Lose more weight
after the honeymoon phase?

You want to lose weight, but it’s past the honeymoon phase of your Gastric Sleeve (or bypass). Yes, it is possible! Read or listen to know what to expect.

Goal Weights, Expectations,
and Metabolic Adaptation (oh my)

Prefer to listen? Play the clip below for my audio clip reading this blog post!

One of my Premier Access members emailed with a big question:

“I had someone tell me the reason I was regaining weight after my second year after sleeve surgery was metabolic adaptation. What is this and is this a possibility? I can not lose my last 20 pounds and have gained about 20 back.”

More on metabolic adaptation in a bit (let’s save the big words for later). Though the big idea in this question is on so many other minds.

Can you lose more weight past the honeymoon phase?

Is your goal weight realistic?

Buckle up my friends, we are going to talk through it all. But before we move forward, I want you to know that I’m on the other side of this screen with pom poms in hand. Can you lose weight past the honeymoon? YES, YOU CAN! ‍

In this post, we are going to cover:

Goal weights
Expectations in the later years
What is metabolic adaptation

But first, we are going to start with some encouragement from a post-op patient who has been in your shoes.

Let’s normalize weight fluctuations (for everyone, even after surgery)

We know we have an issue with black-or-white thinking. We all (yes, me included) struggle with what is “on or off” and “good or bad.”

We tend to think of the phases of weight loss in black and white too.

The honeymoon year is the weight loss phase. You better hit your goal weight before it’s over or it’s too late. Once you’re at your goal weight, then you are in the maintenance phase. Annnnnd that’s it.

We are either losing weight or staying at the goal weight. And if we aren’t doing either of those we are failing at life.

Might I suggest we burn all that down to the ground and start over?

There are seasons in life when our bodies will fluctuate in body weight. There is one season of life I would like to yell from the rooftops to let weight change be normal: adolescence.

Oh, I wish we emphasized how normal and healthy it is for teens and times of puberty. Sheesh, what a great time to deal with increased weight when you’re a TEENAGER at the height of body insecurity.

I spent so many of my teen years worried about my weight and ended up gaining more weight because I was trying to skip meals. I would end the day ravenous. I wonder what it would have done for 16-year-old Steph to know it was normal and eating lunch would help, not hurt.

There are plenty of Seasons or situations when our body weight will fluctuate. Menopause is another one which makes sense. Your entire body is changing, bones, organs, and all. Body weight is the culmination of all those things, so it’s going to fluctuate.

This is another reason why I’d like to demote the scale from our favorite method of measuring success.

Write this down:

Focusing on habits that support your health will keep those fluctuations from taking over your health.

What the honeymoon year is and isn’t

You’ve probably heard about the honeymoon year or honeymoon phase after Gastric Sleeve or Bypass. It’s true, that the first year is the most powerful. Portion sizes are at their smallest, metabolism is at its most efficient, and weight changes are most significant.

The honeymoon is a great time to focus on habits that will extend beyond that year.

Establish your meal pattern, your water routine, and your vitamins. Determine how you’ll get in movement during your busy week and when you’ll plan out your meals.

When the honeymoon year is over, surgery doesn’t disappear. The clock doesn’t strike midnight and you’re back to sweeping floors.

After the first year, you may not have all that extra turbo boost but you have an incredible tool to help manage your hunger. If you established your routines in the first year, you’ll transition just fine into the later journey.

If you got off track or didn’t have the best routine, to begin with, you can start any dang day you’re ready. You don’t go back on a Honeymoon to work on a marriage. You start right where you are.

Will weight loss be as impressive as the first 6 months after surgery? Probably not. Give yourself compassion that managing weight is really hard. Take some powerful deep breaths and remind yourself that you’ve done much harder things in your life. You’re more than capable of building up your habits again.

Goal weights and what to expect in the later years

We talk about goal weights all the time. I see them on Instagram profiles under GW. I get emails saying “20 more pounds to my goal.”

Goal weights can be super tricky. I hesitate to even try to talk about them because of course we want a goal. I love a goal. However, some goals are more indirect than others. We can only control what we put in, but we can’t control what will come out.

Bariatric programs may (or may not) give a goal weight or an estimated weight to reach.

Trouble is, our bodies don’t always work as the textbooks say. We don’t live in a vacuum. We live in the real world with very different bodies. There seems to be a gazillion different things to impact someone reaching a specific target weight.

