Over my lifetime I've set a great many goals,
and I reached the majority of them.
This taught me that while a Plan will help direct my path,
 the Reality of my journey will always be very different from my Plan.
Life just tends to always work that way. 

At this moment I feel like I’ve arrived at the end of the line. 

As a 5’0” tall, “reduced obese” sedentary 70 year old female, my weight continues to creep upward, no matter what macronutrients I eat or don’t eat; no matter how small I keep my portions; or how hard I work to keep my calories low.

This last calendar year I continued with my best efforts at recording every bite taken in a computer food journal, every single day.  Sometimes I ate large amounts of food, and sometimes I ate tiny amounts of food.  Sometimes I ate a “balanced diet” and sometimes I ate “low-carb; sometimes I ate “high-fat, moderate protein, low-carb”;  sometimes I worked to keep my calories around 1000 calories per day; sometimes I worked to have only two 5-bite meals of whatever.  My computer eating records show that my overall 365 day calorie average was about 780 calories per day.  That number was the total of all my big eating days combined with my small eating days, divided by 365 days. 

At this point in my life, I am elderly, and although I am in excellent health overall, I have developed a problem with my right hip which restricts my activities, and I lack the ability to do physical “exercise” except for brief periods of slow walking.  However, over the past ten years I’ve run many extensive personal experiments on how various exercise affects my own bodyweight, and the results have proven to me that however much or however little I exercise has almost no effect.  Apparently my metabolism adjusts down to keep me from dropping weight during periods when I engage in heavy exercise… however it does NOT adjust up to keep me from gaining weight when my food intake goes up whether with or without exercise.

During most of this past year, I’ve weighed in my mid-130s - which gives me a BMI in the “overweight” range.  During the past 9 years I’ve worked and worked on maintaining my large weight-loss, and tried to drop as low as possible inside the “normal” BMI range.  The middle of a “normal” BMI range is, for me, 115 pounds.  I struggled to drop and stay below that number for the first couple of my maintenance years, without success, then … while continuing consistently with my ongoing struggle at a food intake averaging around 1050 calories daily … my weight began climbing.  Instead of bouncing within a 5 pound range between 110 and 115, it bounced between 115 and 120.   Then despite a few more years of working hard to drop back to those lower numbers, my weight climbed to bounce between 120 and 125; then over more time, while eating even fewer calories, and additional exercise, my weight climbed to bounce between 125 and 130; then between 130 and 135.  This past several months, my weight has been bouncing between 135 and 140. 

There appears to be no end in sight.  This has been happening over a 9 year period. Since my activity cannot go up, and it is unlikely that I can tolerate consistently eating under a daily average of 780 calories,  it looks like an ongoing lifetime struggle will result in - at best - a gain of a few pounds each year for the rest of my life.  The good news is if I live another ten years to age 80, maybe this creeping gain will only bring me another gradual 20 pound gain, bringing me just slightly over my BMI border of obesity, allowing me to retain a total net loss of approximately 110 pounds … which would still be better than the alternatives - which are: Morbid Obesity or Death (whichever first appears).

At this point, I’ve tried just about every type of dieting, way-of-eating, lifestyle, or “non-dieting” including all types of intermittent fasting.  In fact, this past month, I did a couple of weeks of 24 hour alternate day water fasts, one 36 hour water fast, and one 72 hour water fast combined with a High-Fat/Low-Carb/Moderate-Protein eating plan.  Same results as with most extreme plans, about a 7 pound loss initially, with a slow regain back up to baseline.   Discouraging, since I’ve consistently experienced that same result dozens of times while experimenting with many different food plans.

Some food plans actually eliminate my motivation to live.  Long-term water fasting tends to make me feel ill, AND eliminating my food rewards makes me long for death. The one plan I have refused to experiment with at all is a vegan diet.  Frankly, I find my death preferable to eating Vegan, which appears to start by eliminating all animal products, continue on to extremes like minus grains, salt, oil, sugar, and no cooked foods, all interspersed with long and short periods of intermittent total water fasting.

My body is now near the end point of a lifetime of dieting, and I must admit that I’ve lost hope that it will ever normalize to "intuitively" sustain a weight under morbid obesity.

Because of my own experience, and my close observation of the experiences of many others,  I’ve come to believe that the longer a person’s body has spent well over the borderline of obesity, the less ability that body has to ever recover itself back to the natural weight tendencies it may have had at birth.  My own body appears to be an example of this truth.

