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Asked by a visitor: I have lost a 100 pounds and hit my goal weight. I really want to maintain this current weight, what do I do?
Our bariatric dietitian answers:
Congratulations on hitting your goal weight! Now, the real work comes in. . . . maintaining that weight loss. This is where lifestyle changes really make the difference. As you begin to settle into your new life and new weight, remember it is those daily choices of eating the right foods and staying active that have the most impact on weight.
If you begin to notice weight gain, take a look at old or new habits that may be creeping in to your life. What can you do to turn those actions around? We all fluctuate a few pounds and that’s completely normal but just be aware of those lifestyle habits that help your success and those lifestyle habits that tend to hinder your success.
Reasons for Weight Gain After Weight Loss Surgery
The above video shows the common reasons for regaining the lost pounds post bariatric surgery as well as a strategy to keep the bonus pounds away:
“Hey everyone. So, I’ve had a few questions on weight regain recently and I wanted to go ahead and address those today. There are really three main reasons for weight regain.
1) Stretched Pouch and Post-Bariatric Overeating
The first one has to do with your pouch. Initially after the surgery, that pouch is very tight…it’s a little bit unforgiving and you just can’t eat a lot, which is obviously one of the main reasons we all have this surgery is to decrease those portion sizes.
But again, as time goes on, if you’ve been eating with meals, if you’ve been eating past the point of fullness regularly, that can cause your pouch to stretch unnecessarily.
So, that’s something to be really cautious with. Pay attention to those hunger and fullness signals. At the first sight of fullness or a little tightness in your pouch, go ahead and stop eating so that the pouch can maintain its good size to help with weight loss.
2) The ‘Ghrelin’ Effect on Eating Habits
The second reason some people tend to regain weight is the change in gut hormones. Initially after the weight loss surgery, a lot of appetite stimulating hormones are decreased. But as time goes on, they tend to normalize, they regulate themselves and so you have an increase in your appetite again. So ‘ghrelin’ is the main hormone we tend to blame for this.
We are not really sure why all the reasons are after surgery that it is decreased, but it does tend to come back. So, that is something to pay attention to. It is okay, we do want you to feel hungry between meals and that is normal…that is kind of a part of life.
It is having the hunger, that fullness,and learning how to regulate it that is important. Make sure that you are eating foods that:
- are high in fiber
- have good protein source
- are lean proteins
Some good healthy fats like the nuts and seeds can all help maintain the hunger-fullness balance.
3) Return to Old Habits and Forming New Bad Habits
The third reason people tend to regain andprobably the most common that I have seen is a return to old habits or developing new habits. This can be anything from:
- Overeating at meals
- Grazing a lot of chips, pretzels and crackers and fried snacks and sugary things tend to fall in that category
I call those crispy, crunchy carbs because those will always go through your pouch whether you are 3 months out from surgery or 3 years from surgery. Those foods are very simple and tend to go through your pouch pretty easily and can cause that weight gain again.
The Downside of Emotional Eating
Another thing is that some people that have emotional eating can also kind of revert to those old habits again. If you know you’ve been maybe a stress eater or a person who eats when you are upset or maybe when you are happy or when you are really depressed, that tends to come back.
For a lot of people, it disappears for a few months…they sort of have this honeymoon period after the surgery. But, it almost always comes back in some way or the other.
How to Avoid Weight Regain
- Focus on controlling emotional eating
- Work with a good therapist/counselor
- Practice mindful eating strategies
That can help you to be more present with your meals and also be aware of when you are eating emotionally…that can be the first step in recognizing that.
Keeping Away Bonus Weight After Bariatric Surgery
I wanted to talk about those bonus pounds that we can frequently accumulate after we go on a diet or lose weight and then we tend to gain a lot of that weight back…those bonus couple of pounds come along with it.
Let’s say, you lose 10 pounds and then for whatever reason you go off of your diet. You are tired, your healthy eating plan and your exercise regimen and you gain 12 back…those are the bonus pounds I am talking about.
Reason for Putting on Additional Pounds
What usually happens is that as we lose weight, we also tend to lose muscle mass. About 25% of the weight loss you experience is muscle mass…especially if you are not exercising regularly or doing resistance activities.
Let’s say, if you lose 10 pounds and you are not exercising especially or maybe even if you are, you can expect that about 2.5 pounds of that weight is good lean muscle. When you go back to your old eating habits, what you do is:
- You gain back that fat mass
- Then you also gain a couple of extra pounds that replaced that lean muscle that you had
- This is important because that lean muscle is what keeps your metabolism high
It is so easy to gain those extra few pounds back because you’ve lost that lean muscle that was burning those calories.
How to Stay in Shape?
This is extremely important as we go on this journey of weight loss and for a lot of you, start to transition into weight maintenance that you keep up with your activities, whether it is:
- Lifting weights
Whatever you enjoy doing, stay the course, keep working on it, especially for women, keeping those resistance activities, the weights, the hand weights, the pushups. This is why I like yoga and Pilates too because you can use your own weight as a resistance. It really, really helps.
I’m in my thirties, I got two babies now and I can tell how much muscle mass I have lost…especially on maternity leave when you are just sitting and snuggling with the baby, that muscle mass tends to go away quick and it’s a lot, especially as I get older here, to get that back.
And so, as we enter into the days of cold months, I really want you guys to remember to exercise to keep those resistance activities going and to keep that metabolism up as you are trying to bring way and trying to keep that weight off.
Let me know if you have any questions, hope this helps.”