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Perplexed. Surgeon says no such thing as a "stall"



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I dont want to be sarcastic or anything but from personal experiance..I hit the "3 week stall" an it lasted for me almost a month. I didn't change a thing. I didn't go up an I didn't go down. many also call this a "plataeu" and my surgeon an the staff and also in my preop classes from the nutritionist, psychologist/psychiatrist and the nurses who also taught the class yes they all called it the dreaded "stall" to our class. its baffling how all these dr's (surgeon's) teach differantly..:) reminds me of all 4 differant rhumeys I have seen in 4 yrs they all had their own opinions and ways of treating. drove me nuts! haha (don't ask why I made the comment on the rhumey thing just reminded me what I seen with them as well)..:)

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I think our obsession with stalls (by any name) is understandable. We start out as WLS patients with mega-losses real fast. Then we hit the (pretty common) three-week stall. Then, depending on how heavy we were to start with, we settle down to a 10-15 or even 20 pound monthly weight loss for 3-6 months. Then things slow down.

But along the way, when we're weighing daily, we see a graph line (or imagine one) that looks like a trail made by a drunk chicken stumbling up and downhill on his way to the river.

And here's a simple conclusion about why the graph looks like a drunken chicken's trail: Our bodies are not robots. Nor are they gas engines that always get X miles per gallon (or X pounds lost per daily calorie intake). Our bodies are complex carbon oxygen machines that are constantly producing hormones and running fancy and changing biochemistry combustions and repairing our bodies and losing weight and none of those things is linearly coordinated.

Our bodies produce 60-70 hormones that have specific functions. But those aren't all produced at the same rate all the time and vary according to our ages, activities, diseases, times of the month, times of the day, and they can produce interactions among them, too.

For instance, here's just one of the simplest things about Water weight most of us do know about. Remember the pre-op diet that most of us had to do for a couple of weeks? The point of that diet was to reduce the size and slickness of our multi-lobed livers so our surgeons could operate on our stomachs located right next to the liver. The heavier and slicker the liver, the harder it is to man-handle it during surgery and the likelier it is to get nicked or torn during the experience (nicked or torn liver = very, very bad thing). Anyway, the point of that pre-op diet was to use up all the glycogen (look it up) that's stored in the liver. And when the glycogen is used up, we also lose a large amount of Water in which that glycogen is stored. Hence, our very rapid weight loss during the pre-op diet (and that's lost at the beginning of almost every diet in the world).

Here's another thing: I think about the number of extra capillaries and nerves that my body grew when I was fatter but that I no longer need now that I've lost 77 pounds. What happened to those things? At what point does my body break those down? And when and how are those waste products excreted? And how does that process affect the arc of my weight loss graph? I got lots more questions, too!

So here's the bottom line: Our bodies do not lose weight in a straight, linear progression to goal. That is a fact. We all know that. Why not? Because (as Elode said), it's complicated. It's very, very complicated.

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@@kndoster I laughed out loud when I read your description of the surgeon and his response to your question. His (IMO) stupid response tells me that he obviously he has no clue about what it is like to actually be a bariatric patient.

Just glad for you that he was a good surgeon!

I know @samuelsmom. He definitely is not a surgeon I feel I can really talk to. I knew going into this that he wasn't going to provide me with much emotional support. It's just kind of a shame that I have legitimate medical questions for him and I felt so dismissed at my last follow up, like all of my questions are so silly. You are right, he definitely does NOT know what it's like to be a bariatric patient. He was however, the best surgeon in my city by far. Now that the surgery is over though, I definitely need to get into a good support group.

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This is such a tough question for so many reasons! One is that we’re all different…so while you might lose 1, 4, 2, and 6 pounds per week during a four-week period, I might lose those same 13 pounds by losing 3, 3, 3, and 4 pounds. Even more likely would be that we might lose the same amount after a year of eating the same, but maybe wouldn’t lose the same in any given four-week period.



Something else is that you have to have a definition of “stall.” I don’t know if there is an official one, but I do know that some people get alarmed and call it a stall if they don’t lose weight for a couple of days, while other people wait for several weeks before calling it a “stall.”



I know that every time I’ve “stalled,” there have been things for me to fix in my diet – I wasn’t perfect, even if I lied to myself that I was or truly thought I was…and then figured out what I needed to fix.



Part of me thinks this is just semantics…does it matter if it’s called a stall? We have to eat right and exercise, and our bodies will do what they do!


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@@kndoster - Sounds like your surgeon is one of those doctors who is not a gifted communicator! :D I've had a few of those over the years. I had an orthopedist who was a total jerk every time I saw him, but he fixed my foot better than anyone else around, and that was the job I needed him to do. It's tougher with something like WLS because we also need ongoing followup and emotional support too through all this. We aren't done when our incisions heal like we are with most surgeries. Most of us will see our surgeons only 2-3 times more after the surgery, so don't worry too much about him. It's probably not too unusual for him to be a bit disconnected from the post-op side since his job is more of a mechanical process (cut, move things around, sew, done!)

So I hope you have a good nutritionist who can help support and guide you and cheer you on as you continue with your journey because you will need that for years. You will get the "real scoop" of how things go for real WLS patients from the NUT or from a WLS support group. You are doing great BTW! You have the hardest part behind you.

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I concur with everything everyone has said on the subject of the original post started by @@kndoster. Whatever name you want to call it, my body has experienced it. I will go days, as well as a week or two, with the scale fluctuating up, then down, then up again, then down again, then one day it will go down 2 lbs. and stay, and the cycle begins again. As long as my weight continues to go down from my starting point months ago, I'm a happy camper. My decision to have the surgery wasn't just about losing weight, more importantly, it was about improving my health and the state of my fatty liver, diabetes, and hypertension.

