3 yr post op- REGAIN- need help and direction!

Hi everyone, although I'm new to this site, I'm not new to bariatrics or online forums. I am almost 3 years post op. I am struggling a lot. I had  pretty good amount of weight loss initially and did really well, taking my pre-op BMI from 41 to 28. But I've struggled with regain and have regained about 25 lbs overall.

There are many factors, including a job change (and new insurance) physical relocation, and a devastating personal loss of a parent. I had to change doctors and met with a new surgeon (the only one within 2 hour drive that my insurance covers now) a few months back. I liked him, but the only suggestion for me was diet pills or revision to RNY. The NUT suggested I do a 'post op' diet of several shakes a day, jello, soups, etc.

I would love to hear back from others who have struggled with regain. HOW did you lose it, and what program did you follow? I know many people will say the best plan is the one the surgeon gives you, but four shakes a day don't seem to carry the nutrition that I need at 3 years post op! I have considered Keto but there are a lot of macro guidelines that seem tricky and I don't want to do it wrong and jeopardize myself further!

So...anybody with regain out there who can give me some advice? THANKS

Many people recommend going "back to basics". 

I recommend that you take several days to track honestly what you are now eating before making dietary adjustments. Look without judgement at your macros and calories and decide what needs adjustment. 

At 3 years out I would recommend a minimum of 100 grams of protein per day. It may be very hard for you to keep your carbs under 40, but I would strongly recommend a carb level of no more than 80 per day. I am also a firm believer in not being punitive to yourself when attacking regain. A severely restricted calorie level, doing a post op liquid diet, eating rabbit food are all punitive in nature as far as I'm concerned. Eat a lot of dense protein to maintain a sense of physical satisfaction. Flavor foods and add enough fat to keep you emotionally satisfied, too. I used to also think that going hard core, cold turkey was the way to go, but research shows that easing into a new food regimen has better long term results. You need to find a way of eating that you can now sustain in maintenance. Losing your regain will be practice for the way you will eat for the long term. Make sense? 

Best of luck. 

Hi there, I have no advise for you. But simply wanted to say that 25 pounds is peanuts! You cdo this on your own. Do not despair. 

She's concerned and regaining at a time post-op when many people experience problems with regain. It's not peanuts when it's happening to you!

Hi mi75  

Welcome to OH!

You have already taken the hardest step by saying enough is enough and now I want to get back on track.  Here are some steps I hope will help you. They helped me...  

Planning/Preparing

Remember when we were preparing for surgery?  How many meetings, classes and such did we attend?  We were told the more prepared we were the better our chances were for success.  And they were right. Go through the house, car and work place and get rid of trigger foods.  Stock up on foods that will keep you on track. I removed every bad carb/sugar temptation and replaced it with lots of protein, veggies, grains and fruits. 

Journaling

Get back to journaling.  This will help you identify when you feel like eating, stress factors and any triggers in your life.  Once you identify these factors, this will help you put tools in place to keep you from eating.  It became clear I was not taking time for me anymore. I worked my day job and then spent the rest of my time caring for my husband.  It was easy to reach for fast, prepackaged food.  Since I purged my home I have to eat clean as there are no other options LOL

Use a tool to track you're eating and exercise like Getting Started with Health Tracker.  Once I started to track ever bite and drink it became clear why I had gained.

Goals/Rewards

Make a list of goals for yourself.  Make them realistic and small.  Some of mine were move more, purge all junk from my home, eat more protein.

Food

In general, a long term post-weight loss surgery eating plan includes foods that are high in protein, and low in fat?, calories, and sugar. Important, vitamins and minerals are provided as supplements. (if you had a different surgery adjust this to your food plan).

Water

Water is our Best Friend. I have to say I never went back to pop or any bad drinks, however I was drinking tea like crazy. What is wrong with drinking tea?  I was either using sugar or 3 equals and 3 sweet n lows per 32 ounce glass.  So I was either pushing to be diabetic or get cancer.  I found once I started carrying a bottle of water around 24/7 (yes had one at my bedside) I lost the cravings for the sugar and I KNOW those artificial sweeteners are not good for me. Look I am old and if you add up all the artificial sweeteners I have consumed I am sure I am at the rat in the lab getting cancer threshold.

MOVE!

I can't say enough about how key this was for me. The reason I kept my weight off for almost 10 years was no matter what, I kept moving.  If I could not go to the gym I would walk. I loved Zumba, bootcamp workouts, lifting weights. When I stopped, the weight started coming back.  So for me I am starting slow to avoid injury by walking and using some of the workouts on my Demand TV.  Find something you love to do and it won't feel like a pain in the *** to do daily.

Support

If it's an option "run" don't walk to a support group.

Keep me posted on how you are doing.

Thanks!  I am here today for the same reason - I am 2 years out and regained about 20 pounds that I don't want to keep and need to keep my inspiration up.  I particularly love the reminder about returning my focus to classes, this chat, and journaling, all of which I did regularly when I was preparing and losing!

Throw the shakes away and eat real food.  Weigh your portions and track them.  The only way to lose weight is to eat less calories than you burn.

mi75,

Sorry you're struggling with a 25-pound regain.  Although I'm not dealing with this problem right now, I do have several friends who are.  

The friends who seem to be having the best success in losing regain are those who are doing keto or very low carb.  That's not to say they plan to go keto / low carb forever, but they're doing that for now. 

I don't know if you're tracking yet.  Some patients hate tracking.  But I'll testify here that meal planning and tracking for nearly 3 years now (even a few months pre-op) has been the biggest tool I've used in conjunction with my sleeve that has helped me control and maintain my food intake.  

Once you lose the 25 pounds -- and it won't come off as fast as it did initially, no matter which eating program you choose to relose the weight -- you'll have to figure out how you're going to eat for the rest of your life to avoid regaining again.  And obviously, you'll need to make some changes to how you've been eating / exercising lately.  

I hear you on the stresses you've been under.  At least half of the therapy I've undergone for the last (nearly) three years has been devoted to learning how better to cope with the stressors in my life, of which there are many (caregiving, spouse's cancer, demanding job, deaths in the family, pet deaths, etc.).  

Many of us became obese because we didn't put our own needs first and because we didn't know how to meet our needs while feeling the demands from others at home, at work, and elsewhere that we help them meet their needs.  I have a theory about that -- we HAVE to meet our needs first.  And we have to be unflinching about doing so.  We shouldn't feel guilty about it or apologize for doing so.  Doesn't mean we have to kick others and their needs to the curb.  But we must care for ourselves first, because no one else will or can.  

Our challenges are FAR from being just about food.  How we navigate those while eating and exercising in ways that help us either lose weight or maintain weight can be complicated.  I certainly haven't found it to be a simple thing.  But I do know it is a problem worth solving and KEEP solving!  

Very best to you.  

Hullo, there.  ;)  

Please let us know how y'all do on the low-carb reset program (I saw your other post about approach y'all finally decided on).  Very interested to hear about your progress.  I think your other program plans -- journaling, seeing a psych, etc. -- also sound great.

Momentum is a powerful force, so roll on and onward and upward!  :)