Tuesday, January 29, 2008

Losing weight the right way......

For those who are regular readers of this blog, you have probably noticed a downward trend in my satisfaction with having had WLS. I guess the fact that I have had some really bad problems with the malabsorption properties of the RNY. Not to mention that I may be facing a new surgery because of an ulceration or fistula or combination of both. I don't know the full spectrum of it, I'm still undergoing tests. Won't know the full extent until the endoscopy is done. Just waiting on insurance approval first---ugh!!!

Anyway, one good thing that has come out me having had WLS, is I finally know how and what to eat to lose and maintain my weight. I researched the net and read a vast number of studies, books, etc dealing with nutritional science. Here's a formula that I have been using. Maybe you can put it to use yourself.

There are loads of ways to lose weight out there and they all work at first. Then you stall out. The reason for the stall can vary. Many times your body has just reached a set point and has to play catch up. On the typical low-fat lower calorie WLS followers adhere to, your body just rebels. You aren't supplying it with the nutrition you need so it hangs on to every morsel you put in your mouth.

Another problem with the way of eating of most WLSers, is there is too much protein consumed. Excess protein consumption without the proper fat intake is not healthy for you. It leads to Rabbit Starvation Syndrome.

I thought I would share some of the things I have found to be helpful in losing weight the right way. Many factors come into play here. There is no one size fits all formula. It has to individualized for that person. Your height, weight, age, activity level are just the basic factors. I'll use myself as an example.

You start off with your BMR (basal metabolic rate), the number of calories you'd burn if you stayed in bed all day. Then you factor in the daily caloric needs based on your activity level.

A way of calculating a safe minimum calorie-intake level is by reference to your body weight or current body weight. Reducing calories by 15-25% below your daily calorie maintenance needs is a useful start. You may increase this depending on your weight loss goals. As a guide to minimum calorie intake, the American College of Sports Medicine (ACSM) recommends that calorie levels never drop below 1200 calories per day for women or 1800 calories per day for men. Even these calorie levels are quite low. Cutting calories by more than 50% below your daily caloric needs is considered starvation mode.

Now that we know how many calories we need to have each day. We then determine how to break those down into fat, protein, and carbohydrates. For these examples I'll use the carb levels I was on at both times. You can always adjust your carb level up to what is doable for you. I believe in lower carb intake to keep down insulin levels.

Next is the protein requirements. If you are just starting on a low carb eating plan, your protein needs for the first few weeks will be greater than after that time frame. Once we know all the above data, we can then figure out just how much fat we should be taking in.

At time of my WLS----43 years old, 5'2", very sedentary, 375lbs, female


Daily Caloric Needs--2851

Calories Needed to lose weight--2423cals/day to 2138cals/day
2851x15%=428, 2851-428=2423;
2851x25%=713, 2851-713=2138

Carbs--20gms/day, 80cals/day

Protein--for beginner-224gms/day, 896cals/day;
old timer-165gms/day, 660cals/day
224x4=896; 165x4=660

Fat--for beginner-161gms/day to 129gms/day;
old-timer-187gms/day to 155gms/day
80+896=976, 2423-976=1447, 1447/9=161,
2138-976=1162, 1162/9=129
80+660=740, 2423-740=1683, 1683/9=187,
2138-740=1398, 1398/9=155

So when I first had my WLS, I should have been taking in oodles of calories instead of the 1000-1200 I started off at. At that low level, I was in starvation mode. Plus the recommendations of 70gms of protein by my surgeons office was WAYYYY off. At the weight I was at, I should have been taking in over 200gms/day. I'm glad I upped my calories after the first 6months. Maybe that's why I lost so well.

Now let's look at me now, 47 years old, 5'2", moderately active(gotta be truthful here), 155lbs, female


Daily Caloric Needs--2170

Calories Needed to lose weight--1844cals/day to 1627cals/day
2170x15%=326, 2170-326=1844;
2170x25%=543, 2170-543=1627

Carbs--40gms/day, 160cals/day

Protein--for beginner-126gms/day, 504cals/day;
old timer-66gms/day, 264cals/day
126x4=504; 66x4=264

Fat--for beginner-131gms/day to 107gms/day;
old-timer-158gms/day to 134gms/day
160+504=664, 1844-664=1180, 1180/9=131,
1627-664=963, 963/9=107
160+264=424, 1844-424=1420, 1420/9=158,
1627-424=1203, 1203/9=134

I'm maintaining right now on 1800-2000 cals/day---so that is about right.

