Weight loss surgery is supposed to be the final answer to obesity. Ideally, you use your sleeve, band or pouch as a tool to help you lose weight, and that tool continues to keep you in check as you maintain goal weight.

But that’s not always the case. Many Weight Loss Surgery patients find that losing weight is easier than maintaining weight loss. You may already have some hint of that if you were a long-time yo-yo dieter before surgery.

So why is it so hard to keep the weight off, and what can you do about it? It can be harder to keep the weight off than lose it in the first place because:

• You might gradually be less strict with your food choices as the occasional treat becomes more frequent and bigger.
  
• Your restriction may not feel as, well, restrictive as it did right after surgery.
  
• Your metabolism is slower and you don’t need as many calories as you did before.
  
• You don’t have the motivation that comes from seeing the scale go down as a reward for your good eating habits.
  

But a little challenge doesn’t have to get you down! After all, you’re a WLS patient, and you’re in it for the long haul! Here are some things to think about as you are losing weight, approaching goal weight, or even working on maintaining your goal weight. This is just Part 1 of the two-part series, so stay tuned for Part 2!

I Hate Counting Calories!

Yes, logging your food can be tedious. Some people even find that counting calories makes them anxious or causes them to fixate on food. Maybe immediately post-op you could skip the calorie counting and still lose weight because you had so much restriction. Maybe, in the beginning, you forced yourself to log foods for a few weeks or months.

What if, when you’re at or near goal weight, you can’t face the thought of counting calories? You still have a few options that can work.

• Go back to the meal plan you got from your surgeon or nutritionist and stick to it. If it says ½ cup of oatmeal, it doesn’t matter whether you know how many calories that half-cup contains. You can be certain that if you follow the plan, your total daily calories will add up to the amount in the plan.
  
• Log once a week. This can help you stay on track as you make sure your portion sizes are still working out for you and you are choosing the low-calorie, high-protein foods you think you are.
  
• Focus on another nutrient, such as protein. If you hit your target grams of protein, stick to small portions, and make sure all of your protein and other foods are the nutritious ones you’re supposed to be eating – think lean proteins, vegetables, and healthy fats, for starters – you have a good start towards eating the way you should.
  

Carbs Are the Devil!

Maybe it’s carbs, maybe it’s sugar, maybe it’s pizza, or tacos, or ice cream that you avoid in your weight loss efforts. Whatever it is, there’s a good chance you’re trying to avoid it as you lose weight. Weight loss surgery patients can be tempted to go low-carb, paleo, or sugar-free. That’s fine, as long as you can keep it up long-term.

If you can’t, you’re setting yourself up for a rough time. What happens when you hit goal weight and you flip a mental switch in your head? What if you go from low-carb to letting cookies, bread, and pasta back into your diet? What if you go off paleo and find all sorts of processed foods that are delicious and convenient? What happens next time you come face to face with an order of chicken wings and dipping sauce for the table?

You may be better off planning for a diet that will work long term. While you are still losing weight or while you are early in the maintenance phase, take inventory of your feelings. Be honest about what you can and cannot live without, and develop a plan to address it. Then practice!

These are some possible ways to approach your food fears.

• Think “healthy, portion-controlled carb” instead of “low-carb.” Aim to get in healthy carbs such as oatmeal, lentils, fruit, sweet potatoes, and yogurt rather than avoiding all carbs.
  
• Consider the good and bad of the paleo diet. While the guidelines to avoid processed foods and refined sugars can’t hurt, it really necessary to avoid nutrient powerhouses such as beans (think: protein, fiber, and potassium)? And is it really possible to avoid all processed foods for the rest of your life? What happens if you run short on time? A good strategy may be to get in the habit of reading labels so you develop your ability to choose healthy (or at least, “healthier”) packaged meal helpers.
  
• Make up your mind about trigger foods. Are you the type who can be satisfied with one potato chip when you get a craving? Or are you best off avoiding the chips altogether? Is there a similar substitute, such as kale chips, that can work for you? If you’re not sure, experiment so you know how best to handle cravings.
  

Maintenance has its share of challenges, but you can overcome them to be able to experience all the joys of hitting that goal weight you dreamed about for so long. Just like you did when you were getting ready for weight loss surgery and losing weight, you can take a carefully planned approach to maintenance that considers your own preferences. Stay tuned to Part 2 of the two-part series!

Great timing, as usual, Alex! Thanks for the post. I'm right at the point where my hunger is coming back and I'm transitioning into maintenance. Tricky time! D: