Simple steps to get back on track after sleeve gastrectomy

“I’ve fallen off the wagon!” “Help! I’ve gained weight again and I don’t know why…” “All my old habits are starting to creep back in and I don’t know what to do!”

If you’ve been thinking along these lines lately, don’t worry – you are not alone. I hear these kinds of comments all the time in the clinic, especially when people hit the two to four year post-sleeve mark when the “honeymoon” period comes to an end and some of the weight starts to sneak back on again. The good news? There is always something that can be done to help you get back on track after sleeve gastrectomy. Although every person is different and the reasons you might be feeling like you’re not making the most of your sleeve will be individual, in this post, I wanted to share a few base points to get you started back on the path to long term success.

Feeling like a failure??

Before we get into the more practical tips, it’s important to change your thinking around this. Try not to beat yourself up or feel guilty. I know that might be easier said than done, but it’s true. Beating yourself up about being a “failure” will just make things worse, especially if you tend towards food for emotional support. Rather than dwelling on the past or the negatives, think about all the things you have achieved so far, where you’ve come from, the positive things you’ve gained and the habits you have kept since your surgery. Then, think about what you might need to adjust to move forward. A sleeve is a journey and a bit of weight regain is part of that journey. Getting back on track with your habits is the next leg of the journey. If you feel like your mindset is holding you back, I would strongly recommend you check in with a psychologist in person or online (Glenn Mackintosh from Weight Management Psychology has some great online courses).

Speaking of support…

This is my first tip. Have you checked back in with your WLS team? If not, stop reading right now and call them to make an appointment. Seeing your dietitian and/or psychologist is the first point of call – we’re here to help you! Don’t be embarrassed or think you need to lose some weight before you go back because we’ll be disappointed in you… we won’t. I promise. What we can do is give you practical ways to help you start making forward steps again and support you to get there.

Also check in with family or a trusted friend who can support you. The online VSG community (including our very own LWAS Community) can be a great place to find support if you don’t feel like you can talk about your weight regain with anyone else, too.

Go back to the beginning

Often I find people who have regained some weight, have started eating like they did before their sleeve – maybe your portion sizes have increased? Maybe your food choices and become more rushed or careless? Maybe the quality of your meals means you’re not staying full very long and grazing between? If any of these sound like you, go back to the basics of eating with a sleeve – focus on protein and vegies, look at how you’re eating (slow down, be mindful) and check in with your appetite to ask if you’re actually hungry when you eat or if you’re eating for other reasons. Try to go back to the basics for a couple of weeks and see how you feel. Often I find just reminding people of what the basics are is enough to slow or stop the weight gain without trying to change things too dramatically.

Run through this checklist of your current habits to see where you need to focus your efforts. Are you:

• eating protein at each meal and snack?
• eating (at least at lunch and dinner) a meal that is half protein and half veg?
• eating a variety of foods throughout the day/week?
• taking 20-30 minutes to eat your meal?
• taking teaspoon-sized mouthfuls?
• concentrating on your meals while eating (not eating in front of the TV or computer or in the car!)?
• eating only when you’re hungry?
• asking yourself if you’re hungry before you eat?
• drinking at least 1.5L of fluid per day?
• choosing calorie-free fluids during the day?
• taking your supplements each day?
• moving throughout the day?
• taking some time each day for yourself?

Keep it simple!

Finally, have you found a few things you might need to work on in the checklist above? Great! But beware… Don’t try to change everything all at once. Pick one or two things from the list to focus on each week – small sustainable steps are always better than death-defying leaps. Have think about the one thing that is impacting the others and go for that. For example, if you’re not drinking enough you’ll often feel more hungry and tired and make poorer food choices, so if you choose just to focus on water you’ll often inadvertently impact the other habits, too!

Good luck!

I’d love to hear what has worked for you or what you struggle with – comment below and let us know. Also remember you can book a one-on-one appointment with me anytime, or join or LWAS Community for extra support on this part of your WLS journey.