Are you experiencing a weight loss plateau after gastric sleeve weight loss surgery? In 2023, it’s a common predicament that many bariatric patients find themselves in: You were losing weight dramatically after the surgery, and now the scales are not budging. A weight loss plateau can be very common in the aftermath of an operation.
Introduction
Undergoing gastric sleeve surgery is a significant step toward achieving weight loss goals and improving overall health. It's typical for individuals to hit a plateau in their weight loss journey after undergoing gastric sleeve surgery as the body adjusts to its new anatomy with a reduced stomach capacity. Weight loss stalling can be a normal part of the post-bariatric surgery journey, but try not to let them discourage you too much. This article explores the reasons behind this stall and provides strategies to overcome it.
Understanding Weight Loss Plateau After Gastric Sleeve Surgery
What is a Bariatric Plateau?
Bariatric plateau refers to the stalling of weight loss after the completion of bariatric surgery. Gastric sleeve surgery, gastric banding and gastric bypass surgery are all bariatric procedures that are performed to directly help the patient to lose weight. Typically occurring after the three-week mark post-op, a gastric sleeve weight loss plateau is when the rapid weight loss slows down or stops altogether. Bariatric plateau is very normal, temporary and is generally caused by the body’s attempts at adjusting to a new diet and an alternative energy source.
Why Does Weight Loss Stall Occur?
There are many reasons for you to have stopped losing weight after bariatric surgery. In many cases, a weight loss plateau may occur as a result of the patient not implementing a healthy lifestyle. This leads to weight gain. Even if you’re doing everything right: eating well, exercising regularly and getting enough fluids, a gastric sleeve weight loss plateau may be inevitable during weight loss. Furthermore, gradual weight gain can be normal during a bariatric plateau. One reason a patient may have plateau is that the body adapts to the dramatic weight loss and defends itself against further weight loss. Let’s not forget that when one undergoes gastric sleeve surgery, we’re altering the digestive tract and changing the way the body consumes, absorbs and digests food and liquids. The body’s natural defence system when it is put under stress will work to protect the vital organs and maintain steady health.
Patients often report a 3-month stall after a gastric sleeve or a 2-month stall after a gastric sleeve, which can be discouraging. Others may face a 4-month stall after gastric sleeve, or even a 6-month stall after gastric sleeve, as the body adjusts to long-term changes.
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What many don’t realise is that patients will often hit a plateau after gastric sleeve surgery, because of physiology, rather than their diet or habits. The important thing to remember is that this part of the journey is normal, and if necessary, you can follow your doctor’s advice on how to break a weight loss plateau and how to avoid weight regain after bariatric surgery. While gastric sleeve weight loss plateau is not ideal, it may be the kick that you need to truly understand that weight loss surgery is not the secret potion to fast weight loss.
The Initial Rapid Weight Loss
Gastric sleeve patients will typically experience rapid and dramatic weight loss immediately following the stomach pouch surgery; after a few weeks of adjusting, your body will naturally slow down this process. Often the first few weeks of repaid weight loss is a combination of water, muscle and fat.
During the first two weeks our patients do burn a lot of fat because they are eating almost nothing, but about 2/3 of the weight loss is actually from shedding water. In fact, at the end of that rapid weight loss phase most patients are a bit dehydrated as a side effect of this water shedding (even if they are drinking all the recommended fluids). Then during the 3rd week, the body “catches up” on its fluid balance. The daily increase in water during these few days leads to a frustrating weight loss stall, even though there is still some serious fat burning happening. Once the body catches up on fluid, the weight begins to come down at a more steady pace that actually does represent fat loss.
The Role of Metabolism
As you lose weight, your metabolism will change and adapt at the same time. While your body will continue to burn muscle and fat cells, your metabolism will inevitably change during this process which can lead to a ‘plateau’ in the months that follow gastric sleeve surgery. It goes without saying, however, for most patients this plateau or temporary pause in losing weight can be incredibly frustrating. However, it’s important to remember that this is all part of the journey and is a necessary step in ensuring that your metabolism adjusts to meet your new weights and need habits.
A slower metabolism after surgery decreases daily caloric needs. Post-surgery, individuals may experience increased insulin sensitivity, altering metabolic rate and energy utilization.
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Strategies to Overcome a Weight Loss Plateau
1. Keep a Food, Weight, and Exercise Journal
When you undergo bariatric surgery, you’ll be instructed to keep a food, weight and exercise journal for post-operative analysis. Keeping a journal also helps patients to keep on top of diet and exercise; letting go of old habits and reinforcing the good habits that they should be adhering to. Once a patient experiences dramatic weight loss, they tend to put journaling on the backburner. However, a journal can really help you to understand how to break a weight loss plateau after gastric sleeve surgery, through your own patterns.
Tracking meals, snacks, and beverages exposes patterns that may be overlooked. A journal can reveal behaviors, like late-night snacking, that contribute to a weight stall after a gastric sleeve.
2. Reassess Your Diet
Under the supervision of your dietician, you may need to reassess your diet. Even if you’ve been eating a healthier, more balanced diet than ever before, adjusting the intake of different foods can help to break the weight loss plateau and overcome limited fat burning after gastric sleeve surgery. You may be able to shift your intake of different macronutrients, or your protein sources may need adjusting.
