Well we are almost a week in to the Level 4 lockdown here in New Zealand, and aside from all the other challenges this brings, it also makes it hard for us to keep losing or maintain our hard won weight loss. Even though this situation is new and unprecedented we can apply some of the evidence out there on avoiding weight regain following bariatric surgery. This gives us three areas to focus on.
Eating only for hunger
There is good evidence that eating fast food, binge eating, continuous eating, eating when full and consuming liquid calories all increase the risks of weight gain after bariatric surgery. While avoiding fast food should be pretty easy during this time, being confined to our houses, stressed and bored makes snacking very tempting. Suggestion for avoiding this include having a routine, including normal meal times as recommended by your dietitian. Make sure you continue to eat your protein first as protein helps maintain muscles and keeps us feeling full for longer. If you are further out from surgery listen to you body – is this really hunger? If not, walk around the house, read a book, make and drink a cup of tea, keeping your mind engaged on other things is one of the keys to avoid snacking and grazing. Also make sure you are keeping your water intake up. Water helps us to feel a little less hungry and also avoids dehydration.
This gets on to the subject of liquid calories. Our bodies that are usually very good at balancing our hunger to match our physical activity do not account for calories consumed as liquids. This means that liquid calories sneak in for free. Use this time to break the habit of liquid calories, you can’t go to your favourite coffee stand anyway so why not develop a taste for homemade tea or coffee without milk or sugar? Soft drinks and fizz are also big sources of liquid calories, so something else not to panic buy at the moment. Unfortunately alcohol also counts as liquid calories with a glass of beer or wine containing about 125 calories, about as much as a slice of pizza, so remember not to overdo it during the lockdown.
Again this is likely to be very different during the lockdown, but here we have two things in our favour. First, we are allowed to leave the house for local exercise through walking, jogging or cycling in our bubbles. Second is that the evidence tells us that after weight loss surgery, avoiding sedentary behaviour (being still) is more important than any specific exercise.
In addition to weight management, physical activity reduces the risk of heart disease, diabetes and some cancers. It also improves our mood and lowers stress levels. The World Health Organisation recommends at least 150 minutes of moderate aerobic physical activity throughout the week (things that get your heart rate up) as well as muscle strengthening activities on at least 2 days per week.
So make it part of your regular daily routine to go outside for a walk, jog or bike ride every day, either by yourself or in your bubble. There are plenty of on line routines too for activity at home including yoga and app based workouts. Be creative and look around for something you enjoy. Check our a few links here and here. Lastly, just make sure you get up and walk regularly, up and down stairs if you have them but even just around the house to keep the blood moving.
The third important behaviour associated with less weight gain following bariatric surgery is regular weigh-ins. While many people hate standing on the scales, and are please to break this habit after bariatric surgery, people who weight themselves once a week or more have less weight regain than those who weigh in less frequently. We recommend ongoing weekly weigh-ins to keep an eye on where things are tracking and allow people to make changes when necessary before these become too difficult. Avoid weighing in too often though as day to day fluctuations are far more about fluid status and hydration than body composition.
It is probably best to assume that the level 4 lockdown is going to last beyond April so make it a goal to improve our your health during this uninterrupted stay at home time. Remember also that we will be continuing our follow-up clinics as telehealth consultations during level 4, and please contact us if you have any other questions or concerns.
Say home, stay safe and kia kaha,