Seven months out from VSG and gaining? What's going on?

Question

I was sleeved 1/5/15 & was a revision from lapband to sleeve. I started at 312 with pre-op, was 303 the day of surgery & got down to 224 but am currently gaining & am at 228. I haven't hardly lost anything over the last month & what I've lost has come back on. I'm tracking my food intake & eating anywhere from 800-1200 calories with most days being in the lower range. I get 60-80 grams of protein a day & breakfast everything morning is a protein shake & water. I'm so confused as to what's wrong.

Ariel Ortiz, MD, FACS · Answer

I´m glad you ask for help. Weight gain can be very frustating, especially after surgery. It is best to reach your surgeon and nutritionist ASAP to work on your specific case. In the meantime, please measure body fat, if you are losing fat but gaining muscle your shouldn´t have a concern; over time the muscle will burn more fat and weight will continue dropping off. There are many ups and downs before weight stabilizes at 2 years after surgery and the most important indicator that you are doing it right is body fat (fat% in your body). I´m enlisting the most common causes to weight regain after bariatric surgery:- Skipping meals. Plan 5 meals in a day, patients who skip a meal will over eat at the next meal enlarging the pouch and eating more.- Combining solids with liquids. Once solid foods are flushed down from liquids, hunger kicks in a lot sooner and leads to grazing. - Grazing. It is very easy to add up calories and not being aware of it. Establish an eating pattern and stick to it.- Drinking calories. Another way to add up calories. Drink water and herbal teas (without sugars), avoid any other liquids.- Eating the wrong carbs. Filling carbs such as flour, bread and pastas limits nourishing foods therefore the body´s ability to work (fat burning).- Not taking bariatric supplements. A low calorie diet limits the amount of nutrition you can get from food. Bariatric supplements provide the elements necessary for the cell´s willingness to work (known as metabolism). - Being sedentary. Our body needs to move and exercise to eliminate toxins, regulate hormones, burn fat and build muscle; all these related to weight control. - Losing weight from muscle, not fat. If daily protein intake is not enough, your body will use muscle mass as a protein source further reducing the capacity to burn fat (muscle is our only fat burning machine). And, fat burning exercises like cardio stear weight loss from fat, rather than muscle. - Avoidance of resistance exercising. During the first months, there will be extreme weight loss and some muscle loss is expected. To make the most out of these first months, some resistance training should be included to promote muscle building. - Sleeping less than 8 hours in a day. Sleeping is a physiological need. Studies have shown that people who sleep less than 6 hours will most likely gain weight. Surgery is the best tool available to make changes, I hope this helps identify what can be improved.

Wiljon W. Beltre, MD · Answer

Don't panic, you are doing okay.  You are probably making muscle which weights more than fat.  Getting on the scale may not reflect what is really going on.  If you want to measure progress, use a measuring tape and measure the circumference around your arms, waist, and thigh.  If you are losing inches, then you are losing more weight than what you think.  Of course, measuring your total body fat % is the best way if you are able to do it.

Seven months out from VSG and gaining? What's going on?

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Seven months out from VSG and gaining? What's going on?

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