Hang in there, @@kndoster!! Take your surgeon's stall statement with a grain of salt and move on to the business of taking care of yourself.

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@RJ'S/beginning

What is the saying? Oh yes, the only difference between God and a surgeon is that God doesn't think He's a surgeon. I think I have that right...

That and Doctors bury their mistakes....LOL

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What I do to keep my head in the game (and away from freaking out) is remembering that this is a marathon, not a sprint. My weight loss "stalled" for about ten days.. No worries! I was still twenty pounds lighter than I was. I just decided to not worry. And eventually the weight loss resumed. My "no freaking out" policy is really helping me. ????

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Aww, I feel like some of the responses are harsh.. It has to be confusing for your doctor to put big expectations on your weight loss, bigger than your own, then tell you that stalls don't exist.. and I understand about not just telling you it happens, deal with it.

Edited by Chrystee

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Aww, I feel like some of the responses are harsh.. It has to be confusing for your doctor to put big expectations on your weight loss, bigger than your own, then tell you that stalls don't exist.. and I understand about not just telling you it happens, deal with it.

Thanks for your support @Chrystee. It truly was and is confusing. Just trying to find my way in this brand new world. Appreciate your kindness :).

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@@kndoster Hopefully this response will be "non-generic" enough...

A weight loss stall is an extended stretch of time where your efforts are not resulting in weight loss. Some patients may experience a stall in their weight loss days after surgery, some weeks after surgery, and some may not get their first stall until months after surgery. Regardless of when it happens, you are not alone. But why do these even happen especially when you are eating so much less? Let’s talk about some related topics.

When you lose weight rapidly chances are you are losing lean body mass (muscle) and fat. Your muscle plays a big part in the burning of calories by keeping your metabolic rate higher so you want to hold onto your muscle and even make more muscle. Eating 60 to 75 grams of Protein per day will help maintain lean body (muscle) mass. Metabolic rate is the amount of energy (calories) your body will burn at rest while just maintaining your bodily functions like breathing, circulating blood, repairing cells and changing hormone levels, for example. An increased metabolic rate is not the only reason for keeping muscle. You want to keep muscle so you can use them to exercise and burn even more calories. Weak muscles make exercise more difficult so build muscle with strengthtraining and aerobic work.

We always hear that eating too much causes weight loss to stop. But how about not eating enough calories? If you are losing weight rapidly due to a drastic drop in food and/or calorie intake, your body will naturally slow down its metabolism in order to conserve energy. It goes into kind of a hibernation mode. Your body thinks you are “starving” and holds onto every last calorie. Make sure you are taking in the correct amount of food for the amount of time you are post operatively.

Never skip meals. If you are exercising frequently, you may need to add an extra Protein shake to fuel your body. Of course, the opposite may be true. Are you eating more than you should which is causing calorie abundance and fat storage? Refer to your manual for meal measurements and calorie intake suggestions and make sure you are drinking plenty of Water throughout the day. Water aids in maintaining bodily functions.

Another thing that can slow down weight loss through increased hunger is sleep deprivation. Those who do not get at least six to eight hours of sleep per night are at greater risk of increased ghrelin levels (hormone that makes you hungry) and decreased leptin (hormone that decreases hunger).

If you do the same routine every single day your body may be accustomed to this. Make a change to get things moving again.

Here are quick tips for getting through a stall:

  • Exercise! And if you do the same exercise, change up your exercise routines. Use different muscle groups.
  • Concentrate on Protein to help keep muscle.
  • Stay well hydrated
  • Make sure you are getting enough protein/calories if you are exercising a lot or if it is time for a meal-volume change. If it is not time for a volume change or you are at maintenance, make sure you are not eating too much throughout the day.
  • Get at least six to eight hours of sleep per night.
  • Follow all the rules of the pouch/sleeve every single day and for life. If you fall off the wagon, just get back in and start over.

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I love it when someone asks a question then tells us what NOT to say. It truly tickles me. :D

Ohhh I know, it makes me wanna say that 'it has to do with glucose and your body catching up and adjusting to your weight loss', but I will not say it. ;)

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I think he probably meant something other than what he said. Of course stalls exist. Not everyone calls them stalls though. My mom refers to them as plateaus. It's not exclusive to WLS patients. EVERY diet out there or every weight loss journey includes "stalls". It's impossible not to. You may think it's generic or whatever but it really is just your body adjusting to the changes you're causing. That's for people sticking with the program. Of course the ones not sticking with it, grazing, etc. have other reasons for stalling. It's scientific fact your body will go into starvation mode, shut down your metabolism, and conserve as much energy as possible if you significantly reduce your diet. That's why it's up to us to exercise to keep our metabolism up, and get enough Protein to maintain/build lean muscle. It's why we can't cut out carbs or calories completely because we need fuel to function. We "trick" our bodies into burning fat while consuming a fraction of what we are used to. And since our stomachs are smaller, we have a physical barrier to help with the mental need to eat. Our bodies were designed efficiently. Eat, burn, eat, burn. Stop eating, stop burning.

So I think either he was talking about something else, OR he's an a** that wanted to make you think there was no such thing so you would work harder. Psychological so to speak.

so I guess He Knows Better, and that negates the thousands of patients who have experienced stalls, and in addition gets you to feel crappy and like a failure. nice guy, just a bit of IthesurgeonamGod Syndrome. nurses have a lot of experience with this syndrome. dont worry, just do what you are supposed to do. it is like steps, not like a smooth curve. love sara r.n.

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ill say this whether asked or not, stalls are a term for non visible weight changes. But that doesn't mean there aren't body changes going on at the same time. So you can be burning fat and replacing fat weight with Water weight or muscle weight. so you can lose inches etc but not have a discernable weight loss for a specific time period.

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