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Reposting something I posted elsewhere: First, the most common reason for any stall, including the dreaded 3-week stall is simply that you are retaining more Water. There are a few reasons this happens, but around the 3-week mark it comes down to the fact that your body is adjusting to a low carb intake after converting from glycogen to ketones for energy. More water is needed to burn glycogen, so you were retaining more water pre-surgery than you are now that you're using primarily ketones for energy. At about the 3-week mark, your body eventually recognizes that the water loss is long term, so other mechanisms have started kicking in to start holding on to more water. This water loss due to the change between glycogen and ketones is the primary reason for "keto flu", and something that increases your risk of dehydration early after surgery. The other "reasons" for plateaus really don't apply as much at the 3 week mark, but will become more important later in the process. Let's cover those too though so you're prepared: As you lose more weight, your overall metabolic rate will slow down. People sometimes think fat is not metabolically active, but that's not true. Less fat means your metabolism slows down, even if you retain the same amount of muscle. As you lose weight, it takes less effort to move, so the amount of calories you burn from activity also drops quite a bit. As you progress, you'll be able to eat more and especially if you're not tracking intake closely by weighing and measuring your food, you can easily be eating a lot more than you think. This one may be TMI for some, but you may simply be retaining more stool. This is going to be hard for some people to hear, but I can tell you one thing it's not, and that's hormones. Yes, various hormonal processes negatively impact weight loss in a myriad of ways, but they don't overcome basic physics: if you eat less than you are burning, you'll lose weight. What these hormones can do if they're out of whack, is not good things like slowing your metabolism, increasing your hunger, screwing with water weight, or even fooling you into thinking you're eating less than you are. So, with all that sciency stuff out of the way, what do we actually do if we're in a stall? Well, I think it depends on when it happens and how long it lasts: If it's early (a.k.a. the 3-week stall), just keep doing what you're doing and you should be fine. I know people don't like that advice, but as I said, it's just water, so don't worry about it. Later on, especially if the stall is lasting longer than 2-3 weeks. that's when I think it's important that you look closely at what you are actually burning, as well as really tracking what you are eating. If you don't know your BMR (Basal Metabolic Rate), you should. The closer you are to goal, the harder it is to get the balance right between intake and output to make sure you're not eating too much, so fixing this starts with knowing your BMR and accurate food logging. There's a lot of anecdotal advice thrown around about "ways to break a stall", but there seems to be little scientific evidence for any of it. Most of it certainly won't hurt to try, e.g. breaking up your routine in terms of diet or exercise, but just understand that this change may or may not have had any impact. If it makes you feel better to be proactive, go for it. Longer term, there is one piece of solid advice that's backed up by lots of research: Even if you don't really like working out, do it anyway. Those WLS patients that make a regular habit of exercising for 45 minutes to an hour most days a week are significantly more likely to reach their goal and maintain the weight loss. (One caveat here: significantly changing your exercise routine can make you retain water and possibly even add muscle, so don't freak out if you see a stall or even a gain.) I'll take that exercise advice one step further and say you really should be doing some form of strength training. This is also backed up by lots of studies, but the great thing about strength training is that it makes your burn more calories even at rest (in other words, it increases your metabolic rate). There are lots of other benefits, but the metabolic benefit is the most germaine to the stall question. Those that do strength training are less likely to stall during weight loss.

The U.S HHS Office of Disease Prevention and Health Promotion created a generic recommendation for all Americans: For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) to 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. Preferably, aerobic activity should be spread throughout the week. Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week. Adults should also do muscle-strengthening activities of moderate or greater intensity and that involve all major muscle groups on 2 or more days a week, as these activities provide additional health benefits. To provide more structured advice, I'd need to understand a few things. First, what do you hope to accomplish from an exercise program? Some common goals might include: Improve overall health (e.g. lessen risk of heart disease, diabetes, etc.) Get stronger / Make day to day living easier Help control weight regain (notice I didn't say lose weight as you can't out exercise a bad diet) Improve mental health / reduce anxiety & depression Sleep better / Have more energy Improve body composition (more muscle mass = more calories burned even at rest) Look good naked Next, are their specific activities you like or don't like? Some people hate gyms, others love them. Some people like to "play" to get exercise (think sports/outdoor recreation), while others love the solitude of walking/running by themselves. Basically what I'm asking is for you to do some self-reflection and think hard about what you think might work best for you. Finally, can you be more specific about what resources you have available? You mentioned a gym (which is not entirely needed), but beyond that? Do you have or can you get: A heart rate monitor (e.g. fitness watch or strap) A place to walk outside or access to a treadmill Other exercise/recreation equipment such as a bike or stationary bike, kayak or canoe, Nintendo Ring Fit Wii Fit, etc. A set of exercise bands and/or dumbbells, Sufficient space to workout at home if you don't go to a gym I'd also really like you to fill out your profile here on Bariatricpal. Details matter. In addition to that, it would be helpful to know some things like: Your age How you'd rate your current fitness level If you have any specific physical or health issues that might impact what exercises/activities you're able to do In short, the more details you can provide, the more tailored I can make a recommendation. Best of luck.

