STALLS - DON'T PANIC
Disclaimer 1: Before following any information provided by myself or anyone else on the internet consult your doctor before making any change to your diet or program. This is my OPINION based on reading dozens of recent research studies but should not be interpreted as medical advice.
Disclaimer 2: There are always exceptions. Each person's biology is unique and while I believe most of this information applies to a vast majority of people who get weight loss surgery, it will not apply to 100% of the people 100% of the time.
STALLS AFTER THE FIRST MONTH
Our bodies are not designed for weight loss, they are designed to protect our energy stores (fat). By design, our biology actively fights losing fat (aka, losing weight). Losing weight isn't natural, and that is why it is so hard sometimes,
even with weight loss surgery.
For 99% of humanoid history, food was scarce. There were no grocery stores, processed foods, and such. Our genetics protect our weight from starvation. It's not something we can change on a whim. Although the best side effect of weight loss surgery is the affect on hormonal signals that allow us to lose weight without our body fighting it so hard, there are times when your body will resist or slow down. It's natural and although frustrating, not something to get too worried about. Keep making good choices and don't do anything radical like cut back calories to a super low level.
Almost all of us will stall for days, weeks, or even months before we reach our nadir weight.
BREAKING A STALL
Here's the bad news, there really isn't a specific method or action you can take to break a stall. People try lots of different things and when the weight does go down, they usually correlate the last thing they tried as the thing that "broke the stall."
The truth is that it was probably more complicated than that. It doesn't hurt to try to change some things up here and there, but the most important thing you can do is to continue making good choices around food, hydration, and add some strength training (if cleared to do so by your doctor).
This battle is won or lost in the kitchen. It's all about the food and hormones. Your focus should always be on the food. If what you are eating isn't working for you, make small changes to your diet and find the foods that work best for your biology. We are all different. There is no single diet that works for everyone. Don't think because someone posts they are "low carb" or "keto" or "vegetarian" or whatever diet religion they do that it will also work for you. It may not.
WHAT TO DO: First, validate your food intake. Has anything changed? If not, you then need to ask, do I need to change something? There is no single diet that works for every person. You'll see people give advice like "you've got to do keto" or some other specific diet. The fact is, you don't know if that diet will work for you or not. It might be the worst thing you could do, but it could also be the best. Although it would be nice to say, "here's the key" it just doesn't work that way. What you need to do is find a diet that not only helps you lose weight and remain leaner but is one you can also follow for the rest of your life without it being a burden.
However, regardless of which diet religion you choose to follow, there are a few things that you should consider:
- Avoid these things most of the time:
- ultra-processed foods (10 ingredients or more)
- refined grains
- artificial sweeteners
- anything with added sugar
- Consider adding more of the following:
- 20-30 different plants per week (this doesn't have to be huge quantities and includes not only veggies but also herbs, spices, nuts, seeds berries, fruits, fungus, etc. This high amount of diversity will feed your gut microbiome and send satiation signals.
- I'm not saying you need to be a vegetarian, this can be done on any low carb diet
- ensure you are getting enough protein (animal or plant-based)
- ensure you are very well hydrated
- Also, consider:
- If you are doing frequent cardio - stop (see below)
- If you aren't doing strength training - start (see below)
EXERCISE IS NOT A GREAT WEIGHT LOSS CATALYST!! (but it is a great HEALTH catalyst)
If you browse online WLS communities, you will often see posts about people "exercising 5 days a week" or more and saying they aren't losing any weight and trying to figure out what they are doing wrong. What they may be doing wrong is actually working out too intensely. During the first 12 months, we are generally on a very low-calorie diet. Although our bodies are releasing fat during that time, it can still be very protective of it, and that is what happens frequently when people over exercise, especially cardio.
Your body goes into energy protection mode and actually slows down your metabolism. Your brain sees the following: very few calories coming in and a high need for calories to provide energy for movement. I know it seems counter-intuitive, but the best track to take for the first 6-12 months is walking (as brisk as you like) and periodic (2-3 days max per week) resistance exercise to minimize muscle loss, which has more net effect on calorie burning than cardio.
