Weight loss surgery has become the norm, these days, with hundreds of thousands of obese men and women going under the knife to undergo one of the most significant medical moments of their life. Doctors will tell you how things should go the first year, but rarely tell us what is beyond the first 12 months after your surgery!

Here are some of the best five “rules” we’ve found for WLS past the first year!

  1. “Protein First” Switches To “Veggies First” Most bariatric surgeons with any training in nutrition these days have their patients change their diets slightly after the first year. Rather than sticking with a high protein diet, they will switch their diets to a more plant-based plan. Doctors Duc Vuong and Matthew Weiner are two of the most highly regarded bariatric surgeons in the United States, and they both do this with their patients after the first year.
  2. “Sliming” Is Still a Thing If you eat too much, especially with the VSG (Vertical Sleeve Gastrectomy), you WILL get sick. There is a phenomenon we know as “sliming” where you will vomit up … well, a slimy substance before anything else comes up. Sound gross? ‘Cause … it is. And not-fun.
  3. Your Weight Loss WILL Slow Down The closer you get to goal, the slower your weight loss will go. This is because you have less weight to lose, so your metabolism is catching up with it. You will also experience more, and sometimes longer, stalls. And most surgeons will tell you NOT to freak out unless your stall goes longer than 3 (3??? Yes, 3!!) months.
  4. Months 12-18 Are What Really Set You Up For Success or Failure It’s not the first year, but the first few months of the second year that set the stage for the rest of your WLS life. You’ll be able to eat more. You’ll be able to eat a bigger variety of foods. You’ll experience slower weight loss and more stalls. It will be tempting to start trying to find the “next best thing” to jump start the weight loss again or to just give up all together. Instead, it’s important to go back and see “rule” number 1. Remember that it’s a PROCESS. The first few months of surgery, the weight just fell off. Now is when the REAL work begins.
  5. Movement and Plain Water Are Still NOT Optional The first year, you might have been able to fudge a little on your exercise and water intake. You were losing fast without a workout. You had enough protein shakes to keep you hydrated. Plus, you’re allowed Crystal Light, right?? So, first, to clarify something – exercise is NOT necessary for weight loss. It’s necessary for good quality of life. But if you become completely sedentary – especially after you’re close to goal – your weight loss will slow down, and may even stop. And the water? Well, here’s the thing – PLAIN water is the very best hydration tool a WLS patient can have. I hear so many people say, “I don’t like water” and I continue to tell them, “Well, suck it up buttercup”. Because, anything containing caffeine (tea, coffee), sugar (juice, infused waters), or artificial sweeteners (Crystal Light, Wylers, Mio) contribute to dehydration (so … they actually do the OPPOSITE of what the purpose of drinking stuff is), they also stimulate the appetite, and can crash your metabolism. I’m not saying these things are a complete no-no – you can still have them. You just need to be sure you’re getting 32 oz (about 4 standard size water bottles) of plain water every day. NO EXCEPTIONS.