I had my every-three-months follow up appointment with my weight loss surgeon. This is the worst period of weight loss I’ve experienced since my surgery almost two years ago. I had ups and downs and the last couple of weeks were better, beginning with the post-Thanksgiving detox. However, overall, the total number of pounds was somewhere between few and pitiful.
Frankly, I’m puzzled. I believe that I’m doing good with my food plan. For sure I’ve stepped up my exercise. Simple math of calories in and calories burned should have added up to more significant weight loss, but my body apparently didn’t get that memo.
I went down the list of info with my doctor, explaining what I eat each day and how much physical activity I do. I don’t know what I was expecting in terms of advice, but I know I wasn’t anticipating that his suggestion would be that I cut out more calories. Seriously? I eat between 800 and 1000 calories a day and between my regular basal metabolism rate I burn more than 2000 calories daily. Honestly, I cannot fathom how in hell I’m going to eat less, take in fewer calories. The doctor acknowledged that I’m taking in quality with high protein and low carb. However, he feels that perhaps my body’s metabolism is lower/slower than normal. He went into a lengthier explanation about how cells of the body, etc. but I had a little trouble following the explanation and difficulty focusing on what he said. I do know that in his mind, reducing volume — cutting by a quarter in his words — is the strategy I should try.
Friends, color me shocked and shade that with some accents of dismayed and confused. Emotionally, I’m in full revolt tonight. I’m pissed off, even though I’m not sure at what or at who my anger is directed. It’s unfair of me, I guess, to be ticked off at my surgeon. I guess I wanted some magic solution that would wipe out the slow progress and put me back on the path of rapid loss. It isn’t his fault that I had unrealistic expectations. He told me what he medically believes. It just didn’t jive with what I wanted to hear.
Pointless as this is, I think I’m angry at my body, my stubborn, holding-onto-fat, cells and my underperforming, uncooperative metabolism. I resisted whining in the doctor’s office but, believe me, I’m whining to myself here at home and mentally stamping my feet in tantrum mode. I don’t want my metabolism to be slow. I want it to rev up and melt the freaking remaining pounds off of me asap.
I can’t let this derail me. I have to reconnect with my own focus and remember the promise to “go to any lengths to get it”. If that means cutting back on the already small portions I eat and compensating with even more water if I’m still hungry, then that’s what I’ll do. Or at least I’ll try my very best to do so and remember to have convenient small snacks available if all of the exercise triggers the need to eat. All that I can do is my best effort and hope that it’s enough to keep me going. I hold onto the thought that even though I didn’t lose the amount of pounds I hoped, at least I lost and didn’t gain. I know I’ve reduced my body size and my percentage of body fat. I am still moving in the right direction, even if I’m moving slowly.
To share a quick funny, in our appointment the doctor cautioned me about the approaching holidays. “It will be tough, he reminded me. “Lots of food around all of the time.”
“Dr., food is all around me all of the time every day,” I replied. “It has to be my choice to not eat it.”
On a brighter note, I ran into Kohl’s while I was “off the rock”. I needed new black pants that go all of the way to the tops of my feet versus stopping at capri or cropped pant length. Before I could get to the Women’s Department with its more familiar clothing sizes, geared toward heavier women, I had to walk right by the Misses Department. I get really confused about all of the different departments in a particular store, but I decided to brave the Misses section and see if I could figure it out. Yes, I know, it sounds on the surface like I’m pitiful. Imagine a grown woman of almost 56 getting confused and intimidated by store clothing departments. Still, if you don’t know and have never shopped them, you really need time or help to navigate and find the clothing you want.
The good news is that I went into the Misses section and found the Simply Vera Wang line. “Oh what the hell,” I thought. I grabbed a gray sweater that I thought was pretty and went to a dressing room to try it on. I’m at a weird place with clothing sizes. In some I’m still an XL, as opposed to a 1X, 2X, 3X or 4X. In other styles or cuts, I’m a L with tops. I can wear a 16 W pant, but still need a straight 18. Anyway, I found a couple cute sweaters from Vera Wang in XL. They look terrific with the new pants I purchased. I’m almost as pleased about my navigation of the store as I am about the clothes themselves. It’s a great advancement for me to take this on, silly as that sounds. I’m so glad I was successful.
Weighty Matters 
I agree with all the other commenters. Your surgeon sounds off his rocker. :p
I think you should find encouragement in how quickly you came up with a strategy to comply with the surgeon’s instructions. Impressive.
