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Can you choose your weight after bariatric surgery?

Can you choose your weight after bariatric surgery?
16 February 2021 Laura Eggerichs

Can You Choose Your Weight

after Bariatric Surgery?

What do you want to weigh after your WLS?  Is it a weight you were at before? Did someone on your surgical team suggest it?  Maybe you need to hit a certain weight to accomplish one of your non-scale victories?   While it can be helpful to have an idea of where you want to land, the main issue with setting a goal weight is this:  You can’t actually decide what you weigh after bariatric surgery.  We discussed this a little bit in last month’s post about choosing progress over perfection, and we realized that the topic is big enough that we need to give it its own post. So here it is: why you can’t choose what you weigh.

You Can’t Predict how WLS will Affect You

There are a lot of averages after WLS: average percentage of weight loss, average portion size, average hunger levels, etc.  But those are averages, and there are always people on both sides of the average. While your behaviors will determine part of this, there are many things outside of your control that influence the amount of weight you lose after surgery. These include your age, sex, genetics, gut bacteria, metabolic conditions like PCOS and diabetes, the surgery’s effect on hormones that control your hunger and fullness, and more. We’ve all seen people where their weight just seems to melt away regardless of what they do. On the flip side, some people are super strict yet the scale just doesn’t want to budge. With these two scenarios, it’s most likely their bodies vs their behaviors that are playing the bigger role.

Set-Point Theory 

Anyone who has lost weight knows that it’s not just about losing.  It’s about maintaining.  That’s because our bodies resist weight loss, fighting to maintain that higher “set point” weight. Some researchers think that bariatric surgery moves this set point down.  Many people have experienced losing weight pretty steadily for the first 12-18 months after surgery, and then all of a sudden it sort of…stops…despite efforts to lose more. And there it is, the new set point!  That point may or may not be where someone would choose to be.  In some cases, people can lose more, but the efforts involved are often too much to be sustainable long-term.  Just another basis why you can’t choose the number you see on the scale.

The Influence of Your Behaviors after Bariatric Surgery

You’ve probably noticed that we’ve only touched on what you can’t influence. So you may be thinking, “Well, my behaviors must play a role.”  And of course, they do!  In a study from 2016 on over 2000 patients, the 3 main behaviors that influenced weight loss after bariatric surgery were: weighing regularly, stopping eating when full, and avoiding continuous eating (grazing) throughout the day.  People that were consistent with these healthy behaviors lost 14% more on average than people who adopted none of these behaviors.  But as you can see, 2 of the 3 behaviors that influence weight loss the most are partly controlled by how the surgery affects your hunger and satiety hormones.  It’s easy to stop eating early and avoid grazing when you don’t feel hunger – not so easy when you do.

Another behavior that can affect your weight is exercise. But it doesn’t always make the scale go down, especially if you are doing muscle-building activities.  Instead, you might notice your clothes getting looser even while the scale moves down a little more slowly, is at a standstill, or even goes up a little.  This can actually be a deterrent to exercise for some, but don’t let it be!  Rather than look at the scale, pay attention to all the positive impacts exercise has on your health, both physically and mentally.

Remember: It’s Just a Number!

The number on the scale is just a number – don’t let it control you!  In some cases, getting to a goal weight can mean adopting unsustainable behaviors to stay there, like exercising for hours a day or being so strict with your food that you feel chained to a certain meal plan.  So rather than focus on a number, focus on what you can do and how you feel.  The scale does not tell you if you have more strength and endurance, take fewer medications, make healthy food choices, drop sizes, take your vitamins, go on new adventures, or just overall feel better!  Your weight will land where it will, and that’s ok –  because you can’t decide what you weigh anyway!

 

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