Not to chap anyone's Cheeks, But....

According to the Mayo Clinic's Information for Bariatric Surgery Weight loss, 800 calories per day for the first year is what is expected for patients.  1200 per day after that??

This seems extremely low - according to the information I have been given on CC, for the calories I need to be eating each day to lose.  (At least 1600). 

Can anyone explain this, and explain why it IS working for obese people to eat only 800 per day and lose TONS of weight and keep it off for the long term, and all the indicators on this website say to NEVER go below 1200???  They say under 1200 is starvation mode and your body will start to shut down and retain....  I call bull on this number. 

Now I am certainly not advocating going that low, I am just trying to understand why it IS working for surgery patients. 

Fire away!~

My first guess is because they don't have 800 calorie days most of the time, and then have a day worth of 800 calorie meals.  They are forced to be consistent.  They probably have that 800 calories spread out over a very long period as well.  Lastly, they probably have insulin problems, or something else which causes them to have some sort of genetic fat storage, which isn't how normal people usually react to food. That's my guess.

the logic behind 1200 cals is that you need to eat that much in order to get proper nutrition.  some drs will say you can eat a little less, some will say that you shouldnt eat below your bmr.  the mayo clinic says 1200 is about the minimum... but their studies put people on 1200 and then exercise without adding back... so, you can see, there isnt a whole lot of agreement on what is proper to get appropriate nutrition, fuel your body, and lose weight.

very low calorie diets (below 1000) DO work but the unintended consequence is that your metabolism slows to the level that it gets used to eating and for some people they arent really ever able to eat more than that without gaining weight.  starvation mode is a bit of misnomer-- it means that your metabolism has slowed to the point where it is hanging onto whatever you are eating-- if you eat little enough, you will still lose weight you just wont be very healthy or energetic or be able to eat a whole lot in the future if you cant fix up your metabolism afterwards. 

It is really simple. The surgery immediately reduces the size and capacity of their stomach. It can not hold more than that. That is the purpose of the surgery to reduce the amount of food a person can eat at one time, in hopes of surgically reducing their caloric intake. Over time, they are able to increase the calories, and "stretch" their stomach. They also have to be careful, because the have sutures on their stomach. Anyone who has had the surgery, please correct me if I got it wrong. That is what my good friend had to do... hope that helps

But I guess they are getting enough proper nutrition in that 800 calories?

I had a friend who as well, had the surgery and she is doing wonderfully maintaining at about 1200 calories, and she exercises frequently.  She is happy and healthy.  Very energetic.  

And...they are being monitored by a physician. Normally overweight people who go on a very low calorie diet usually arent under a physicians supervision. I say go for it if you are seeing a doc and he is monitoring you.

VLCDs (very low calorie diets) can be done under two conditions

1) The patients are monitored by doctors

2) The danger that is presented by a patient's weight it greater than the dangers associated with eating less than the 1200 boundary.

And the weight loss WILL slow down on these diets - a patient 400lb may lose 100lbs, but that will be it, and 300lbs would still (for most heights) be obese.  There's an article floating around on the fitness boards (I think melkor posted it) called 'obesity at 700 cals a day" that can explain it.

From the Center for Obesity Surgery's website: In addition to surgical complications, some people experience long-term deficiencies of vitamin B12, folate, and iron.

So...that could be one reason why it's important to eat enough...because some people have serious vitamin deficiencies when they don't.

Bariatric patients can not eat over 800 cals a day nevermind 1200.  Are they pre op patients or post op? 

I signed up for a boot camp.  I'm trying to lose 10lbs my trainer told me to eat 1250 cals in a day,  I'm trying but I'm not hungry so I don't eat.  I've been eating between 800 and 1000 cal.. and I'm not losing weight.  They informed me I'm starving my body and I had to eat more. So I'm going to try really hard this week to eat the 1250 so I can lose at least a pound this week. I'll let you know if it works.

The whole theory behind why gastric bypass works is forced malnutrition (decreased absorption of nutrients). Anyone who has ever had the surgery will tell you about how much of their nutrition must come from supplements because their body will always be incapable of obtaining it from food.....the "1200 rule" is for most normal, healthy adults.

the 1200 minimum is to protect us from feeding off our own body.  if you're 500 pounds, you want your body to feed off itself.

