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Obesity and Weight Management

Starvation mode after gastric bypass?

11/24/2008

Question:

I had gastric bypass in Feb of this year, and am having a severe struggle with weight loss. I was instructed to eat 80-100g of protein per day, and eat 1000-1200 calories, and exercise 3-5 times a week (I`m doing 45 minutes of step aerobics 3x week and brisk walking for 20 minutes the other two). My thyroid`s been tested more than once with normal results. I don`t understand what`s wrong. Adding carbs outside of veggies causes me to put on weight overnight,which is terrifying when you`re working SO hard! I`ve been to my surgeon, my primary care physician, and my endocrinologist. Something is wrong and I`m at my wit`s end. I`ve done so much reading and trying this and that, that I`m ready to throw in the towel. The whole reason I had this surgery was to keep from becoming a Type 2 diabetic, which runs heavily in my family (I`ve already been gestationally diabetic). I`m so scared that if I can`t get lower than 230 (where I`ve been at for FIVE months!), I`m going to end up being diabetic. For the first time in my life, exercise is enjoyable and it feels good. But it`s not doing me any good in the weight loss department. What`s wrong???!

Answer:

There is often a natural phenomenon after gastric bypass surgery that involves a transition from faster weight loss when the weight seems to slide right off to a period in which further weight loss is even more dependent on your diet and exercise habits. Making the diet and exercise changes are very important to increase the likelihood of long-term success after weight loss surgery.

Also, reasonable expectations after gastric bypass show a typical loss of 60-70% of your excess body weight after about 2 years. Your surgeon’s office can calculate this goal for you. However, weight loss after any type of weight loss surgery is very dependent on the individual and factors such as age, type of surgery performed, metabolism level, sex, weight before surgery, and adherence to the diet and exercise regimen. Some people lose to their goal or more, but some do not.

If your physicians feel you can tolerate it, you may wish to add weight lifting to your exercise program. The muscles you build may help burn calories even when you are not actively using them.

I also encourage you to contact your surgeon’s office about a weight loss surgery support group or look for one in your community. It will be comforting to talk with other patients.

Good luck to you!

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Response by:

Lisa  Martin Hawver, MD Lisa Martin Hawver, MD
Formerly Clinical Assistant Professor of Surgery
No longer associated