I'm 3 1/2 weeks post op from gastric sleeve surgery and everything is going great. I'm following the protocol to the letter and gradually losing weight. Saturday night my significant other and myself took my two nephews to dinner. I was able to order a bowl of soup/broth with no issues. During the course of dinner I used a spoon and took a taste of the queso that my nephews had ordered. My significant other then proceeded to lecture me about food choices. I told her that soft cheese was ok on my current protocol. This didn't seem to make much difference to her. It sort of hurt my feelings but I didn't say anything. Am I overreacting or should I be thankful that I have someone watching over me so carefully. She has been 100% supportive of me in all ways. I just guess I felt like it was unnecessary for anything to be said at all. It's not like I wolfed down a basket of chips and ate the whole bowl of queso. I was kind of proud of myself as I thought "wow...that's the least amount of queso I've ever eaten in my life!

I never imagined I would get replies. Thank you! You all have really helped me “slow my roll”. I am a low bmi patient and I guess that made me cocky. My surgery is happening in a place I affectionately call a surgery mill. I have not even been to an office or met a medical professional. It has all happened over the phone. I lied a little bit about how much I weighed and figured I better eat a lot and become that weight. Now I just feel ashamed a lethargic and out of control. Sigh.

I don't know your stats or your fitness levels so my advice has to be generic. Keep it simple and cheap. Just start walking. Walk a little more each day. I was almost disabled, my exercise was vacuuming a room in my home and then resting an hour. Cleaning a room and resting. Sitting to chop foods and resting. Standing to make the food and being done for the day. Just by loosing weight and walking I have come such a long way. Tomorrow I am going to take a 8 hour train journey, alone with luggage. I am excited and not a bit fazed about doing it. I couldn't do it before It has been found that exercise only contributes to a small amount of weight loss and you need to up your food intake to fill your hunger. Gyms are not for everyone. If you find one locally, ask for a trial period and see if it suits you. Some gyms are very snarky places where you may be very judged and feel uncomfortable. Good luck on this wonderful journey

yeaaa, I am built the same way. Even at my biggest, I always carried my weight in my torso with skinny legs. It is like a Elephant on stilts. UHG! lol Now, I am just straight... like a thick green bean no shape what so ever. Oh well. at least I am healthier and smaller!

It’s important to Relax! Use the tools set before you. Keep talking this out. A lot of it is mentally and emotionally charged. Center those two and ease in right behind the physical aspects. It’s so easy to have transfer addiction and obsession. I’m telling you that I experienced mental fatigue that set off a chain of reactions in my body system after system. The mind is very powerful and it can impact so much. So I believe it you trust the tools provided, make a plan and don’t deviate from the plan. Be comfortable with yourself, forgive yourself for regain and keep your course of action. You will be successful. I am 20 years out and have experience just about everything that comes with having weight loss surgery. I am also a pharmacist and have been like a community resource for the docs in my circle. It was a struggle to keep the weight off and to get back on track after regain. sw 296 lw: 126 regain weight 177 cw 145-150. But it is possible.

Yay!!!! Me too I am 20 years out and have experience just about everything that comes with having weight loss surgery. I am also a pharmacist and have been like a community resource for the docs in my circle. It was a struggle to keep the weight off and to get back on track after regain. sw 296 lw: 126 regain weight 177 cw 145-150. But it is possible. Any updates? How’s are journey going now?

I am 20 years out and have experience just about everything that comes with having weight loss surgery. I am also a pharmacist and have been like a community resource for the docs in my circle. It was a struggle to keep the weight off and to get back on track after regain. sw 296 lw: 126 regain weight 177 cw 145-150. But it is possible. Did you get the help you needed? It’s been a while since you posted, how are you doing now? Any Update?

I am 20 years out and have experience just about everything that comes with having weight loss surgery. I am also a pharmacist and have been like a community resource for the docs in my circle. It was a struggle to keep the weight off and to get back on track after regain. sw 296 lw: 126 regain weight 177 cw 145-150. But it is possible. 2020 and 2021 broke me mentally and physically. I was a front line healthcare provider struggling with my own bought of Covid and pneumonia then being rushed back to work to help serve my community. My staff experienced so much loss personally and collective but our cooperation didn’t seem to care at all…this had me rethinking my entire existence. So much of my identity was my job, it was where I escaped all my personal tragedies. My place of escape became a even bigger tormentor. I had a breakdown suffered anxiety and major depression to the point were 3 doctors took my of work on disability. The mental distress factor plays such a larger role in how we cope and what we use to cope; our hormones and the selection of meds we need despite our desire to keep weight off. Support is so important. An advocate is so important. A provider that listens and understands your complaints is extremely important. You are on the right track! I know this was a few months ago, how’s everything going with you now?

I am 20 years out and have experience just about everything that comes with having weight loss surgery. I am also a pharmacist and have been like a community resource for the docs in my circle. It was a struggle to keep the weight off and to get back on track after regain. sw 296 lw: 126 regain weight 177 cw 145-150. But it is possible.

