3 year post-op plateau

Question
Hello Karla,

      I'm fairly new to this site so please forgive my ignorance. I'm 27 years old and had the Roux-en-Y done in April of 09'. I've went from 352 lbs to a current weight of 230 lbs. Very proud and happy with the weight-loss but not quite happy enough. I've pretty much been overweight my entire life and want to finally put it to an end and wear those sexy clothes I've always wanted to wear. I go to the gym 4-5 times a week, do stationary biking for up to 40 minutes every time I go (and yes it's put at a level where I make myself feel like I'm definitely having to put in the effort to get my heart rate going), and weight-lift every other day. Problem I seem to have is my diet. I have always been the stress-eater and I know it's got to stop. I need to know how many calories I should be consuming maximum per day. I am 5 ft 8 in to give you an idea. I also would like to know how much protein I should be taking in daily. I could really use your advice because I'd really like to get myself down to 140 lbs and am hoping to lose at least 1-2 lbs a week if at all possible but can't seem to get myself there and have struggled with this for over 6 months now. I continue to "yo-yo" between 230-240 and it never seems to go down any. Please help. Thank you for your consideration.
Sincerely,
Rosa

Answer
Hi Rosa:

Congratulations on your success! Maintaining a 122 pound weight loss is such an amazing accomplishment.

If it's been three years, your calorie needs should be similar to a "normal" woman who weighs 230 pounds.  Understand that with your excess skin, it might be harder to get to exactly 140 pounds, but that's no reason why you can't still lose more weight.  It sounds like you're doing everything right regarding exercise.

You should be able to lose on a 1650-1800 kcal/diet... so think of it in breaking up your meals into four 400 calorie meals or so.  (Usually people go a little bit over, which this allows as well as for 100 or so extra/fun calories)  As for protein, most people find that they have more satiety (fullness) if they consume more, so I would go for at least 75-80 grams/day if you can (so 20 grams of protein per meal).  One way to make this easy is to write down pre-calculated meals of food you like.  Include meals you can easily order at restaurants you like, etc.  (So, perhaps it's an Egg McMuffin plus an apple you bring for a breakfast from McDonald's. (An Egg McMuffin has 18 grams of protein, so you could either consider that close, or bring an hard boiled egg white or reduced-fat Laughing Cow cheese wedge with you.)  Another meal might be a shrimp appetizer, side salad, and so much dressing, etc.)  I think Prevention magazine has a bunch of 400 calorie meals on their website, so check there.

Be sure you're still getting your vitamins in.  Have you had your annual blood work yet?

One really easy option is to join something like Weight Watchers which would give you accountability.  A lot of bariatric patients do join, although you might want to keep your surgery to yourself. (It's up to you, but some other members can be a bit catty regarding it. ;))  I think the typical allotment is around 29 points these days, it might be a little more for your weight plus the 35 "extra" points to use during the week.  The nnly thing I would do separately is to pay attention to protein a few days per week just to check and make sure you're getting it all in.

I have every confidence that you can do it Rosa.  You've already been an incredible success, so there's no reason why you can't achieve your dream.

Good luck,
Karla

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