Weight Loss Plateaus After Bariatric Surgery

Hitting a road block while losing weight occurs frequently for all of us and it is no different after bariatric surgery. While the long term goal is for patients to lose approximately 1-3 pounds per week, the first several months will typically yield even more rapid weight loss. At some point this weight loss will slow down or stop entirely – commonly known as a plateau.

Of course, not all pauses on the scale are plateaus.  As you begin to exercise more frequently, you will build muscle. Muscle is denser, and therefore heavier, than the same volume of fat. Therefore, during this time, you may not lose any weight (or even gain some) as you replace fat with denser, heavier muscle. As a result, it is important to use other measurements, such as your waistline, as secondary points of reference. Again, do not get discouraged if you are not losing weight as you increase your exercise regimen – this may be perfectly normal. If you are sticking to your dietary plan, continuing to exercise and see no movement in your measurements or weight, mention it at your next appointment.

What to do About a Weight Loss Plateau

As with any dietary change and reduction in caloric intake, our bodies start to adapt, usually by slowing the metabolism in preparation for what it thinks maybe a prolonged period of starvation. At this point, many patients begin to worry that their weight loss has stopped and this is the end of their progress. This is not often the case. There are several ways that we go about addressing weight loss plateaus, some of which are detailed below:

• First, it is important to remember that our bodies do not adapt to new circumstances immediately. Therefore, there is no harm in remaining on a plateau for a few weeks before trying to lose weight again. This pause allows your body to adjust itself to a new lower rate and as long as you continue to follow your post-operative instructions, there is no harm in this.
• Our bodies can also become accustomed to same old diet and exercise routine. It is therefore important to challenge yourself with exercises that build different muscles and dietary plans that offer the same nutritional intake, but with different foods.
• Of course, there are also times when you may have strayed from your postoperative instructions – even slightly – which can have cumulative effects over days or weeks, and can lead to a slowing of your weight loss. The best way to determine if this is the case is to keep a comprehensive food and exercise journal noting everything you’ve eaten and all of the exercises you’ve performed. Analyzing this against post-op instructions can show where you may be falling short. Further, using an app-based journal can be even more helpful for tracking exact calorie counts in addition to moods, cravings and workouts.
• Lastly, you may have to modify your diet to reduce calories, cut carbohydrates or increase your intake of protein. We do not suggest you do this on your own. Consuming too few calories can be dangerous and counterproductive to your weight loss goals. Before starting any calorie restriction modifications, please contact our office.

Longer-Term Weight Fluctuations

At some point between one and two years after surgery, you should expect your weight loss to slow and start looking toward the maintenance phase that will continue for the rest of your life. During this time, weight fluctuations are perfectly normal and nothing to be concerned about. Further, gastric bypass patients should expect to regain approximately 5 to 10% the weight they formerly lost, again considered very normal. You should only be concerned when your weight does not return to normal over a short period of time, or if the weight gain is significant, uncontrollable and there is seemingly no underlying cause.

Ultimately, rest assured that our team is here for you for whatever concerns you may have. Do not be discouraged, rather use the support resources around you to overcome challenges such as weight loss plateaus, uncontrollable cravings and fluctuations that may concern you.