Considering making a video about all I know about WLS ,getting rid of unwanted weight; free to the community. I want to present irrelevant information; something people would want to hear. Would anybody be interested in this? Answer "YES" if I should make the video

I am 20 years out and have experience just about everything that comes with having weight loss surgery. I am also a pharmacist and have been like a community resource for the docs in my circle. It was a struggle to keep the weight off and to get back on track after regain. sw 296 lw: 126 regain weight 177 cw 145-150. But it is possible. I’ve put together a few lectures from time to time for some of health events. Recently, I've received some messages with questions similar to yours…asking how I got rid of the unwanted weight I gained after surgery. Ive given lectures on this and I also talked about my struggles with how I wanted to have a fuller life without a negative body image. I’m finding many of us struggle with this after WLS.

it's when you go through a period (usually about 1-3 weeks) when you don't lose any weight - or maybe gain and lose the same pound for a 1-3 week stretch - even though you're sticking to your program.

liveboard15 - it looks like your measurements haven't changed in 3 months but you lost 10 pounds so you could be gaining muscle too. Looks like even though the numbers don't scream huge loss you are still going. Good luck and congratulations on the loss so far.

Thank you all so much!!!! I can feel the weight loss but still don’t see it in myself. It’s weird! But thank you all for your comments ❤️

It's not uncommon for weight loss to slow down or plateau after initial rapid weight loss. There could be a variety of reasons for this, including physiological changes in the body, changes in activity levels or physical activity, changes in diet, or even certain medications or medical conditions. It's important to remember that weight loss after surgery is a journey, and it's not uncommon to have ups and downs along the way. It's important to focus on making healthy lifestyle changes that are sustainable over the long term, rather than trying to achieve rapid weight loss. If you're concerned about your weight loss progress, it's a good idea to talk to your surgeon or another healthcare professional for guidance. They can help you identify any potential issues and work with you to develop a plan to help you reach your goals.

Your goal will change as you get closer to a healthy and fit body. I wouldn’t even worry about a goal weight as much as a fitness and general health level. As others have said, your body and lifestyle will reach a set point where your weight is healthy and happy and then it will stop. Most people gain some weight back anyway. I’m 8.5 months out and 130 lbs at 5’7”. My body is still slowly losing maybe 2-3 lbs a month and I’m not concerned if I end up at a low bmi as I ignore it anyway. Obsessing over my weight only leads to stress eating anyway 🙃 I probably eat more than I should but am a fairly active single mom so my calorie burn can handle the amount of calories I eat. Enjoy the ride and your body will end up where it’s supposed to be. 😃

My first stall happened about 2 weeks post surgery and lasted about a month. Now, I seem to stall about every other week. *shrug* As long as I'm staying on track, I'm not worried. The weight is coming off - even if it's a bit slower than I'd like.

Buyer's remorse is normal. Being tired and dizzy and sluggish is normal. It took me a couple of months to start feeling like I was myself again. Like you, I was a low-BMI patient with other health factors that got me approved. Also, like you, I tried all the diets - and nothing stuck. Only 5% of people will keep their weight off, long term, just with diet and exercise alone. Bariatric surgery is BY FAR the best way to keep your weight off for life. Don't be fooled, we still have to diet and exercise, but the surgery helps us do that. Hang in there. This too shall pass. It might pass like a kidney stone, but it WILL pass.

Before my pre-surg diet, I had some food funerals. Not so much binge eating, because I was not allowed to gain weight. But, I did eat things that I knew I wouldn't really be able to have after surgery. I started therapy about 2 months before surgery. I knew that I had issues and would probably have even more issues after surgery, so I got that going. Have you considered working with a counselor? They might be able to help.

I've heard that from others. They make special cushions with tailbone cutouts. So far, my tailbone isn't bothering me, but I imagine it probably will when I lose some more weight. I still have a fair bit of padding on my rear. LOL!

I’m a bit nervous since I’m five months past surgery tomorrow and I’ve only lost a little over half of my excess weight. I spent most of October and November in a stall, did well in December and so far in January I’ve lost a little bit but not a lot. I still have 17-18 kilos to go to get to a healthy BMI, and I’m not going to get there in a year if I will only lose a kilo a month from now on. I lost a total of 19 kilos in the first five months, most of it in the beginning and then in December.

This isn’t a NSV, but everyone reading this thread HOPEFULLY can give me some insight. I am 18 months PO. I have lost 156 lbs. (total) BUT, WHY do I bite the inside of my mouth when I chew sometimes! Is it the weight lost in the face, sagging to allow me to ‘bite it easier’ now?

I don't know how accurate this calculator is overall, but it was helpful for me to see a baseline trend of what could be expected in the first year on a month-to-month basis compared to people of the same demographics (age, gender, height, weight, ethnic group, and WLS type). That being said, my chart predicts an average weight loss of 12 lbs in the first month, and I lost 9.5 lbs in the first 5 days after surgery. I'm only on day 9 post-op now, but I am 5'3", my surgery weight was 221 lbs, and I was at a BMI of 39 on surgery day. https://riskcalculator.facs.org/bariatric/ Hope this helps! Sent from my Pixel 5 using BariatricPal mobile app