Help Me Help Him

I've been lurking for a while but need some advice. The hubby and I have both been working on losing weight, and have had some success but regaining the weight in the past. I'm doing alright with calorie counting and some days at the gym, but he's struggling and getting frustrated.

Background: he's been obese his whole life. When I met him 16 years ago, he was 6'4 and 575 pounds. He had bariatric surgery, lost about 225 pounds, regained about half of that after the initial weight loss. He had complications which caused him to vomit after every time he ate or drank anything for probably a year before he finally went back to his surgeon and had his original surgery (old fashioned stomach stapling, was always supposed to be a two step surgical weight loss) converted to a gastric sleeve. He didn't really lose weight while this was going on and I think his metabolism got royally messed up by the constant vomiting -- very few things would stay down appropriately because of the complications with scarring.

The surgical revision has been about a year or so ago now, he's no longer having vomiting and can keep food down and eat what is almost a regular-sized meal. It's easier for him to eat small meals/snacks though. He's been to multiple dietitians of questionable quality, some tell him he's not eating enough, some say just watch what he eats, but he really has no idea how many calories per day to shoot for, amount of protein, etc. This past week we started calorie counting again and he gained 5 pounds while eating around 1000 calories per day and is just super frustrated by it. I feel like at 6'4 and 435lbs that is just not enough calories, but I'm at a bit of a loss to figure out how to add calories without going to unhealthy foods and while not getting him to try to eat more than he can handle. To top it off he works third shift, so mealtimes can be wonky.

I do most of the grocery shopping and meal planning for us and I want to know what I can do to optimize his nutrition and weight loss -- any advice would be helpful.

submitted by /u/midnightmagnolias
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