Silversurfer
New Member
Hi all
There's been much talk of late about weight lose plateau's following WLS, so i dug this article up and have attached here, its a bit long but worth a read through for anyone concerned about plateau's. Hope it helps or maybe answers some questions.
Reaching a Plateau
Following weight loss surgery, patients may lose weight fairly rapidly at first, and then as time passes the weight loss becomes more gradual. Commonly, weight will stabilize at about 18 months after RYGB and DS. During these 18 months, weight loss does not follow a predictable trend, but can be erratic with alternating periods of significant weight loss followed by no weight loss. Charting this weight loss may give the appearance of a stairway. It is not uncommon for patients to question why their weight loss has stalled at times, and wonder if they are doing something wrong or if the operation is not functioning properly. This same weight loss trend may be seen after LAGB, however the weight loss will be more gradual and steady, averaging 5-10 lbs per month, but continuing for up to 3 years. Plateaus may occur if the band is not appropriately tightened, and therefore if this happens, the patient should consult with their surgeon for a possibly band adjustment.
Day to day or even week to week, fluctuations in weight loss occur due to other factors beyond just loss of fat mass. Water weight is probably the most common cause of this variability. This is dependent upon hydration status. Other factors other than fat mass that may result in inaccurate weights are current contents of the gastrointestinal tract, gaining muscle mass, or menstrual cycles. It is thus recommended that patients should not weigh themselves too frequently due to inherent inaccuracies due to these factors.
There are also specific activities of the patients that may alter weight loss. Exercise frequency and intensity may affect your metabolic rate resulting in weight loss plateaus. The exercise may increase muscle mass, which although beneficial in many ways, may result in slower weight loss. Eating habit adjustments that may seem innocuous can affect weight loss as well. It is recommended that a patient eat several small meals a day high in protein. An increase in the meal frequency to high (grazing) or a decrease in the frequency by starving during the day and binge eating at night may reduce one’s ability to lose weight.
For the operations that have a malabsorptive component (Roux-en-y gastric bypass and Duodenal switch), the gastrointestinal tract may adapt over time to its new anatomic change. This adaptation may allow for better absorption of the consumed food, especially fats reducing the benefit of the surgery. Unfortunately, nothing short of further surgery can avert this adaptation effect. However, once again adhering to eating small meals high in protein may limit this effect.
Anatomic factors exist which may limit one’s ability to lose weight. With the Roux-en-Y Gastric Bypass, the size of the gastric pouch may change over time. If it between the stomach pouch and the intestine may allow quicker emptying of the pouch reducing its effect on satiety and potential weight loss. Once pouch expansion or anastomotic dilatation occurs, they cannot be reversed, and correction can only be obtained through surgical revision. With the gastric band, the stoma may widen due to weight loss at which point the band should be tightened with an adjustment. Weight loss can be resumed after this.
For the same reason, after gastric bypass, a patient should not drink during meals. This activity will result in more rapid transition of solid food from the gastric pouch eliminating the sensation of fullness and resulting in ingestion of larger portions.
In general, it is normal to have periods of plateaus through all phases of weight loss after surgery. It is important for the patient to recognize these plateaus as being normal. Expecting these fluctuations in weight loss to occur can avert patient depression or exasperation with the surgery. Adhering to the basic rules of eating correctly and exercising regularly may shorten the duration of a plateau and lead ultimately to greater long-term weight loss.
What is most important to remember is that weight loss surgery does not guarantee easy and consistent weight loss. The operation is a tool that if used appropriately by the patient can help one achieve successful weight loss. However, if used inappropriately, overall weight loss may fall below expectations. enlarges, it will accommodate larger meals. -- - In addition, anastomotic dilatation
There's been much talk of late about weight lose plateau's following WLS, so i dug this article up and have attached here, its a bit long but worth a read through for anyone concerned about plateau's. Hope it helps or maybe answers some questions.
Reaching a Plateau
Following weight loss surgery, patients may lose weight fairly rapidly at first, and then as time passes the weight loss becomes more gradual. Commonly, weight will stabilize at about 18 months after RYGB and DS. During these 18 months, weight loss does not follow a predictable trend, but can be erratic with alternating periods of significant weight loss followed by no weight loss. Charting this weight loss may give the appearance of a stairway. It is not uncommon for patients to question why their weight loss has stalled at times, and wonder if they are doing something wrong or if the operation is not functioning properly. This same weight loss trend may be seen after LAGB, however the weight loss will be more gradual and steady, averaging 5-10 lbs per month, but continuing for up to 3 years. Plateaus may occur if the band is not appropriately tightened, and therefore if this happens, the patient should consult with their surgeon for a possibly band adjustment.
Day to day or even week to week, fluctuations in weight loss occur due to other factors beyond just loss of fat mass. Water weight is probably the most common cause of this variability. This is dependent upon hydration status. Other factors other than fat mass that may result in inaccurate weights are current contents of the gastrointestinal tract, gaining muscle mass, or menstrual cycles. It is thus recommended that patients should not weigh themselves too frequently due to inherent inaccuracies due to these factors.
There are also specific activities of the patients that may alter weight loss. Exercise frequency and intensity may affect your metabolic rate resulting in weight loss plateaus. The exercise may increase muscle mass, which although beneficial in many ways, may result in slower weight loss. Eating habit adjustments that may seem innocuous can affect weight loss as well. It is recommended that a patient eat several small meals a day high in protein. An increase in the meal frequency to high (grazing) or a decrease in the frequency by starving during the day and binge eating at night may reduce one’s ability to lose weight.
For the operations that have a malabsorptive component (Roux-en-y gastric bypass and Duodenal switch), the gastrointestinal tract may adapt over time to its new anatomic change. This adaptation may allow for better absorption of the consumed food, especially fats reducing the benefit of the surgery. Unfortunately, nothing short of further surgery can avert this adaptation effect. However, once again adhering to eating small meals high in protein may limit this effect.
Anatomic factors exist which may limit one’s ability to lose weight. With the Roux-en-Y Gastric Bypass, the size of the gastric pouch may change over time. If it between the stomach pouch and the intestine may allow quicker emptying of the pouch reducing its effect on satiety and potential weight loss. Once pouch expansion or anastomotic dilatation occurs, they cannot be reversed, and correction can only be obtained through surgical revision. With the gastric band, the stoma may widen due to weight loss at which point the band should be tightened with an adjustment. Weight loss can be resumed after this.
For the same reason, after gastric bypass, a patient should not drink during meals. This activity will result in more rapid transition of solid food from the gastric pouch eliminating the sensation of fullness and resulting in ingestion of larger portions.
In general, it is normal to have periods of plateaus through all phases of weight loss after surgery. It is important for the patient to recognize these plateaus as being normal. Expecting these fluctuations in weight loss to occur can avert patient depression or exasperation with the surgery. Adhering to the basic rules of eating correctly and exercising regularly may shorten the duration of a plateau and lead ultimately to greater long-term weight loss.
What is most important to remember is that weight loss surgery does not guarantee easy and consistent weight loss. The operation is a tool that if used appropriately by the patient can help one achieve successful weight loss. However, if used inappropriately, overall weight loss may fall below expectations. enlarges, it will accommodate larger meals. -- - In addition, anastomotic dilatation