I don’t think the following article applies to me personally at this stage in my life - where, if unchecked, my body will naturally lead me only back to morbid obesity, but I believe it contains good advice for young women, or for older women who have recently become overweight or borderline obese.

Be Careful, because
your Mind is Affecting your Health and Metabolism.
         By Caroline Dooner  - Over the Moon Magazine

You actually can’t control your body with external factors like diets. You just can’t.  It backfires. Your body is smarter than you. Which is why dieting, ultimately, after the occasional brief time of “working”, always fails. Your body is wired to slow down when you try to control how you eat. When you restrict – even in the tiniest way- your amazing, smart body freaks the fuck out, and slows down.

Even when we think about restricting and eating less, it slows down our metabolism, keeps the hormone ghrelin high and makes us stay hungry. This is called “mental restriction”. And it is just as bad for us as physical restriction. Physical restriction is actually eating less. Mental restriction is just thinking about eating less.

Mental restriction manifests as guilt, shame, “I shouldn’t eat this”, “I hope I don’t eat this whole thing”, “I’ll let myself eat this, but I really shouldn’t”, “I’m gonna have to make up for this later at the gym”, and on and on. You know the voice. All of those thoughts are so normal in our diet culture. We are taught that thinking that way is responsible. We think, “If I don’t feel shame over food, how will I ever be healthy? How will I ever like my body if I’m not controlling what I put in my body?”

So I am here to lovingly tell you that we were taught was wrong. Food shame is not responsible or healthy, and not only does it rob us of joy now, it actually messes with our bodies. My anti-diet journey came about because of a genuine, no-joke epiphany after ten years of obsessive diets and seeing my entire life through the lens of weight.

“What I am doing is NUTS.”

I had the strongest sense that my body and appetite would normalize if I just freaking ATE. I knew it. And thankfully, I did a good amount of reading then that totally backed up my internal guidance. I adopted what I like to call “the nourishing mentality”. In my mind I had this image of actually repairing and “reviving” my metabolism by eating.

So every time I ate, instead of thinking “Oh man, this is so bad for me. This is going to make me gain weight. Ugh this isn’t quite on my diet”… I thought: “Yessss. Nourishment. This’ll repair everything. This’ll help. This is exactly what I need. My body can handle lots of food, and is happy to have all of this.”

That shift makes a big, big, big difference. And you might think it shouldn’t. But if you read about leptin, ghrelin, and how our bodies actually react differently to eating based on what we THINK about what we are eating, it makes total sense. And what that means is… you can control your metabolism with your mind. But not the old way. Not the punitive, perfectionistic, fear-based control. Not the way that will only let you be happy if you lose weight. No, that way doesn’t work.

Instead, we are supporting our metabolism in the way the celebrates our bodies and trusts them to take the lead on this whole “food thing”. Our bodies actually work better when they are nourished and amply fed. Let’s finally get your mind on the same side as your body.

My 3 Principles investigation is still ongoing, however, today I am setting some new eating boundaries for myself ... which means I'm starting another new-diet-experiment-of-one. 

I'm not ready to share specific details of my own personal plan, but it is based on the information and recommendations provided by the Canadian kidney doctor, Dr. Jason Fung, at www. Intensive Dietary Management.

My current experiment will be different than any diet that I've previously tried, although (of course) many built-in similarities do exist between this specific diet experiment and some of my past diet experiments.

I will be continuing with my practice not to share details about a diet experiment while it is still ongoing.  So, why even share this much? Because I want to, and since this is my own personal Blog, I can.

We all have choices on how we are going to live our lives, and where we are going to place our focus.  My choice may not resemble your choice. I am a “reduced obese” person who has maintained a “normal” weight for more than 9 years, after a lifetime of Yo You Dieting. See ABOUT ME for details.

Doing this has required my constant vigilance, ongoing effort, and tremendous focus, and even though I have been more successful than 95% of everyone who has ever accomplished a large weight-loss, it is been a tremendous personal struggle, and year-after-year, despite CONSISTENT and CONSTANT effort, my weight has continued to slowly creep upward in small increments over time.

This is despite the fact that the recorded daily calorie average of my food intake has been dropping lower and lower each year.

For example, at the start of 2015, my weight was the same as it was at the start of 2014, however, the average daily calories of all of my daily food intake during the year of 2014 was only 754 calories.

In 2013, the average daily calories of all of my daily food intake was 1033. So my average daily food intake was about 280 daily calories LESS than the prior year, and during that prior year, from the start of 2013 until the start of 2014, my body gained 8 pounds while eating that 1033 calories per day.

