Anyone who chooses to have weight loss surgery doesn't expect to fail. The expectation is this will be the end of your weight loss struggles. Unfortunately, the journey is continuous and does not end once you have lost the weight and achieved your goal weight.
The journey isn't always smooth. There are always bumps in the road even for the most successful patient. If you find yourself veering off your path and your journey getting rocky here are some tips on how to get back on track after weight loss surgery.
The first thing you need to do is figure out where you have gone off track.
What have you been eating?
The best thing to do is keep a food journal for a few weeks to see exactly what is and is not going into your mouth. When examining your food journal ask the following questions:
- Are you eating protein at each meal? We stress this before your surgery. Protein helps fill you up and keeps you feeling fuller longer. Patients who are not consuming sufficient protein may also be breaking down muscle tissue. The less muscle you have the lower your metabolism, which makes weight gain easier.
- Are you eating more starches (bread, pasta, rice)? Starches fill you up quickly and are calorie dense. Often when more starches creep in patients end up eating less protein, fruit, and veggies, but more calories.
- Are you including vegetables and/or fruit at each meal? Fruit and vegetables are low in calories and rich sources of fiber. Fiber will help you also feel fuller longer. These food are often replaced of higher calorie, but less nutritious foods.
- What are you drinking? fluids do not fill your stomach for a long period of time. Liquid calories really add up. Make sure your only drinking beverages that are calorie free. It's really eating to pack in a few hundred extra calories from a fancy coffee, fruit smoothie, or glass of wine.
- Are you snacking between meals? First, find out why you are snacking. Are you really hungry or just looking for something to do? If you are hungry look at what you are eating during meals and increase protein and/or fiber if necessary. If you do need to eat a snack try to keep snacks less than 100 calories. If you are not really hungry you need to find an alternative activity to combat boredom.
- Are you exercising? For weight loss and weight loss maintenance, it is recommended that you exercise at least 3 times each week for at least 45 minutes. Weight loss is, of course, more about what you eat then exercise, but the most successful patients I know exercise regularly. Quick weight loss will decrease muscle mass. Our bodies can not just lose fat without breaking down muscle. The problem is that muscle is what we call "metabolically active". What this means is that muscle requires energy even at rest. People who have higher muscle mass will require more calories making their metabolism higher. Less muscle = lower metabolism.
The second thing that you want to do is attempt to determine why you went off track in the first place.
When patients get off track and start gaining weight the first thing they often do is go straight to me or the dietitian in their surgery practice. Surgeon's and other health professionals will send you to us as well. We are of course the nutrition experts, however, the reason you may have gone off track may not have anything to do with food at all. The food or eating choices, although not great, may be the cause of your weight gain, but something else has likely caused you to make those choices.
I can't count how many times I have to tell patients that I can give them suggestions for better meals and snack choices, but if they don't get to the root cause of why they are not making these choices already they won't stay on track. They may be eating better, but they are still eating for reasons other than nourishment.
So, what are some reasons causes patients to get off track?
Unsupportive family and friends
I have heard so many stories from patients who struggled because family and friends chose not to be supportive of their efforts. Here are some examples:
- significant others who insisted on eating out frequently
- a spouse who did all the cooking and snuck in extra calories into his wife's food
- a family member who brought trigger foods into the house
- a spouse not sharing in childcare and house chores to free up time for their loved one to exercise
- family members or coworkers becoming food pushers
Poor time management skills
Let's face it everyone is busy. Many of my patients are balancing work (sometimes multiple jobs), family, and school. There is often very limited free time to meal prep and exercise. Health may have been a top priority when the patient first had surgery, but years later their health crept further and further down on the priority list. You need to make yourself and your health a priority no matter what!
Stress
Stress is probably the most common issue. Stress can come from lots of places.
Financial stress may lead someone to have to work longer hours or work more than one job decreasing their self-care time.
Emotional stress often leads to stress eating. Many patients prior to surgery have a history of coping with stress through food. Eating when they are happy or most commonly sad or upset.
Bariatric surgery only changes the size of your stomach. Surgery does not change your brain. After surgery, you have the same job, same family, same spouse, same children, same problems. Surgery can you lead you to a healthier life, but not a completely new life.
So how do you fix this? I will always suggest that patients seek out the help of a mental health professional. A psychologist or psychiatrist can help you not only with stress management, but also help you work through barriers that may be caused by others around you.
