A reader emailed My Bariatric Life and asked bariatric dietician Elizabeth Anderson for her perspective on ending a weight plateau. Learn how to get your question answered.
I need help with daily meal planning for weight loss again. I had surgery 7 years ago and I am having great difficulty losing weight again. What suggestions do you have?
How to Get Off a Weight Plateau
I’m not 100% sure what you mean when you say, ‘…having great difficulty losing weight again.’
Did you regain some weight that you’d like to lose? Or, have you been on a weight plateau?
As I’m writing to you I’m 30,000 feet in the air on my way to Portland OR to present “Parachuting Off the Weight Plateau” at the Weight Loss Surgery Foundation of America’s annual convention.
I mention this because I’m really excited to meet the hundreds of WLS post ops who will be there for the learning, laughs and love.
But I’m also bringing it up because my presentation might shed some light on your situation.
Picture this: you are on a weight plateau in the middle of the desert. I believe you’ve got 5 options or ‘flight paths’ if you will, to help you parachute off the ledge and get yourself safely to lower ground, i.e. weight loss.
Here are your tickets to ride:
- Anti-obesity medications
- Revisional surgery
These are the five areas I check with my regular clients when they feel they’re stuck on a weight plateau.
Let me give you a brief round-up of the questions to ask yourself or your doctor to see what might nudge your weight down.
Are you eating enough protein every day? Like between 60 and 80 grams? Are you eating your protein food first? Are you using a 7-inch plate for your lunch and dinner?
Buy the Bariatric Portions Plate on Amazon.
This handy little trick makes weighing, measuring and counting calories and fat grams unnecessary. The size of the plate and portion recommendations keep your meals balanced and modest.
And finally, are you having portioned snacks or are you grazing and sorta skippin’ meals? For a quick round-up of protein recommendations, watch my YouTube video:
Exercise. The data is in: WLS post op who exercise most days of the week at a moderate intensity (you can talk but not sing) avoid a weight plateau and lost more weight than folks who only rely on their surgery for weight loss. How much exercise is recommended to lose weight? Check out the recommendation from the American College of Sports Medicine (ACSM). Be sure and check with your health care provider to find out what, if any, changes need to be made to the recommendations based on your health history.
Support Can Be Beautiful
Support/Therapy/Counseling. More research results here too. Data shows patients who attend support groups loss more weight than those who don’t go or have the option. Also, important, the research shows almost 75% of patients requesting WLS have some history of mental illness in their past i.e. depression, anxiety, PTSD or substance use disorder. When you put these facts together with the unusually high prevalence of suicide attempts by bariatric patients, you can see why having strong and sometimes professional emotional support, is an absolute must.
What’s a Drug Got to Do with It?
First question you’ve got to ask yourself: could one of my current medicines be either causing weight gain or making weight loss difficult? Ask about weight neutral meds going forward. There’s a great list published on the Obesity Action Coalition website.
Also talk with your primary care about your weight plateau and the use of anti-obesity medications. Currently there are 5 approved by the FDA on the market. They all have been proven effective at decreasing body weight by at least 5 percent. These medications aren’t for everyone and they don’t work for all patients. They come with risks and benefits not the least of which is cost.
Review and Revise?
Last but not least is surgery revision. If you and your provider determine diet, exercise and lifestyle changes are just not working, it’s time to look closely at your first surgery to see if it’s still working for you. This is usually done by endoscopy under light sedation. If your pouch, sleeve or stoma has stretched, there are a range of surgical techniques that can correct the problem.
There are also several options to take your original surgery to the next level—perhaps advancing from the sleeve to a bypass or from a bypass to a duodenal switch, which adds an malabsorptive aspect leading to greater weight loss.
Until next time, be GOOD to you,