Reverse the Post-Op Regain

Let’s Take Action: Four Practical Strategies to Stop Weight Regain

• Suraya Nikwan • Episode 5

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Our conversation today provides guidance and strategies on how to get started with reversing the post-op weight regain. If you’ve had bariatric or weight loss surgery and have experienced weight gain or a long-term stall, this is for you. We discuss my top four strategies to get started with: 

  1. Identify what the main issue is by keeping a food diary 
  2. Work out what you’re eating and if you are not eating enough
  3. Discuss the importance of keeping fluids away from your meals 
  4. My most important tool for success

 

Working through each of the four strategies outlined in today’s episode should help you feel empowered and clear of how you can start managing any weight regain post-op, while waiting to see your surgery or dietetic team. 


Below are any resources discussed during the episode:


I hope you found today’s conversation interesting and practical. 


Helpful Info:

DISCLAIMER

The advice provided in the podcast is general in nature and is not intended to constitute or substitute for dietetics, nutrition, professional or medical advice. You should not rely on the information presented here as medical advice. It is important to consult a medical professional for personalised medical or dietetic advice for your specific circumstances.

In the last four episodes of our first week, we discussed the various reasons as to how weight regain can occur after bariatric surgery. I hope now you realise that there are many more factors in play rather than just “diet and exercise”. 

Weight regain is often complex and we know obesity is a disease. The body likes carrying extra weight and will always fight against this. 

So when should you start worrying about the risk of weight regain? I would suggest that anytime you notice a stall and it has been over six weeks, it would be ideal to start looking at the strategies in this episode.

 Also, if you have experienced some weight regain within the 5-10% of your lowest weight. For example, if your lowest weight was 70kg, but you are now 80kg, you have increased 12.5%, which it would be helpful to slow the regain, reverse or maintain this weight as soon as you can. We need to prevent the gradual gain before you feel too overwhelmed and it becomes a big mountain to climb. What we need to do is to figure out what strategies work for your unique body, to prevent weight regain from recurring. 

Today, I wanted to give you four strategies to start working through. I by no means think that you should complete all four right off the bat. Take one, write it down, see how it works in your life, and implement it. Once you have mastered it, then revisit this episode or notes from this episode to see if you can implement another. Doing a little bit each day adds up to a big change over the course of the week, month, year. You’ll be surprised if you are accountable and take action, that you’ll wake up one day with a new improved you. 


Let’s get started on the four strategies to prevent weight regain today.

Food Diaries 

The first step in any strategy to make changes, is to be truly honest about what you’re eating and drinking. We cannot make changes until you know what you need to change. 

When documenting a food diary, write down everything - at least for one week. Don’t change your diet. Don’t change anything - just document it. . What is in your drinks? Those snacks you eat while you’re waiting for the food to heat up. Anything you eat while preparing dinner. Anything after dinner. 

Write down the time you eat and drink, which I’ll get to in point three. It may also be helpful if you feel emotions are related to your food choices, write down how you feel while eating as well. 

Food diaries are like budgets. The first step before actually preparing a budget is figuring out where your money is going in the first place. So, I like to apply the same strategy with changing your diet. I don’t want to make you eat in a really awkward, very different way and timings than you like. You are the expert of your body but we need to make some changes to help support your body to be nourished. This will then help you have the energy to exercise and minimise micronutrient deficiencies. I have a really easy to fill out food diary in the show notes to get you started.

Count up your protein intake 

Secondly, the next strategy is to take your food diary and start counting up how much protein you ate each day. You can find this information freely online. I recommend using the NUTTAB database which is run by the Food Standards Australia. This is the most accurate level, however you can also find the protein amount on the food packets. Keep in mind how much you’ve actually consumed - from adjusting the protein that you have eaten depending on what “one serve” is, then, as you know after weight loss surgery, you might not actually eat ALL the food on your plate. Have your best guess as to how much you’ve actually eaten so you don’t inadvertently count 20g protein for 80g of chicken, when you managed only half of the 80g serve. Technically, you only have eaten 10g of protein. 

To help you with this, I have placed a protein table with the most common protein foods I see patients having after weight loss surgery. I hope this can help you too. 

Just for reference, the absolute minimum is 60g protein after a sleeve gastrectomy and 80g protein after a bypass or SIPS procedure. In practice, I individualise it based on the person’s height and weight, but I cannot do that now. Compare how the minimum recommended protein intake should be compared to your actual food diary record. Can you see where you need to improve? 


Eating Time - No Grazing


So, you’ve done your food diary and you’ve counted up your protein. I want you to look at how often you were eating and drinking. 


Look first at fluids and food. Did you keep your fluids away from meals? The ideal amount is at least fifteen minutes before and thirty minutes after? But I prefer at least thirty minutes before meals, no fluids. And thirty minutes after your meal. If you are eating and drinking at the same time, try to keep the fluids separate. If you eat and drink at the same time, it washes the food through the stomach too fast, which will leave you hungrier sooner. There’s a great Youtube video I’ll link in the bio if you’re curious about the visual of this.  

Next, look at how often you’re eating during the day. How many hours between breakfast and morning tea? How many hours between any main meal or snack. My ideal recommendation is keeping meals and snacks at least three hours apart. The sweet spot is eating every three to four hours, but never longer than five hours. If you eat too soon, it can be classed as grazing. Eating too often will cause weight regain because it is usually carbohydrate based foods that keep you feeling hungry and often precipitate eating frequently. 

So my next challenge to you is to eat every three to four hours - keep within that sweet spot and see how full you’ll feel.


Plan Meals
My last strategy is to plan your meals. Working off the last point, planning meals will make your life easier. Start by writing down what you like eating for breakfast, snacks, lunch and dinner. Then work out how much protein that is in each option. I would then suggest having this list on your fridge or pantry, when you’re hungry and need to look for a snack or meal.

To take it one step further, plan out your meals for the upcoming few days so it is one less decision you need to make.  You could write this down on paper or on your phone. 

There are so many other strategies that we could discuss besides these four. I thought that these four main strategies are the cornerstone of your diet to get started. Let me know how you go by connecting with me on Instagram. I’m @thebariatriccollective. 


I look forward to chatting with you next week.