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Acknowledging Regain Post Weight Loss Surgery – Bariatric Edition

I like this topic.  I like to hit it straight on and discuss it because regain does happen.  I don’t like to dance around this subject.
I have this great job of helping my clients get prepared for their weight loss surgery procedure.  They are nervous and excited and ready for a big change in their life.  They are sick and tired of battling against obesity and all the health issues that accompany it.  
We discuss their travel and surgery itinerary in detail.  We go over the pre-op diet and we begin to discuss the post-operative guidelines.  I make sure that ALL questions are answered BEFORE they arrive in Mexico.  This reduces anxiety and gets them ready for what’s to come.
There is this big learning curve.  It’s like learning to drink water again, and learning how to chew food again.  It’s baby steps post-surgery … and the weight starts to fall off.  It’s such an exciting time.  It’s learning how to work with a new, tiny tummy.
Those first 12 months … that is the time to learn about nutrition and proper eating habits and macro-nutrients and how to balance them.  
Is weight loss surgery permanent?  
Well, it is a permanent adjustment to your stomach and in some cases, intestines.  What it is not is guaranteed is weight loss and maintenance for the rest of your life.  If you want those things, then you will have to work for them.  “Working for them” means eating the right diet and staying or becoming active. 
Weight loss surgery is a tool.  I know you have heard this so many times but what does this mean?  How is it possible that I can have over half of my stomach removed but yet my weight loss maintenance is not guaranteed?  How is it possible that I could regain weight with only half of my stomach?  
If I weigh 240 pounds when I have surgery, and I am consuming only 600 to 800 calories daily post-op, then it means that I am going to rapidly lose weight.  This is a true statement.  This makes sense.  Now, I just hit onederland!  And I am consuming 1000 calories a day.  I am still losing weight but it is going more slowly now.  The scale is not moving quite so quickly but I am still happy and getting closer to my goal of weighing 150 pounds.  
Two scenarios 10 months post-op
Scenario One: What does my daily diet look like?  What do 1000 calories look like?  
Well, on a good day, I have a protein shake for breakfast that I make in my blender.  I have some cheese and nuts as a snack and a tuna salad for lunch.  I made chili for my family for dinner and I ate some of that.  I had another half shake in the evening while watching Netflix.  Of course, this is a good day.  
Scenario Two: What does my daily diet look like on a bad day?  I think I ate 1000 calories?
I may have a fancy Starbucks latte before my work-day begins.  Sharon brought some muffins to the office so I had one of those with a half banana.  Hey! Banana is a fruit so stop rolling your eyes.  We went out for lunch with the girls from the reception and I ordered the cheeseburger but I only ate half the bun and a handful of French fries.  I was feeling hungry mid-day so I made a healthy decision and purchased a protein bar from the snack area.  I was feeling tired when I got home but the kids were starving so we ordered a pizza.  I only ate one piece of pizza and the second piece I only ate the pizza toppings.  I stayed up a bit later than normal and when I was feeling peckish at 8 pm, I got myself a small bowl of grapes and a glass of orange juice. WELCOME TO THE CARBOHYDRATE ROLLERCOASTER (and it’s hard to get off)   
If scenario one is a typical day in the life of my post-op bariatric client, then I can see how they are going to have success moving into the 2nd year.
If scenario two is a typical day in the life of my post-op bariatric client, then I can see how a regain is going to occur in the 2nd year.
See how easy that was to predict?  It is not the bariatric tool that fails, it is the patient that fails the tool by feeding themselves incorrectly.  
What happens if we have fed ourselves incorrectly and we have experienced a regain?  Is everything lost?  Of course, all is not lost! It is time to take control of your diet and make good food decisions.  You need to make a plan.  You need to get to the grocery store.  You need to do some food prep.  You need to be the boss again. 
Time has a way of passing so quickly.  You wake up one day and you are 6 years post-op.  Does that mean that you are a bariatric senior and the rules from year one and two don’t apply to you?  Of course not.  They apply to you more than ever.  You are a bit older and your metabolism may be slowing down a bit more.  You may be having hormonal fluctuations.  You will need to be even more careful.  You will need to feed yourself correctly and make wise food decisions day in and day out.
This is why you hear the expressions “weight loss surgery is a tool” and “the struggle is real”.  
We need to constantly use our tool correctly in order to avoid the struggle of regain.  Your bariatric procedure is an advantage over not having surgery.  It gives you a fresh start.  You need to take that fresh start and then really make the changes you need to make.  I am talking about sodas, fancy coffees, fast food, inactivity, refined and processed carbohydrates.  
If you are feeling depressed because you’ve had a regain then I suggest that you grab one of my free nutrition plans and get ready to make some important changes.  All of my plans work if you work them.  They are based on real food – real, whole, live, fresh, natural food.  There are no tricks or gimmicks.  They will get you back to the place where the scale is moving and you are hitting your goals again.
This is the journey.  
I hear people say “I didn’t have weight loss surgery to live on a diet”.  Well, unfortunately, we cannot eat like teenagers and expect to have good health and our goal weight.  This is just the reality.  There is no surgery that you can have that enables you to eat pizza, hamburgers, and chicken nuggets while drinking soda and expect to remain healthy. 
I have never had a client tell me that they have had a regain from eating chicken and broccoli.  The reasons for regain are clear to me and they should also be clear to you.  It’s all the little decisions that you make each and every day that determine your outcome.
Join me in 2020 and let’s work together to improve our nutritional habits and our overall health.
Here’s to healthy long-term health.  We really ARE what we EAT.
Healthy Hugs to You!

About the Author: Sheri Burke is a Registered Holistic Nutritionist and Bariatric Surgery Coordinator at International Patient Facilitators in Tijuana and Cancun, Mexico. She has worked with bariatric surgery clients for over 10 years and especially enjoys providing nutritional guidance to pre and post bariatric clients.  In her free time, she enjoys spending time with her husband and two teens and cooking up a nutritional storm in the kitchen.

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