2 Years Post-Op: Can't Lose More Weight

[SpartanMaker 1,024]

5 minutes ago, catwoman7 said:

just a note on BMR - I've heard this from both a former dietitian of mine and from a nutrition class I took a couple of years ago at UW-Milwaukee on obesity and weight loss, so it's likely true (seems to be the case with me, anyway...). It's very common for formerly obese people to need to eat 300-400 calories less per day than a person of the same height/weight/activity level who's never been obese in order to maintain their weight. So in other words (and I'm just pulling this example out of the blue), if a calorie calculator tells you that it takes about 1800 cal/day to maintain your weight, if you were formerly obese, that could mean that for you, it's probably more like 1400-1500 calories to maintain. That being said, I do agree with some of the others that you may be underestimating your calorie intake since I would think you'd be losing weight at that intake level. It might be helpful to cut back by about 100 cal/day for a couple of weeks and see if the scale starts moving again. if not, cut another 100 calories for a couple of weeks. Rinse and repeat until the scale starts moving. I've had to do this a few times to get things moving..

Research does support the idea that BMR will be lower in a formerly obese person vs. someone of the same body composition that was never obese, but the magnitude of the effect was only 3-5%. I'm not discounting the 300-400 calorie number entirely, I'm just saying that if it's accurate, only maybe 50-70 calories of that is coming from BMR. The rest is coming from something else like activity level.

Keep in mind that the most common way to quantify total daily energy expenditure (TDEE), is with a 4 component model:

1. Basal Metabolic Rate (BMR). This is sometimes listed as Resting Metabolic Rate (RMR), although that is slightly different. Either way, this is a way of quantifying how much energy your body burns just to keep you alive.
2. Exercise Activity Thermogenesis (EAT). This is calories burned in intentional exercise, such as running, cycling, etc.
3. Non-Exercise Activity Thermogenesis (NEAT). This is all the other activity you do aside from intentional exercise. You can think of this as things like cooking, cleaning, shopping, etc. Some people refer to this type of thing as "activities of daily living", although other things also fall into the NEAT bucket like fidgeting, how much you stand vs. sit, etc.
4. Thermic Effect of food (TEF). Note there is no such thing as a negative calorie food. That said, it does take some calories to digest the food we eat. On average, it's about 10% (so if you eat 1500 calories, it takes 150 calories to digest that). Note that Protein tends to be a higher percentage, yet another reason to eat more protein. While it's potentially possible that formerly obese people are somehow more efficient at digestion (meaning some of the effect could come from here), this could only account for a very small difference since TEF is just a small percent of your overall calorie burn to start with.

The reason I wanted to list all that is if BMR of formerly obese people is only downregulated 3-5%, then any potential 300-400 kcal/day difference would have to come from somewhere else like NEAT. Since NEAT is known to be lower in obese people as well, it's likely the bulk of the difference here is simply coming from less daily movement (perhaps habit?). This also means it's likely highly variable. The good news to me is this should also mean it's changeable as well.

Food for thought.

[WendyJane 14]

Just to chime in to the original question posed by BrandiBird, yes, sometimes we hit a plateau and we must deal with that. If it goes on for a while, you may want to talk to your provider, and/or their dietician that you talked with prior to surgery. Plateau's happen now and again and you might not be doing anything wrong. Your body is adjusting to the new you that the surgery created. Try not to be down on yourself, and Celebrate the little wins that you have every week, no matter how small or large it might be. And if you truly are depressed please seek some therapy, it is worth the cost to get someone who understands bariatrics.
Wishing you well!!!

[catwoman7 11,233]

23 hours ago, SpartanMaker said:

Research does support the idea that BMR will be lower in a formerly obese person vs. someone of the same body composition that was never obese, but the magnitude of the effect was only 3-5%. I'm not discounting the 300-400 calorie number entirely, I'm just saying that if it's accurate, only maybe 50-70 calories of that is coming from BMR. The rest is coming from something else like activity level.

Keep in mind that the most common way to quantify total daily energy expenditure (TDEE), is with a 4 component model:

1. Basal Metabolic Rate (BMR). This is sometimes listed as Resting Metabolic Rate (RMR), although that is slightly different. Either way, this is a way of quantifying how much energy your body burns just to keep you alive.
2. Exercise Activity Thermogenesis (EAT). This is calories burned in intentional exercise, such as running, cycling, etc.
3. Non-Exercise Activity Thermogenesis (NEAT). This is all the other activity you do aside from intentional exercise. You can think of this as things like cooking, cleaning, shopping, etc. Some people refer to this type of thing as "activities of daily living", although other things also fall into the NEAT bucket like fidgeting, how much you stand vs. sit, etc.
4. Thermic Effect of food (TEF). Note there is no such thing as a negative calorie food. That said, it does take some calories to digest the food we eat. On average, it's about 10% (so if you eat 1500 calories, it takes 150 calories to digest that). Note that Protein tends to be a higher percentage, yet another reason to eat more Protein. While it's potentially possible that formerly obese people are somehow more efficient at digestion (meaning some of the effect could come from here), this could only account for a very small difference since TEF is just a small percent of your overall calorie burn to start with.

The reason I wanted to list all that is if BMR of formerly obese people is only downregulated 3-5%, then any potential 300-400 kcal/day difference would have to come from somewhere else like NEAT. Since NEAT is known to be lower in obese people as well, it's likely the bulk of the difference here is simply coming from less daily movement (perhaps habit?). This also means it's likely highly variable. The good news to me is this should also mean it's changeable as well.

Food for thought.

yes - it was probably total energy they were talking about and not BMR (it's been a while, so I don't remember exactly - other than there was a difference if you were formerly obese)

[learn2cook 611]

On 04/17/2025 at 08:34, ynotiniowa said:

Good morning. I'm not discounting anything SpartanMaker posted above. However, I was in the exact same boat as you. I was eating 1200-1400 calories, religiously measured/counted everything, plenty of Water, I played with my macros till I was blue in the face and for 10 months I did not lose and I did not gain. I'm a nurse so I probably have more background in nutrition than most, so I'm confident in how I was eating was appropriate and what most providers would "recommend". In February I went to my two year follow up. My labs were perfect, my vitals on point and I had not lost one ounce since the last visit nearly a year prior. After having a long conversation with my bariatric provider, the only change since the losing stopped was I was pretty much into full menopause. We discussed options and ideas on how to "overcome" the hormone influencing my insulin processes that was affecting my metabalism hurdle I may possibly be facing. She said based on her research Zepbound might be a great option as it also can help in reducing "hot flashes" which I was having twice a day, everyday. Long story short, even with my insurance, Zepbound would have been around $700 a month, so I choose to do the my budget friendly compound Tirzepatide route (the compound equivalent to zepbound) with my provider's blessing. I have been on the weekly injections for 6 weeks and have already been able to shed 19#. I have not ate any differently, no change in my physical activity AND the hot flashes are gone. I'm not suggesting this would be the answer you need, but it's been a game changer for my journey. Good luck ❤️

I was going to say the peri-menopausal syndrome has struck again. I had to switch to 50mg DHEA while the hormones were swinging around. I had my various doctor’s blessing. It is a hormone therapy treatment so please talk with your physician. Formal Hormone replacement therapy would have been better but alas, insurance. Now I’ve weaned off to 25mg at age 57. I live just fine on 900-1200 kcals at 5’4” and I’m not frail, I weight lift and have a super active job, and walk 20-30 minutes a day. Each of us is different. Soups make me very full, and salads when I can’t stand the hungries.