check the ingredients and their caloric worth. The info can be found online. They are often loaded with fat and calories, even the low fat ones. Beware especially of the slider foods--those that goe down easily, and are high in calories at a small volume.

Your best bet for success and maintenance is to learn what foods are good for the body, what are not, choose the foods wisely, and in amounts that are enough to maintain your body and your daily activities, no extras, and to set up a healthy life style that includes regular exercise.

Maintaining a healthy weight is a lot of hard work for anyone, even those who do not seem to have weight issues, and seem to have maintained within the healthy range throughout their lives. As an example, one of the members of this board once said to me in a note that "my thin friends would skip lunch when there was a party later that day. I didn't understand it then, but I do now." Once you have lost the weight you need to, if you go back to your old foods and your old eating patterns, you will gain back. Your small pouch is only a tool. It needs a lot of TLC on your part for it to do the job it is meant to do.

Hope this helps.

[DocSanae]

Originally Posted by Perfesser

The malabsorption lasts as long as you have your plumbing re-routed to bypass the stomach. CT

Um, sorry, NO, and I have explained in my post why. For fat, carbs and protein, do NOT bank on the fact that the malabsorbtion will remain--the gut surface adjusts per square inch to absorb more than it did before. Our body has lots of reserve functions that go into active duty when something is lacking. For example, why do you think anyone can survive on one kidney or one lung? Or a quarter of the original liver, all taken out due to something--accident or illness. It's the same with our guts. Taking a third out, even half, doesn't leave a permanent dent in the functions. True, the longer bypass method has gone out of style because of severe malabasorbtion, but even with that, the major issues were vitamins and mineral absorptions, and not protein, fat, and carb absorbtion, which are our main sources of energy and body parts.

[GinaMarie]

It's so confusing

[DocSanae]

Originally Posted by GinaMarie

It's so confusing

Confusing as in?
Keep in mind that the honeymoon period, the rapid weight loss period coincides with the time window that the body is adjusting the absorbtion issue, and so still can't absorb the amount it needs--thus malabsorbtion. The honeymoon/rapid weight loss period ends once the body has adjusted and regained the ability to absorb the amount that's necessary to support life.

Beyond this time window, you have only the size of your pouch, and your ability to make the correct choices, to maintain your weight. By this time, you shouldn't need to LOSE weight any more, you only need to maintain, so, this is enough to make things work for the rest of your life.

[kitcatcopycat]

Thanks for the explanation Doc!

[ChristineR]

Thank you for your help Doc! When I get lattes, I always have them made with skim milk. Is it okay to count that as one of my protein snacks for the day?

[Perfesser]

Here is the nutritional information on Starbucks drinks. You can enter the type of milk you use and see what effect it has on calories, the different types of fat, protein, etc.

Starbucks Nutritional Fact Sheet

CT

[DocSanae]

Originally Posted by ChristineR

Thank you for your help Doc! When I get lattes, I always have them made with skim milk. Is it okay to count that as one of my protein snacks for the day?

If your nutritionist said, no, then I would not. It's wiser to follow your surgeon and nutritionist's instruction, as they can talk to you face to face, one on one, and actually OBSERVE how things are with you. You should not try to test the boundaries that you may end up regretting later--think back of how you arrived to the point that you decided that you needed the surgery to straighten things up for your health. Better to be safe than sorry.