Goal Weight vs Body Composition after Bariatric Surgery
What is a good goal weight after bariatric surgery? How much weight should you expect to lose? Are you losing fast enough? Do we look at goal weight or body composition after Gastric Sleeve, Bypass or DS?
These are the questions constantly swirling around the mind after utilizing a surgical treatment to treat Obesity. How do you know if it’s working? And hidden within these questions is the anxiety and fear of it not working. A difficult emotion to manage.
There are many “ways we could go” when these questions arise. Goal weight questions trigger so many other questions like how many calories or macros to eat, or how to manage stress eating, or how long a stall usually lasts.
If you can relate, and you’re feeling a bit lost be sure, and get on my waitlist for my upcoming free workshop Take Your Next Best Step.
Why Your Scale Isn’t Telling the Full Story: A Better Way to Track Your Progress
If you’ve ever wanted to throw your scale out the window or felt a rush of emotions during your morning weigh-in—whether happiness or frustration—you’re not alone. The scale can be a source of confusion and frustration, especially when its numbers seem to move at a snail’s pace (or not at all).
Since the invention of the home scale, we’ve all grappled with those flashing digits. But here’s the thing: the scale isn’t the best way to measure your progress, especially if you’re focusing on obesity management or post-bariatric surgery nutrition. There may not be a ‘goal weight’ after bariatric surgery. Stay with me!
What Is Obesity and How Do We Track Progress?
To talk about tracking, we first need to define what we’re treating: obesity. Obesity is a chronic disease characterized by an excessive accumulation of body fat, leading to potential health issues. Body fat, also known as adipose tissue, plays a significant role in our overall health. In fact, adipose tissue is now considered an endocrine organ that contributes to the hormones in our body.
According to a recent CDC report, 23 states in the U.S. now have more than one in three adults living with obesity. Given its complexity, treatment plans for obesity vary from person to person. Bariatric surgery and new GLP-1 medications like Wegovy and Zepbound are some of the most powerful tools we have today.
But when it comes to measuring progress, the scale isn’t telling us everything. Simply looking at total weight loss and how much you have to lose until you reach a goal weight doesn’t reveal whether the loss is coming from fat, muscle, or bone. It’s crucial to dig deeper and get more accurate assessments.
Understanding BMI and Its Limitations
You’ve probably heard of BMI (Body Mass Index)—a ratio of height to weight that many of us have looked at with frustration. There’s even a joke that says, “According to the BMI chart, I’m too short.” But here’s the truth: BMI is only a screening tool for obesity, not an actual clinical assessment. It was never meant to be a goal weight to hit after bariatric surgery or a true reflection of body fat.
Inside my Premier Access Membership, I do a deep dive into goal weights and weight loss expectations after surgery. While BMI assesses risk, it doesn’t measure body fat, which is what we need to focus on. After all, obesity is a disease tied directly to the accumulation of body fat, not just weight.
The Real Goal: Losing Fat, Not Just Weight
For overall health and reduced risk of disease, the goal is to lose body fat—not just pounds. We also want to preserve lean muscle mass. When we talk about fat-free mass versus fat mass, we’re distinguishing between body fat (the stuff we want to lose) and everything else, including muscle, bone, and connective tissue (the stuff we want to keep).
More advanced tools can even break down how much muscle you have in each arm or leg. These assessments help ensure you’re losing fat while maintaining muscle—a critical factor for long-term health and metabolic benefits.
Contrary to popular belief, muscle doesn’t “weigh more” than fat. A pound is a pound. But muscle takes up less space, so our goal is to become leaner, not just lighter.
Protecting Muscle During Weight Loss
Resistance exercise and adequate protein intake are key to protecting lean muscle mass during weight loss. If you’re looking for high-protein recipes to help you hit your goals, I’ve got you covered—be sure to check out my recipe library on Bariatric Food Coach.
Studies have shown that after bariatric surgery, 70-80% of total weight loss comes from fat, with the remainder being lean mass (including muscle). While it’s normal to lose some muscle during weight loss, we want to protect as much of it as possible.
Beyond BMI: Body Fat Percentage and Visceral Fat
More helpful than BMI are measurements like body fat percentage, waist circumference, and visceral fat—the dangerous fat around your organs. Where your body fat is located makes a big difference in your health risks.
But how do you measure these things?
Tools for Measuring Body Composition
There are several ways to assess body composition, each with varying levels of accuracy and accessibility. Here are three of the most commonly used methods:
DXA Scan – Often used to measure bone density, this scan also provides data on body fat and lean tissue.
Bod Pod – This device measures air displacement to assess body composition but is less commonly used due to its requirement for specific clothing like a swimsuit and swim cap.
Bioelectrical Impedance Scales – The most convenient option, these scales use electrical signals to estimate body composition. While not as accurate as DXA, many medical-grade versions (like the Seca scale) are close to the gold standard.
If your obesity medicine or bariatric clinic doesn’t offer these types of body composition analyses, don’t worry! You can advocate for it using this free letter template.
You can also check out local gyms or clinics offering InBody scans. Even if your home scale includes body fat measurements, know that it won’t be as accurate as a medical-grade device. However, it can still provide useful trends over time—just don’t obsess over daily numbers.
In Conclusion
The number on the scale isn’t the full picture. Tracking body fat percentage, visceral fat, and lean muscle mass provides a far more accurate reflection of your progress and health. If your doctor or clinic doesn’t offer these assessments, use this letter template to advocate for better measures.
And if you have more questions, leave a comment—I’d love to hear what else you’d like to learn about!