Brief Answer:
Hello and Good Morning!

Detailed Answer:
So, if I am hearing you correctly, you started gaining weight after your jpouch was inserted. I see also that you have tried many diets, shakes and diet pills. How about we start with what you are able to eat and strive to eat a balanced diet while lowering your calories to lose weight. In pounds you are 161 pounds. You want to set your weight goal to what is reasonable and achievable. A good weight for you would be 120, but that may not be realistic for you.

Generally, calorie wise, I put my female clients on a 1200 calorie plan, slightly lower in carbohydrates. THE MOST IMPORTANT THING FOR YOU TO DO IS LEARN WHICH FOODS ARE HIGH IN GLYCEMIC INDEX AND GLYCEMIC LOAD. These types of carbohydrates in individuals with a j pouch who suffers weight gain must switch their types of carbohydrates eaten. Also, try to limit saturated and trans fats replacing them with omega-3 fats, extra virgin olive oil and canola oil. Eat only lean proteins (white meat of chicken, turkey, low fat cheese, cottage cheese) If you suffer from gas and eat beans you need to learn to prepare them correctly by soaking and draining and to recognize that broccoli, cabbage, cruciferous vegies may increase gas, but you did not mention if that was a problem for you. Drink Lactaid milk if it gives you gas.

J-pouch patients often have bowel problems. If they are an issue, let me know.

Please go buy liquid or chewable multivitamins. Taking a pill form will likely not be absorbed. You should start these immediately.

No carbonated drinks, no sugar, no juice (only fresh fruit or canned in its own juice and don't drink juice), no gatorade and no fad diets.

It is most critical for you to start and maintain an exercise program. Do you need help with this? What can you do and how many times a week can you get exercise in? Goal: 150 minutes per week at 70% maximum heart rate. Heart rate for you is determined by 220 - 30 (age) = 190 x .7 = 133 is Target heart rate. The procedure is, warm up before exercise and cool down after. After your warm up gradually work up to your Target heart rate of about 130 beats per minute (count for 30 seconds should get 65 beats). Use your wrist or a watch if you have one.
A mixture of cardio exercise, some strength training to build muscle and yoga/tai chi to balance your body.

Add yogurt with active probiotics to your breakfast meal.

Now, I have laid out the basic tenants of the approach you should be taking toward losing about 2 lbs. per week. I am sure questions might arise and I encourage you to read this answer over, google your list of low glycemic index/load foods and study them, see if you can draft an exercise program and if you want to go over it with me, I am here to help you.

Just remember we are on different time zones as I am on EST in US so your query didn't reach me until after I had gone to bed after working until 9 pm.

Also, if writing me again, please include your medications. I need to know if you are still on cortisone/prednisone. Also, tell me why these other diet approaches failed and what were the main problems with them. Thank you for contacting me at HCM. Please feel free to write back for clarifications or more questions. It has been nice consulting with you. XXXXXXX Shattler, MS,RDN

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Brief Answer:
Doing some more research

Detailed Answer:
Hello again ! Have you done anything I suggested at all? I didn't hear of anything that you have implemented of what I suggested above. I do not see that you are on a cortisone, so that should not be aggravating your weight.

Start having oatmeal for breakfast. Lots of soluble fiber that will diminish appetite.

Drink green tea for thermogenesis, to raise your metabolic rate.

You mean your ferritin levels are 9.5? You aren't talking about your Hemoglobin are you? Perhaps you are being treated for iron deficiency and have B12 deficiency due to the nature of your surgery. A ferritin level indicates iron levels. A low hemaglobin can be caused by iron/copper deficiencies (microcytic anemia) or B12 and folic acid (macrocytic anemia). And, when you have a combination you cannot tell what kind of anemia you have until specific blood work is done. You may need B12 shots and a healthy dose of B vitamins for the folic acid and other B vitamins that could be making you tired due to a lack of these.

Juicing can help get nutrients in while taking in liquids rather than chewing on salads. Read up on it.

In the meantime I can do more research and see why you cannot gain weight after this procedure. Is this your last day for a follow-up? This is something I would have to do a little more research on. Thank you for your follow-up; try to take some of my suggestions and see if they work at all. Hope to hear from you again. XXXXXXX Shattler, MS,RDN

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