Today’s food choices, from upper left: I ate most of the rest of the omelet I ate yesterday for brunch, plus 3 pieces of potato; a sample of green chile chicken Frito pie at the grocery store (YUM); Trader Joe’s dark chocolate nibs (I ate 6 pieces; this is a great way to get a chocolate fix for 8 calories!); multivitamin and calcium supplements x2; glass of Isopure Zero Carb; deli sliced house-roasted roast beef and Tillamook sharp cheddar cheese cubes; green chile chicken casserole.
This weekend was a pretty busy one in my household. Lots of planning, cleaning, shopping and cooking for the week got done. While I was menu planning for myself this week–hubby is on soft foods, so ground beef, egg whites with cheese, applesauce and protein shakes are the order of the day for him for the next few weeks–I started to think about the nutrient balance I’m getting daily.
I’ve already written about how much I miss veggies, and how right now, there is a distinct lack of those in my diet. The absence of veggies is not for a lack of trying, believe me. Once I eat my dense proteins, there is simply no room for anything else in my sleeve. Unless I revert back to supplementing most of my meals with protein drinks to get in my required protein, I can’t fit veggies into my eating plan. But I’m trying–note the green chile sauce in my green chile casserole, and I did cook sausages with peppers and marinara for this week. I’m also going to give green beans a try this week with the barbecue chicken I made myself.
This brings me to the meat (ha!) of the post: should a post-op VSG diet be a low-carb diet? Or should it be more nutritionally balanced, keeping in mind that protein should always be the priority. This is something that both puzzles me and gives me fits.
If you cruise around the OH VSG board, most of the successful vets will preach the virtues of a 600-800 calorie diet that includes 80-100 grams of protein and between 20-40 grams of carbs daily. I was told at my last follow-up appointment that eating fewer than 800 calories daily would screw up my metabolism, and that I should be eating 800 calories as a minimum daily intake. I was told that if I ate between 800-1000 calories weekly, my weight loss would speed up. I was not advised as to carb grams, or fat grams for that matter, only protein. And I was told I was getting plenty since I get between 60-80 grams each day, and on some days even more.
Then I look at the plan given to me by my dietician, which doesn’t give a set amount of calories until one hits maintenance (between 1200-1600), but does encourage a variety of foods (oatmeal, fruits, yogurt–all things typically high in carbohydrates) be incorporated into one’s daily plan, so long as protein is first priority.
It is all pretty confusing. I can’t complain about the weight I’ve lost to date eating the way I have been eating–I think I’ve done pretty well so far. But I don’t feel right not eating more plants, especially given that I ate quite a lot of plant material in addition to my meat before I had surgery. Unfortunately right now I’m pretty limited as to what plant material I can have–it must be cooked pretty soft; raw veggies are not sitting really well in my sleeve right now. And I can only have a tiny amount each time.
I need to know that if I decide not to follow the pack on my eating plan–not doing ultra low carb, but keeping protein high–that I can still be successful. I’m not talking about going out and eating breads, pasta, tortillas and rice (things verboten per my surgeon)–I’m talking about having a bit of corn or mashed potatoes with my chicken breast every once in a while. Or eating a bit of broccoli and green beans with my shrimp or fish every so often. I need to know, can I still lose weight and eat carbs too? I don’t want to have to take a fiber supplement or something to make myself have BMs every day. I’ve been pretty fortunate in that I go at least once nearly every single day. I just want to enjoy a little veg and fruit each day as a part of my daily eating. I want balance in my eating, and the way I’m eating now is clearly not balanced, in my opinion. Will eating a more balanced approach slow down my weight loss? Probably. Will it make the weight come off slower? Probably. But I don’t necessarily want to lose it all so fast that I am left with unsightly sagging skin. The way I see it, the more slowly it comes off, the more chance my skin has at bouncing back a little. I’m already starting to see the trouble spots because of the loss of 70 pounds in 2 months, and I don’t like it. But hey, I’ve lost 70 pounds! So there is that.
It may be time to visit with my dietician again to have her help me with this because there is only so much advice from the interwebs one can absorb, filter out the good bits from the bullshit, and glean useful information from. I think I’ll give her office a call tomorrow morning on my planning period after I take my morning walk. I’ll get this figured out yet, and I’ll get the hang of this VSG life eventually!
La Guerra de La Gorda 
I have this debate daily. My doc told me at one point that they want me at 1200 cal a day … It is all so confusing – especially since all doctors use different plans and everyone’s body reacts differently! Good luck!