Bariatrics is a team approach for the reasons I touched on. Your surgeon gives you the tool to lose weight. Your dietitian and psychologist give you the skills and strategies to use that tool to the best of your ability. You took the first step by choosing to have surgery. Make sure you use all the resources available to you to be successful. You don't have to take the journey alone. Using the help and resources available to you will help make your journey smoother. There might still be bumps in the road, but your team will be there to point you in the right direction.
DANIELLE BERGER says
Thanks for sharing.
Jennifer Pullman says
I hope you find this helpful.
jack morris says
after my bypass i went into prison poor diet lack of exersise i put on 7 stones
Molly says
Anything and everything is still helpful; I need to be reminded of the reality with weight loss following surgery. I’m twenty one years post bariatric surgery; the challenges are on-going but my willingness to fight for post weight loss hangs with me. Encouragement is key. Thank you!!
Shoog says
After WLS should I see a dietician or a nutritionist to help me figure out meal plans?
Theresa Sitton says
I had the ruiny gastric bypass in June or July of 2009 and i had lost down to 170 pounds from 304 in two years. I was living in Texas at the time and then i came back to Arkansas because my twin brother had been told he had lung cancer, so I came home, then I went to help my sister with her dying husband and I was eating the same things she was and before I knew it I had gained overe 180 pounds and now I weigh234pounds and don't know what to do to get back on track. I lost all of my books I got after having the surgery and now i can't remember what I can and cannot eat can you help me? My email is [email protected] can you send me the foods i can eat ?
kelly roberts says
I have not had surgery yet but reading it from this point of view hopefully will help. thank you
Jennifer Pullman says
Hope this helps! Good luck on your new journey.
Katherine Carpenter says
I am almost 4 years out. I have not reached my goal weight yet. I am struggling with a stall. I am trying to find out about exactly how many proteins, carbs, and calories I need a day. Can you help?
Jennifer Pullman says
Send me an email: [email protected]
Liz says
Hi Jennifer,
Can I gain some advice on how much I should be eating. I'm 3 years post op and have lost 54kg though have stalled. I still need to lose a further 25kg to reach my target.
I have fears I have undone or stretched my stomach again, though I am lucky to eat more than two pieces of toast in a sitting. I want to be strong enough to get to my goal weight without getting an upgrade on my existing surgery.
Any advice or guidance, I would be most grateful.
Thank you in advance.
Regards, Liz
Jennifer Pullman says
Without knowing you and your history I can't tell you how much you should be eating. Over time you will be able to eat more food. Most surgeons would say it's hard to stretch the stomach, but that is up for your surgeon to evaluate. Follow the steps in the post to see if any of those strategies help. I would reach out to a dietitian in your area who specialized in weight loss surgery and also make a visit to your surgeon.
Ruby Bradford says
I had my gastric bypass in 1996, back then things were different. I am 75 and have gained all my weight back. Please help by telling me at my age what and how much to eat so I could get my weight back down. I was not ever followed or told what and how much to eat that I can remember, I didn't even no not to drink with my meal. I need to lose 100 lbs.
Jennifer Pullman says
Feel free to send me an email, however I can not practice nutrition across state lines. I suggest reaching out to your insurance company to see if they cover nutrition services and if they do find a dietitian that specializes in Bariatric surgery in your area.
Sylvia Romero says
Hi Jennifer, I am struggling with not losing more weight. I have lost 60 lbs but since my surgery in 2018. Was 216lbs before.I believe I am eating correctly but not getting in much exercise. Most of my foods are protein very little carbs. I eat no bread, rice or pasta. So what can I be doing that I am on a stand still with losing weight. They want me to be at 135 to 140. Don’t know how to get there.
Jennifer Pullman says
Hi Sylvia! Without knowing your full history I can't give you specific advice. I would hope that if your surgeon wants you to reach a certain weight they would connect you with their dietitian. If not I would reach out and schedule an appointment with the program dietitian or find one in your area. Maybe start logging your food to see how many calories you are eating. Also, are you exercising?
Cooper says
Thank you for this article! I am a little over 5 years out but I am struggling with weight gain. I have gained 30lbs since my lowest weight 2 years ago. I desperately want to get back on track!! Can you advise on a weekly meal plan to help me jump start my weight loss again?
Jennifer Pullman says
The menu for regular food that you can download when you sign up for my newsletter may be helpful.
