Can You Lose Too Much Weight After Gastric Sleeve?

Gastric sleeve patients have struggled with being overweight or obese for years—maybe even a lifetime. So the concept that one can lose too much weight seems very foreign. The good news/bad news: Shedding too many pounds usually isn’t an issue for gastric sleeve patients. But it’s certainly possible to get on such a weight loss roll that you decide to decrease that speed or even put a few pounds back on.

Identify the Issue
Weight is more than a physical issue; it’s also a mental issue. What I mean is that being overweight for a long time can really mess with your perspectives. Sometimes, patients who’ve never been within a healthy weight range begin to panic that they’re wasting away when they’re actually at a perfectly “normal” weight. It’s just such a drastic change from what they’ve always seen in the mirror that it can feel frightening. This is totally normal. Some patients “get it” with a quick explanation from their physician; others may need to look into counseling to help them reconcile their new reality with a lifetime of body image issues.

Keep in mind that 18.5 to 24.9 is considered a healthy body mass index (BMI), which is calculated based on your height and weight. For a person who is 5’4” tall, that’s a range of roughly 110 to 145—a pretty big spectrum. Some will feel good at the lower end of the range, and some will feel good at the higher end. It’s all good! Even if you’re below 18.5 and are technically underweight, that doesn’t mean you’re necessarily in any danger. BMI is a way of categorizing weight, but it’s not a diagnostic tool. Only a physician can determine if you’re at risk of illness because of low body weight.

Next, determine whether you’re uncomfortable with that the scale says or with what the mirror says. People who’ve lost a lot of weight can see sagging skin, which may prompt thoughts of gaining some weight back in order to “fill out” that skin. But a better option is skin removal surgery, a very common procedure for bariatric surgery patients. Another idea: Hit the gym! Putting on muscle (a little or a lot) can help both men and women look and feel better.

Gain Weight the Healthy Way
Sometimes the answer truly is to gain some weight. But unless directed by your physician, using unhealthy foods to gain weight isn’t the way to go. First, putting bad stuff into your body is counterintuitive to your mission to improve your health. Secondly, it can be a trigger for patients who’ve fought being overweight all their lives. It can be a slippery slope from putting on a few pounds and feeling great to putting on a lot of pounds and feeling lousy.

The simple answer to weight gain is adding some carbs to your diet. But rather than reach for cookies or potato chips, increase your consumption of complex carbs like brown rice or whole wheat pasta. You undoubtedly remember from your overweight days that carbs go down very easily, and it’s no different after you’ve been sleeved. By upping your carb count, you’ll stall at the weight of your choice and/or gain pounds.

Time it Right
If you want to slow the pace of your weight loss, you can do that at any time. But if you’ve decided to put some weight back on, I advise you to wait until you’ve had the sleeve at least a year. Ask some of your sleeve brothers and sisters: Losing weight happens at the quickest pace that first year, and it can get tougher after that. Sometimes weight comes back on without patients trying, and I’d hate for you to intentionally add pounds only to discover down the road that you’re fighting the battle of the bulge again.

Keep in mind, too, that the more weight you lose, the fewer calories you’ll need. When you weigh 300 pounds, it takes quite a bit of energy (calories) to keep that size body in motion. But when you weigh 150 pounds, you burn far fewer calories because there’s not as much mass to power. So I recommend living at your new weight for a bit and getting used to the number of calories it takes to maintain that new physique before jumping on the “I need to gain some weight” train.

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