By Alita Cobb
Bariatric patient & co-host of bariatric podcast Bari Banter.
You’re a few years post bariatric surgery, you have hit your goal weight and settled into life with a gastric sleeve/ bypass, what now?
By now the chauffeur has well and truly gotten out of the driver’s seat and you are in full control, the surgery is no longer forcing you to be in a calorie deficit, your restriction isn’t as tight as it used to be, old habits are popping their little heads up again (just one Freddo Frog won’t hurt!??) and you may not be as motivated because the scales aren’t moving anymore. The reality is that maintenance is not glamorous, it is hard, and unfortunately, it is for the rest of your life.
We have put together a list of some of the most common struggles patients experience post weight loss surgery and how to best navigate the maintenance phase.
Stall / plateau after weight loss surgery
Stalling or plateauing after any sort of bariatric surgery is very common and is generally caused by the body’s attempts to adjust to your new diet and lifestyle. Even if you are doing everything by the books, it is almost inevitable, so don’t freak out – you are not failing and the surgery is still working. A bariatric stall, whilst not ideal, is a great opportunity to reinforce that weight loss surgery is not a magic wand, use this time to refocus on what your bariatric team has told you and realign with your goals.
Tips to getting out of a stall:
1. Go back to basics – remember what your bariatric team taught you at the very start of your weight loss journey. Protein first, stay hydrated, don’t over complicate things, move your body daily, make sure you are getting enough sleep. Book an appointment with your dietitian to reassess your bloods and adjust your daily intake to suit where you are at in your journey.
2. Write it down – keep a journal to track your daily food and exercise behaviours. By writing it down you are not only keeping yourself accountable, you are also more likely to make better choices. You will be able to look back through the week and see what patterns are forming that could be slowing down your weight loss progress.
3. Get moving – It can be tough sometimes, but exercise after weight loss surgery needs to be part of your daily routine, without it you could be putting your weight loss success on the back burner. We aren’t asking you to run a marathon or lift 100kg, start small, make it manageable, something you enjoy and chip away at it every day. Don’t try to rush progress. Remember, a step forward, no matter how small, is a step in the right direction.
4. Self care – a stall can be stressful, frustrating and can really take a toll on your mental health. Looking after your mental health is just as important as looking after your physical health. Surround yourself with a great support network, set time aside to practice self care and do the things you love, and reach for professional help when you need to.
Regain after weight loss surgery
Firstly, it is important to know that you are not alone if you experience regain after weight loss surgery. About 50% of bariatric patients will experience regain after hitting their lowest weight. Whilst it can be disheartening, try to remember just how far you have come, even if the scales have increased, you could still be fitter and healthier than you were at your lightest. Skinny doesn’t mean healthy. While a little bit of regain is ok, if the scales are increasing and your weight is starting to become a problem, try these things to help you gain control again.
Evaluate your lifestyle – There are so many factors that play a part in maintaining a healthy weight, medical, psychological, lifestyle and diet – just to name a few. Take a step back and evaluate your current lifestyle, what has changed since you started gaining? It could be as simple as old habits slipping back in
or an energy imbalance (consuming more or less energy than you need), that can easily be spotted and changed. But there are some factors that are a little harder to pinpoint. Could stress or your emotional state be playing a part? Have you started a new medication or are you suffering from a medical condition? Have you gone through a major life experience? All of these things affect our metabolic state and a trip to see your bariatric team or GP could be beneficial to helping determine what is causing the regain.
Monitor your liquid calories – If you are gaining weight but “eating healthy” take a look at the liquids you are consuming. A lot of people are aware of the calories they are consuming through food, but forget about the calories in liquids. Iced coffees, soft drink, chocolate milk and alcohol are a great way to bypass your restriction and add a large amount of calories into your day without realising it.
Look out for transfer addiction – a lot of bariatric patients will go through some sort of transfer addiction post weight loss surgery. While some can be a good transfer, like exercise, others can be detrimental to your success, like alcohol consumption. Keep an eye out for transfer addiction and seek help or advice if you find yourself struggling.
Touch base with the team – It is never too late to touch base with your bariatric team. There is no need to be embarrassed or feel like they will judge you. They genuinely care and want you to succeed. Making an appointment with your bariatric dietitian or bariatric psychologist might be exactly what you need to get back on track and get motivated again.
Revision surgery / Medication – If you have tried all of the above and feel like you are making no progress, revision surgery or weight loss medication could be an option for you. Your bariatric surgeon and his team would evaluate your individual situation (lifestyle, diet, physical and mental state) and make a decision that is best for you. Remembering that bariatric surgery is a tool, in order to reach your long-term weight loss goals and prevent weight regain, it’s crucial to make lifestyle and behaviour choices to support having bariatric surgery.
Lack of motivation
The weight has come off, the scales have stopped moving and you are no longer getting the external validation from your friends and family. It is so important to remember that your bariatric journey is more than just a number on the scales, it is about the lifestyle you are creating for yourself. If you are lacking motivation the best place to start is to “remember your why”. What was the reason why you had surgery in the first place? Are you working on yourself every day to achieve that goal? Try to take the focus away from the scales. Progress photos are a great way of monitoring your success without getting on the scales. Set yourself non scale related goals and focus on the small wins you are achieving. Walking faster or further than before, climb a mountain, try stand up paddle boarding etc. The scales will stop moving, so having something other than weight to focus on is a great way to stay motivated. Surround yourself with like minded people and a great support network. Take to social media. There are so many amazing accounts out there that support bariatric journeys, that promote a healthy lifestyle and offer tips, recipes and support for your weight loss journey. Attend the different weight loss surgery events that are happening near you, from support groups, gala nights, clothes swaps and sporting events there are so many ways you can meet new people and connect.
The definition of insanity is doing the same thing over and over and expecting different results. Maintenance can be boring and unglamorous, but you didn’t come this far to only come this far. Refocus your goals and keep going. The team here at Sunshine Coast Medical Weight Loss Centre are in your corner. We want nothing more than you to achieve your weight loss goals and start living the life you deserve. If you are struggling with anything, please give us a call and touch base. You’ve got this!