Weight loss Stalled? How to beat a Plateau.

Stalls in weight loss and weight plateaus are common after surgery. Keep in mind, you probably didn’t gain the weight one pound a day, or even one pound a week. So, expecting to continue to lose weight as quickly is unrealistic. After a few months of a stalled scale; diet, exercise, and other aspects of life may need to be examined to figure out what could be the culprit. 

Lets go through some adjustments we could make when the scale isn’t moving in the direction we want. First, it’s important to understand, is it really a plateau? The scale can be your biggest enemy because it doesn’t tell you if you are losing fat, just mass. Take inventory, do clothes feel looser? Do you feel healthier? Losing inches instead of pounds still means your fat cells are shrinking. A true plateau is no weight lost and no inches lost in four weeks. If inches are being lost, but not pounds, you haven't stalled. Be happy you are still shrinking — becoming healthier, getting into smaller clothes, and building a strong body. Measure your arms, waist, hips, thighs and bust once a month. Write these numbers down on a chart to watch yourself shrink. 

Logging Intake

If inches and weight stop coming off for longer than 4 weeks, then changes need to be made. Tracking food in a journal is the best way to understand what’s going on in your body. Using a food logging app such as Baritastic or MyFitnessPal calculate your calories, protein, fat, and carbohydrates eaten. Many of us think eating one or two M&M’s every time we pass the candy bowl is no big deal. But, if we walk past the candy bowl 10 times a day, that equals 80 calories, 11 grams of sugar, and three grams of fat. Make sure to track everything you consume.  

Calorie Intake

Once you’ve logged your meals for a few days or a week, look back at the numbers and assess if you are getting too much or too little. Not enough calories can prevent the body from losing weight. This may seem counter-intuitive, but if your body is starving for energy, it is not  willing to give up fat, its best source of stored energy. Instead, your body slows your metabolism and burns less fat when it consistently doesn’t get enough calories. 

Calorie needs post-surgery: 

0-3 months after surgery - 600-800 calories a day.

3-6 months after surgery - 800-1,000 calories a day.

6-9 months after surgery - 1,000-1,200 calories a day.

9 months and longer after surgery you should be getting a normal amount of calories for the average person of your weight, height, and age. 

Protein Intake

Not consuming enough protein will slow weight loss. Protein makes up every muscle, tendon, and tissue.  Without enough protein in the diet, the body pulls protein from muscle stores, not fat stores. Muscle loss makes weight gain easier. Calculate how much protein your body needs by dividing your current weight by 2.2. For example, a 200 pound person should eat 91 grams of protein each day (200/2.2=90.9). Remember, food is fuel, not the enemy.

Good Vs Bad Fats

Eating the wrong type of fat can stop weight loss. Not all fats are bad, we need them to make food taste good, to transport vitamins, for long term energy, and to protect our organs and cells. Monounsaturated and polyunsaturated fats are the types we should eat daily. These fats come from nuts, seeds, avocados, olives, nut butters, and oils. We should reduce solid fats like butter, fat in animal meats, milk, yogurt, cottage cheese, and cheeses. Take inventory of where your fats are coming from. Try to replace at least one bad fat food for one with a good fat everyday. 

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Simple Carbs

Carbohydrates provide fuel for our brains and give us short bursts of energy. Too many carbohydrates during meals can prevent you from eating other, more important, nutrients like protein and vegetables. After we eat carbohydrates, our body releases insulin (FAT CANNOT BE BURNED WITH INSULIN IN THE BLOOD). Remember, after weight loss surgery all protein on your plate should be eaten first (20-30 grams), vegetable or fruit eaten second, carbohydrates last. Only if you’ve eaten the protein and a half cup of vegetables should you even think about having carbohydrates — limiting them to two bites. That is two bites of rice, potatoes, corn, tortilla, pasta, and bread. You can eat 5-6 small meals a day, this would add up to 10-12 bites of a carbohydrate, totally acceptable after weight loss surgery. 

Fruits and Vegetables

Lack of fruits and vegetables will prevent weight loss. High protein diets are filling and can limit your intake of fruits and vegetables.  Start with just a few bites per meal, then increase as you’re able to eat more. Did you know that it is recommended to get 5-8 (1/2 cup) servings of fruits and vegetables a day? If you have a meal without a fruit or vegetable, you’re missing out on important vitamins, minerals, phytochemicals, antioxidants, and fiber. Fiber helps you feel full and stay full longer. Fiber gives you larger, easier bowel movements. It is hard to lose weight if you are constipated. If you have a bowel movement less than every other day, your body needs more fiber. 

Water Intake

Low water intake will slow weight loss. Our bodies can survive weeks without food, but only a few days without water. Water is essential in our bodies to transport nutrients, maintain body temperature and lubricate our tissues. Too little water intake makes it difficult for our bodies to have a bowel movement and to use fat as energy. Eight glasses of water a day, or 64 ounces is the minimum recommendation. Taller people, heavier people, those who do laborious work may need 90-128 oz of water a day. 

Grazing

Grazing will cause a plateau. Grazing includes: eating while standing up, eating out of a bag or box, eating while watching TV/reading/working/driving/on the internet. When we do these activities and eat at the same time, we tend to eat more without realizing it. If our brain is busy while we eat, it doesn’t realize when the stomach is full. Cravings, which come from our brains, are not satisfied if we eat while doing other things. 

