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Bariatric Re-Gain Reflections 2020

I want to reflect over 2020 and let you know what I have learned over the years … nothing to do with covid or viruses … what I want to discuss is the latest on re-gain, the latest bariatric news, and the best way to use your bariatric tool to get you where you want to be.
I hope everyone had a lovely little holiday break. We are sitting between Christmas and New Years’ as I type this. I can still feel the holiday cheer as we wind down from Christmas and wind up for the New Year celebrations. 
I don’t know what our New Years Celebration will look like this year? We normally have some friends over to help us celebrate. This year it is unbelievable that it is “illegal” to gather with anyone that is not living in your home. If you would have told me this last year, I wouldn’t have believed you.
Let’s just take it day by day and we shall get through this together. It doesn’t matter what your political beliefs are. It doesn’t matter what your religious beliefs are. It doesn’t matter what your personal beliefs are. What we ALL want is to get back to some sort of normalcy and as quickly as possible.
I’ve been working with bariatric clients for 12 years now. Each year I learn more and more as I accompany each of you on your journey to weight loss and wellness. I see some of you reach your goals. I see some of you get very close to your goals. I see some of you have re-gains. 
Each one of you starts with the very best intentions. I get that. Our will-power and motivation take us to a certain point and then we need to have some solid lifestyle changes in place to keep us going. It’s not easy. It is a daily decision that we make to get healthy and to STAY healthy.
Let’s talk about the size of the stomach and the “stretch”. There are many people out there that talk about sleeve or pouch stretching. This is TRUE. When we first have our surgery, our stomachs are tiny BUT they also have a lot of inflammation for the first 4 to 6 weeks. This makes drinking water difficult. It makes eating an egg difficult. But, as time passes, the inflammation goes down and we suddenly have more space to eat.
This additional space does not mean that your sleeve has stretched. It means that the inflammation has gone down. It means that “for right now”, this is how much space you have in your sleeve. As time passes, the sleeve or pouch will get a bit bigger. This is normal. The stomach is made of stretchy material and it will stretch a bit with time. 
Will your stomach ever go back to the size of a floppy handbag or a football. No, but it will allow more food to fit in there. 
This is something positive because nobody can survive with a stomach the size of an egg. Sure, we would be very thin BUT we would also have no hair, no teeth, and issues with our bones. We need to eat sufficient food to avoid nutrient deficiencies.
The bariatric pouch is meant to help you get the weight off QUICKLY. Quickly is the magic word here. Our goal should be to lose weight within the first year and then go into maintenance. Maintenance is a place where we eat sufficient food but also a place where we eat the right foods – prioritize protein, fill with fat, reduce carbohydrates.
If these get skewed, and we start to prioritize carbohydrates, this can lead to a re-gain or a long weight-loss stall. I am not making this up. I see re-gain every day and when I ask my clients “why” they had a regain, they will always tell me that they made errors with their food choices. They started adding back the foods which caused them to gain weight in the first place.
Bariatric surgery is not magic. It is just a tool that we need to use properly to lose weight and to keep it off long-term. If you’ve had a re-gain, it is time to go back to the basics. You need to choose water over soda or juice or artificially sweetened beverages. You need to eat your protein FIRST. You need to try to get your 8 hours of sleep each night. You need to lower your stress levels. You need to get active.
The weight came off quickly post-surgery because you had a TON of restriction and also because you choose the correct foods. What happens when we have more space and make bad decisions? Re-gain occurs. I want to say that a bit louder… RE-GAIN OCCURS.
Can we beat re-gain? Yes, but it’s going to be a lot harder than it was when we first had our tool. 
“But I thought that weight loss surgery was permanent”. It is! But, time marches on and our bodies change internally and externally. As time passes, we will have a bit more space to eat more food. Now it becomes incredibly important to fill the pouch with the right foods (like solid protein). If we choose potato chips, hamburgers, and pizza, you need to expect re-gain to occur.
Let’s compare plastic surgery now to bariatric surgery. Plastic surgery is permanent right? It is, but if I have my breasts lifted when I am 30, gravity still marches on. My breasts will not be the same as they were when I first got them done 5 years later. They are going to be headed south again.
The same goes for varicose vein treatments. The same goes for facelifts. Time goes by, our body adapts, changes occur. 
Let’s look at bariatric surgery as a way to lose weight quickly. Let’s not drag it into the 2nd, 3rd, 4th, and 8th year. As the years go by, it gets harder and harder. We should be focusing on maintenance and not weight loss.
Another option is to have revision surgery. We can make the sleeve smaller or we can revise the sleeve to the bypass or we can redo a bypass so it is new again but,,, same principles apply. We must try our best to lose weight during that first-year post revision surgery. 
These are the things that I have come to believe after my long journey assisting my bariatric clients.
If you are stuck. If you need help. Reach out to me, please. We can try to intervene with a dietary approach or we can discuss revision surgery.
If you are doing great, but you are worried about the future, reach out to me. I can explain maintenance and how we can work to keep our weight where it is today.
If you are having a hard time, reach out and I can be your cheerleader and accountability partner.
I am sending you healthy, happy vibes as we all move into 2021.
Sheri Burke RHN

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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