[elliejon]

Dr. Sanae,

I haven't posted for awhile. My name is elliejon and I am now 13 months out. I have lost about 80 lbs and do not want to lose anymore than this. People tell me that I need to gain weight and that I am too thin. I weigh 143 lbs and am 5ft 6 in. tall. I try and eat as much and as often as I can. I, only this month, am able to eat meat. I do eat lots of cheese, nuts, vegatables, orange juice, soups, etc. I try to eat the things that are good for me. My problem is.....GAS. Does that ever go away??? I have tried gas-x to no avail. I can't seem to get an answer to this. Does anyone else have this problem? I get dehydrated easily so I try and drink as much fluid as I can but some days I am tired with absoutely no energy. I have complained to my doctor but he says this will pass.....gosh, it has been 13 months. Anyhow, I would love your input on these issues. Thank you so much in advance.
elliejon

[DocSanae]

Hi ellie, glad to see you back.
Congratulations on your fabulous weight loss, you're doing very nicely.

From your height and weight, your BMI is at 23.8 which is pretty much at ideal.
People may tell you you are too thin, too skinny, but as far as medical standards go, you are at a very good place. One of the reasons people will tell you you are too skinny is that they are not used to seeing you at what medically is considered the normal healthy weight.

To maintain your present weight, daily intake should be around 1400-1600 kcals. Balance that out at around 60-80g protein, around 40g to 60g at most fat, and the remainder from carbs. If you are worried about too much carbs, as this will put the carb intake at 180g per day, then take in the higher end of protein and good wholesome fat, and if you have room, veggies and carbs.

About your tiredness, how's your blood lab results? Are they good? Even if they are, around this time, the stores may be decreasing, which will not show up in regular blood labs, so getting VB12 shots, making sure you are getting in all the vitamins and minerals you need to get in.

(((((HUGS)))))

[Christy0283]

Doc, I seen your notes to elliejon about recommended daily cals. How do we know how many calories we need to get in for our bodies to continue to lose weight at a good pace, but not so low that our body thinks we're starving it?

[DocSanae]

Christy, truthfully, there is no set theory yet for how to count calories for gastric bypass patients in particular.
However, other than that you've had gastric bypass, how your body functions is no different from the average Jane/Joe.
In other words, you need a set amount of energy for your body to maintain life itself, and then more for all the daily activities that we do. This is calculated basically from our height and weight, and then our gender and age also comes into play, because men have higher muscle (which burn the majority of our calories) ratio than women, and with age, our metabolism rate goes down. I've put up the standard equation used to calculate resting energy expenditure in another thread.

The recommended calories for weight loss is minus 500 to 1000 of your daily need, plus, the lowest amount recommended being, 1000-1200kcal for women, 1400-1600 for men.

The maintenance calorie recommendation for ellie, I calculated from her height and weight, and subtracted about 200 kcals from the result there, because having been on low calories for some time will slow down your metabolism, so your true daily requirement may come out lower than what standard calculations indicate. If she keeps losing at the recommended calorie, then addind 100-200 should balance it out.

[Christy0283]

Wow, Doc. I'm totally confused. You can see my weight and I am 5'6 1/2 and am 34 years old. Any idea now how many cals I should be getting in and be able to lose weight? I don't think I'm going over the number at all. I'm basically concerned about if I'm getting enough and be able to still lose weight and my body not think I'm starving it.

[DocSanae]

Christy, at this point, just get in your protein and water, and don't worry about the rest. You still need time to *learn* your pouch without getting scatterbrained about other things.
At your height, after you've reached goal and in maintenance is when you need to start counting and balancing, if you must. Untill then, just follow your surgeon's instructions. You've already lost more than half of what you want to lose in less then 6 months, which is very good and way above the standard curve of losing.
((((((HUGS))))))

[Christy0283]

Thanks Doc for all of your advice. I do seem so overwelmed sometimes. I've got to learn that even if I lose it slow, I will eventually get there. Thanks again, and you and all of your knowledge are much appreciated!!!