NEW ways to fail after weight loss surgery

9 Ways To Fail After Weight Loss Surgery

August 10, 2020

Ways to Fail After Weight Loss Surgery

From the title of my article, "9 Ways To Fail After Weight Loss Surgery" you may be thinking I don't want to fail after weight loss surgery! There is a common misconception that most people who have bariatric surgery regain their weight back. This is simply not true. The vast majority of patients are able to sustain their weight loss, as long as they adhere to lifelong habits that include a healthy diet and exercise. You didn't have surgery to fail so I'm sharing the ways to fail after weight loss surgery!

According to the American Society for Metabolic and Bariatric Surgery’s (ASMBS) website, “As many as 50 percent of patients may regain a small amount of weight (approximately 5 percent) two years or more following their surgery.

However, longitudinal studies find that most bariatric surgery patients maintain successful weight-loss long-term. ‘Successful’ weight-loss is arbitrarily defined as weight-loss equal to or greater than 50 percent of excess body weight.

Often, successful results are determined by the patient by their perceived improvement in the quality of life. In such cases, the total retained weight-loss may be more, or less, than this arbitrary definition. Such massive and sustained weight reduction with surgery is in sharp contrast to the experience most patients have previously had with non-surgical therapies.”

As a bariatric patient, you have made an important and impactful decision to change your life. You might find yourself worrying about the possibility of facing the same outcome as everything (fad diets, quick weight loss followed by rapid reversals, ‘cleanses,’ etc.) you’ve tried before. Maybe you have regained some of your weight, and are working to get back on track.

There is no fancy diet, no perfect macronutrient balance, no flat tummy-tea, or waist trainer that can get you there. I know this is not the answer that most people are looking for, but basic, consistent habits will get keep you on the road to sustained weight loss and get you back to it if you’ve gone off course. If you can relate to any of the following, you might need to consider making some changes to ensure your success.

9 Ways To Fail After Weight Loss Surgery

Failure to Plan Ahead

Planning ahead is essential in our busy lives. This is especially true if you have a family and a full-time job. You cannot achieve sustainable weight loss on the fly.

My recommendation is to look at your week ahead.

Figure out how many meals you will need. Preferably, write this down in a planner or a calendar. Are you home by dinner to cook each day? Do you need to prep both lunch and dinner? Do you need to set breakfast out the night before? If you don’t have time to set aside to prep, you can also make large dinners each night, and save some for lunch the next day.

Look up easy to make recipes and their respective ingredients online. You can check out recipes on ObesityHelp. Then, take an inventory of your pantry and fridge and make a list of the missing ingredients. Now, take that list and go food shopping on the weekend, and carve out some time to make those recipes.

Failure to Cook for Yourself

This point goes hand-in-hand with 1. above. Cooking for yourself is a form of self-care. If your eating habits consist of take-out and frozen meals, it is unlikely that you will be successful. You do not have to be a master chef, but you do have to learn to make a few basics.

When you cook at home, you tend to consume fewer calories. I always tell my patients that when you eat out, assume you have eaten no fewer than one thousand calories.

One easy tip is to buy frozen, steamable veggies. These are very cost-effective and just as nutritious as fresh veggies, and much better than canned. You can also buy your choice of proteins in bulk, pre-marinade, and store it in freezer bags. Rotisserie chickens also come in handy in a pinch, remove the skin, shred and use in a variety of dishes.

Getting started can be intimidating or feel overwhelming. If you feel completely lost in your own kitchen, you might consider taking a cooking class. Plenty of kitchen gadgets are available now that can make home-cooked food both tasty and healthy, like air-fryers, Instant Pots, slow cookers, etc.

If resources are limited, you can use YouTube or Pinterest for basic recipe ideas. If you follow Bariatric Bubble on Instagram or Facebook or check out our website, you will also find very easy to follow, high-protein, bariatric-friendly recipes.

Not Prioritizing Protein Intake

Protein, protein, protein. How I love thee … and so should you. Protein is a weight-loss powerhouse. Protein is thermogenic, meaning that your body burns calories to digest it. Yes, you heard that right, you BURN calories when you eat protein.

Protein is also very satiating. It can keep you full longer than if you eat a meal devoid of it. When you start your meal with protein, it will ensure that you get full quicker, leaving less room for other foods you may not need to be eating.

Try this ‘3, 2, 1 Rule’: Start with 3 bites of protein, then 2 bites of veggies, and finally a single bite of carbohydrate. Repeat until you are full.

