Hi, everyone! I’m 11 months post-op from VSG and I have a bit of a dilemma. I have not been losing any weight as of about 6 weeks ago. I’m 38, 5’5”, and currently yo-yoing between 177 and 178 during every weekly weigh-in. I still want to lose about 30 more pounds to put me in a healthy weight class. Nothing has changed with my eating habits - I still eat very small portions, mostly solid protein, and do not snack much during the day. Since the surgery, I have had some issues with orthostatic hypotension (dizziness from low blood pressure) and hypoglycemia (low blood sugar), so I would be very surprised if my diet needed any adjustment right now.

I should mention that I am coming off of ten years of disability for early onset degenerative disc disease, so other than twice-weekly physical therapy, exercise has been completely foreign for me, hence the excessive weight gain. I’ve had four neck surgeries and countless back injections and procedures. At my heaviest, I couldn’t stand for more than 10 minutes without excruciating pain in my lower back. However, in the last month, I’ve been feeling well enough to start seeing a personal trainer once a week and easing into a light workout routine (dynamic stretching, light free weights, strength training, etc.). I’m also walking more frequently and for longer distances.

My question is this: could the lack of weight loss be due to rebuilding muscle from my new exercise regimen? Or should I try to adjust my food intake again and see what happens? I have my one year checkup with my gastric surgery team coming up next month and I plan to talk to them about this issue, but I wanted to seek out any advice on here, too.

Thanks so much in advance!!

As we get closer to a normal BMI weight loss does slow down. For me it slower about 20, but Now I am 9 pounds from “normal” and I am stuck!! I don’t do a lot of exercise either other than walking. It is possible it’s just a long stall but if it doesn’t break soon you will have to explore the possibility that you have put yourself into maintenance. At that point you will have to log and see exactly how many calories you are currently eating and consider cutting them by a bit to start the loss again. You say you eat three small meals and don’t snack much but you would be surprised how much the calories can vary based on that. Maybe before cutting calories speak to your dietician because of the low BP and blood sugar (I am not experienced with those).

2 hours ago, WickedPissah529 said:

I still want to lose about 30 more pounds to put me in a healthy weight class

I really empathize with this, but - ! - you unfortunately don't get to set your new weight set point at surgery. Your body may decide this is where you're good, and fighting it too hard could lead to a new cycle of overeating --> restrictive dieting --> more overeating ...

Is there not a chance you could be happy where you are now? (And if not, why?)

I'm BMI 26.8. Heck, last week I was BMI 28 for a while. I am well within a healthy weight range by any account but the BMI scale.

Edited March 21, 20224 yr by Guest

5 hours ago, WickedPissah529 said:

could the lack of weight loss be due to rebuilding muscle

Absolutely.

all I can say is that the last 20 lbs were a bear for me to lose. We're talking like two lbs a month, despite the fact I was really working at it. And after being down there for a few months, those 20 lbs came back on - and here I sit.

I do know that it's very common to have a 10-20 lb rebound after one hits their lowest weight - but in my case, I also wonder if maybe where I am now is where my body really wants to be (my set point). That's not to say I couldn't lose it again, but that would involve dropping back on my calories, and having to fight to get down there again - and then continue to struggle to keep it there.

of course, you could also just be in a long stall, too. Mine tended to last longer the closer I got to a normal BMI.

Or...yes - it could be that you're building muscle.

long story short - it's hard to tell. It really could be any of these things. That's a good idea to run it by your team next time you see them. In the mean time, just keep up with the good eating and exercise habits....sounds like you've done really well so far!

And there's another component here: science. I don't know what your surgery teams promise you, but mine showed me their actual statistics. After a year, their RNY patients were a little above 80% EWL and their sleeve patients a little under.

That's an average, which also means some fall under that. At no point should any bariatric patient expect to lose 100% of their excess weight (and we do. not. need. to.)

I know this may be hard to hear for any individual patient, but if you think about it, it's liberating. Losing 70% of your excess weight is excellent. Losing more is even more excellent. You're not a failure if you don't get to 100% EWL, you're the very rare exception if you do.

Everyone is different and it sounds like you have come a VERY long way- so congratulations!! Seriously, 177 is great! I only chime in because I am the same age & height. I’m not sure what you do for diet but, I keep track of my calories, protein, carbs & fat. I stay under 1200 cal/day (was closer to 800-1000/day first 6mo) & min 70g protein per day. TBH there are days where I feel like I didn’t eat a lot but my calories are high because of seemingly healthy choices that were higher cal and I need to adjust how/if/when I eat certain foods. If I didn’t track I would have no idea this was happening. I’m now WNL but that last ONE POUND took 6 weeks to lose. Lol. Notably, I don’t exercise a lot but am trying to increase.

First, congratulations on your weight loss & that you are feeling stronger & are able to be more active. How great is that!

As @MiniGastricBypassDude said you don’t get to choose your body weight set point. Yes, you might be in or close to maintenance or in a prolonged stall. Yes, building muscles could contribute to the weight loss pause but also the more muscle you have the more calories you burn so you may need a calorie increase to compensate. Certain medications can also hamper weight loss. But logging your food & speaking with your dietician is always a good place to start. It can be easy to get a little complacent with portion sizes, etc., not meet protein goals or there maybe something missing in your diet. Sometimes a small tweak is all that is needed.

The low blood pressure many experience after surgery is usually caused by an initial lack of nutrients from the restricted diet & dehydration. It’s why it’s usually a temporary experience. The same for the hypoglycaemic episodes you may have experienced. (Unfortunately I experienced them both before surgery & still do now almost three years post surgery. The low blood pressure is worse & occurs every day. Carrying my old weight actually used to help because it raised my BP to a normal 120/80 with just occasional drops. Didn’t expect that!) They get better as nutrition & portion sizes increase & fluid levels are maintained.

You mentioned you have your annual check soon. How often do you see your surgeon or their team? How frequently do you have blood tests? I still see my surgeon’s colleague every three months & have a 3 monthly blood test so it always surprises me when people have follow ups much less frequently.

All the best.

Wow, you guys! Thank you a MILLION TIMES for all of the advice and support!! This certainly has been a life-changing journey, and ultimately, I’m just so glad I did it. All my blood work and vital signs have improved drastically since the surgery, with the exception of the hypoglycemia and the low BP. I probably am being a bit too strict with my goals - I still have to work on accepting that I don’t have the same body that I had when I was 23 and working out five days/week, before all the spine stuff started. I will take all of your suggestions to heart and will definitely discuss all options with my surgical team next month. Thank you, thank you, thank you!! ❤️