Weight Loss Stalls after Surgery

The scales are dropping regularly, you’re doing all the right things and everything is peachy. Until it isn’t, your weight loss has stalls after surgery. The scales won’t move! What? Why? How?

First off, weight plateaus are common and happen after surgery! If you have noticed a weight plateau, it does not mean that you are doing anything wrong nor does it require you to “break through” it. It’s all part of the journey.

You may be feeling anxious, guilty, ashamed, and/or reluctant to attend your follow-up appointments. However, before you throw in the towel, there are a few things worth considering when it comes to weight plateaus or weight regain after surgery.

First off, we’ll cover the basics.

Are you following surgical guidelines?

• Are you prioritizing protein? Aim for > 60g / day
• Are you drinking enough water? Aim for a minimum of 1.5L / day
• Are you getting regular exercise? Aim for up to 30 minutes / day x5 per week

Are you strength training?

If you are doing regular strength training exercises, this can cause your body to temporarily hold onto water, slowing your weight loss and the number on the scale to budge. Don’t fret! Building muscles is important for your metabolism, so be patient with the process and keep up your efforts.

Weight loss after bariatric surgery

Weight loss after bariatric surgery is most noticeable- and most significant- early on. This is typically due to your body adapting to a lower calorie diet and adjusting to finding alternative energy sources to find fuel to run off of.

At first, your body will turn to your muscles and liver to use up the energy stores found there. Then, it will eventually turn to your fat stores and lean muscle mass for fuel.

As your body burns muscle, your metabolism will begin to slow down. This is typically reflected on the scale when you begin noticing a stall in your weight.

Weight plateaus can last 2 – 6 weeks (or longer) during your first year of surgery.

There are other reasons for why you may experience weight plateaus or weight regain right after surgery.

• Surgical reasons: your gastric band may be malfunctioning or not restrictive enough, your gastric pouch may be enlarged, your intestinal connections dilated, or you may have a connection between your stomach and remnant stomach (bypass patients)
• Your hormones are recalibrating
• You may be pregnant
• You may be menopausal
• You may have high sugar levels and are off of your diabetic medications
• Some of your medications may cause weight gain as a side effect
• You may have stopped smoking

• You may have a hormone disorder such as Cushing’s disease or severe low thyroid function (hypothyroidism)

Permanent weight plateaus are more likely to occur about 1-1.5 years after Roux en Y gastric bypass and sleeve gastrectomy, and roughly 2.5 years after adjustable gastric banding surgery.

How to overcome weight loss stalls after surgery

Rather than focusing on the number on the scale that doesn’t seem to budge, try measuring your waist circumference with a soft tape measure and pay attention to your body composition and inches lost versus the number on the scale.

In addition, be sure to check in with your eating and movement patterns. Sometimes, old unhealthy habits find ways of sneaking back into your new bariatric lifestyle, such as:

• You’ve been grazing, nibbling, and mindlessly munching more often
• You’re consuming high energy foods (fast food / processed foods) and sugar-sweetened beverages
• You no longer have symptoms related to dumping syndrome
• You feel like you’ve lost control over your urges and are binging more often
• You are less consistent with your healthy eating behaviors after weight loss surgery
• You’re drinking more alcohol
• You’re less active during the day and are more sedentary
• When you exercise, you aren’t doing enough moderate-and vigorous- intensity exercise
• You may have an injury limiting your exercise

If any of these ring true with you, try focusing on one at a time and work on it consistently until you feel like you’ve mastered it before moving onto the next habit. Before you know it, you’ll be breaking through your plateau in no time!