(and i just flashed back to the choreographer in Bring it On: when you diet, your body feeds on itself.  if you eat less, your body will eat your ass.  i probably didn't get the quote right, but you know what i'm talking about, right?)

800 calories is still classified as "low calorie"  and right on the cusp of "very low calorie." The thing is, low and very low calorie diets DO work, but if the conditions that caused the weight gain are still present after the diet is stopped (for example, no exercise, no strength training, eating too much too quickly) then people regain. It's that simple. I think there's a lot of misinformation about the so-called "starvation mode." I don't really think the "starvation mode" exists in the way people think.

Yes, your metabolism goes down during calorie restriction, but not enough to STOP your weight loss- it just slows a bit, but you still lose more rapidly than you would on more calories, especially if you stay active. Think about it. People keep raving about how if you don't get enough calories, you're going to burn up your water, muscles, your heart, and all your vital organs INSTEAD of fat. Then what the heck is the point of even HAVING fat? Your body is going to be just as efficient at preserving muscle tissue as it is in preserving fat while dieting low cal on a lower metabolsim. Your body does not want to lose too much of either. You naturally gain muscle and fat when you eat; you naturally lose muscle and fat when you don't eat. I read a study somewhere that said that fat to mucle loss during very low calorie diets (less than 800 calories) with no strength training is about 60/40.

I'm certainly no expert, but there's a lot of misinformation out there that gets quoted from site to site to site with nothing to actually back it up. Here are some links from people who probably should know.

In the end, I guess it's up to each individual to make up his or her own mind about what's going to work and what isn't.

http://win.niddk.nih.gov/publications/low_cal orie.htm#adverse 

http://www.weightwatchers.com/util/art/index_ art.aspx?tabnum=1&art_id=35501

http://www.obesityresearch.org/cgi/content/fu ll/9/suppl_4/S295

Honestly, I've known three people who've had this surgery and only one has been able to keep the weight off. 

The other two ended up using meth for one reason or another, I think they thought it might help keep weight off, but also they never dealt with the emotional reasons they had gotten so big (One of the gal's actually made herself gain 30 lbs so she would qualify for the surgery).

I myself have often considered this option, but know I'm not heavy enough to qualify and realize if I don't deal with my reasons for my weight problems, they won't get better no matter how I lose it.

I guess this doesn't really answer anyone's question, just states my personal observations...  I can add that the gals experienced all kinds of health problems from not getting the nutrition they needed.  Two of the gals lost all their hair from lack of protien.

FYI gastric bypass is not a cure all.  You may not lose all the weight with it if you don't change your eating habits.  You still have to exercise and eat better, but you will eat less.  Now, you can eat less and still not lose it all if you don't eat well.  A member of my immediate family had the surgery and lost about 100 pounds.  They still need to lose 80 or so, but due to diet (you can't eat alot at one time, but can eat a little many times a day) has not.  Also the stomach can get larger again over time (how large I don't know). 

i dont know where you got your info, but ladydesira is right.

havent you ever read about people who've had the surgery 1 or more years after they got it done? most people STRUGGLE to keep the weight off.  absolutely it works long term for some! but most people gain so much back. and thats at best. 800 calories IS NOT GOOD. its just that thats the only amount they can handle. they become malnourished. im completely against this procedure. im beginning to get upset and im not going to get into my loud-mouthed opinions of it, but i feel like it's doctor assisted anorexia. 

im done. i keep writing stuff and getting angry and opinionated then erasing it because im trying to stay neutral so im ending my response now haha. 

Original Post by jenniferger:

I think there's a lot of misinformation about the so-called "starvation mode." I don't really think the "starvation mode" exists in the way people think.

...People keep raving about how if you don't get enough calories, you're going to burn up your water, muscles, your heart, and all your vital organs INSTEAD of fat. Then what the heck is the point of even HAVING fat?

Excellent point.  Why do we have fat if the body is not going to use it in times of need?  

