Get Back On Track 2

8 Steps to Get Back On Track After Bariatric Surgery

July 10, 2019

Has the excitement of having weight loss surgery dwindled for you? Have you gone back to some old unhealthy behaviors? Well, you are not alone. As the rate of weight loss slows down or stops, and your priorities shift away from meal preparation, the habits that promoted weight gain can creep back into your daily routine.

After significant weight loss, physical changes occur, and your body adjusts metabolically and feelings of hunger return. Unfortunately, continuing to lose weight or even maintain the weight you lost becomes more challenging. Here are eight simple steps that will allow you to continue to be successful and get back on track after bariatric surgery.

8 Steps to Get Back On Track

Acceptance

Avoid negative thoughts and understand that relapse is part of the stages of change. Don’t dwell on the fact that you went off course but instead identify what will motivate you again. Write down three reasons you need to resume healthier habits.

Example: Write your Why clearly and post it where you can read it daily. You want to ride the amusement park rides comfortably, or you want to stay off insulin.

Journal

Keep a food diary for at least one week. Online apps like MyFitnessPal, LoseIt, or Baritastic, provide valuable feedback on nutrients like protein, fiber, and sugar. They are beneficial in determining how to “budget” your intake of protein and fiber while staying within a reasonable calorie range. Track what you eat, the time you eat, the exact amount (use measuring cups) and how you feel after.

Example: Use a hunger vs fullness scale (Still hungry =1, Satisfied =3, Too full = 5).

Find Your Direction

Take the guesswork out of change and find your direction. Remember basic guidelines: protein goal is 75+ gms/day, fiber 20 gms/day, fluid 64+ oz/day. Review each meal you logged and determine if you are dividing your intake throughout the day. If not, start with modifying one meal each week.

Example: Aim for 20-25 grams of protein at breakfast, lunch, and dinner and include the rest in 1-2 small protein based snacks. It may take 3-4 weeks to balance out all your meals but adjusting slowly will reduce stress and give you more time to identify new recipes.

Meal Spacing

Your meals/snacks should be 3-4 hours apart. Grazing will lead to unnecessary calories and prevent adequate fluid intake. On the flip side, sipping non-caloric fluids between meals will help prevent eating too frequently. It’s a win-win.

Example: Remember to eat slow, chew your food well, and do not drink while eating.

Drink Water

Yes, I am referring to plain water. You can infuse with lemon, cucumber, frozen berries, ginger but avoid artificial sweeteners, carbonated liquids and limit caffeinated beverages. Monitor your intake and make sure you are adequately hydrated by drinking at least 64 ounces of water daily. Set your timer to remind you to start sipping 30 minutes after a meal and aim for 16 ounces before your next meal or snack.

Example: Using a water bottle with a time marker can be extremely helpful, you can order one online or make your own with a Sharpie.

Move More

Exercise is essential in maintaining weight loss. Aim for at least 150 minutes a week of approved exercises. Breaking the time down to 30 minutes daily for five days a week will help make it manageable. You can even divide it into 15 minutes twice a day. If you already meet this recommendation, remember your body will adjust to your usual routine.

Example: If you have been walking 7,000 steps a day, your body burns fewer calories doing those same steps three months later (especially if you weigh less). Therefore make a change every 4- 6 weeks to maximize the effect.

You can adjust:
Duration (length of time)
Frequency (number of times a week or even per day)
Intensity (aim for moderate to vigorous)

Speak with a physician or physical therapist first if you have any injuries.

Set Goals

Set specific, measurable goals, and plan non-food rewards. It is hard to stay on track if you only measure success on the scale, keep in mind that non-scale victories are just as important. The key to success is commitment, and knowing you will have something to look forward to makes a difference.

Example: Drink 64 oz of water daily for 30 days or consume 75 gm protein for seven days, and you will treat yourself to a massage or new workout gear.

Don't Do It Alone

Follow up care with a dietitian trained in bariatrics is vital to not only healing and the initial weight loss but for long-term success. A dietitian will make specific recommendations to ensure you are maximizing your results, meeting your nutrient needs, and maintaining a healthier lifestyle. In addition, consider finding a support group (in-person or online). Speaking to others that are going through a similar situation can be empowering.

Example: If you returned to old behavior and eating emotionally due to depression or anxiety, it is best to seek the support of a trained psychologist.

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Remember weight management is a dynamic process and these 8 Steps are the beginning of a new journey. Your weight loss results will not be as quick as they were in the initial weeks after surgery so it is important to have reasonable expectations to avoid disappointment. Stay focused, consistent and think positive. You can do it!

Andrea D’Oria-Cameron

ABOUT THE AUTHOR

Andrea D’Oria-Cameron has been a registered dietitian for more than 17 years. She has a master’s degree in Clinical Nutrition from New York University and worked at SUNY Downstate Medical Center & GMHC before moving to Seattle, WA. At that time, she began to specialize in weight management working as a research dietitian for Fred Hutchinson’s Cancer Research Center. After returning to New York, Andrea obtained a position as a bariatric nutritionist for NYU Langone Medical Center. She has a Certificate of Training in Adult Weight Management and is a New York State Licensed Dietitian-Nutritionist.