Jacqui Lewis - BHSc Nutritional and Dietetic Medicine
Weight Loss Plateau After Bariatric Surgery
What is a weight loss plateau, and what, if anything, do you need to do about it?
Have you ever felt that sinking feeling of "Uh oh, this is it, I'm not where I want to be yet,
but my weight loss has come to a standstill?
Considering the goal of Bariatric Surgery is often fixated on weight loss.
The thought of linear weight loss ending is downright scary for some.
This is a source of distress even before surgery.
Let's discuss weight loss "norms" after Gastric Sleeve or Bypass Surgery and how to overcome a weight loss plateau.
Is it a plateau?
Is weight loss always linear?
Will a weight loss plateau go away on its own?
Is there more you can do to get over a plateau in weight loss?
And when to get help.
The first stage directly after your surgery is called rapid weight loss. The surgery is "metabolic," indicating it affects the hormones that manage metabolism. When the surgery changes these hormones, for the first time for some patients, the body can finally use stored fat for energy.
Changes to hormones called leptin, ghrelin, and insulin combined with a large caloric deficit due to the teeny tiny tummy you now have = RAPID weight loss. It's like a switch is finally flicked on, and it all starts to happen - FAST!
And it can be exhilarating.
This dramatic weight loss can last between 3-9 months. When supported by new eating habits and appropriate Bariatric Multivitamins, most patients can lose a large percentage of their excess weight within the first year and remain healthy.
The rapid weight loss stage is also known as "The Honeymoon Period" because it seems like all your ducks are in a row, and you've likely not felt this good in a long time.
How to Get Past a Weight Loss Plateau
Firstly: Remember this is very normal!
A Gastric Sleeve weight loss plateau typically occurs after the 3-weeks post-op, when the rapid weight loss slows down or stops altogether. Bariatric plateau is very normal and temporary and is generally due to the body's attempts at adjusting to a new diet and an alternative energy source.
Second: Don't be too quick to throw your toys out of the pram!
Third: Put your coach's hat on so you can talk kindly to the voice in your head who wants to scream "Fail."
It's unlikely you have failed if you have been listening to your team, crossing your T's, and dotting your I's as far as your food and activity levels go. Remember that nothing is linear, and there might be something else your body is working on at the moment. Particularly so soon after major surgery, it's good to remember that A LOT is happening behind the scenes!
As we said, this is pretty normal in the early stages, so keep doing what your team has advised, and you'll start to lose again in no time. It's part of the ride!
What to Do if You Feel Stuck on a Plateau
After the rapid weight loss stage, as you start to settle in, there is a range of things that will make weight loss happen more slowly; the key players are:
The ratio of carbs to protein intake
Sleep length and quality
The sum of calories in and calories out
Around the 12-month mark after any bariatric procedure is where the research indicates some things start to change.
Some are biochemical adaptations; some are habits - we can only control the 'habits' part in most cases:
- Carbs sneak back into the diet.
- Protein is no longer well prioritised.
- Stress/emotional eating return.
- Some hunger will return.
- Not eating enough overall.
How to Break a Weight Loss Plateau
Like anything in life - change is as good as a holiday, and our food and activity habits are no different. They need to be tweaked regularly so the body will keep responding.
The signs of weight loss plateau are where weight loss has stalled despite your best efforts and regain or when weight is sneaking in the wrong direction.
The first tip is always shocking, but I will put it out there:
Get OFF the scales!
Yes, weighing too regularly is a fabulous way to do your head in! Yes, I know you are here to lose weight, but don't let that be your only measure.
Look at the overall composition of your body before you ruin your day by weighing yourself only.
Weigh once a month only (take your scales to a friend or family member's house if you need to), but do measure your girth, put on an old piece of clothing, or keep an eye on how your clothes fit and feel.
Mix it up - your body needs a constant reminder of what you want it to do. As you get fitter and stronger, you need to keep increasing the loads you place on it so that your weight loss and muscle gains are continual.
Suppose you keep doing the same thing over and over.
In that case, your body becomes more proficient - expending less energy to do the same thing with less effort - essentially, this is what "getting fit" is.
But the load/stress you place needs to be increased, or your gains will reduce.
The same goes with your calories - if you eat 800 calories every day for months, your body will adapt, whether running a marathon or sitting in the lounge. 800 calories are all that's going in, so the metabolism gets set to that.
Weight loss can stop here altogether if you are not meeting your needs.
It's a survival mechanism, and it's often the cause of plateau, stall, and regains.
Always check back with your team to ensure you are eating enough food to allow consistent weight loss and a
healthy long-term metabolism.
Experiencing a plateau is standard in the early stages of Weight Loss Surgery. Generally, weight loss will resume after a short period if you follow:
- A Healthy Bariatric Diet
- Exercise Regularly
- Live a Healthy Lifestyle
What to Do When You Hit a Weight Loss Plateau
1. Long-term goal should be to build a good base of muscle mass by integrating strength training as part of your exercise regime.
Over time you will:
a) Burn more energy every day quite naturally.
b) Boost your metabolism.
Regular resistance training, such as body weight exercises or weight training, will support the growth of lean muscle tissue.
Combining your efforts with resistance training and spot-on protein intake every day will help push you off a plateau.
It's akin to installing a V8 engine in your car - the more muscle you have, the higher your metabolic rate will be. This is the key to continued weight loss and prevents regain.
2. Ensure you use a Bariatric Portion Plate/Bowl and live an active lifestyle.
3. If you have tried everything and are still not where you want to be - check in with your dietitian early. They will often see the gaps where you can't, and you'll be back on track before it's too big of a problem.
These are all crucial to dealing with plateaus and weight regain after your Bariatric Procedure.
But most of all, don't beat yourself up over this. Plateaus are normal and common. They happen to almost everyone, and you don't have to struggle with this tremendous psychological burden alone.
There are so many supporters out there, both in person and online. A small step is reaching out; just talking about it often helps. And remember: This, too, shall pass!
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