This website is very informative and helpful, but many times I open threads and 5 to 10 posts are urging people to eat more, eat, eat, eat!  

Again, I am not advocating starving in any form.  I personally eat at least 1600 per day on my own journey.  I am just trying to get down to the scientifics of the matter. 

My best friend had this surgery and trust me, if he took in 800 calories that was alot.  Its not a choice, if he ate a little too much or the wrong thing...it all came up.  So 800 calories for the first year is about right.

This 1200 calorie thing has gotten way out of hand around here...let me debunk the myth that has been bugging the hell out of me since I got here.

The myth: "You need 1200 calories per day or your body goes into starvation mode and you won't lose weight."

This is said probably 10,000 times a day here. It's true that your body goes into a "starvation" mode if you're under 1200 per day. It's ALSO true however, that if you're burning 1800 calories per day and eating 1799, your body goes into the same "starvation" mode. 

 Starving your body of EXTERNAL energy is the entire purpose of a diet. When you don't put enough calories into your body, it turns to your fat stores and begins to convert them into usable sources of energy...thus depleting your fat deposits and becoming your primary source of weight loss.

The reason for the 1200 mark is simply that it's been determined at about 1200 calories you can expect to get a balanced diet with the necessary nutrients in sufficient amounts, if you put any effort in at all. Eating 800, 900, or 1000 calories a day can work if you're ensuring that you get all your proper vitamins, essential fatty acids, and essential amino acids (by way of complex proteins). There is just a ton of effort and planning that have to go into making this work, and therefore it's not feasible for an average person...hence, "eat 1200 and you've got a pretty good chance at maintaining a healthy life style, while losing weight (since even the smallest people burn 1500+ in a normal day." 

I should put a disclaimer in that the starving of your body, mainly from carbohydrates and sugars (a real danger if you're eating too few calories) is a bad thing to do because your red blood cells cannot use the ketone bodies (products of fat catabolism) for energy. Yet another complexity to eating less than 1200 a day. With all that said though, it is not the starving of energy that's bad...that IS A DIET...it's the POTENTIAL and LIKELY starving of essential nutrients.

Excellent post, Swimfreak!  Very well said!  :)

 

Original Post by swimfreak26:

This 1200 calorie thing has gotten way out of hand around here...let me debunk the myth that has been bugging the hell out of me since I got here.

The myth: "You need 1200 calories per day or your body goes into starvation mode and you won't lose weight."

This is said probably 10,000 times a day here. It's true that your body goes into a "starvation" mode if you're under 1200 per day. It's ALSO true however, that if you're burning 1800 calories per day and eating 1799, your body goes into the same "starvation" mode. 

 Starving your body of EXTERNAL energy is the entire purpose of a diet. When you don't put enough calories into your body, it turns to your fat stores and begins to convert them into usable sources of energy...thus depleting your fat deposits and becoming your primary source of weight loss.

The reason for the 1200 mark is simply that it's been determined at about 1200 calories you can expect to get a balanced diet with the necessary nutrients in sufficient amounts, if you put any effort in at all. Eating 800, 900, or 1000 calories a day can work if you're ensuring that you get all your proper vitamins, essential fatty acids, and essential amino acids (by way of complex proteins). There is just a ton of effort and planning that have to go into making this work, and therefore it's not feasible for an average person...hence, "eat 1200 and you've got a pretty good chance at maintaining a healthy life style, while losing weight (since even the smallest people burn 1500+ in a normal day." 

I should put a disclaimer in that the starving of your body, mainly from carbohydrates and sugars (a real danger if you're eating too few calories) is a bad thing to do because your red blood cells cannot use the ketone bodies (products of fat catabolism) for energy. Yet another complexity to eating less than 1200 a day. With all that said though, it is not the starving of energy that's bad...that IS A DIET...it's the POTENTIAL and LIKELY starving of essential nutrients.

 

Original Post by alicandra:

.  There's an article floating around on the fitness boards (I think melkor posted it) called 'obesity at 700 cals a day" that can explain it.

yea, you should read that article, its very interesting! =)