These are my personal facts, based on numbers which I recorded as accurately as humanly possible, every single day for the past 10 years. For years I felt like Garfield in the cartoon below, but now... instead of yelling "Liar" at the scale, I mentally yell "Liar" or "You Idiot" at the 'Diet Experts' who smugly believe the B.S. and provide to us the results of bad Research, while asserting that "Science Doesn't Lie".

NOTE: that I am a 5’0” tall, 70 year old, sedentary woman with a lower than average metabolism, and according to the Mifflin formula, the AVERAGE woman with my numbers requires only 1237 daily calories to maintain her current weight.

I give you this information so you can see that my recorded calorie numbers are not as far out in left field as some of you might first suppose. You can’t accurately compare my body’s numbers with your own body’s personal calorie calculation requirements if you are larger, taller, younger, more active etc.

That said, the difference between 1237 and 754 is around 480 calories, which is a reduction of nearly 40% of the “Average” calorie requirement. Remember, THIS CALORIE AMOUNT is to MAINTAIN my current weight. . which right now is just above the BMI borderline of “normal”

The past 4 years of the DietHobby ARCHIVES contain many articles detailing and discussing my struggles to maintain my weight-loss. Very few people lose as much weight as I have lost, and only about 95% of THOSE successful people have achieved the type of maintenance success that I am currently exhibiting.

I often question how long I can continue to eat such excessively tiny amounts of food while watching my weight continually creep upward; whether I am willing to continue my current behavior for the rest of my lifetime; and I honestly don’t know. Right now, I’m just taking it one-day-at-a-time, while searching for Guidance.

I can vouch for the accuracy, and I do agree with the mindset, of the following article based on my own knowledge and personal experience.

Failed at Dieting?
Welcome to the Almost Everyone Club!
                    by Ragen Chastain, www. danceswithfat

A question that I get asked pretty often is “If dieting doesn’t work, how is it possible that it’s such a popular recommendation even by doctors?”  I’m glad that you asked!

For the last 50 years the research that has been conducted regarding long term weight loss has shown that weight loss almost never works long term.  Yet we are constantly told by the media, the government, our doctors etc. that anybody who tries hard enough can lose weight and keep it off. Plenty of studies have shown that the body has a number of physiological reactions to weight loss that are designed to regain weight and then retain that weight. 

Yet we are told that those who regain their weight have just “gone back to their old habits.” But what really happens?

So a person begins one of a thousand intentional weight loss  (also known as a “lifestyle change”) programs.  They lose weight at first, then between 2 and 5 years after the loss they gain back all of the weight plus more, despite diligently maintaining their diet behaviors (aka “lifestyle changes”). They report these happenings to their doctor only to be told that they must not have been properly counting calories, they must have overestimated their movement. Their experience, they will be told, could not possibly have happened, it is impossible because…physics!  Or they tell their doctor that they couldn’t mentally and physically continue their dieting behaviors (aka “lifestyle change”) and are told again that they just weren’t trying hard enough.

All this despite the fact that their experience is exactly what the research tells us to expect. When millions of credible first person accounts match up with what research has found, typically that’s a good time to jump out of your bathtub and run around naked yelling “Eureka, I’ve found it.”

So why is dieting such a popular recommendation?  Those who are perpetuating this “weight loss works’ culture are doing a couple of things frighteningly well.

First, they are doing a great job of obfuscating the evidence.  Remember when a study found that Weight Watchers participants lost around about 10 pounds in six months and kept off half of that for two years (giving them a 3 year efficacy buffer but who’s counting) and Karren Miller-Kovach, chief scientific officer of Weight Watchers International at the time won the “I Said It With a Straight Face Award” when she told the media: “It’s nice to see this validation of what we’ve been doing.” Five pounds in two years.  Five pounds in two years.  Five freaking pounds in two freaking years?!?!?!?!?!.  But every time I say something about Weight Watchers people tell me how well it works (often, defying all logic, telling me that they’ve “done Weight Watchers 6 times and it worked every time“.)

Or the National Weight Control registry claiming to prove that weight loss works when the truth is that they would need 32,990,000 more success stories just to show a 5% success rate for dieting over the time they’ve been collecting data.  They’ve only managed to gather about 10,000 success stories since 1994, so they just moved the goal post and claimed victory at the fact that their numbers indicate that dieting works .009% of the time which means that if you walk to your Weight Watchers meeting in the rain you are three times more likely to die from a lightning strike than lose weight long term.

