Weight Loss Stall or Plateau
A weight loss stall or plateau is a period of time during where there is no weight loss according to the scale and there may be no loss of inches according to the tape measure. This is why it is so important to take body measurements before surgery, so the patient has a reference as the weight loss progresses post-op. We suggest taking measurements of the chest, waist and hip, neck, upper arm, thigh and calf.
Be aware it is very common for weight loss to "stall" shortly after surgery. Diana explains the reason for this below.
The Inevitable Stall
By Diana C.
Our bodies use glycogen for short term energy storage. Glycogen is not very soluble, but it is stored in our muscles for quick energy -- one pound of glycogen requires 4 lbs. of water to keep it soluble, and the average glycogen storage capacity is about 2 lbs. So, when a patient is not getting in enough food, the body turns first to stored glycogen, which is easy to break down for energy. Then when 2 lbs. of glycogen is used a patient will also lose 8 lbs. of water that was used to store it -- voila -- the "easy" 10 lbs. that most people lose in the first week of a diet.
However, when the body stays in a caloric deficit state the body starts to realize that this is not a short-term problem. Then the body starts mobilizing fat from adipose tissue and burning fat for energy. But the body also realizes that fat can't be used for short bursts of energy. So, it starts converting some of the fat into glycogen, and rebuilding the glycogen stores. As it puts back the 2 lbs. of glycogen into the muscle, 8 lbs. of water has to be stored with it to keep it soluble. So, even though the patient might still be losing energy content to their body, the weight will not go down or it might even gain for a while as the retention of water dissolves the glycogen that is being reformed and stored.
What You Can Do About a Stall or Plateau
If a patient is experiencing a post-op weight loss stall or plateau further out there are a few possible causes. First, check that are you really in a stall. If the scale has stopped moving you may be losing inches, so check your measurements.
Too Many Carbs?
Carbohydrates can start sneaking into foods without any awareness of how quickly they are adding up. If there is struggling with weight loss the patient may want to examine their daily carb count. Keep the carbs under 50g a day and see if that makes a difference in weight loss. Do not eat carbs before bedtime as it triggers insulin and initiates fat storage.
The Daily Plate
For more tips on keeping a food journal see the Personal Nutrition Guide.
If there is under-eating or going more than 4-5 hours without eating, the body will shift into fasting mode, slow the metabolism and conserve stored energy (fat). This can contribute to a weight loss stall or plateau. Make sure the consumption of food is small meals or small snacks throughout the day, also, ensure to meet daily protein requirements. Try eating some protein with every meal or snack. For more information on protein requirements see our section on Protein.
An adequate level of water in the body aids in the effective breakdown of fat. The daily minimum recommendation is 64 fluid ounces of water a day. If a patient is in ketosis they will need to drink even more water to ensure the ketones are flushed out of the system. If there is any exercising or the patient lives in warm/dry weather there needs to be a higher consumption of water.
Exercise can increase metabolism and burn fat. Strength training will build muscles and will boost fat burning. In a stall a patient can try increasing the volume of exercise or changing up the routine to overcome a weight loss stall or plateau. If the exercises have been mainly aerobic activity, try doing a bit of strength training; if they have been mainly strength training, try an aerobic work-out.