Last month I said I wanted to talk about how bariatric regain happens, but I first want to talk a little about hydration. I was at the gym early last week and saw a woman with the water jug in the pic above. I thought it was such a great idea I stopped her and asked her if she didn’t mind if I took a pic of it. It is EXTREMELY important to make sure you get in your recommended amount of fluids everyday. My doctor wants me to get in 64oz of water per day, but please make sure to talk to your doctor about the proper amount of water for you.
Keep in mind that after weight loss surgery, you will no longer be able to gulp down water like you used to. Post-op, you are going to have to sip all day long to make sure you stay hydrated. I know that sounds daunting, but that’s how it’s going to be unfortunately (and that’s a small price to pay for the benefits you will get out of surgery!). And please, stay vigilant of the 30/30 Rule, which means no eating and drinking at the same time. You should not drink liquids between 30 minutes before and 30 minutes after your meal.
I myself have problems with getting it in my water too, to the point where I had a terrible muscle cramp in my arm that had me running to the ER because it was in my upper-left arm and it had me thinking it was more of a cardiac event. Thank God it wasn’t, but it did make me more aware of the fact that I have not been getting in enough fluids, unless you count the coffee I had been going overboard on. In addition, I was discussing my vitamin intake with my doctor, and it turns out that I have not been getting in the proper amounts either. So I’ve got some work to do…
Now, how do you regain weight after weight loss surgery? Unfortunately, it’s pretty easy to do so. There are a number of factors that come into play, some within your control and perhaps some that are not – reverting back to old habits, getting addicted again to the sugar/carbs, and eating in excess of what your body needs etc. According to a study published in the International Journal of Obesity, “Overall, up to 20% of all bariatric patients lose <50% of their excess weight and are considered surgical failures. The etiology of failed bariatric surgery is complex and most likely multifactorial; contributing factors include technical complications, patient-specific postsurgical eating habits and poor compliance with routine postoperative follow-up.”
I’m still in the “honeymoon phase”(the first 6-12 months after surgery where you get the greatest amount of weight loss), and I can see where I’ve had stalls or slowed loss during weeks where I’ve eaten too many calories – even on healthy low-carb foods (for example, I didn’t realize that one cup of mixed nuts has almost a full day’s worth of calories, and I caught myself grazing on smoked almonds for the whole day!). The “honeymoon phase” can trick you into thinking you are eating all the proper amounts…An article review published in Psychosomatic Medicine further explores the cause of post-op regain after the “honeymoon period”, noting that “in about 30% of patients, weight regain occurs at 18 months to 2 years after surgery. Binge eating behavior, which is common among the morbidly obese, may recur after surgery and is associated with weight regain. Energy metabolism may affect the outcome of bariatric surgery, but it has not been systematically studied in this population. Presurgery psychosocial functioning does not seem to affect the outcome of surgery, and psychosocial outcome is generally encouraging over the short term, but there are reports of poor adjustment after weight loss, including alcohol abuse and suicide.”
None of this is to scare you off from having bariatric surgery…it’s to open your eyes to what’s ahead of you. It’s ALOT of work! Proper meal planning, to me, is the biggest key factor in this whole process (second to balancing stress and your emotions, in my opinion). Consult with your doctor and/or registered dietitian for help with meal planning, so you make sure you are always getting in enough protein. Keep a bottle of water by your side at all times (I have a pitcher on my desk that I try to make sure I finish by the end of the work day). And also speak with your doctor if you are having issues with managing sugar cravings; my doctor recommended chromium picolinate to help with this, and I do find this to be effective, but again, talk to your doctor to discuss what is best for you.
What do you all think? I’d love to hear from you!