The second thing that they do alarmingly well is to discredit what are actually completely credible first person accounts of dieting failure.  Hundreds of thousands of people have diet failures every year.  Some of them have been convinced that they suddenly lost the ability to accurately maintain their diet behaviors, like people are saying “that’s weird, last week I could totally measure a cup of pasta but this week I forgot what a measuring cup is or how it works, so I just ate the whole package of spaghetti.”  They are told that they must be doing something wrong if they are regaining weight.  They are excoriated and discredited as “trying to justify their fatness”  (as if we need justification to exist in our bodies.)

But the diet industry and its cronies do it with shocking success.  Millions of people saying “I had the exact experience that research said was most likely” and somehow the diet industry, the government, and the medical establishment are able to discredit all of us in the eyes of the greater culture, often while continuing to profit.

This is all by way of saying that if you’ve tried dieting and ended up regaining all of your weight, or all of your weight plus more, then welcome to The Almost Everyone Club, we aren’t exclusive and we don’t have jackets (yet!) but we do have evidence and experience.  You have the right to claim and own the fact that you are indeed a credible witness to your experience, and you can refuse to allow someone else to substitute their completely  fabricated (and highly lucrative) experiences for your actual ones, and you can insist that they stop the diet roller coaster because you want to get the hell off.

About 23 years ago I had an RNY gastric bypass surgery. You can learn more about that, and my subsequent years of dieting, by reading ABOUT ME. This resulted in me eating an extremely low-calorie diet during the first 6 months after surgery, and a very-low-calorie diet during that following year. This type of eating caused me to lose 110 pounds during that time period.

The dieting industry makes billions of dollars every year by marketing its foods, supplements, and services. It encourages people to use MORE foods and other diet products, while people actually need to use far LESS. As a result, most people are unaware of how VERY LITTLE FOOD is required by a person wishing to lose weight - especially by a person who has an obese body with a great deal of stored fat which needs to be used as energy.

For the first few months following a gastric bypass surgery, a person’s calorie intake is between 300 and 600 calories per day. The recommended meal portion size is 1/4 cup for a solid meal and 1/2 cup for a liquid meal.

The volume of the plated meal in the picture at the top of the page is about 1/3 to 1/2 a cup which is MORE than 1/4 cup of food.  To reduce the amount food on that plate to 1/4 cup, visualize removing some of that little round potato. 

Immediately following surgery, the stomach size is very small - about 1/4 cup, or the size of an egg. The opening that allows food to pass out of one’s stomach is also very narrow. For this reason, it is important to take only two to three sips or bites at a time of any NEW food and then wait 10 minutes before taking more. This will help a person learn one’s limits and tolerance. Liquids will empty faster from the stomach than soft solids.

See Below for the standard Dietary Guidelines for after Bariatric Surgery, provided by the University of California San Francisco Medical Center:  

Dietary Guidelines After Bariatric Surgery

General Guidelines
• Eat balanced meals with small portions.
• Follow a diet low in calories, fats and sweets.
• Keep a daily record of your food portions and of your calorie and protein intake.
• Eat slowly and chew small bites of food thoroughly.
• Avoid rice, bread, raw vegetables and fresh fruits, as well as meats that are not easily chewed, such as pork and steak. Ground meats are usually better tolerated.
• Do not use straws, drink carbonated beverages or chew ice. They can introduce air into your pouch and cause discomfort.
• Avoid sugar, sugar-containing foods and beverages, concentrated sweets and fruit juices.
• For the first two months following surgery, your calorie intake should be between 300 and 600 calories a day, with a focus on thin and thicker liquids.
• Daily caloric intake should not exceed 1,000 calories.

Fluids
• Drink extra water and low-calorie or calorie-free fluids between meals to avoid dehydration. All liquids should be caffeine-free.
• Sip about 1 cup of fluid between each small meal, six to eight times a day.
• We recommend drinking at least 2 liters (64 ounces or 8 cups) of fluids a day. You will gradually be able to meet this target.
• We strongly warn against drinking any alcoholic beverages. After surgery, alcohol is absorbed into your system much more quickly than before, making its sedative and mood-altering effects more difficult to predict and control.

Protein
Preserve muscle tissue by eating foods rich in protein. High-protein foods include eggs, meats, fish, seafood, tuna, poultry, soy milk, tofu, cottage cheese, yogurt and other milk products. Your goal should be a minimum of 65 to 75 grams of protein a day. Don't worry if you can't reach this goal in the first few months after surgery.