I am learning more from your blog then my doctors office and dietician. I wonder if we need to use vegetables as sauces and purees similar to what you are doing to try and get it in ? How is your husband doing with pain and eating ?
Glad to be of help! I try to use veggies in sauces as much as possible since it is about the only way I can seem to get them in. I’ll keep doing it until my capacity increases a little more, then I’ll move to 3 oz dense protein plus 1 oz veg.
Hubby is doing great. No pain, just a little slight discomfort, and he has moved on to soft foods. He is doing really, really well. Thanks for asking after him.
Ya know… after my long 7 month process to get the surgery and now being almost a month out, over that time I have been on numerous VSG boards. I have come to the conclusion that EVERYONE is different in what they eat, and what they can tolerate and just what they do in general when it comes to surgery. I think if you are still losing the way you want to, then just keep doing what you are doing… its workin’ for you!
I eat carbs. Obviously, protein and veggies are my first priorities when it comes to meals but when I want something to munch on, I have some baked pita chips or things like that. I dont swear off carbs because I dont think its realistic to never have them again and I dont want to deprive myself. Carbs wont stop you from losing weight… what my surgeon says is just that they arent high in nutritional value and with us being able to eat so little, we need to get all the protein and vitamins in that we can. Carbs are basically just empty calories.
Overall, just keep doing what you are doing and you can have some carbs! If you notice that they stop or slow your weight loss, then just remove them from your diet! No biggie! I havent noticed a change in my weight loss since eating them. 🙂
I am insulin resistant (T2 diabetes) and it seems more clear than ever that carbs are a really bad idea for me. If you can have some and eat them in moderation, more power to you. But I can’t seem to eat things like potatoes or bread in moderation, so I abstain 100%. As soon as I start slipping up and eating more carbs, I fall off the wagon and I gain weight. My BGL spike and I start getting hungry all the freaking time. As long as I stay low carb, I have no hunger. I have to accept low carb/high fat for life.
As far as a balanced diet goes, well, we wouldn’t expect a smoker or an alcoholic to smoke or drink in moderation because it’s a balanced approach, so for people who struggle with carb moderation, there’s no need for balance. There’s nothing essential about carbs, unlike protein and fat. Even fiber has proven to be overrated, you don’t actually need it. People have survived, thrived really, in climates where they really eat vegetables, and as long as they have fresh meat and lots of fat, they do just fine. I like vegetables and all but mostly as a vehicle for fat.
I too am a T2 diabetic but I don’t think I’m insulin resistant–at least I have never been told that I was. Right now, the carbs I’m eating tend to be mostly non-starchy. When I do have starchy carbs, they are potatoes, and in really tiny quantities (like 6-10g carbs max, about 25% of what I allow for total carbs). As a biologist, carbs to me are essential as cellular respiration runs off of glucose–that’s how the process works chemically. Fats and proteins can be used, but energetically they are tougher to process and do not yield the same quantity of ATP as a gram of carbohydrate does.
I think as long as I don’t stray toward things like bread, rice, pasta and tortillas that I’ll be okay. My sleeve is pretty tiny and I want to maximize what space I have for eating proteins and colorful veggies, when I can fit them in.
Well, by definition, T2 diabetes means you have insulin resistance. I dunno why healthcare providers leave that out, cause it seems relevant to me. Per Wikipedia: “Diabetes mellitus type 2 (formerly noninsulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes) is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency.”
Also, efficient is not the same as essential, the way fatty acids and amino acids are essential, so my point still stands. Glucose may be essential, but dietary carbohydrates are definitely not, thanks to gluconeogenesis (say that one three times fast). As far as efficiency, are you comparing glycolysis and gluconeogenesis? When you are keto-adapted, you are using ketone bodies for almost all your fuel. It’s true that a very small amount of glucose is needed for certain functions, and that gluconeogenesis is a less efficient than glycolysis, but ketone bodies themselves are MUCH more efficiently synthesized into ATP than either process, unless I am mistaken.
I’m not trying to be combative, I swear. Obviously you (and everyone out there) has to do what’s right by them. For me, that’s a super low carb, no exceptions diet, one that I hope to maintain after VSG surgery.
Thank you for this post. For me, the seeming lack of fresh fruits and veggies has been a big sticking point in weighing the pros and cons of WLS. After being blitzed in the past decade about how fresh produce is what we should be eating, to go and switch to a diet that relies a lot on protein powders and drinks and bars (at least in the beginning) seems … I don’t know. Then, protein before produce, which seems opposite … I know in the end everyone has to find what works for them. But don’t you wish we came with individualized instruction manuals!?!