Facilitator: Chris Bovos, RN, CBN
Taken from The Bariatric Times, November 2016
There is a lifelong threat of weight regain after surgery. A small amount of weight regain (3 – 5%) is expected after a patient reaches their lowest weight; but maintaining that weight loss is a challenge for most patients.
Some of the areas we looked at include:
Risk factors for weight regain include:
- Preoperative binge eating, which can become loss of control eating after surgery;
- Depression – many of the drugs used can increase weight Need to get depression under control prior to surgery and monitor after surgery;
- Night eating or grazing – early, brief intervention can improve this.
People frequently have trigger foods that trigger the dopamine or reward response.
- Need to identify what your triggers are and avoid them;
- Keep a food journal. Most people begin to have more liberal meals once they have lost their weight, and need to become aware when they are eating high glycemic, high-fat and carbohydrate-rich foods by journaling every day;
- To “reset” things, cut to 1000 – 1200 calories a day for women; 1200 – 1600 for men;
- Follow the physician orders and nutritional guidelines:
- Meet daily fluid goals of 64 ounces a day at least;
- Wear CPAP – poor sleep can increase cortisol and slow your weight loss;
- Eat 3 meals a day – skipping meals slows your metabolism.
- Get at least 1200 mg Calcium with Vitamin D each day to improve body’s ability to burn fat;
- May need to take a metabolic boosting medication.
Meal composition and portion control are critical:
- 50% of your plate should be lean protein;
- 30% of your plate should be vegetables (non-starchy);
- 20% or less should be complex carbohydrates – not processed foods;
- Eat slowly and take 2 bites of protein to 1 bite of something else – helps keep protein a priority, and wait 5 seconds between bites.
Focus on making your muscles healthy in addition to losing weight
- Muscle has a higher metabolism and increasing lean body mass increases metabolism;
- Begin with 150 minutes/week and work up to 200 – 300 minutes a week;
- Once you lose weight, your body is so much more efficient at using energy that you have to work harder than you did in the beginning;
- Any kind of activity can be modified – don’t say “I can’t”.
The most vulnerable time for people to start regaining is at 2 years’ post op. Usually will see one of the following start:
- Going from 3 meals a day to grazing;
- Intake has switched from protein, fruits and vegetables to carbohydrates, sugars and fats;
- Decreased physical activity;
- Loss of Control eating.
- Eat real foods, not packaged foods (eat food that will rot over time);
- Make protein a priority and omit all processed food, sugar and simple carbs;
- No snacking or grazing. Be aware of mindless eating (eating from boredom);
- 8 glasses of water daily, and don’t drink with meals or 30 minutes after meals;
- Walk as alternative to driving. Take the stairs;
- Follow up with physician and support groups;
- You can regain control!