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Regain – Why Does Regain Occur? – Bariatric Edition

Regain – Why Does Regain Occur?

We have a lot of new clients who have joined our closed support group and we also have a lot of new clients who have recently had surgery. I often get this question asked, “why does regain occur”.
My new clients seriously do not understand the concept of regain, what it is, and why it occurs. I wanted to address this topic for them today. It’s also a great reminder for our bariatric veterans who absolutely understand the concept of regain and need a gentle reminder.
I know that when you are newly operated and have your new sleeve or bypass intact, that you cannot phantom the idea of regain. I mean, how can anybody have a regain when their stomach is so teeny tiny? Water is hard to get down. Will I ever be able to eat chicken? How can I live on so few calories/ nutrients each day?
This is what it feels like to be newly operated and I am here to tell you that “this is only a phase, and your new tummy will not be like this for the long haul. When you just have surgery, there is a lot of inflammation involved. It takes time to bring that inflammation down and we work through steps together to reduce inflammation and to build up your diet.
This is the very beginning of a life-long journey. Your stomach will not remain that teeny tiny size forever. The inflammation comes down, and the stomach is made of stretchy material. The pouch enlarges over time. Will it ever be the size of a football again? No, but it will get bigger.
The “pink cloud” that newly operated people float on is just the best feeling in the world. You can eat, feel satisfied quickly and move on with your day. You no longer feel famished all the time. You work through the bariatric guidelines and time passes while you recover and get closer and closer to your goal weight.
Fun times! Life will always be perfect like this. (WRONG)…. and this is when you come crashing down from the pink cloud. You have a bit more space in your pouch. You used to feel STUFFED with only three bites of tuna/mayo but now you feel like you could eat a lot more. Hey, what about adding a cracker or two to my tuna? That cheese looks great. I should add it to my salad. I don’t think it would hurt if I had one of those tortillas with my lunch? That popcorn will make an excellent snack later this evening. I think I should keep those fajitas I ordered at the local Mexican eatery. I didn’t eat them all but if I try again in an hour, I will be able to eat more of it ……
See how that happened? I just set myself up for a BIG stall and a BIG regain.
This is exactly how regains occur.
I am here to tell you that you need to be vigilant. If you see a 5 pound regain, you need to stop, take an honest look at your eating habits, and do something about it asap. You’ve worked too hard to go back.
I know, I know, if you are newly operated, you will tell me “oh, I would never have a regain”!! Hey, don’t judge too harshly because it CAN happen to YOU too. It can happen to all of us.
Have you ever lost weight (before your surgery), and then gained it back? This is the same thing. If you are not vigilant, and you don’t have some safety nets in place (good diet, physical activity, sleep hygiene, stress relief) you can have a regain.
Bariatric surgery doesn’t just “stop working one day”. We stop working the bariatric lifestyle. Your tool is still intact. Your eating habits have changed, and therefore regain occurs. It doesn’t happen for no reason at all.
Once the “pink cloud” phase has passed and we get on with our jobs, school, kids, family, events, etc., our eating habits can take a back-seat. Let’s face it, life can get in the way sometimes. We have tragic events happen. Pandemics happen. Divorce happens. Death happens. Job loss happens. Depression happens. All these stressful events can lead us down a very slippery slope.
Let’s just look at the past year and a half ,,, who was expecting this to happen? I have spoken with so many clients who have experienced regain during this period. When you are about to lose your job, eating a salad doesn’t seem that important. French fries feel good when your boss tells you that they may have to let you go. Spending 24/7 with your beloved partner may not have been the easiest time to say “no” to the wine bottle.
Let’s face it – life gets hard sometimes. Therefore, regain can occur. I’ve seen it throughout my career, and I am not just talking about the pandemic. My clients had regains before the pandemic and they will have regains once the pandemic is over. Regains can happen.
Please don’t think that it could never happen to you.
Now, how can we prevent these regains?
Your diet needs to be in check “most of the time”. I find that routine is so powerful.
  • Wake up at 8 am
  • Coffee and eggs for breakfast
  • Go for a walk and a stretch,
  • Work for 4 hours
  • Prepare lunch
  • Work some more
  • Meet some friends twice a week to touch base
  • Have dinner at least 3 hours before bedtime
We don’t need to have some crazy complicated food routine. If you like eggs for breakfast, then have eggs for breakfast. If you enjoy a chicken salad at lunch, then eat your chicken salad. If you enjoy your walking routine, then get out there and do it. Sure, it’s fun to try new recipes but you don’t need to be reinventing the wheel every week.
When I get out of my routine, I enjoy it. But I also enjoy my routine so getting back to it isn’t so terrible. Create a routine that works for you. If you hate working out at 6 am, switch it to 6 pm. If you don’t enjoy cooking every night, then do some food prep during the weekends to make it easier. Find what works for you.
One last thing to mention. If you’ve had a regain, please reach out to me. It’s not something to be embarrassed about. I can help you. We can work on your diet, or stress relief techniques. If the regain is out of control, and you’ve made serious attempts, maybe a revision surgery is something that would be in your best interest.
Don’t hideaway. This will not make the issue better. We are stronger together. If this is something that worries you, put a plan into place. I can help.

Healthy Hugs. I have my hand gently on your back.


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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