Shirley Dillard says
I had Gastric Bypass Sleeve surgery done about 7 years ago I did real well for the first 4 years and lost 184 pounds but have gone through some stressful times since then I’ve gained almost all my weight back and I’m dissapointed in myself I realize it’s my fault for just letting myself go now I’m ready to get back on track I went to my nurse practitioner yesterday and discussed this matter yesterday so if there’s any advice you can help me out with will be greatly appreciated.I have lymphedima in my left leg so it’s hard for me to do certain exercises because I can’t lift my leg up very high I do keep busy though I babysit my granddaughter 5 days a week who’s 2 years old so that’s a task in its self I have a 19 year old daughter who’s with me she tries to help out doing things for me like taking out the trash and getting things that are delivered to me because I have 15 stair steps to climb up and its difficult for me unless I hold the rails and then I’m really tired after I climb them so any advice will help
Thank you
Jennifer Pullman says
How about chair exercises or just walking? There are videos online for walking at home called "Walk Away the Pounds".
Melissa says
Hi, I gain my it's only been 4 years for. Dr said my stomach isn't stretched but I gain 80 lbs back
Jennifer Pullman says
I would reach out to your doctor for those concerns. The stomach doesn't usually stretch. The issue is that patients find ways to eat higher-calorie foods. Sugary beverages, snack foods, high-fat food etc. I would reach out to your insurance to see if they cover nutrition counseling and find a dietitian in your area to speak to.
Carol says
I need help! I decided to get back to basics on January 4, 2021. I eat less then 800 calories a day, and 60-70g of protein daily. I drink 64 oz of fluid daily. I'm 3 years out and have gained back 60 out of the 120 lbs that I originally lost. It's been 10 days. I'm trying, I just don't want to loose hope.
Tina says
We can do it I’m right there with you Let’s do it again!!!!!
Paula says
I had bypass i 2017 ive regained 30lb i signed up to weight watchers and gained 2 lb in the first week of doing the diet perfect i have many health issues and i cannot exercise would eating 800 cals per day make me lose weight ? I have no clue how to lose weight now very frustrated .. the gain came because i didnt really ewt food id have crisps biscuits when i was hungry s i learned they didnt give me that bursting feeling ... ive been eating what i want but have made sure its the 800 cals or less would you think this will restart my weight loss
Elizabeth says
I just had bariatric 3 weeks ago. I’m finding I’m hungry all the time, can only eat small meals, BUT i am able to eat ANYTHING and not feel sick. Is this normal?
Jennifer Pullman says
Everyone is different. That's great that you can tolerate anything.
Dianne says
Hi my name is Dianne and i am almost 41/2 years out from sleeve surgery. I didn’t have a lot of support. Before the surgery i had tons of help after not so much. I slowly went back to my old eating habits. I need help getting back on track. I gained more than half of my weight back
jennifer thompson says
sleeve jan 15 2020 now may 2021 gained 15 lbs back what best way to reloose it . I eat 3 protien bars a day and decaf coffee water also protien meat for dinner and not much bread or pasta potatoe and salad i do eat small amounts .. i did have dunking carmal swirl iced coffee and wheat crawlers with low fat cream cheese what else can i do more exercise
Jennifer Pullman says
It would be a good idea to reach out to your surgeon and see if you can make an appointment with their dietitian or contact your insurance to see if you are covered to see a dietitian in your area. It's best to work closely with someone in your area to see what changes you can make. Weight loss isn't one size fits all, so I can't give you specific advice online or based on the info you gave. I can tell you I would start by eating more real food and get rid of all those protein bars. Eat 3 meals per day consisting of protein and vegetables/fruit. The goal is to always return to real healthy food not to live on protein shake or bars for the rest of your life.
Pamela Scaife Miller says
Hi Jennifer my name is Pam I had a sleeve done 2017 I have gained 10 pounds can you help me out to get back on track My eating habits is not good at the moment I do walk in exercise Please give me some advice how to get back on track with my weight When Pandemic Hit I couldn't exercise at the gym
Jennifer Pullman says
I am not able to give individual advice over the internet. Weight loss is not one size fits all. The steps I outline in the article are a good place to start. Are there ways you can exercise without to a gym? What can you do to make your eating habits better?
Gloria says
Need help have gained 25 lbs back after sleeve surgery eating the wrong foods would like to loose 50 lbs what can I do.
Jennifer Pullman says
Weight loss is not one size fits all. I would suggest you reach out to your surgeon to see if you are able to meet with the program dietitian or consult with an RD in your area. We can't practice in every state. A good place to start is by following the info in this article. Eat less of the wrong food.
Kristi says
This was so helpful. Thank you!