Hi Bariatric Friends, I hope that you are all well. I am writing because I had a hypoglycemic incident a week ago. Spent some time with the doctor and the ER. So I saw the nutritionist (i.e. NUT) yesterday. She is relatively new to my surgeon's bariatric practice and her advice matched what MANY of you (i.e. Kat W., Grim, NYMOM and others) have been telling me all week. In particular, she wants me to cut down IMMEDIATELY on the frequency of eating. The ER doc wanted me to eat carbs AND eat every 2-3 hours. The NUT thinks I just went too long without eating. She says bariatric patients have different food requirements than normal people OR diabetics. She wants me to back to eating ONCE every 5 hours for a meal. A bite is a chickpea sized bite, chewed to applesauce consistency, eaten over a 30 minute period. Don't measure...don't count carbs or calories...just focus on time eating, hunger/fullness and eating evey 5 hours. Also, 30 seconds between bites. Each meal is to consist of a) A protein, b) a vegetable OR a fruit (i have been eschewing fruit as of late as it just goes bad on me) and c) if there is room a starch (i.e. pasta, rice, bread, cracker). If I must have a snack- it is to be a protein. Like jerky, dried flavored chickpeas, cottage cheese, protein shake, apple with pb or apple with cheese. 5 minutes of snacking should equal 1 hour of fullness. So if I am going to be 2 hours late eating dinner, then I should have a 10 minute snack. Oh yes, the NUT is a fan of cottage cheese. She calls cottage cheese a well balanced food! The NUT anticipates following these rules-I will lose 0.25-2 lbs a week. We have rescheduled for followup in late october. Now, for those of you that don't believe that there is such a thing as starch sensitivity- I have a data point for you. When I walked into the ER a week ago, I weighed 158 lbs. 7 days of eating every two hours, and including starches, I have managed to GAIN to 164 lbs! That is 6 lbs in 7 days folks! The NUT really impressed upon me to stop the frequent eating and to cut way back on the starches, she felt the ER doc told me that because my body was still trying to come back from the metabolic challenge of hypoglycemia. Also, I have an appointment with my surgical PA THIS friday and will discuss these measurements (i.e. the hypoglyemia, the crazy weight gain in the presence of carbs, the generalized weight gain from lack of exercise) and I will be calling the endocrinologist (who should be back from vacation) today. The experience and support here at OH is amazing and spot on. I just want you guys to know that. Have a great day!

That's great! It sounds like you have a workable plan now.

Yep! The info..just so much to wade through.

It is really important to utilize the team approach and OH members are literally the wide receivers of my team. They know what is going on, and are totally on the ball.

I am about to do my fantasy draft this weekend, cant you tell?

That incident sounds scary; so glad you're OK.

Thanks for the great info; hope it all works out for you.

You might want to look back at your Hypoglycemia post as none of what the NUT said matches what the OH folks told you. They were saying stay away from carbs, eat dense protein and eat every 3 hours. Don't be disappointed if you gain weight following the NUT'S plan. You should most definitely be measuring and watching your calories.

As for exercise I would bet you cash money it had nothing to do with your weight gain. I haven't been able to exercise for two months since I twisted my left knee and I have lost 4lbs. It came down to me watching what and how much I ate. Heck I went to three cookouts over those two months and I just made sure I was aware of what I was sticking in my mouth.

If you continue to not monitor how much you eat and continue to eat carbs, fruits, starches instead of dense protein you will gain weight.

I agree. And the nut wants me to eat protein forward. Vegetable.. Starch is ONLY if there is room left. All snacks are to be proteins.

I tried the eating for 30 minutes rule that she had today...and I wanted to be done at 20 minutes. I was getting that "No" feeling. It isnt that I feel full I just feel "No. Sick of this. Don't want more"

Tomorrow I will measure how much I do eat over the 30 minute period and compare to what I did pre-gain.

Thank you, Lady G - I thought I was in the Twilight Zone there, for a minute...

I was thinking...They said WHAT?????

You need good fat. A lot of it.

I only eat starched when I need to gain weight and I only eat no more than 1/2 serving at a time, with meal. That has a lot of proteins and fat.

I hope you got BS meter. When I was trying to mange my BS levels and hypoglycemia - I poked myself up to 10-15 times a day. to find out my body response to different foods - or lack off, time elapsing after meal, etc etc.

you are a scientist - you should be able to figure out the variables and adjust the plan. it is trial and errors. what work for someone - may not work for you. I am very sensitive to potatoes. 1/2 tsp may cause a RH even if I eat that with fat and proteins. EVERY TIME. But - I can have rice or quinoa- 1/2 serving and be fine. my fiend -she jokingly says that just looking at rice makes her BS drops.

Good luck.

You are so right about the variability. Last night I woke up with night sweats, took my bs and it was 143! This is after eating dinner.

Breakfast was 2 hard boiled eggs with everything but the bagel seasoning. Took my pre-lunch BS and it was 105. I would have expected lower given that my breakfast is hard boiled eggs.

The only thing that I could think bumped it up was an herbal tea. I read the ingredients and it has apple and peach juice concentrate in the tea bag BUT when you read the nutritional panel it says 0 g carbs and 0g sugars. How can you have a juice concentrate but NO carbs in there. I wish they would be honest and put something like 0.25 g or something like that.

Well getting ready to stab myself again. In light of elevated BS, I chose to have hushwee salad (ground beef, onion, cinnamon, tomatoe, cucucmber, lettuce and tzaki) instead of the protein shake. I had 3 frozen peach sliced in it for some flavor. I will save it for dinner before tae bo.

What pre lunch number were you hoping for? IMHO, as a Diabetic, and multiple decade nurse, 105 is fine as a fasting BS, much less a pre lunch reading...

Obviously there is something I'm not understanding