After weight loss surgery, there are often phases in which the weight loss seems to stall. There may be various reasons for this. A typical reason is that the diet has not been fully adapted to the new circumstances. For this purpose, it is important that detailed nutritional advice is given as part of the preparation, which also includes the necessary behavioral changes after the surgery. A well-prepared patient has realistic expectations and can better prepare for the time after the surgery. If you do not lose enough weight, it may be due to these five issues:
You are not eating enough calories
What may sound illogical at first glance has to do with the change in hormone levels. One of the most important hunger hormones, ghrelin, was almost completely removed. It is formed in the part of the stomach that is removed in gastric sleeve surgery. So you don’t feel hungry anymore afterwards. The stomach has been reduced from the size of a flat football to the size of a thumb. You don’t feel like eating anything, so you don’t. Many people believe that the less they eat, the faster they lose weight. Unfortunately, this does not apply to everyone. If the body is not supplied with enough nutrients, it starts to “burn” muscle as well as fat. The more muscle you lose, the harder it is to reduce further muscle mass and achieve weight loss. This then leads to the “plateaus” – the standstills. The body also assumes that something is wrong and tries to maintain every gram of weight; so the body is working kind of against you.
How many calories you should eat depends a lot on how long ago the surgery was. There is no point in forcing yourself to eat, but you should set goals. During the first four weeks, you shouldn’t worry about calories. As soon as you reach the phase where you can eat more or less normal food, you should first set a goal of 800 kcal per day. Slowly increase this to 1000 to 1200 kcal. 1200 kcal should be your daily minimum. Eating less will slow down weight loss in the long term. In many cases, however, this amount will still be too little. That depends entirely on individual needs.
Too unbalanced diet
If it has been four or more weeks since surgery, it is important to include solid sources of protein and healthy fats in your diet. The first thing you need to do is make sure you consume enough protein. The basic need for protein can be determined relatively easily. The ideal weight is used as a guide: for a height of 1.70 m, for example, this is 70 kg. This corresponds to the approximate protein requirement in grams per day. In this example, that would be 70 grams of protein per day. This is only a general recommendation for minimum requirements. For greater weight loss, you would need a larger proportion of protein.
Once the protein requirement has been determined, the total ratio of macronutrients must be considered. A common question is how many grams of protein, fat and carbohydrates should be eaten for optimal weight loss. There is no general answer to this. Rather, it is about the ratio of the individual components to each other: food should consist of 10-35% carbohydrates, 30-40% fat and 35-50% protein. Care should also be taken to ensure that the total sugar intake does not exceed 25% of the daily intake.
Too much unsolid food
After surgery, many people have problems returning to solid food. It is often said that poultry or other protein-rich food cannot be eaten. After a while, an aversion to solid protein food develops. When that happens, we continue eating foods that “glide down well”: yoghurts, potatoes, creamy soups, even ice cream and similar foods. This meal is not balanced and lacks substance. This means that you get hungry again more quickly. Also, the proportion of simple carbohydrates in relation to proteins and fat is too high. It makes sense to take a look at your own eating habits and see if you might be eating too much of this type of food. This can have an impact on weight loss.
Too much exercise too soon
If you have decided to have bariatric surgery and are focused on losing as much weight as possible as quickly as possible, you may be tempted to plunge into sports after the surgery and give everything for quick results. In fact, not eating enough while also exercising like a pro will hinder weight loss. It is always good to walk in the fresh air after such a surgery. Anything more strenuous than walking should wait until all surgical wounds have healed well. In general, you should wait six to eight weeks after the surgery before you start with “real” sports. You should also be able to eat the minimum calorie amount (see above) without any problems before you start doing more than the already recommended walking. You should wait before eating 800 to 1200 calories before exercising.
No sport at all
Even if eating habits are responsible for at least 80% of the success after a surgery, the 20% share of success that sport has should not be neglected. Lean muscle increases metabolism because it takes more calories to maintain it. The more of this lean muscle you have, the faster calories are burned. If the surgery was performed six to eight weeks ago and the diet is balanced, then a balanced endurance training program can take you to the next level of fat loss. If you don’t know how to best perform this endurance training, then it is advisable to work out a program in a sports club, fitness center or with the help of a fitness trainer that suits your abilities. Such training can often be done at home.
Overall, you should be patient. The excess weight was not gained overnight. And even though in many cases the weight drops very quickly after such a surgery, it does not disappear overnight. It is normal to experience stages where your weight loss seems to come to a standstill. Also, weighing too frequently can give the impression that weight is stagnant. Give your body a few weeks to adjust to the new situation and to work off the stored fat. Patience is a very important part of this process.
It is very important to remember that everyone is different and has different needs. There are general recommendations to help point you in the right direction to achieve optimal fat loss, but there are also many factors that affect the rate at which fat and calories are burned. You will need to adapt the information given over time and see what works best for you. There is no general diet that is perfect for everyone.
Sometimes patients feel discouraged when they compare themselves to other patients and do not lose as much weight and fat as them. This is also due to the fact that everyone works differently and there are many factors that influence this process. Talk to your dietitian if you have problems losing weight after surgery.
There are many answers to the question “Why am I not losing weight after surgery?”, which depend on the individual situation. If none of the above points apply to you and you still do not lose enough weight, then it may be that the surgical method chosen was not the right one for you.