The amount of protein you will be able to consume will vary based on when and what type of surgery you had. Most people can only consume around one or two ounces of protein for the first few months. This will gradually increase to three to four ounces. Ultimately, you will be able to consume no more than about five ounces of protein, if you are also planning, as you should, to add veggies to your meal.

Investing in a food scale is a worthwhile investment for every patient. As a rule of thumb, one ounce of lean protein is equal to seven grams of protein. You can also look up the protein content of specific foods online or using websites and apps.

Every meal and snack should include a protein, and we encourage our patients to plan this ahead of time. As a rule, never eat a carbohydrate without a protein. If you are a new bariatric patient, protein also prevents hair and muscle loss (your muscles are key to your metabolism).

Your protein requirements will vary on a number of factors—goal weight, age, level of activity, etc. Most people will have a goal of 60-100 g per day. Discuss your particular goal with your surgical program or dietician.

Not Enough Exercise—Especially Resistance Training

You cannot rely on motivation to exercise, and it is fleeting. Building good habits is essential. Exercise is not the key to weight loss, but it is the key to weight maintenance. This is especially true of resistance training, such as weightlifting. Building muscle is the key to your metabolism. Your body actually burns calories to maintain the muscle you have built!

One pound of muscle burns about 6.5 calories per hour. Muscles burn 5.5 times more calories than fat tissues, which burn about 1.2 calories per pound per hour.

If you have never really exercised, weights may seem intimidating. I recommend you start with a regular routine, which may be as simple as walking. I usually recommend Leslie Sansone’s Walk at Home for Beginners, or apps like Couch to 5K.

Remember, eventually, this will not be enough. You should be engaging in 250 minutes per week of moderate-intensity exercise to make a difference. One of the best forms of exercise that include cardio and strength training in a short period of time is called high-intensity interval training, or HIIT.

This type of exercise only works if you are doing it with intensity. You can find these types of exercise on Youtube or Popsugar, and many local gyms will offer classes. You can always work out at home, too. Some examples of good home workouts include P90x or Insanity. Exercise should be scheduled. It takes an average of 66 days to build a habit, but this will differ with the individual.


When you are dehydrated you are more apt to snack or overeat.

Maintaining adequate hydration is important for hunger control. DRINK. WATER. NOW. Seriously, go have a big glass. You know you’re thirsty.

Drinking Your Calories

This includes excessive alcohol. This is a mistake that is overlooked by many, many people. Calories in drinks are everywhere—juices, creamers, soda, Starbucks coffees, energy drinks, sweetened teas, alcohol, etc.

You need to read the labels on everything you consume and ask if beverages have added sweeteners when ordering out.

You should essentially try to consume sugar-free, calorie-free beverages at all times with very few exceptions. Some flavorful, low-calorie alternatives include lemon or frozen fruit added to water, Crystal Light, and unsweetened teas.

Drinking with Meals

Waiting at least 30 minutes before and after meals to consume liquids is a strict, hard, and fast rule at most bariatric programs. When you eat and drink with your meals, you will likely get full too quickly and be hungry sooner, which can lead to grazing.

You can also push the food out of your pouch or sleeve at a quicker rate, which can leave your stomach feeling empty, prompting you to eat again.

Unfortunately, chronically drinking and eating at the same time may cause stretching of the new stomach, leading you to eat larger meals. This new habit can be difficult for many people. Setting a timer can help and try to keep liquids out of reach during mealtime.

A Lack of Support

An excellent support network is integral to weight maintenance. This includes support from family and friends and attending regular support groups that your program should offer. Here you will reinforce healthy habits and hear from other people who might be struggling with similar problems.

You can also motivate yourself by being motivational and inspiring for others who are struggling.

Stress Eating and other Psychological Issues

Most patients who undergo bariatric surgery in Centers of Excellence, such as our program, are required to go through a rigorous psychological evaluation. This determines whether you are in the right mindset for surgery and if you have any barriers that would prevent your success.

You may need to address things like emotional eating or substance abuse before surgery.

Luckily, most programs have access to therapists and other facilities that can help if you need it and should be available to you, even post-surgery. Check with your provider for help.

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Lorraine Rojas


Lorraine Rojas, PA started her professional career in a Bariatric Center of Excellence in Syracuse, NY. Subsequently, she joined another Center of Excellence at her present position in Torrance, CA. As a result, she has learned the highest standards of care in Bariatric Surgery and non-surgical weight loss. Her positive, caring persona is paired with a continued thirst for deeper understanding of the ever-growing field of bariatrics and weight loss science. Along the way, she has managed to be a source of inspiration and guidance in the lives of thousands of patients struggling with obesity.