Supplements
You must take the following supplements on a daily basis to prevent nutrient deficiencies. Please remember that all pills must be crushed or cut into six to eight small pieces. You are not able to absorb whole pills as well as before surgery, and it can be difficult for the pills to pass through your new anatomy.

Multivitamins
Take a high-potency daily chewable multivitamin and mineral supplement that contains a minimum of 18 mg of iron, 400 mcg of folic acid, selenium, copper and zinc. Brands that contain this formula include Trader Joe’s and Centrum Adult chewable multivitamins. Take two tablets daily for at least three months after your surgery, and then one tablet daily for life.

Calcium Supplement
Take 1,200 to 2,000 mg of calcium daily to prevent calcium deficiency and bone disease. To enhance absorption, take the calcium in two to three divided doses throughout the day - for example, a 500 to 600 mg supplement taken three times a day. Calcium citrate is the preferred form of calcium.

Vitamin D Supplement
Take a total of 800 to 1,000 International Units (IUs) of vitamin D each day. This total amount should be taken in divided doses of 400 to 500 IUs twice a day. Vitamin D should be taken with your calcium supplement. If you prefer, you can take a combination calcium-vitamin D supplement to avoid taking multiple pills, so long as it contains the proper dosages.

Vitamin B12 Supplement
Take 500 mcg of vitamin B daily. It can be taken as a tablet, or in sublingual forms placed under the tongue.

Other Supplements
Some patients need additional folic acid or iron supplements, particularly women who are still menstruating. Your dietitian will discuss this with you.

Diet Progression After Bariatric Surgery

Immediately following surgery, you will begin with a clear liquid diet. You may gradually start adding thicker liquids to your diet after you are discharged from the hospital.

Two weeks following surgery, you may progress to blended and pureed foods. You may use high-protein (more than 20 grams protein), low-calorie (less than 200 calories) liquid supplement drinks or powders to meet your protein requirements during this period.

It is important to know that following surgery, your stomach size is very small - less than 1/4 cup, or about the size of an egg. The opening that allows food to pass out of your stomach is also very narrow. For this reason, it is important to take only two to three sips or bites at a time of any new food and then wait 10 minutes before taking more. This will help you learn your limits and tolerance. Liquids will empty faster from your stomach than soft solids.

If you overeat or eat too quickly, you may experience nausea or pain. You should avoid rich, creamy liquids such as gravies, sauces and ice creams.

Diet in the Hospital

You will receive clear liquids such as juices, Jell-O and broth as your first meal following surgery. Juice and Jell-O are high in sugar content, but your portions will be very small at this stage. Gradually increase the amount you drink at each meal as you can tolerate it.

Diet for the First Two Weeks Post-Surgery

You will begin adding thicker liquids that are high in protein and low in fat and sugar. (For examples, see the list below.) You may use high-protein, low-calorie liquid supplement drinks or powders to meet your protein requirements during this period.
The goal is to consume small portions that will empty easily from your pouch. Begin with 1 tablespoon portion sizes and increase to 2 tablespoons as tolerated. Begin drinking 1/4 cup of liquid at a time and increase to a 1/2 cup as tolerated. Your daily caloric intake should not exceed 400 calories.

It is also very important to stay well hydrated. Drink 1 to 1.5 liters of water or other non-caloric liquids per day.
Recommended thicker liquids:

• Nonfat or 1% milk, if you can tolerate milk
• Lactose-free or soy-based low-calorie drinks
• Sugar-free pudding
• Sugar-free, nonfat yogurt
• Low-fat cottage cheese
• Blended broth-based soup or other low-fat soups
• Refined hot cereals that are low in fiber, such as cream of rice or cream of wheat. Make them with extra liquid to create a soup-like consistency. Do not eat oatmeal.
• Optional high-protein, low-calorie liquid supplement drinks (drinks containing less than 200 calories and more than 20 grams of protein in an 8- to 11-ounce serving).

To increase your protein intake, add 2 tablespoons non-fat dry milk powder, egg substitute or powered egg, or other protein powder to each 1/2 cup of nonfat or low-fat milk. You can also add these to soups, hot cereal and other thick liquids.
Remember to drink 1 cup of water or other non-caloric fluids between meals. Take a multivitamin supplement every day.

