Updated: Feb 6, 2019
This article was also featured in Obesity Help.
One of the things I love about being part of the team for weight loss surgery patients is the excitement and the hope that each patient has prior to surgery. On a daily basis, I speak with patients about all of the reasons why they want to have surgery and the hopes they have for a brighter, healthier future. Despite the fact that I spend a significant amount of time talking to patients about the possible struggles that come after the surgery, most patients are gung-ho to make a go of it. Fast forward to twelve or eighteen months after surgery, the patients I speak with are not as enthusiastic about the life changing event they made months prior.
The reality is that weight loss surgery is life changing, but a lot of the changing needs to happen after the surgery on the part of the patient. The surgery is the first step to making lifestyle changes that need to be long lasting for continued success. The patients I speak with during this crucial period are still happy about the surgery but are somewhat discouraged about either the plateaus or the needle on the scale moving in the wrong direction. This is the time to get back on track.
There is no magic formula to getting back on track after the honeymoon of the initial surgery has gone. I generally suggest to patients to go back to the beginning. Review all of the information that you were given at the beginning of the journey. Here is a list of things to keep in mind!
1. Don’t drink your calories. Don’t work against yourself by taking in liquid that has no nutrition value. This includes any coffee drinks that you might think are a great way to get the day started! Most of the drinks at Starbucks and other popular coffee chains are filled with calories. Of course, this does not mean protein shakes or other meal replacement liquids. Make calories count by focusing on lean protein, fruits, and vegetables.
2. Avoid sugar. Sugar is the ultimate empty calorie. It will make your blood sugar climb and cause cravings. This includes hidden sugars. Avoid foods that have sugar in the first three ingredients. Certain foods and condiments have more sugar than you would think like ketchup for example.
3. Protein! Protein! Protein! Protein should again be your primary focus at meals. Remember your mantra! Protein, then vegetables, then fruit and if any room (there won’t be) then carbs. This is probably the biggest area where patients wander after surgery. I always ask when patients talk about hitting plateaus, “How much protein are you getting a day?” The most common answer is, “I don’t know.” The goal is between 60 and 100 grams of protein a day. Protein helps you maintain your muscle mass while losing fat and it helps you feel full longer between meals.
4. Don’t snack. This seems like an obvious one; however, difficult habits die hard. This can hamper long term success. For those of you who graze or eat without thinking about it, those calories add up. Stick to high-quality meals and avoid junk food. If you are hunger, go for a protein shake or other meal replacement.
5. Skip alcoholic drinks. Sure we tell you to avoid alcohol right after the surgery but for many people this one also creeps back into the menu. Alcohol is full of empty calories. It also can slow your metabolism down'
6. Chew! Chew! Chew! Remember the digestive process starts as soon as you see or smell food. Your brain needs time to process that you are eating. Chewing your food slowly helps to process your food and tell your brain that you are full. If you are not chewing up your food, it can also feel like it is stuck and will be harder for your stomach to digest. Take a bite and then put your fork down allowing yourself plenty of time to chew!
7. Find a support group. Get back on track by finding a support group whether it is virtual, online, or in-person. Studies consistently indicate that patients that utilize support—in any form—will be more successful than those who do not. Don’t go it alone. We are more successful as a group. The group holds us accountable
8. Again, this seems like a no-brainer, but we all get off track. If you are exercising and not seeing results, maybe it is time to change things up. Get a personal trainer or simply try something new. Our bodies tend to get used to what we do on a regular basis. Spice things up with interval training or add some light weights to the mix. Remember muscle burns more than fat—so build up that muscle!
9. Stay hydrated. Drink lots of water. Dehydration can mask itself in hunger. Before reaching for something to eat when you perceive that you are hunger, drink some water first. I can’t tell you how many times I talk to people post-surgery who have let their water intake decrease.
10. Find healthy coping skills. Many times people come to surgery because they have used food as a way to cope with stress. Now is the time to find other ways to cope with stress. It might be exercise, talking with a friend, finding a new hobby, etc. Just find something that is going to help you with your day to day stress.
11. Schedule a follow-up appointment with your surgeon or primary care physician. After surgery, many patients only see the surgeon one time for a follow-up. Depending on the type of surgery you had, you may need yearly blood work. If you are vitamin deficient that might also account for some fatigue. Checking in with your doctor is also a great way to get back on track.
12. Avoid simple carbs. Simple carbohydrates are highly processed foods such shite bread, pasta, sugar and white rice. The rule of thumb is if it is white, it is probably a simple carb. Try more complex carbs like brown rice or go for vegetables.
13. Eat mindfully. When you are eating, you are eating. Focus on what you are eating. No more eating during meetings or watching television. If you are multitasking while eating there is a good chance that you will not stop when you are full.
14. Pick one skill to work on each day. Generally, change does not happen overnight. Pick one skill to work on first. If you are not getting enough water, then focus on getting eight glasses a day. Make that your goal for the day or the week. Once you have mastered that skill, move on to another one.
Start with these steps to get back on track. If you continue to have problems with maintaining your weight loss, then it is probably time to really get serious and enlist some help of a Weight Loss Surgery coach or get back on your surgeon’s schedule for follow-ups and meeting with the team that got you started. It is possible to get back on track. Remember that a healthy lifestyle and maintaining your weight is a marathon and not a sprint!