6 Months Out . . . REGAIN?

Hello everyone:

I am frustrated, but more frightened. I am only 6 months post-op and in the "Honeymoon Period" where weight loss is typically easier.

So far, I have been fortunate to lose a total of 80 lbs in both my pre-op and post-op phases. Ideally, I would like to lose another 40 lbs to reach my goal weight.

I have lost only 3 lbs over the past 3 months. I've had persistent nausea with some vomiting since my first post-op day. Initially, this was due to a stricture. After that was dilated, I continued to have nausea every time I eat dense protein.

As a result, I have difficulty meeting my daily protein goal. I can reach my daily fluid goal if I'm persistent. At times, I become hungry and reach for foods with a higher carb content. These foods don't make me nauseated. I know that this food choice is not helping my weight loss journey.

Despite further testing by my surgeon (second EGD) and bariatric medical provider (upper GI series), no answer to the continuous nausea has been found.

I'm frustrated about the weight loss standstill, but more fearful of weight regain. I've started to second-guess the decision that my Bariatric Program and I made that I was a good candidate for bariatric surgery!

I'm trying to regroup and readjust my diet and exercise plans to better meet those of a bariatric surgery patient. I'm also working with my Psychiatrist on my issues with food choices, eating patterns, and my body image.

Has anyone else had this problem of post-op weight regain in their first year post-op? How did you manage it?

Thanks everyone!

---Joyce

Hi!

Are you measuring and tracking everything you put in your mouth with something like MyFitnessPal? If you're not, that's the best place to start because you can't make good choices about what to change without knowing exactly what it is you're doing.

Nausea can easily be a result of dehydration, which seems plausible in your case as you say you're only reaching your fluid goal if you're persistent. And fluid goals can be too low for some people - so the goal you're reaching might still have you dehydrated.

From there... I'd recommend trying to do an elimination diet. If you know one thing you can eat without nausea (cottage cheese or yogurt, perhaps?) eat that for a day. Then add in something else and see what happens. Track everything. Carefully read ingredient labels for any prepared foods.

Sometimes it can take the body time to be able to eat something again after WLS. There are people at my support group who weren't able to eat chicken for 9+ months post-op without nausea.

Also, try to let go of the "honeymoon period" mindset. I know it's frequently promoted around here, and yes, it's definitely good to maximize weight loss as much as you can in the beginning, but you're not doomed to failure if you don't reach your goal weight within some arbitrary time period. You -can- keep losing weight for as long as you're willing to work at it. You can maintain your weight for as long as you're willing to work at it too.

Hi Gwen:

You provided a lot of useful information and suggestions in your post. Thanks.

---Joyce

You're welcome

Hate to tell you but you are an example of people who can gain or stop losing even in a first year post op. I know you are trying your best, and I myself deal with GERD and nausea even so far out and it is much easier to grab easy to eat carbs, or even a fruit.

I have to take medication that probably cause the nausea, but at the point I can't stop them. So I manage. I take ginger, ginger capsules, ginger tea, etc. I also have medication for nausea I take if needed.

As Gwen mentioned, drinking enough liquids is critical.i drink at least 100 is of liquids every day. Most days more than that. I often have 20 oz of diluted coffee, then 20 oz of tea, followed by more tea, often with ginger added. In the morning I often drink at least 60 oz of liquids. Then drink more during the day.

I try to eat dense proteins, often with veggies. I made think stews, or soup like stews. That really helps get the food with dense proteins in. Fish is easy. I cook chicken with lots of non starchy veggies in my pressure cooker, making sure there is more chicken than veggies after cooking. I then drink the rich bulion and eat the dense stuff app 10 min later. So I get the good liquids, and I get the sense proteins with some veggies.

At close to 11 years post op, and right now I am within my doc goal range, and up 2 lbs from my personal goal range. I ad a few regains, gaining app 20 lbs above what I should be because I stopped paying attention to my eating. I never let gain myself more than 20 lbs, and my doc, PCP, also watch that for me, not allowing me gain too much. So far we are doing good.

You may need they some meds, or get some OTC meds for nausea. Drink more liquids. The liquid may also help you lose weight. When I get hungry, I sometimes reach for more liquids, discovering that my hunger was in a fact a thirst I felt.

I could say "try" to get more dense proteins in you, but in my book, trying is not enough. "Do, or don't do, there is no try " (famous line by Yoda )

Good luck.

HALA, I always love a good Yoda quote. He's the master!

Hi Hala:

Good recommendations. I will do and not try!

---Joyce

Have you considered that acid maybe causing the nausea? Acid symptoms are not always heartburn. I speak from experience. If you are on acid medicine maybe it's time to change it - something I had to do. First one just stopped working.

Hi Cynthia:

Good thought. I was placed on a PPI (Prilosec) 20 mg daily by my surgeon post-op. When I started to have problems, he increased it to 2 Prilosec per day without any improvement.

I just had an upper GI series last week. It showed some reflux.

I think I'll try an H-2 blocker, like Pepcid, since they always seemed to work better for me than PPIs.

Thanks for the suggestion!

---Joyce

Sometimes we move away from the basics we need to lose and stay at goal. Here is a list, make sure you are still doing all the things you did in the beginning. Stay tough, you can do this

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. If you didn't make a Weight Loss Surgery bucket list when you first had surgery do it now. GREAT reminder of all the things you can enjoy in life after losing weight.

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. I found once I started carrying one of the metal bottles of water to keep it cold I drank water all day.

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. Grab a cart and walk all the isles at your local box store. 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. Come here on OH daily for support and participate in one of the food threads. It helps you be accountable and also great ideas for food prep.

Keep me posted on how you are doing.