Weight Loss Woes

We commonly see weight loss surgery patients panic in the early stages following weight loss surgery. It may be in the first few weeks, or the first few months.

A surgeon we work, Dr Justin Bessell, regularly says he is not particularly interested in what a patient of his weighs two weeks after surgery, he is interested in what they weigh two years after surgery. Why? Simply because those who are able to maintain weight loss in the long term are those who will get the most health benefits.

However, we understand that the purpose of weight loss surgery is to lose weight, so it is normal to feel anxious about if the scales don’t move. Particularly as we see people setting high expectation and placing excess pressure on themselves before they are even booked for surgery.

Patients will often ask how much they should expect to lose during the pre and post op period, hoping to hear a magic number. Some may also expect us to be able to tell them how much weight they will lose each week/month/year following surgery. When a member posted in our support group “How much weight did you lose in the first four weeks following surgery?”, the answers varied dramatically. Some responses included:

  • “I’ve just had surgery, so not much help, but I only lost 3kg pre op.”
  • “It’s 3.5 weeks since my surgery and including the pre-op stage I’ve lost 17kg.”
  • “8kg including pre-op.”
  • “2kg and 2kg pre-op.”
  • “I’m only 9 days post-op but have lost 14kg, 7kg of that was pre-op.”
  • “I’m down 9kg 4 weeks post-op.”
  • “I was slow to start. It’s taken me 3 years but I’ve lost 80kg.”
  • “I had surgery 17 months ago and am only around 10kg lighter.”
  • “I lost 70kg in 14 months.”
  • “It took me the best part of 5 years to get to my goal…. Lots of ups and downs but I have lost 120kg.”

As you can see, the variation in weight loss is huge. There is no normal rate of weight loss prior to or following surgery. It is therefore crucial not to become fixated on the numbers and just as important not to compare yourself to others.

Post Surgery Pauses

Some people will see dramatic weight loss immediately post surgery and some will not. Following surgery people experience fluid retention and/or fluid shifts within the body. If weighing frequently, this can appear as weight gain on the scales, causing concern. This is nothing to be concerned about and will resolve.

In the first few weeks following surgery, those who have experienced significant weight loss prior to their surgery may find their weight will stabilise. This is also normal, as the body pauses to check what is happening. The body realises that to continue to lose weight at a rapid rate constantly may be detrimental, so will pause and regroup. Again, this is nothing to be concerned about and will resolve.

Slow Weight Loss

With the significant physical, emotional and financial investment In surgery, it is understandable that people want results. They want a return on their investment, and they want it fast! This unfortunately, is not always reality.

You did not gain all your weight overnight, and neither can you lose it that quickly. Take for example Jane, a weight loss surgery patient who has lost 120kg: “It took the best part of 5 years for me to get to my goal. It took 40 years to get to my heaviest weight, so it made sense it wasn’t going to come off overnight.”

Bariatric GP, Dr. Helen Patroney, sums it up beautifully: “Living with bariatric surgery is a marathon, not a sprint.” You need to be patient and hang in there.

Monitoring

What better way to ensure you are losing weight than by weighing regularly, right? Well, not always.

Consider the client who tells us they weigh morning and night and are amazed at the difference a day can make. Or the client who comes for an 11am appointment starving hungry saying they haven’t eaten a thing as they expected to be weighed and wanted to be as light as possible. For this person, eating breakfast would have been a far better choice in terms of a sustainable, healthy behaviour to help achieve their goals.

Jumping on and off the scale every time you walk past them is not effective monitoring. Weight fluctuations day to day are not an effective measure of overall weight loss. Recent food intake, fluid retention, hormonal cycles, bladder and bowel contents are all factors which will cause daily fluctuations in weight. Often the less frequently you weigh (within reason), the easier it is to see a trend.

Weight Loss Reality

The reality of weight loss is that it is not linear. Take the following graph for instance of a person’s weight fluctuations over a month. Their weight decreases, it increases, and it plateaus. However, over time, there is a positive trend in the downward direction. This is what weight loss often looks like.

Weight Loss Graph

Personal Responsibility

Part of our role as dietitians is helping people really understand what surgery will and won’t do for them; that surgery alone does not guarantee you will lose weight; it is a tool that can assist you to lose weight when teamed with lifestyle change.

We often hear comments of weight loss surgery that are alarming to us. Some believe surgery will give them the motivation to stick with a healthy lifestyle, that if they invest so much money in having surgery, they will have to lose weight. Some tell us that once they have the surgery they will start exercising. Some believe they will be forced to eat healthy food after surgery or won’t be able to eat what they want to eat or desire to eat after surgery, so it will be fine. It is misconceptions like this that can set people up for disappointment when the results they are expecting to see do not eventuate.

Surgery doesn’t ‘make’ you eat healthily. It doesn’t fix non-hungry, habitual or emotional eating. It doesn’t magically remove calories from high energy liquids and easy to eat snacks. It doesn’t make you love cooking a meal instead of grabbing a takeaway on the way home after a busy day.

What surgery will do is help you eat smaller serves of food and feel more satisfied on those smaller serves if you eat in a way that allows it to do so.

Colleen Cook is a successful weight loss surgery patient from 1995 and is the author of the best-selling weight loss surgery book, The Success Habits

of Weight Loss Surgery Patients. It is based on her research of the most successful long-term patients and the habits they have in common as they maintain their weight over time. I love this quote from Colleen:

“Successful patients took personal responsibility for staying in control. They were found to have a general feeling that maintaining their weight was indeed their own responsibility and that surgery was a tool that they used to reach and maintain a healthy weight.”

Having been through surgery herself, Colleen knows that surgery itself does not cause weight loss. She understands that to be successful with weight loss surgery, you will need to take responsibility for your lifestyle choices.

If you are not achieving the weight you hoped for, it is worth considering if whether you have taken responsibility to ensure all healthy lifestyle foundations are consistently in place. Your food choices, eating patterns, eating technique and your activity levels. It is also worth considering how long these foundations have been in place. You need to be in this for the long haul?

Robert Collier once said, “Success is the sum of small efforts, repeated day-in and day-out.”

If you need assistance with ensuring your foundations are in place, check out our Support Options.

Image above courtesy of courtesy of core-trainingpt.com.

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