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5 Surprising Plateau Busters!

As a practicing bariatric surgeon for the last ten years, I’ve seen a fair number of patients, typically six to eighteen months post surgery. Most of the patients have been compliant with their post surgery instructions, taking their vitamins and, in their own words, “doing everything right,? BUT have just stopped losing weight prior to reaching their final weight loss goal. This can be very frustrating for them as they have experienced good initial weight loss results from surgery, and overall feel much better than they did prior to their surgery. As this “plateau? phenomenon occurs, the patient experiencing it may make an appointment in a state of panic, thinking that they’ve reached some sort of brick wall and will never start losing weight again. In most cases, there are only two ways to break a plateau: reduce calories and/or increase fitness. “Oh, no!? you might say. But, let’s not just think in terms of adding more time in the gym or counting every single calorie once again, let’s look at some surprisingly simple behavioral modifications that could help bust that plateau and jump start the stalled weight loss process.

Please remember that every patient is not the same, and therefore, it may be wise to consult your surgeon to make sure there is not a specific underlying health issue that may need direct attention when experiencing a continuing plateau.

Plateau Buster #1
Stop unconscious grazing…
As time passes post surgery, it is easy to slowly, but surely, add more and more “soft calories? to your diet. A shared bite or two of your child’s ice cream, a scoop of mashed potatoes while putting away the dinner, or continually nibbling the cheese surrounding the fruit plate at a party as you chat, are all examples of unconscious grazing. These are high calorie foods, and because they seem to go down easily, you may not be considering them as part of your daily food count. Pack and keep sliced apples or carrots readily available for snacking if you must. If you want to enjoy the party, go right ahead, just make a conscious effort to scan the table first, fix a small plate of some right foods, and never snack directly from the table.

Plateau Buster #2
Find a new fun…
You know the saying, “Old habits die hard.? And, you may say right back, “But, I’ve already given up so much!? The good news is that with this buster you’re not giving anything up, rather you’re adding a fun new activity in addition to your exercise routine. Any fitness routine, if done the same way over and over again, will need to be taken up a notch. Not to say you must spend more time at the gym. The old habit I’m referring to is continuing to do the same sedentary social activities you did before weight loss surgery, such as going to the movies or watching TV. Now that you’re losing weight and feeling better, why not try taking that kayak lesson you dared not (due to not fitting in the Kayak) pre-surgery? What about a short hike with the kids? You may be surprised by your new stamina. Those white water rapids are calling! Dust off that bicycle, find that old basketball hoop in the back of the garage, go dancing, or, if you need to, take dance lessons. Does your city have a greenway or river walk path to explore? Think activity, not exercise, and let your imagination come up with new FUN ways to expend energy.

Plateau Buster #3
Meal replacements…
I’ve seen many plateau patients benefit from stopping food altogether and going on a certified Meal Replacement Plan for two weeks (I recommend the Bariatric Advantage brand; however, your surgeon’s office may have another brand that they prefer). You can do it! It may be just what you need to jump start that weight loss once again. A tip is to vary the routine: add half a banana to the vanilla, put a couple of drops of mint flavoring into the chocolate, or add three ice cubes for half the liquid and smoothie it up with a good liquid blender.

Plateau Buster #4
Chewing slowly…
Too simple you say – well, not so fast. I myself have really had to work on this one. We live in such a fast-paced world that when you sit down to eat, you can easily and unconsciously rush through your meal as well. You may have practiced chewing slowly right after your surgery, due to those first fears of eating something wrong or sensing that first immediate full feeling. However, as stated before, old habits die hard. You can easily start eating fast again and forget that chewing slowly and enjoying our food does matter. You not only cut down on consumption (less calories), you will learn to enjoy your meals again. When eating out, take time while you chew to look up and observe those around you. It will allow you the time to chew slowly and you’ll have fun people watching as well. Sometimes my wife and I pick out a couple or group and try to sum ’em up: “Why they look like they are celebrating,? “Must be a father/son talk going on over there,? “Boy, she looks mad! Wonder what he did?? Anyway, you get the idea. We actually had the pleasure of watching a young fellow propose to his gal one night! He was so nervous, he had forgotten his camera, so we took a picture and emailed it to them the next day.

Plateau Buster #5
Stop drinking calories…
“But, Doc, I’m working out at the gym three times a week, just like you said.? Great job! But, when you work up a good thirst from that workout, what are you drinking to quench it? Easy to grab those gym “healthy smoothies? isn’t it? Do you know if they are sugar-free? I’ve seen smoothies with as many as 800 calories per serving! What about those vitamin waters or juice drinks they have readily available in the gym vending machines or at your workplace? Remember your pre-surgery instructions on reading labels, especially drink labels. Don’t be fooled by “gotcha!? labels that say natural or healthy. They still can be loaded with calories. To be on the safe side, take your own water to the gym or the office. If you must have flavor in your water, try adding a squirt of lemon or lime juice or sugar-free crystals.

Hitting a plateau is not uncommon, so first of all, don’t beat yourself up over it. If it has only been a week or so of no weight loss, give yourself a little more time, you may begin losing again on your own. During that initial plateau period, try to determine what might be the culprit and make a correction. If you continue to stay in the plateau phase after a couple of weeks, try the plateau busters discussed in this article. Remember, follow-up care is essential in successful weight loss from surgery. Don’t think your surgeon will be disappointed that you’ve stopped losing weight! We’re not going to be, we’re going to be happy that you let us know things have gone off track so we can help get them back on track. Good luck busting those plateaus!


Peter L. Henderson, MD, FACS, ASMBS is a surgeon in private practice with Raleigh Center for Weight Loss Surgery in Raleigh, North Carolina. He has had the pleasure of performing weight loss surgery for over ten years, and thoroughly enjoys following along his patients’ paths to a healthier life. For more information visit: www.alasurgery.com

Peter L. Henderson, MD, FACS, ASMBS
Raleigh Center for Weight Loss Surgery
2801 Blue Ridge Road, Suite 101 
Raleigh, NC 27607
Phone: 919.781.0815
Toll-free: 1.888.640.THIN
ObesityHelp Profile: Click Here


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