The miracle of technology! I’m writing this at 36,000 feet in the air– on my way to Portland OR to present “Parachuting Off the Weight Plateau” at the Weight Loss Surgery Foundation of America’s annual convention.
I mention this because I’m really excited to meet the hundreds of WLS post ops who will be there for the learning, laughs and love.
And….I’m eager to share some new information from the research that I’ve learned and I believe is game-changing.
But first, back to parachuting.
Picture this: you are on a weight plateau in the middle of the desert. You want to, need to get down to lower ground (or weight.)
As I see it, you’ve got 5 options or ‘flight paths’ to help you parachute off the ledge and finally get ‘unstuck.’
Here are your tickets to ride:
- Anti-obesity medications
- Revisional surgery
These are the five areas I check with my regular clients when they feel they’re stuck on a weight plateau.
Let me give you a brief round-up of the questions to ask yourself or your doctor to see what might nudge your weight down.
Are you eating enough protein every day? Like between 60 and 80 grams? Are you eating your protein food first? Are you using a 7-inch plate for your lunch and dinner? This handy little trick makes weighing, measuring and counting calories and fat grams unnecessary. The size of the plate and portion recommendations keep your meals balanced and modest. And finally, are you having portioned snacks or are you grazing and sorta skippin’ meals? For a quick round-up of protein recommendations, watch my YouTube video here: https://www.youtube.com/watch?v=bVnG8B3NdFg&index=6&list=UUOSwaP9_B9SGYpoe1TduGcQ
Exercise. The data is in: WLS post op who exercise most days of the week at a moderate intensity (you can talk but not sing) avoid a weight plateau and loss more weight than folks who only rely on their surgery for weight loss. How much exercise is recommended to lose weight? Here’s the recommendation from the American College of Sports Medicine (ACSM): http://www.acsm.org/about-acsm/media-room/news-releases/2011/08/01/acsm-issues-new-recommendations-on-quantity-and-quality-of-exercise Be sure and check with your health care provider to find out what, if any changes need to be made to the recommendations based on your health history.
Support Can Be Beautiful
I’m not talking about Jane Russell here but remember those bra ads??
Support/Therapy/Counseling. Data shows patients who attend support groups loss more weight than those who don’t go or have the option. Also, important, the research shows almost 75% of patients requesting WLS have some history of mental illness in their past i.e. depression, anxiety, PTSD or substance use disorder. When you put these facts together with the unusually high prevalence of suicide attempts by bariatric patients, you can see why having strong and sometimes professional emotional support, is an absolute must.
What’s a Drug Got to Do with It?
First question you’ve got to ask yourself: could one of my current medicines be either causing weight gain or making weight loss difficult? Ask about weight neutral meds going forward. There’s a great list here: https://tinyurl.com/m4uyxeo Also talk with your primary care about your weight plateau and the use of anti-obesity medications. Currently there are 5 approved by the FDA on the market. They all have been proven effective at decreasing body weight by at least 5 percent. These medications aren’t for everyone and they don’t work for all patients. They come with risks and benefits not the least of which is cost.
Review and Revise?
Last but not least is surgical revision. If you and your provider determine diet, exercise and lifestyle changes are just not working, it’s time to look closely at your first surgery to see if it’s still working for you. This is usually done by endoscopy under light sedation. If your pouch, sleeve or stoma has stretched, there are a range of surgical techniques that can correct the problem. There are also several options to take your original surgery to the next level—perhaps advancing from the sleeve to a bypass or from a bypass to a duodenal switch which adds an malabsorptive aspect leading to greater weight loss.
Until next time, be GOOD to you,