The ‘set point theory’ argues the body is going to level off where it’s going to. The body has a set point before surgery. If you’ve felt like you’ve gained and lost the same 20 pounds you know what I’m saying. Your body finds its balance at a set point.

Surgery is said to be an opportunity to reset your set point. When you stay the course the best you can on your post-op eating plan, you can get the most out of your surgery. Ideally, settling at a new set point. What that set point might be is hard to tell.

You may not want to hear this (and I’m not one to ruffle feathers) but we only control what we control.

Do your best to live a healthy post-op lifestyle, and let go of how that will pan out exactly on the scale.

It could also be said the main goal of a weight loss surgery is to no longer be obese (when the BMI is under 30). Many research studies will define a weight loss surgery as a success when the patient has lost half the weight they were overweight. (If someone was 200 pounds overweight and they lost 100 the surgery would be a success in research terms for many studies).

If you’re looking for some sort of goal to know how you’ve done, a BMI of less than 30 is a wonderful goal. Losing half of your excess body weight is a wonderful goal.

Does that mean you won’t ever weigh 140 pounds? I’m not sure. But I am more interested in your water, food quality, sleep, and movement for your overall health. Plus, we want to maintain what you HAVE lost to keep you at the lower set point.

What the heck is ‘metabolic adaptation?’

Let’s take that fancy word and boil it down a little. Metabolic is a big word describing the fueling process in the body. Adaptation is a fancy word for change.

When the member asked me her question, she said someone told her she was regaining in her second year because of metabolic adaptation.

Meaning, she was further out now and her metabolism is slowing down from the honeymoon.

Portions naturally increase a little after surgery and hunger may creep back up. Don’t be afraid of these things. It allows us more space to get great nutrition and hunger can be controlled with the right habits.

The metabolic rate (how many calories are burned) of a patient is lower over a year after surgery by the very nature of that person eating less and weighing less.

Metabolism goes down when you lose weight (more on what to do next).

A patient who started at 300 pounds will have a higher metabolism right after surgery compared to a year later when he or she weighs 190 pounds.

Weight may fluctuate at this stage in the game. It’s okay, we are normalizing fluctuations. We can look at the weight change and consider what tweaks to make related to water, food quality, movement, and sleep.

It does not mean the person is doomed to go back to 300 pounds. There are always options to manage fluctuations and support the body staying at the new set point.

By the way, the new set point is not a maintenance phase per se. It is a range of weights your body is settling into with your new pouch and post-op habits. We can’t control that set point, but we can support the body staying there and not going back to its former one.

If you’ve gained a significant amount of weight back since surgery, you can still create a new set point. It will take time and consistency, but the body can do it! 

But can you still lose weight after the first year after surgery?

The biggest question and concern of all.

My pom poms are flying high my friends! Patients lose weight beyond the first year of surgery ALL THE TIME.

Patients lose regained weight after surgery ALL THE TIME.

Healthy inputs in the body will yield healthy results. Give it water, give it quality food, give it good sleep, keeping it moving. It will respond.

Will it respond perfectly according to your plan? (Do my kids follow my directions the first time?) No, because life is hard.

Bariatric surgery means you have an incredible advantage that does not expire. You didn’t stretch it out (more on that here).

That means beyond the first year, you can still use the tool. It may take getting back to basics and it will go more slowly, but be encouraged that there is no need to feel total despair if your honeymoon year is over.

How to keep the metabolism going strong

Finally, let’s wrap up this loaded conversation with some practical take-home messages.

I mentioned when you eat less and weigh less, your metabolism goes down.  This would make someone years out from surgery have a lower metabolism than when they were pre-op.

I have good news. Maintaining healthy, practical habits will prevent metabolism from dropping further. These habits help you maintain a good metabolic level for your body allowing you to stay at your new set point.

Keep a consistent meal pattern (avoid skipping meals)

150 minutes of movement a week (maintain an active lifestyle)

Have a good sleep pattern (sleep plays a major role metabolically)

These three areas can make a big impact on better (or worse) metabolism.

If you need to re-visit habits, check out my 10-Day Habit Refresh Series.

And remember to join the waitlist for my newest course! In late April I will launch “After the Honeymoon: Managing Regain after Surgery” in my Premier Access Membership library!