I can easily divide my pile of queries into quite definite themes – the most popular being weight stalls and weight regain. These can happen at almost every stage post-op and worry WLS patients the most (apart from medical emergencies which thankfully are rare). Why do they happen; what can I do about it; and do they happen to everyone is the usual mantra?
The feature below caught my eye as a good guideline to general weight-loss and diet plateaus so well worth the read, below it is my advice specific to weight-loss surgery patients – it’s not so different but certainly enough to make an impact on the results you’ll get. With just 14 weeks to Christmas and the holiday season there is plenty of time to incorporate these ideas so that the scales move again (in the right direction!) for a more slender outcome.
The cursed “plateau” is something many dieters are familiar with. After a certain period of successful reduction in weight, the scale won’t budge anymore. Day after day pass, and you’re not losing any more weight. This can be incredibly discouraging. In fact, many people lose faith at this stage and rebound back to their original weight.
STEP ONE: Is this really a plateau?
Body weight can fluctuate by a few pounds up and down during the course of a day or week. If less than 10 days have passed, it’s too early to declare a plateau.
If you are early on into your diet and all you lost so far is water weight, you are in for a surprise. Let us explain: the first 5-15 pounds lost tend to shed quickly because the body taps into glycogen stored in the muscles for the energy it needs. Glycogen is bound to water, in a ratio of 1:2. This means that burning off 1 pound of glycogen also releases 2 pounds of water. Unfortunately, the party ends rather quickly, once the glycogen excess has been depleted. From that moment onwards, the rate of weight loss slows substantially.
STEP TWO: Have you adjusted your calorie needs?
The body’s daily calorie needs are calculated based on your metabolism, which is a function of body weight and composition. As we lose weight, the body needs less calories, and a new daily calorie requirement has to be calculated.
Here’s an example: you started dieting at 145 pounds and hope to get down to 110. In order to lose half a pound a week, your daily calorie needs were 1750. You dropped 20 pounds and are now at 125 (yay!). Your current calorie requirement is just 1600, 150 calories less than when you started out.
STEP THREE: What has changed?
You have been plateauing for several weeks. Your calorie intake is adapted to your current weight. Something else is amiss. Go over your daily ritual and try to figure out what you’ve been doing differently in the last few weeks.
* Are you sleeping less?
* Are you stressed more than you have been in the past?
* Has the composition of the food you are eating changed substantially – for example, more carbs and less protein? More processed food vs. whole foods?
* Has your exercise regimen eased up?
If you pinpoint what changed, try to revert to the previous habits that seemed to be working for you. Sleep more, go back to your true and tried menu plan, and find ways to reduce your stress levels (easier said than done, we know).
STEP FOUR: Reassess your goal weight
Everyone knows it’s much easier to lose the first 10 pounds rather than the last 10 pounds. Not everybody is meant to be thin. Perhaps the plateau you have reached is actually the right weight for you?
If you still have tens of pounds to shed, are sticking to your plan and adjusting calories based on your current weight, you may need to step up your weight loss game. This can be a further modification in calorie intake, or an increase in calories burned from exercise.
STEP FIVE: Speak with a health expert
If all of the above haven’t helped and you are still flat for several weeks, consider meeting with a physician or dietitian. There may be an underlying medical issue that has developed: hormonal imbalance, thyroid, insulin resistance or other maladies.
In summary, weight loss plateaus shouldn’t discourage you. They are just an additional facet of your health journey, and in fact, give you an opportunity to improve your health by further modifications of your nutrition and exercise habits.
Feature courtesy of Fooducate
AND WHAT WLS PATIENTS CAN DO!
Also take a 5 step approach:
- Re-examine your diet and see if you have adhered to the basics of a high protein, low-fat and low-sugar regime. If you honestly have then consider upping the protein and reducing the carbs further to shift the balance. Often this small adjustment brings immediate and tangible results.
- Check your portion size – it’s easy to pile your plate higher as time progresses or to get proportions of nutrients out of kilter. Our bariatric portion plate (details here) can take away some of this guesswork. The scales may well repay you with a loss with this simple adjustment.
- Make sure you are eating enough (sounds silly but so true) and that your hydration levels are good. Don’t allow your body to go into starvation mode nor encourage it to confuse thirst for hunger.
- Up the exercise if possible, sometimes just burning more calories can switch the body into fat-burning mode for weight-loss rather than sticking in maintenance.
- Speak to your bariatric team if these don’t work, especially the dietician. It may well be that you are struggling with a related problem that is hampering your loss or haven’t quite got the eating regime finely-tuned for your stage of eating after surgery.
DO REMEMBER THOUGH … WEIGHT-LOSS ISN’T LINEAR, NO-ONE LOSES THE SAME AMOUNT EVERY WEEK, MONTH ON MONTH, EVEN AFTER WLS. FLUCTUATIONS ARE NORMAL!