Bariatric surgery and weight management are a long-term commitment that require a great deal of follow-through. It is important to keep to the plan that your bariatric health professionals have in place for you, otherwise it can be easy to go in the reverse direction. Remember your team is there to support you throughout this journey, through both ups and downs.
The below is a list compiled from years of many, many patient experiences, in no specific order. As you can see, it is all about behaviors. All of these points are so important in long term weight loss success following bariatric surgery. Here are 10 reasons why you may have weight gain after bariatric surgery:
1. Getting too comfortable: Allowing yourself those extra handfuls or those few weeks without exercise, the “I’ll start up again once this passes” mentality. It all adds up! After the honeymoon phase in the early months following your procedure, things change. It becomes easier to eat more and not be as strict/regimented. Remember, you go through many phases in your weight loss surgery journey. That is why you should talk out a new routine every so often and stay on your toes. Try to take care of “red flags” early before they can spiral out of control. This will help you stay focused and on track as life changes and throws you some curve balls along the way.
2. Not being mindful: You may THINK you are eating exactly the same way or very similar as you did in the beginning, but in fact are not. A handful of nuts here, few hours later another, grazing on little things throughout the day–this can easily happen without even realizing. Tracking food intake a few times per week is a really helpful and important tool to stay mindful and see what you are taking in. We recommend apps such as MyFitnessPal or LoseIt, but you can use a notebook or your notepad on your phone and be fine too.
3. Not following up with your surgeon and dietitian: Follow up care is crucial to any bariatric surgery program. Again, you never want to get too comfortable. You want to utilize your team that is there to support and guide you through this journey. Bariatric surgery experts will give you accurate information– and remember, everyone is different with their needs. It is better to discuss concerns and issues in person, face to face with the experts vs just listen to a peer or someone from an online group. We are here to help you, guide you, keep you motivated– not to judge you or yell at you for certain behaviors. We recommend following up with us (nutrition) every 3-4 months or more often as needed. Weigh ins on our body composition scale are always encouraged as well. You should make sure to follow up with your surgeon regularly to discuss any medical concerns and to get the recommended blood work.
4. Not utilizing the surgery: You have build in portion control! If you stop eating your protein first (and enough of it in general), graze throughout the day vs eating balanced meals, not drink enough fluids, eat/drink together, etc…you are not fully utilizing the amazing tool you were given by your skilled surgeons. Too little protein can lead not only to less satisfaction and fullness, but can contribute to muscle loss. Muscle loss is not something you want– muscle is key in metabolism. Empty calories, such as sugar/sweets and refined carbohydrates, don’t fill you up prior to surgery and unfortunately it stays that way even afterwards.
5. Poor sleep: Not getting enough zzzz not only to exhaustion and less physical activity the next day, but an increase in fat storing hormones (one example being cortisol) which can in turn pack on the pounds. Studies also show people have more cravings for high carb/sugar foods when sleep deprived. Sleep really plays such a huge role in weight management, and the recommendation, which is hard for many, is at least 7-8 hours per night.
6. The all or nothing diet mentality: Remember, the goal of bariatric surgery is to NOT DIET AGAIN! You were given an amazing tool and jump start, but then you need to take over from there. This is about behavior changes, routine changes, psychological changes. No more light switch, on or off, it is time for long term, sustainable changes now that you have built in portion control. Try to avoid describing foods as “bad” and “good.” Or you “cheated” and “failed.” We all have days we may have given into our cravings, have been more hungry, or just were so tired we barely moved. It is all about balance. No need to strive for perfection, just progress. You can’t beat yourself up over it, we have to learn from our mistakes.
7. Not eating actual, balanced meals/grazing: It is so vital to have nourishing and balanced meals. The surgery works best with meals, incorporating protein, fiber, maybe some healthy fats. Balanced meals will keep you fuller longer, help to avoid those night time cravings, and prevent unneeded snacking throughout the day. Not only that, you will get the nutrition your body/organs need to function properly. A car cannot run without gas. Little bites of food throughout the day will not only add up in calories, but will never truly satisfy your hunger. It will also result in less fluids and less hydration since you aren’t supposed to eat and drink together. In a perfect world after bariatric surgery: eat–>fill up–> wait about 20 minutes–> drink your fluids, and in a few hours if you’re hungry again you eat the necessary food.
8. Not exercising, or not exercising effectively: Once you are nourishing and hydrating your body enough, it is so important to start your exercise regimen. It is really the key to maintaining your weight loss. (and lowering stress, building muscle, helping energy, endorphins, among so many other reasons!) It will keep your organs strong, your mind clearer, may even help you reach your fluid goals. Most importantly, it will help you build muscle, which will help to boost your metabolism. It will really come in handy on those days where you may have been off your routine a bit. Each pound of muscle can burn an extra few hundred calories per day, even while you sit at your desk at work. It can be easy to lose muscle in the first year following surgery, so you want to make sure you are building your strength back. Many gyms now offer bariatric surgery specific wellness programs with special rates.
9. Not attending support groups: Studies actually prove that coming to support group helps keep the pounds off! Once every few months or make it a monthly outing. There is always something you learn from each meeting. It is a way to connect with your peers, get back on track, and get motivated again. You should try to put time aside in your schedule to attend– remember, self care and YOU time is really important.
10. Unrealistic expectations: You want to have realistic expectations about the surgery and outcomes when you decide to have bariatric surgery. It will help keep you positive and remain motivated. (which also helps keep the pounds off!) Try to avoid comparing yourself to others, everyone is their own unique individual with their own needs. You have to take into account everyone has a different body type, starting weight, age, etc. Statistics also say it is completely normal and part of this process to gain back 5-10 pounds. Focus on your individual goals and you will get to where you want to be.
Whether you had bariatric surgery 15 years ago or are freshly out, the Dietitians at LBS Nutrition are here to help you with specific, individualized recommendations and to guide/support you on your journey to wellness!