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How do I maintain my weight after WLS?

It was Albert Einstein that said:  “If you do what you always did, you will always get what you’ve always got.”  It’s a quote that fits most things quite well.  Bariatric surgery treats the disease of obesity by physiologically affecting, among other things, our feelings of hunger and fullness making it difficult to always do what we’ve always done.  These feelings along with other factors that are out of our control affect our weight after WLS. But just like for someone who has not had surgery, there are certain choices that will affect your weight loss and keeping it off after surgery. The four main ones identified in a review of 22 studies were:  what you eat, how you eat, support, and physical activity.  We will take these 1 by 1. 

1.  What you Eat and Drink

Eating a healthy diet, limiting alcohol intake, and avoiding excess calories regardless of the source were all related to keeping weight off after WLS.  Perhaps this isn’t surprising!  It basically says to make sure you are getting a healthy balance of protein, veggies, fruits, other carbs, and fats and to limit junk food and large amounts of alcohol. Eating this way will also help to ensure you are getting the nutrients you need after surgery along with your daily vitamins and minerals. 

2. How you Eat after Bariatric Surgery

What we eat and how we eat can go hand-in-hand.   One of the eating behaviors related to weight-regain was grazing/nibbling.  When we graze throughout the day, we tend to include less healthy, snacky foods that quickly add up in calories.  Because these little bits during the day don’t necessarily make us feel satisfied, it leaves us wanting more.   But eating regular meals that include protein and fiber, we tend to feel more satisfied and avoid putting our blood sugars on a rollercoaster ride that also makes us want to eat more.

The other “how we eat” concern is much more involved and not really a behavior per se but a disorder that should be addressed with a healthcare professional: binge eating.  If you have found yourself binging/feeling a loss of control when you eat, it’s important to seek support from a mental health professional, especially one who works with eating behaviors. People who had binge eating disorder before surgery are particularly at risk for this after surgery, so make sure to pay attention to any warning signs and reach out!

3. WLS Support Systems

Support for your mental and physical health from professionals, friends, and family is key to maintaining your weight loss.  It’s sometimes easy to avoid going to see your doctor or dietitian, especially when you know things have slipped a little.  But that’s likely the time when you need the most support!  Support from family, friends, and even your social media crew can also help you make healthier choices and refocus and avoid getting down on yourself when things get off track.

4. Physical Activity

Both being active in your day-to-day and taking part in more intense physical activity that really gets your heart pumping helps to keep weight off long-term.  There’s also more and more research out there showing how sitting all day (as many of us do!) isn’t good for us at all.  The best thing to do is to find activities that you like to do and make them part of your routine whether that’s going for walks during breaks at work, joining a class at the gym, or taking the bike rather than the car when possible – everything counts!

We are not saying that if you follow steps 1-4 that you will get to your lowest weight and stay there forever. As we know there is so much not in our control that affects our weight, and having WLS does not automatically mean that you maintain the same weight all of your life.  So do not be worried if you gain some weight back as the years pass – it’s normal!   And by focusing on the basics of healthy eating and exercise and reaching out for support, you’ll be doing things that keep your body and mind healthy after bariatric surgery.