Sticking to a schedule can prevent grazing. You’re allowed 5-6 small meals a day. Do not eat outside of those mealtimes. Eating at the same time everyday will help your body’s metabolism stay high. If we know to expect food at a certain time each day, our body will learn to become hungry at this time. This allows us to plan for meals and be ready to eat when the time comes. Skipping a meal leads to over eating and making unhealthy decisions at the next meal. At night, your body’s metabolism slows and goes into repair and fat burning mode. Your first meal of the day wakes up your metabolism, burning more calories. Every meal after that reminds the body it will still get energy, keeping that metabolism burning high.

Sleep

Unusual sleep habits will cause plateaus. Lack of sleep will change your body’s hormone cycle, causing the metabolism to slow or increase hunger. Do your best to get 7-8 hours of sleep each day. Eating before bed can interfere with your sleep cycle as well. Food intake causes the body to release insulin (FAT CANNOT BE BURNED WITH INSULIN IN THE BLOOD). Therefore, your body is busy working on digestion instead of going into repair/fat burning mode. This can then make your sleep restless, increasing the hunger hormones in the body. 

Large Portions

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Overeating will reduce weight loss. If we constantly overeat, our stomachs are always slightly stretched, allowing us to eat more and more at every meal. Your stomach won’t stay permanently stretched from overeating, it will shrink back down if you shrink your meals. But, you may experience hunger while doing this. 

Meal sizes post surgery:

0-3 months after surgery - 1/4 to 1/2 cup per meal.

3-6 months after surgery - 1/2 to 3/4 cup per meal.

6-9 months after surgery - 3/4 to 1 cup per meal.

9 month and further after surgery, all meals need to be 1 and 1/2 cups or less per sitting. 

Exercise

Incorrect exercise routines can stall weight loss. Simply walking the dog everyday isn’t going to shed pounds. Your heart rate needs to be elevated for at least 30 minutes at a time, five days a week. This will strengthen your heart and lungs, improve circulation, reduce risk of disease, and reduce insulin in your blood (FAT CANNOT BE BURNED WITH INSULIN IN THE BLOOD).  After 4-6 weeks of the same exercise routine, our bodies become efficient and won’t burn as many calories doing the same thing. If our exercise routine stops making our muscles sore afterwards, then we needs to change it up. Keep a variety of workout videos on hand to cycle through every few weeks. Muscle building is a must for weight loss. Running two hours a day burns tons of calories, once we stop running, we stop burning extra calories. When we build muscle, we create new tissue that will use calories when at rest. Keep track of your muscle building. If you are sore after three sets of ten bicep curls, great! Keep it up! When you stop getting sore, add another set of ten reps until you start to feel sore again. 

Vitamins

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Vitamin and mineral deficiency will prevent weight loss. Lets say you have a deficiency of vitamin D. Your body knows this, it will make you hungry so you can eat more foods with vitamin D. Unfortunately, you don’t know you need vitamin D. Therefore, you eat more, but not necessarily the food containing vitamin D. This causes weight gain, but doesn’t fix the deficiency. Deficiencies can happened 6 months, 1 year, and even 11 years after weight loss surgery. You should have your labs checked at a bariatric office at least once a year. A bariatric office knows to check for more specific vitamins than those your primary care doctor checks every year. 

Taking a vitamin supplement made from a bariatric vitamin company will prevent deficiencies. Vitamins from the grocery store are meant for the average person. After weight loss surgery, the body has different needs than the average person. Therefore, a vitamin from the grocery store will eventually lead to a deficiency unless you are taking 7-8 pills a day. Bariatric companies make vitamins in a variety of flavors and ways to take them. They are almost always willing to send you samples before you purchase them. Ask your bariatric office to help you find a vitamin that fits your taste and lifestyle. 

Medications

Medications can cause weight gain, no matter what you do to prevent it. Did the weight stall after starting a new prescription? Some medications slow your metabolism down, others make you feel hungry. Common medications that cause weight gain are medications for diabetes, insulin (FAT CANNOT BE BURNED WITH INSULIN IN THE BLOOD), steroids, contraceptives, heartburn medications, anti-depressants, and anti-seizer medications. 

Last Resort

If all else fails, its time to start eliminating food additives, caffeine, alcohol and tobacco from the diet. Tobacco causes the body to use more vitamins, which could lead to a vitamin deficiency. Alcohol and Caffeine, even decaf, leads to a burst of energy. After the energy boost, our bodies release insulin (FAT CANNOT BE BURNED WITH INSULIN IN THE BLOOD), slowing weight loss. Check the ingredients label for additives. It might be that your body wants you to eliminate one item, like Yellow-5. Or, your body wants you to eliminate all food preservatives as well. This includes all food colors, Nitrites, benzoates, sulphites, and sorbates. You’ll find these ingredients in every food that comes in a bag, box, or can. These are man made chemicals we add to food to make them last longer in the refrigerator. None of them are healthy for us but, it would be almost impossible for us to have affordable food that lasted long enough for us to eat if we didn’t use them. 

Surgery alone doesn't cause weight loss. There are many factors in our lives that will effect when and how much weight comes off. A change that helped get through one plateau may not help the second time. Don't get discouraged. Keep making small changes in your lifestyle until you find what works best for you. Leave a comment below and let us know what changes you've made to break a weight stall.