People always overestimate how many calories are being burned with cardio, and over the course of one year it might add up to 5-6 additional pounds...for a person who is eating a normal calorie load and not very low calories. Again, with low calories, your body will protect its energy stores. After surgery, your body wants to lose fat and get down to that lower weight, all it really needs is good food choices and hydration to get there.
As I mentioned in the parentheses above, exercise has great health benefits, so I'm not advocating that you avoid exercise completely. There are soooo many health benefits that we get from exercise, but during the first 12 months, moderation will serve most people better than high intensity. Once you reach that low point in your weight, feel free to kick it up a notch as exercise is a much better tool for keeping weight off than losing it. At that point, you'll also be able to consume a few more calories than early on, so increase intensity isn't as big of a deal when your calories are super low.
MOVING FORWARD
Weight loss is not linear. Even though we get a great boost with surgery and the positive side effects it has on hormonal signals, a consistent state of caloric deficit will still put your body on the defensive sometimes. It will slow down, speed up, stall, go up, back down, etc. This up/down/stall process can take many different forms for different people.
We all have to accept these stalls will probably happen, and yes,
they are frustrating, but it's a natural adjustment. As long as you are making good food choices, the fat will burn and you will reach your nadir (lowest weight). After that, you'll probably gain a bit back, which is also natural. However, if you continue to make good food choices, it will be much easier to maintain that weight because your body has a new set point it will defend, and it will be easier to maintain that new weight
if you make good choices.
Every person's body is different of course, so there is no one way to predict each person's experience, which is why
we should refrain from comparing our individual path to others, although I know that can be easier said than done.
Continue making good food choices, stay hydrated, move frequently or exercise, maintain a calorie deficit and you will succeed to the point where your body starts to defend its new set point. Resistance training has been shown to be more effective at keeping your metabolism humming along than cardio, but the fact of the matter is cardio exercise does very little to speed up weight loss. It does a hell of a lot to make you healthier in several ways, but food choices and diet are way more important than trying to burn away fat through exercise.
Even with weight loss surgery, this battle is won or lost in the kitchen. That doesn't mean you should be a couch potato, there and many, many benefits to exercise, and after you reach your weight loss goal, exercise has been shown to be very effective in maintaining weight loss for the long term, just not as great in getting there.
I'm not a doctor nor a nutritional expert,
BUT I am a research study nerd. I read scientific studies for fun, and each week, I read journal articles on health, obesity, and nutrition. I dive deep into the science behind how weight loss surgery works, how our microbiome health is one of the key factors to long-term success, and talk with people who've kept the weight off for several years to find the other common traits for long term success. When I find better evidence and better studies, I may change my mind about some things, but I'm fairly confident that what I'm saying is solid based on science. I also participated in a nutritional study last year that taught me a lot (a study sponsored by Harvard Public Heath, Standford Medical School, and others).
You don't have to take my word as gospel, and you shouldn't. Look into it yourself and read studies and peer-reviewed research papers
. Look for real, unbiased, research that isn't funded by diet or food industry sponsors, if possible.
All that being said, I'll say it one more time as
the bottom line for success:
The battle is won or lost in the kitchen. If you make good food choices, stay hydrated, work in some resistance training, and change your long-term relationship with food, you WILL maintain the weight loss that you achieve after surgery.
I only want the very best for ALL of us.
We deserve this! We deserve to succeed and lead wonderful, high-quality lives filled with incredible experiences..
Disclaimer 1: Before following any information provided by myself or anyone else on the internet consult your doctor before making any change to your diet or program. This is my OPINION based on reading dozens of recent research studies but should not be interpreted as medical advice.
Disclaimer 2: There are always exceptions. Each person's biology is unique and while I believe most of this information applies to a vast majority of people who get weight loss surgery, it will not apply to 100% of the people 100% of the time.