Most WLSers I know are still trying to maintain a lower caloric intake. That is the reason all diets fail, even WLS. The tendency to drop calories is how we have been taught to lose pounds. Some even believe the lower the better. You just have to come to grips with how the human body really works. If calories are dropped too far below your BMR, the body will begin to feed off of itself. It will use your muscle as food---and the heart is a muscle too.

Then you set yourself up for overeating and binging. Plus your metabolism slows to a crawl. Simply because you are not giving the body what it needs. So make yourself a lab rat. Try it for awhile. Just a word of warning though, if your carbs get too high, >60gms/day. You will not lose as well this way. Carb intakes of that amount will cause an insulin response. For most, that will cause you to be hungry more often or cause a stall. Optimum weight loss should happen with higher fat, lower carb. Also, you may not lose right away if you have been following a lower calorie diet. Your metabolism is slower. It will take time to heal and begin working properly again. Resistance training will help with that. It builds muscle thus increasing metabolism.

But that is what I have been able to implement in my life. Maybe you can do it in yours or not. The choice is yours.

If you try this let me know if you have any results. You will need to recalculate your needs as you lose weight, about every 25lbs or so.


OhYeahBabe said...

Thank you so much for spelling this out.

People can't lose weight permanently and retain their health by eating 300 calories of egg whites and lettuce per day, a la Kimkins. Heidi Diaz said her diet was comparable to weight loss surgery patients' medically supervised diets. As per your explanation in the article, most surgery pateints aren't getting a sound diet, and Kimkins is even worse. Sorry to turn your WLS post into a Kimkins commentary, but all those things you said were nutritionally deficient were like a banquet compared to Kimkins.

My blog: Kimorexia

2BIG said...

thanks for sharing.

One huge thing you touched on is folk do it right in the beginning and forget as they get lighter their caloric needs drop so they need to readjust the totals to account for that.
But when you start out too low like with Kimkins.com plan there is no place to go except the ER

OhYeahBabe said...

2big - WORD!
My blog: Kimorexia

Anonymous said...

I can't tell you how glad I am to have read this. I had surgery 2/25 (Aren't you on the livingafterwls site?), and have been stuck on and off. It's a really long story, but I'd lose a few pounds and then . . . nothing. I'd tried everything. Everyone kept saying my calories were too low. I was like, "Duh. That's the point of the surgery, right? So if I can barely eat before I get full, then how in the WORLD can I get in 1200/1400 (or more) calories a day?? The only option is higher calories foods -- either more carbs or more fat. I've done Atkins before, and know that even with WLS, that when you up your calories, it's supposed to be in the form of protein. So I thought -- hm. Same quantity of protein but higher calories. The option is fat. Add fat. So . . . yesterday (Sunday) I changed my fat-free lactose free milk in my shakes to whole lactose free milk, ate a pork sausage patty for breakfast, two chicken thighs for lunch, and a slice of meatloaf for dinner coupled with two double protein drinks. I lost .5 pound on Sunday morning, and .9 of a pound between yesterday and today! I really thought the issue was JUST that I wasn't getting enough protein. And it was, but only to a certain degree. After I didn't lose for about six weeks, my surgeon told me to do two double protein shakes a day, which is 108g by itself, not including my real food. After he told me to do that, I found an online calculator that clearly showed me that the required 80-100 grams was nowhere NEAR what I really needed. But then after I lost 7 pounds that first week, nothing again for about three weeks. That's when I thought maybe I'd only found part of the solution. Now I just hope I dont develop dumping from this. I guess I'll have to see if this is just something I should be doing just to jumpstart, or is this on a regular basis? Anyway, there's real truth to your post, and I'm glad I found it to verify my thinking.