How to Restart: Overcoming Plateaus and Weight Regain After Bariatric Surgery

If you’ve clicked on this blog – I’m guessing you had a pretty successful bariatric surgery story. You prepared many appointments with your doctor, dietitians, nurses, and counselors. You’ve gone through rigorous diet and exercise plans. You’ve put in the time and the work. And I bet you got great results! You probably lost a ton of weight and managed a lot of other health conditions. Now that’s something to be really proud of.

But a very real part of many gastric bypass surgery and other surgical weight loss stories is the plateau. That experience of feeling like progress is stalling or that you are not losing as much weight as you had originally hoped. Others might regain weight months or years after weight loss surgery. You might be surprised to know that gradual weight gain after bariatric surgery happens more often than you think. But it does not have to be this way, and it does not define who you are. Plateaus and regain are yet another challenge that you and other bariatric patients will be able to face and conquer.

When negative emotions about weight gain or plateaus start to creep up, don’t fret. Create a constructive action plan that will help you work through it. Consider the following:

Consider the Why?

Take some time to reflect on why you think you are experiencing a plateau or weight gain.

It’s important to remember that the body does have a natural plateau. If you’ve reached or exceeded the anticipated percent expected weight loss (%EWL) for your procedure – that’s okay! It’s more than okay – It’s great! You might have reached that weight where your body naturally wants to stay. This may mean you can shift to celebrating non-scale health victories or practicing body acceptance.

If you still believe that you could lose more weight, it might be time to do some serious reevaluating of your diet, exercise, and behavior habits and get back to those post-op practices that you did right after bariatric surgery.

Look Back to The Basics.

What lifestyle habits could you reintroduce back into your weight loss routine?

It’s only human nature to slip into old habits.  Have you slipped into pre-surgery habits? Look back at some of the big three lifestyle domains and consider where you could make changes:

Diet. It might be time to dig out those old handouts from your RD about the regular texture diet and continue following those important strategies. This includes a balanced diet with lean protein first. Accompany them with nutrient-rich fruits and vegetables, healthy fats, and complex carbohydrates. Make sure you haven’t fallen victim to “portion distortion,” and keep those post-surgery portion sizes. Restart those supplements, maintain adequate fluid intake, and avoid soft drinks, sugary desserts, and alcohol.

Physical Activity. Do you regularly engage in exercise?  If so, is there an opportunity to increase how often, how long, or how intense the workout is?  Maybe you can shake up your routine or try a new activity. If you are not currently exercising, this might be the time to start again. Don’t underestimate the power of low-impact activities like walking. Every little bit counts.

Behavior. This is a big one, the true root behind all healthy changes. Various strategies of mindfulness, deep breathing, self-care, and gratitude can help promote positive mental health and behavior change.  Working through the emotions around your plateau or weight regain with a licensed counselor can also be extremely helpful.

Talk to Your Doctor.

They might recommend other tools, such as medications or revision surgery.

Remember that changes to diet, activity, and behavior are the first line of defense for tackling regain and plateaus. However, they might not be enough. Even when you might be doing everything right, our bodies are still complex and challenging.

It’s important to talk to your surgeon about other options that can assist you as you navigate plateaus and regain.  The newest anti-obesity drugs have shown to be very helpful after bariatric surgery. Depending on the original procedure, you may have the option to have a  surgical revision that converts one type of bariatric surgery to another type. This would be one of the last options for managing regain.

Lean on Supportive People.

Find the people that will help you through it.

Remember to talk to your healthcare team sooner rather than later.  This includes your surgeon, nurse practitioner, dietitian, counselor, and any other provider that helped you before, during, and after your surgery. They will be able to provide the best guidance catered to you before weight regain becomes too overwhelming.

Lastly, make sure to talk to the family members, friends, coworkers, and other people in your life that will provide positive support and comfort. They are an important part of your team that will help you overcome those obstacles.