After the first six months of bariatric surgery, there is something in our body mechanisms that changes. Our weight loss slows down, some of us reach our goal weight (or are getting very close to), and for some, the weight loss stops completely. It’s at this point that we need to change something up either to gear up for maintenance or to continue losing, getting us to that goal.

For bariatric patients, there are more than one WOE (ways of eating – also known as POE or plan of eating). The hard part is finding exactly what it is that will work for you.

The thing is, you have to TRY these WOE’s out to see if they work for you. And you have to try them for longer than two weeks. Usually 6 weeks to three months is a good gauge to see if a WOE will work for you or not.

Many of us will have a good nutritionist or dietitian that will help monitor and tweak alongside us so that we can try these out safely. For those of us that don’t, however, we have to be very careful that we don’t fall back into the “yo-yo diet” mindset. This is not about finding the “next best thing” that will help us lose all our weight (we’ve already done that), it’s about finding a healthy, sustainable way of eating that we can continue for a lifetime.

Over the next few weeks, this series will go into deeper detail of some of the most common WOE’s that bariatric patients will sustain over a lifetime. Some of these are meant to help transition you into maintenance mode while others are intended to help you lose the next 50 lbs. or to help you get off those last 10-20.

Take note, if you have regained weight, these are not intended for that purpose. Later, we’ll do a series focusing on regain and how to lose it (as this is something that Jen is learning a lot about right now!)

Today, we’re going to talk about the steps to take when you’re changing over to your next WOE.

For continued weight loss:

1. First, talk to your doctor. Make sure they know exactly how long it’s been since you’ve last lost weight. Keep a detailed food log that they can go over with you to help you figure out exactly what you’ve been taking in macro wise (macros = macronutrients which are proteins, fats, and carbohydrates) and calorie wise. They will likely give you their idea on what your next step should be. TRY THIS FIRST. While not every doctor is a nutrition expert, most have experience with patients that are stalling or slowing down on their weight loss so they know their stuff.
2. IF your doctor doesn’t give you any advice, the next step is to see your nutritionist/dietician (if you have one). Tell them the same thing you told the doctor about your weight loss, including the detailed food log. They will likely have more information for you on what you can do to restart the loss. They will walk you through and tweak some things for you, increasing or decreasing things like fats, carbs, and protein.
3. If your doctor doesn’t give you any viable thoughts and you don’t have a nutritionist or dietician, you will have to venture forth on your own. When you do this, be sure that you give a good amount of time before deciding whether or not it will work. A good gauge will be between 6 weeks and three months. In order to do this, raise either your fat, protein, or carb count (most common is to raise the fat levels). An example is, if you’re eating 20-35 grams of carbs a day, you might raise that to 50-75 grams. If your fat is set at around 50-75, you might raise it to 100, etc. When you do this, log everything you eat for two weeks and gauge how your body is feeling and if you’ve lost weight. Gauge this again after four weeks. If, after six weeks, you haven’t lost any more weight and/or you feel sluggish, moody, or are having any other (negative) symptoms, return to the original count and stay there for about two weeks to allow your body to relax. This may actually be enough to jump start your loss. If not, after two weeks try raising another macro. Please know that this is NOT going to be a “quick fix” process – AND YOU DON’T WANT IT TO BE. We got to the point of needing bariatric surgery by trying every single quick-fix diet and fad on the planet. This is something that you want to take your time with to find the most healthful, nutritious route FOR YOU.
4. AFTER SIX WEEKS if you feel great, are losing weight again, and are having no adverse effects, STICK WITH IT. You will hit stalls (again) but know that unless it has gone on for longer than a month it’s not considered a “true” stall. If you hit a stall that lasts longer than a month, you might need to readjust again. It will take time to find that “sweet spot” and THAT’S OKAY. Don’t be discouraged. Not to sound all cliche, but the old saying, “this is a marathon, not a sprint” is very true!

ONCE YOU HIT YOUR GOAL you will want to go on a maintenance WOE. This is a plan that is not going to vary too much from your weight loss plan. It’s going to take some time to find that “sweet spot” that we just talked about that will let you not lose any more weight but not gain any either. ALTHOUGH – please know that when you go into maintenance and slight gain of 5 or lbs. is absolutely normal and to be expected. It is nothing to worry about and will likely level out again.

To go into maintenance, look at things that you’d previously eliminated and begin adding them back in one at a time. PLEASE remember to keep things as whole foods. For example, you might add in more fruit such as bananas, grapes, or apples. Or you might add in a few whole grains such as whole wheat crackers, tortillas, or pitas. Or even more starchy veggies such as sweet potatoes, peas, or corn. We do not advise you to add in more refined or processed foods such as sugar, pasta, rice, etc – these foods can be harmful to many bariatric patients, especially those with an RnY or Gastric Band.

The WOE that you chose will be something that works for you. In future posts we will talk about some of the most popular ones including the Standard American Diet (SAD), the Paleo/Primal Diet, the Ketogenic Diet, and the Plant-Based Diet (remember when we say “DIET” we’re not talking about DIETING, we’re talking about an everyday eating lifestyle).

We hope this post was helpful. Next week we will talk about the classic Standard American Diet (SAD) as it pertains to Bariatric Patients.

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