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How can I lose regained weight after bariatric surgery?

Asked by Joan Ashmun, Portland, Oregon

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I had gastric bypass six year ago and lost 150 pounds and had kept it off. A year ago, I began a desk job for the first time in my life. I have gradually gained about 35 pounds. I have what some consider an alcohol problem since the weight loss.

Could I have changed addictions? Could the weight gain be from a liver or kidney problem? Or just the change in activity and such, with added calories from the alcohol? What can I do to lose the weight again and stop gaining?

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Diet and Fitness Expert Dr. Melina Jampolis Physician Nutrition Specialist

Expert answer

Hi Joan -- This is an important question as people mistakenly assume that their weight struggles are completely over after gastric bypass surgery. As you and many others can attest, this is not the case.

Replacing food addiction with another addiction, alcohol being a popular choice, happens sometimes. It's one of the reasons that it's important to have adequate counseling before and after gastric bypass surgery for optimal results.

With regards to your weight gain, it is very unlikely that it is due to fluid retention caused by liver or kidney problems, but this should be ruled out by a physician. In my practice, I frequently see weight gain when people begin more sedentary jobs such as you describe.

Most people think of calories burned during exercise as being the most critical to maintaining your weight, but what you do the remainder of the day is just as important, if not more so. This is why most experts emphasize increasing lifestyle-based activity in addition to getting regular exercise.

Consider that you burn considerably more calories just standing versus sitting (up to 50 percent more) and you can see how sitting for long periods of time could lead to slow and steady weight gain. This is one of the reasons that television watching is significantly associated with weight gain.

Combine this with the extra calories you are probably consuming from alcohol, which can add up very quickly considering that the average serving of alcohol ranges from 100 to 200 calories, and your weight gain is easily explained.

To lose weight or at least stop gaining, I recommend that you see a trained counselor or therapist to tackle the alcohol addiction. To increase calories burned throughout the day, you have to make an effort to build in activity whenever possible.

Try taking a five to 10 minute break every hour, if possible, to walk around or even to stand up and stretch at your desk. Going up and down stairs if they are available at work burns even more calories.

A Swiss study showed that employees encouraged to use the stairs for three months lost weight, including belly fat, and lowered their cholesterol and blood pressure.

Walk to lunch whenever possible and get up to ask colleagues questions instead of e-mailing. You might even consider wearing a pedometer (step counter) to make sure that you are moving enough throughout the day. Many experts recommend getting 10,000 steps per day, but this can be challenging and time consuming so I suggest seeing how much you walk at baseline and challenging yourself to walk a little more every week.

In addition, you can try waking up 30 minutes earlier and doing a short workout video before (or after) work to offset your sedentary desk job. And try planning more active activities when you aren't at work.

Suggest going for a walk with a friend instead of meeting for a drink or take up an active hobby in your free time. The weight loss may not be dramatic as a result of these changes. but it should help prevent further weight gain and might slowly help you lose weight as well.

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