WLS and weight gain

[saberabbey]

I had weight loss surgery 16 months ago and although I keep to betwee 1000 and 1200 cals per day my weight loss has been stagnate for 6 months. I have M.E so only manage a little excersice every few days. I have been advised to go down to 800 cals per day if I want to lose weight. I still need to lose 2st. Will such low cal intake make my M.E. worse as I feel wiped out already

[Julie Thompson]

Hi Saberabbey

Having ME does make your situation more challenging with respect to weight loss. Unfortunately we have little direct clinical evidence for physical activity levels (a calculation used to find out how much extra energy your body needs for activity) for people who have ME, so calculating your energy (calorie) requirements will be more of an estimation for your specific situation. We also do not have a good understanding of the mechanism behind the lack of energy that comes with your ME, so it is difficult to say if reducing your calories will have an effect. You don't say what type of surgery you have had. If you have had a gastric bipass or duodenal switch operation you will be advised to have vitamin and mineral supplements and regular blood tests to ensure your energy levels are not affected by low iron, low folate or vitamin b12. You might also need extra supplements for other surgery depending on your situation. I think it would be a good idea to talk to your healthcare provider (bariatric team? I assume that you are still being seen by them?) who will check your blood results to ensure that your lack of energy is not due to low micronutrient levels. I would also advise you talk to your dietitian (I assume your dietitian has advised 800Kcal) and explain your concerns, as long as you are managing your protein requirements and micronutrient requirements I do not see a problem with trying 800kcal per day short term to see if it effective, as long as you are being followed up and monitored.

[saberabbey]

Thanks, I had a gastric sleeve done abroad, the surgeon recomends 1000 cals per day, multi vit and calcium supplement, with regular blood tests. Gp advised 800 cals per day and advised no blood tests required other than liver function. If liver function becomes abnormal then b12 tests can be done. I was a bit aprehensive to go bellow 1000cals, but will give it a shot as bulk of food I eat is proteins

[Julie Thompson]

I do not necessarily see a problem with what your surgeon has advised for supplementation as you have not had surgery on your small intestine. Our Bariatric Team normally advise that your levels of iron stores (ferritin), full blood count, electrolyte levels, folate, vitamin B12, calcium & vitamin D (many people who undergo bariatric surgery have low vitamin D levels, so we always advise supplementing calcium and vitamin D,) selenium and zinc are checked on an annual basis and supplemented as necessary. Advice can sometimes vary depending on local protocol but an annual test including the above is advisable.

[saberabbey]

I will ask gp to do tests thanks for info