Expert: Cathy Wilson, ACC-ICF, CLC - 9/7/2009

Question
Hi,

I thankyou for your time.  I am 7 years post op and have gained back 70 lbs.  I was 365 lbs got down to 172 lbs and went back up to 246 lbs.  

I have been working out almost daily, sometimes 2x a day for a month.  Exercise: 1 mile on treadmill--1 mile on the cross trainer, and then wight tanning, 3 x a week at circuit tanning and yoga. I have been doing this for a month and have only lost 3 pounds.

My diet has consisted of high protein-supplement high fiber- no refined sugar or white flour----I stay between 1400 to 1600 calories a day.  

I am thinking maybe I should scrap this plan I am working so hard at the gym and not cheating at all on my food.  Can I go back to using the post surgery plan and start with just liquids and protein supplement like I just had surgery my pouch has already shrunk and I cannot eat much at any given meal anyway.  Any ideas what is wrong with me, why can't I loose the weight did my body change that much to reloose, and would my idea about going back to the beginning work.  Thanks.....Julie

Answer
Hi Julie,

Thanks for contacting me.  You didn't indicate in your question but from how long you're post op and the fact that you didn't mention any fills, I'm going to assume you had RNY Gastric Bypass.  If this isn't true, let me know.

Let me assure you that it is common for weight regain long term.  You are not alone in regaining some of your lost weight.  The good thing is that you have caught it and gotten back on track before you regained more.

The first thing I would suggest is for you to see your surgeon or have tests to check on the mechanical function of your surgery.  Is everything working in order as it should be?  Sometimes your pouch and/or stoma can be stretched or otherwise compromised in some way.  

If everything checks out okay with your procedure, you can focus on your food choices and activity.  From personal experience in regaining weight myself and then losing again, it is much, much slower than it was the first time around.  I lost around 1-2 pounds per week so it was a very different experience than after I had my surgery.  So, a slow weight loss is usual in relosing weight.  The reason why is that right after we have surgery our malabsorption rate is at the highest it will ever be.  As we get further and further out post-operatively, our malabsorption rate decreases and our bodies adjust to our surgeries.  We will always have the benefit of our surgery but not at the highest rate early post-op.  

Your exercise and activity are excellent.  How is your water intake?  You need a minimum of 64 ounces of water.  Water is a big component in losing weight.  It plays a big part in maximizing weight loss.  

Your calories might be a little bit high.  You didn't indicate how tall you are so I can't tell what your BMI is.  Without knowing these details I can't determine for sure your caloric intake.  I would try to stay around 1,300-1,400 calories at the rate of exercise you are doing in order to lose weight.  Also, the type of calories you are eating matters.  How many grams of protein are you eating?  Carbs?  What type of carbs - vegetables, fruit and complex carbs?  How many grams of fat are you eating?  My thinking here is that you might be eating too many carbs to prevent a better weight loss.  A general rule of thumb is to eat two bites of protein to one bite of vegetables, fruit or complex, low-glycemic carbs.  

You could supplement a snack or a meal with a protein shake or supplement.  This far out post-operatively I would question if it would provide satiety long enough for you.  After we've had surgery our pouches are very small so protein shakes are more fulfilling.  Try it and see if it satisfies you or if you get too hungry before your next meal.

Just remember that you lost it once and you CAN do it again.  Yes, it will be slower but you can lose it.  I would encourage you to get involved with a support group in your area or start one yourself.  Join an online support group too.  I have a Back On Track Together group at ObesityHelp that I'd be happy to have you join too.  

Congratulations on maintaining your current weight loss.

All the best,
Cathy, ACC-ICF, CLC
Certified Life Coach, Weight Loss Surgery Coach
Certified Back On Track Facilitator