Post-surgery eating habits should focus on lean proteins, vegetables, fruits, and whole grains to aid weight loss. It is advisable to eat three balanced meals per day that consist of a macronutrient composition ranging from 35-50% protein, followed by fats at 30-40%, and carbohydrates making up about 10-35%. Opting for whole, nutrient-rich foods over processed alternatives can enhance the effectiveness of weight loss efforts. By choosing whole foods, you provide your body with crucial nutrients necessary for maximizing fat reduction.
Protein is the cornerstone of bariatric nutrition. Patients struggling with a gastric sleeve weight loss stall often find improvement by increasing protein intake. Aim for lean sources like poultry, fish, eggs, and plant-based proteins. Adequate protein intake helps maintain muscle mass and promotes satiety, reducing overeating after gastric sleeve surgery. The minimum daily protein intake recommended for weight loss post-surgery is 60 to 90 grams.
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3. Increase Physical Activity
Have you been exercising enough? Sure, it can be tough to maintain a routine of regular physical activity after your surgery, but not exercising can be detrimental to your weight loss journey. If you’re not exercising, or are not able to maintain a routine, and your weight loss has plateaued, schedule some more time for a workout each day.
Regular physical activity is an essential component of the weight loss journey following gastric sleeve surgery. To achieve and sustain weight loss after the procedure, it’s vital to integrate exercise into your daily regimen. Beginning with modest physical activities, such as brief strolls, can aid in recovery after surgery. It’s important to give yourself a six to eight-week healing period before starting any intense exercise regimens. Integrating strength training into your exercise regimen can boost metabolism and assist in shedding pounds after undergoing surgery. It’s essential to maintain muscle mass for continued weight loss following gastric sleeve surgery, as it plays a critical role in increasing metabolic rate.
4. Prioritize Mental Health
A weight-loss plateau and weight regain after gastric sleeve surgery can be stressful, frustrating and really take a toll on your mental health. It’s important to remember that after gastric sleeve surgery, you need to nurture your mental wellbeing as much as your physical health. If you’ve reached a weight loss plateau or gained some weight, don’t let it result in a larger problem. If your efforts towards how to break a weight loss plateau after gastric sleeve are not working, continue seeking support from your weight loss clinic, surgeon, support groups, dietician and psychologist. Remember to look retrospectively at how far you’ve already come with your weight loss journey and how much you’ve achieved.
Managing anxiety can improve adherence to dietary and exercise regimens post-surgery. Accessing mental health support is essential for addressing emotional challenges post-bariatric surgery.
5. Stay Hydrated
Dehydration can mimic hunger, leading to excess snacking. Water supports fat metabolism and prevents false hunger cues. It is advisable to consume 10 glasses of water each day following the procedure.
6. Avoid Sugary Drinks
Sugary drinks, juices, or calorie-dense coffee beverages can contribute to stalls.
7. Manage Stress and Sleep
You're better able to manage food cravings when you're well rested. Manage stress. Incorporating comprehensive health strategies like managing stress levels and ensuring sufficient rest are crucial components for effective control over one’s weight after Sleeve Surgery.
8. Monitor Medications
When progress in weight loss comes to a standstill, it may be necessary to assess whether medications are playing a role. Consistently speaking with your healthcare provider can assist in effectively handling any medication-related side effects that affect weight loss.
9. Consider Revisional Surgery
For persistent stalls, like a 6-month stall after a gastric sleeve or longer, providers may consider revisional surgery as a last resort. Between 7% to 15% of individuals who have undergone initial weight loss surgery may require a second operation, known as revisional surgery, either to improve the results or to rectify issues that emerged from the first procedure. Should complications such as slippage of an implanted band or gastrointestinal problems present themselves post-primary surgical treatment, revisional surgery might be deemed necessary.
The "3 Week Stall"
If you’ve done your reading on gastric sleeve weight loss plateau, you may have heard of the “3 week stall”. As mentioned earlier, weight loss stalling is relatively normal after gastric sleeve surgery. 3 week stalls may be caused by a variety of reasons, namely that the body is working out the best way to adjust to the new stomach sleeve and dramatic weight loss.
If you’re wondering “how long does the 3 week stall last?”, it really depends. It depends on your body, the food you’re consuming, the exercise you’re undertaking and how your body adapts. For some, the 3 week stall will last for a few days or a couple of weeks. Others may experience the plateau for longer.
Understanding the Science Behind the 3-Week Stall
In the first few weeks after weight loss surgery, patients are on liquid diet and calorie intake is very minimal. For that reason, the body is using glycogen stored in muscle and liver. Glycogen is a storage body’s form of glucose or sugar. One gram of glycogen is bound to 3 grams of water, so when as the body uses glycogen, the water is lost. In another word, most of the weight loss the first few weeks after surgery is water weight.
As patients transition and advance their diet, calorie intake increases, and the body starts restoring the glycogen in the muscles and liver. In the meantime, patients are still burning and losing fat. For that reason, patients do not see much weight loss on the scale around week 3 or 4.
The Importance of Follow-Up Care
The importance of follow-up after gastric sleeve care surgery cannot be overstated. Post-operative care is a crucial element of your bariatric and gastric sleeve procedure. For more information on how to break a weight loss plateau after gastric sleeve surgery, you’re going to need additional support from your weight loss clinic. Many patients experience a weight loss stall after gastric sleeve surgery, even when following their program carefully. These stalls are not unusual; they reflect the body’s adjustment to rapid weight reduction.