Yes, consult a nutritionist. Perhaps suggest the surgeon do too. You’ve been growing muscle, babe! and losing inches. And, wow, send us some photos of you in Vera Wang —
I second what Susanne and Skye said. When I read your post I really wondered if what the doctor was saying made sense to do. What about the body’s resistance to starvation? Doesn’t the metabolism slow even more if food intake is too restricted?
To me, your weight might not be going down as quickly now because you’re building more muscle, especially larger muscles in the lower body, with your walking and biking. Muscle weighs more than fat and muscle burns more calories than fat, so t sounds like you’re doing the right things.
If your cholesterol, blood sugar, blood pressure and other health measurements are good, you’re doing a great job of leading a healthy lifestyle. If it takes you a bit longer than other people to reach your weight goal, well we’re all different.
Muscle doesn’t weigh more than fat, a pound is a pound, after all. Rather, it’s that muscle is denser than fat and so you could weigh more but still be thinner. That’s one of the reasons people begin tracking their inches lost rather than weight lost.
My instinct upon seeing the number of calories that you eat, Mary, is to wonder whether or not you’re eating *enough*. Have you thought about experimenting for a few days by eating enough to replace the calories that you’ve burned up to say 1200 or so? I know with weight loss, everyone has a trick and advice, but at a certain point your body can only exist for so long on what are essentially starvation rations. Anyway, it might be worth trying out just to shake things up a bit.
Everyone, thanks for the support and suggestions. I asked the doctor whether my body could be resisting because I’m eating too little. He dismissed this idea.
After the holidays I’m going to call the bariatric nutritionist at the hospital where I had the surgery and see if I can schedule a consultation. I honestly can’t wrap my brain around eating fewer than 600 calories, particularly when I exercise so much.
Hi Mary,
I’m a long-time lurker who is in awe of what you’ve accomplished.
I agree with the others that the surgeon is off-base. I’ve attended courses at a place called Hilton Head Health Institute and they are very firm that the minimum number of calories a person should eat per day is 1300 and only for a few weeks at a time. They recommend that you then go back to the calories you need to cover your basal metabolic needs for at least a couple of weeks until your body recovers from the weeks of low calories. Then drop back to 1300 and the body loses weight again. This has worked well for me.
However, given your type of weight-loss surgery there may be different guidelines which would apply to you. I think you are very much on the right track to contact a bariatric nutritionist.
With your dedication to exercise, perhaps that too needs to be considered in the calorie-count equation. Some days it sounds like you are easily burning an extra 1000 or more calories through exercise, and your slowed weight loss may be your body’s way of telling you that it needs more fuel, not less. Hopefully the nutritionist will be able to help you with that.
Whatever happens, don’t lose sight of how far you’ve already come — celebrate that! Please know that you are an inspiration to me and many others, and I thank you for being so brave as to share your “weighty matters” with us.
What Susanne said.
I think that your metabolism is still adjusting from it’s pre-surgery years of being slow. You have revved it up, but I imagine it will take time to achieve the metabolism you want and, via your exercise, deserve. Maybe you can find a nutritionist experienced with bariatric surgery patients? I find nutritionists know much more about food than doctors do, just as pharmacists know more about drugs. It’s a specialist thing: you really only know about your specialty, especially doctors. I found that out with my mom’s cancer.
Your body will adjust and then your weight loss will return to normal. Honest.
Nodding my head while I’m reading Skye and Cathy’s comments…
Let’s put aside the number of pounds. How do you feel? From what I’m reading, you’re feeling pretty darn good. You’re able to buy clothes you want, you’re healthier than you’ve ever been, you’re experiencing life in a different way.
I think you need another specialist now – as Skye says – the nutritionist seems to be the next step. Surgeons are wonderful for what they do. But as people get healthier, different specialists take over. And maybe a review of your goals? I know you’ve done this as you’ve progressed, so maybe another adjustment is in order. You’ll figure it out, but honestly, the guy was wrong.
The surgeon has a goal — to assist you to lose weight, and it seems as though it’s at any cost.
I read your post with an OMG, what am I reading here? I find that specialists are good in their area (hopefully), but honestly? Suggesting that you go lower in calories than you already are? That’s frightening to me.
For what it’s worth, I think your body needs to stabilize. Your achievements have been significant. The fact that you are moving so much is the key here.
Common sense tells me his approach will border depravation for you (or anyone). I know you want rapid weight loss, but you’ve had that and succeeded. Now it’s the ounce by ounce loss that’ll be your measurement. That’s my two cents 🙂 I know you want more, but be patient. You’ll get there!
Best wishes,
Susanne