[Tiffiany]

My nutritionist stated that I burned 1700 calories per day. I was not active at the time. Recently my surgeon tested my metabolic rate and said that I was burning lots of calories (I forgot to ask for figures). I am very confused and want to use this honeymoon period for all it's worth. My weight loss has slowed down a bunch and yet I am much more active and walk briskly, daily for a minimum of 1/2 hour. This whole thing is confusing to me because I eat less and work out more and the results (although different initially) are now the same as they were if I was participating with weight watchers or the like. Any input?

[qt82699]

not too sure about all the tech stuff, but as long as you are exercizing you are doing what you should be, keep up the great work

[DocSanae]

There's a lot of misconception that the surgery itself will make you lose weight.
The surgery is only a tool.
What is does is 1) limit the amount of food you can eat in one sitting, and 2) by bypassing some of the intestines, reduce the area of absorption.

With 1), as time goes by, you will be able to eat a bit more than you were able to immediately post op, because your pouch was still healing and swollen, so it was not able to keep much food in it. As the pouch heals and the swelling goes down, and it regains its ability to stretch out a bit (now, I know you all dread the word stretching the pouch, but the fact is, the stomach has a natural ability to stretch some when it needs to, and the pouch retains this ability--it doesn't mean that your pouch will balloon up 3 times, 4 times, 5 times it's original size and get too large, what this means is that it will become able to accomodate 3-4 oz food at one time, then go back down to its original size, once the food has passed through)

With 2), our body is very resilent, and it will recover half or more of the ability to absorb that was limited immediately post op.

So, all in all, after several months, your body will regain its ability to get in the nutrition you will need to live.
This means the most important thing you need to learn and adjust to during the period while your body is adjusting to your new plumbing, is to learn about nutrition and to set up good and healthy eating habits and life style. In this sense, yes, what you need to do is no different from weight watchers, or whatever programs and instructions drs will give to their patients when their weight needs to be controled.

The fact that you burn a lot of calories is good. That means that you have a very effective energy consumption/expenditure system.
When we talk of how much calories a person burns, first, there is the basic amount one burns--the amount of energy you need to sustain your body and life. This is determined by your stature--height and weight--, and gender and age. Then, added to this is the amount of energy you use during your daily activities. The total of these two is what you burn daily. At the same weight, if you have a lot of muscles, you will burn a lot of calories because our muscles is the body's furnace, while if you have a lot of fat and less muscle, then you will burn less calories than another person who's the same weight as you but is much muscular. Men burn more calories than women at the same weight because of this--men have more muscles than women.

As you lose weight, the amount of energy you burn daily will go down. You will need less calorie to maintain your body and life because you are at a lower weight, and the amount of calorie you burn with any given activity will also be reduced, because you are lighter, and so will need less calories with the same amount of exercise.
Since the amount of calories you can burn goes down with the weight loss, and the amount you can eat goes up, eventually, the two will balance out, and that is where your weight loss will even out, and you'll go into maintenance.

1700 kcal per day is around the calories needed for a 130-150lb person to maintain their weight. The range in weight is due to the difference in daily activities. Of course, if you were, say, a professional athlete in that weight rainge, you will need a lot more calories.

If my explanation is too complicated, just let me know, I'll try to break it down so it's easier to understand.

[A new me]

Very nicley put Doc. Even some one like me who is almost 9 months post op that is very good useful information. Very nicely put. Kudos.

[qt82699]

thanks for the info doc!

[Tiffiany]

"1700 kcal per day is around the calories needed for a 130-150lb person to maintain their weight. The range in weight is due to the difference in daily activities. Of course, if you were, say, a professional athlete in that weight rainge, you will need a lot more calories."

Sorry Doc, I am still a bit confused. So by your explanation above, I am really not burning enough calories if I am currently at 183? Also, when the metabolic rates are tested this is at a resting rate. Does that matter at all? I mean, if I am burning approximately 280 calories per day in my daily exercise program, how can that be calculated when I am at the doctor's office laying on a table blowing into a machine?

I hope I am expressing this right. I just really want to understand.

[DocSanae]

You add the calories you burn with exercise to your basal metabolism rate. If your basal metabolism has been measured at, say, 1500 kcal, then you add the 280 to it, and you also need to add what you burn during your regular daily activities such as just walking around at home or work, housework, etc.

The estimation of the cals I gave as an example is derived from a very simplified formula that some drs and nutritionists use to give the total amount burned daily.
At your present weight, going by this formula, your daily calorie expenditure should be just above 2000 kcals, so, if you've been told that you are burning around 1700 kcals daily right now and if this is the total daily expenditure, then yes, that does sound low.

However, if your basal metabolism--the amount you burn at resting--is 1700 kcal, then you'll need to add what calories you burn with your daily activities--not only exercise, but with such activities as housework, or walking around during work, etc etc--to that number to get the total you burn daily. On the average, such daily activities (not including exercise that you do as exercise) total to about 200-300 kcals at least, so, when you add the basal metabolism and the activity expenditure, you get 1700+300 which is just about right. Add your exercise count to this, and the number goes up to 2280, which is pretty high for a woman.

[DocSanae]

In regards to exercise, the amount of calories the workout machines say you are burning, is approximate. The program is set to give the number for a preset weight and age, so unless the program allows you to register your actual weight, gender, and age, what the numbers say on the machines are approximate numbers. If you want a more accurate number, you need to find out how many calories per lb a certain exercise burns, then multiply that number by your weight to get the accurate count.

For instance, say, walking at 4mph burns 0.5kcal/1lb/hour, this means that so long as you are walking at the speed of 4 mph, then at your weight, you will burn 91.5 kcal with a one hour walk. (Mind you, this is to show an example, and the numbers I've used aren't the true numbers.)

[BOOTS]

DOC
WHAT KIND OF TOOL DOES THE DOCTOR USE TO FIGURE OUT YOUR basal metabolism rate? I NEVER HEARD OF THIS BEFORE. AND IF MY DOC DOESNT USE ONE HOW OR WHERE CAN I GET THIS TOOL TO FIGURE MINE OUT?

[DocSanae]

It isn't a tool as is. I use the recommended simplified way of calculating calorie needs from the Japan Diabetes Society's clinincal guideline. ADA doesn't give a like method in its most recent guideline but there is an equation to calculate the needs that is widely used, and this is what most nutritionists use. I don't have the exact formula on hand, as I'm at home, now, though. I'll post the equation when I go back to work as the year end/New Years holiday has started here and lasts to Jan. 3.

I have written an article to try to explain this.
How Many Calories Do I Need?