Diet for Weeks Two to Four Post-Surgery

Begin adding very small portions of pureed and soft foods as tolerated. Take very small bites and chew everything very well. Do not take more than two bites every 20 minutes when adding a new food.
Recommended pureed and soft foods:

• Applesauce
• Yogurt
• Cottage cheese
• Well-cooked, pureed vegetables
• Hot cereals
• Mashed potatoes
• Noodles
• Scrambled egg whites or egg substitute
• Canned fruits
• Canned tuna fish
• Lean fish
• Tofu
• Lean ground meats or poultry

Avoid all bread and meats that are not easily chewed.

Recommended Meal Plan For Weeks Two to Eight Until Two Months Post-Surgery

At this time, your caloric intake will probably be no more than 500 calories a day, divided into six to eight small meals.
Recommended portion sizes are 1/4 cup for solids and 1/2 cup for liquids.

Sample Menu
This sample menu includes different foods that are safe for you to eat. You may adjust the menu to fit your tastes and tolerance.

Breakfast
1/4 cup hot cereal made with non-fat milk
Mid-Morning
1/2 cup nonfat milk*
Late Morning
Two scrambled egg whites
Lunch
1/2 cup low-fat chicken noodle soup
Mid-Afternoon
1/4 cup low-fat cottage cheese
Late Afternoon
1/4 cup sugar-free, nonfat yogurt
Dinner
2 ounces lean ground meat
1/4 cup pureed or well-cooked vegetables
Bedtime Snack
1/4 cup non-fat milk
* Add 1 tablespoon non-fat dry milk powder to each 1/4 cup nonfat milk for additional protein.

Remember to drink 1 cup of water or other non-caloric fluids between meals. It is important to take a multivitamin and mineral supplement every day, plus additional iron if required, and calcium and vitamin D supplements two to three times per day.

Recommended Meal Plan for Two to Six Months Post-Surgery
Consume 900 to 1,000 calories and at least 65 to 75 grams of protein a day. For balanced nutrient intake, your daily servings should include:

• 3 servings milk and dairy products (nonfat and low-fat)
• 3 servings meat or meat alternative (lean and low-fat)
• 3 servings starch (limit bread and rice)
• 1 serving fruit (avoid dried fruits and fruits with skin)
• 2 servings vegetable (well-cooked only)

Recommended portion sizes are 1/4 cup for solids and 1/2 cup for liquids.

Discontinue taking high-protein liquid supplement drinks or powders if possible. We recommend meeting your protein needs with food.

Sample Menu
This sample menu includes different foods that are safe for you to eat. You may adjust the menu to fit your tastes and tolerance.

Breakfast
1 egg or 1/4 cup egg substitute
1/2 cup hot cereal
Mid-Morning
1/2 cup nonfat milk
Late Morning
1/2 cup chopped melon
Lunch
1/2 cup low-fat chicken noodle soup
Two Saltine crackers
Mid-Afternoon
1/4 cup low-fat cottage cheese
1/4 cup canned fruit packed in water or juice
Late Afternoon
1/2 cup sugar-free, nonfat yogurt
Dinner
2 ounces lean meat or fish
1/4 cup mashed potatoes
1/4 cup pureed or well-cooked vegetables
Bedtime Snack
1/2 cup nonfat milk

The sample menu offers eight small meals per day. You may wish to eat more or less often, but be sure to eat at least six times each day.

Remember to drink 1 cup of water or other non-caloric fluid between meals. It is important to take a multivitamin and mineral supplement daily, plus additional iron if required. In addition, you must take calcium and vitamin D supplements two to three times per day.

Recommended Meal Plan for Six Months Post-Surgery and Beyond

• Continue consuming 900 to 1,000 calories per day
• Decrease to three meals and only one to two snacks per day
• Discontinue taking high-protein liquid supplement drinks
• Increase the variety of low-fat, low-sugar and low-calorie foods, as tolerated
• Avoid raw vegetables, fresh fruits with skins, dried fruits, breads, popcorn, nuts and red meats only if poorly tolerated

Long-term Dietary Guidelines

Over time, you will be able to increase the variety and consistency of foods in your diet. Some foods may continue to be poorly tolerated, including red meats, chicken, breads, and high-fiber fruits and vegetables. Focus on low-fat, low-sugar and low-calorie foods and continue to count your calories every day. Try to meet your serving goals for all food groups based on the 900 to 1,000 calories diet plan described above.

To stay well hydrated, drink at least 2 liters of water or non-caloric fluids daily, unless this is contraindicated due to a medical condition.

Reviewed by health care specialists at UCSF Medical Center.
This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.