The Dreaded Weight Loss Plateau Post-Bariatric Surgery

There's not many things that can cause the frustration that is felt when your weight plateaus' post bariatirc surgery. You may have been tracking along nicely then suddenly despite changing nothing the weight loss stops. To add to the frustration is the fact that you know you're eating a lot less than you used to and you've been reading all those Facebook posts from people who seem to have doubled your weight loss in less time... #‎frustrated

Here's some things to consider

1. First thing, expect a plateau at some stage. It is totally normal and almost everyone will get weeks where nothing happens or weight loss slows. It doesn't mean that you have failed or no more weight loss is going to occur. Usually weight loss does start again and it may just be a few weeks of 'weight loss holiday' for your body, especially if you've been losing a good amount of weight already. Don't despair just focus on how far you have come and other goals you are meeting rather just the scales e.g. loss of centremetres or drop in clothing size, better eating habits, reduced medication, less pain, better sleep, more energy etc. There are many other success measures and these should be focused on too

2. Please ignore the Facebook posts from others about their weight loss - this is your journey and not theirs. Additionally there are a million and one reasons why they may have been losing weight on the scales at a faster rate and that information isn't usually available to you on their post. Consider some things like: they started at a higher weight than you, they have a bigger muscle mass than you, they are younger than you, they are more active or are able to be more active than you, they may not have certain chronic diseases that affect their rate of weight loss or perhaps they are not eating properly, in which case this isn't a good way to lose weight and can make it more difficult to maintain lost weight later (kind of an important thing). Avoid comparing your weight loss to others.

3. Don't expect the same weight loss each week. The body isn't a machine that routinely does the same thing week in and week out. You rarely will have the same weight loss every week. Some weeks it may be 1kg, other weeks 200g and even other weeks a small gain. Avoid weighing more than once per week and then look at your weight loss from a overall average weight loss over the course of a month. It usually evens out.

4. You lost more at the beginning of your weight loss journey...Of course you did! At the beginning of your journey, you were at a higher weight so required more kilojoules / calories to maintain your weight so the reduction in food intake initially was a lot bigger which equals - more weight loss. Overtime you've lost weight so you require less kilojoules / calories to maintain your weight so the reduction in food intake if kept the same or increased will have less of an impact on weight loss. Additionally as time goes on, often more food can be consumed at meals which impacts the amount of kilojoules / calories you are consuming and thus weight loss. Does this mean you need to starve yourself to keep the weight loss going like before? NO! One of the most important reasons to have weight loss surgery besides losing weight and getting the health improvements that goes with it, is to get into healthy eating and exercise habits and maintain this for life. This is something you need to be adapting during your weight loss journey so that when you reach your goal weight, you are already in a routine that will help you maintain it long-term. There's no point losing the weight quickly but doing it in an unhealthy manner to the point that when you reach your goal you do not know how to maintain it and you stack the weight back on again (it can and has happened!). So make healthy eating and exercise habits a part of your success check list and don't expect the rate of weight loss to be the same during your entire journey.

5. Change it up! Often it can be easy to become stagnant in our everyday routine. We tend to eat the same things and do the same exercise. The body becomes very good at survival so if you are doing the same thing in and out everyday then you'll sometimes see that weight begins to plateau. So take a look at your dietary intake and exercise habits, can you change any of these? Enlist the help of health professionals e.g. a bariatric dietitian, exercise physiologist or PT to help you make changes.

6. Dietary intake...This can make a huge impact on your continued weight loss. Post-surgery you won't be able to eat as much food as before, you may have taste aversions to some foods and other foods may not go down as well. (This varies from person to person and some have no problems at all). Your food choices can really impact your weight loss and long-term health. If your dietary intake is low in kilojoules / calories but your food choices aren't healthy or you are not getting the nutrients you need each day then can you really expect your body to work properly long term? The body needs a variety of nutrients daily to keep running, if you don't provide this then you'll eventually see problems in your weight loss and health. It's crucial to work on improving your dietary intake as soon as possible post-surgery but note, even if it's been a while since you had your surgery, it's never too late to start. You can always restart working towards the healthier you. It's a good idea to enlist the help of a bariatric dietitian in this case, they can help you learn which foods you need to include, do a meal plan for you thus helping you achieve your goals.

This isn't an exhaustive list of things to consider but just a few and common things I encounter when I see patients post-bariatric surgery. Future blogs will discuss this topic further.