This post is by Kathy Stevens, RD and Fitness Expert.  Read her other blog posts here.

Congratulations! 
You made the decision to have the surgery and did it!  However, that's just the beginning. 

With the growing popularity of different types of bariatric weight loss surgery surgery, we must also realize that these procedures are not a complete solution to life long weight control. Many past patients have reported great weight loss with a gradual regaining of the weight regardless of the surgical intervention.  You may be asking yourself, how can this be? Or why would someone let that happen? But more importantly for those contemplating such weight loss measures; how can I prevent that from happening to me? 

It's all in the math (but easy!)
How it happens is basic metabolic math.  If you eat more than your body needs, even in small increments throughout the day, you will gain the weight back. For every 3500 calories of excess food you intake you gain one pound of fat.  Excess is any amount over your daily metabolic needs also referred to as you Maintenance Metabolic Rate (MMR).  Your MMR is a combination of the calories you burn at rest (Resting metabolic rate: see formula below) plus the calories you burn in activity throughout the day (step 2 formula below).

1) Resting Metabolic Rate (RMR) is the number
    of calories required for your  body to perform vital functions. 

•Estimate RMR by using the Harris-Benedict equation:
–Males = 66 + (6.3 x body wt in lbs) + (12.9 x ht in inches) – (6.8 x age in yrs)
–Females = 655 + 9.5 (4.3 x body wt in lbs) + (4.7 x ht in inches) – (4.7 x age in yrs)

2) Maintenance Metabolic Rate (MMR) is the number of calories required to maintain your body weight.

•Determine MMR by multiplying the RMR by the appropriate activity multiplier:
–Sedentary = RMR x 1.2 (little or no exercise, desk job)
–Lightly Active = RMR x 1.375 (light exercise/sports 1–3 days/wk)
–Moderately Active = RMR x 1.55 (moderate exercise/sports 3–5 days/wk)
–Very Active = RMR x 1.725 (hard exercise/sports 6–7 days/wk)
–Extremely Active = RMR x 1.9 (hard exercise/sports & physical job)

Be Active!
Inactivity can add to the problem because your body learns to be a great storage tank verses a lean moving machine.  When we are inactive, over long periods of time, we can lose vital muscle tissue due to disuse. That muscle tissue loss can result in a lowering of your resting metabolic rate, making it harder and harder to stay in the proper energy/caloric balance. Thus you must remember that, surgery is only a tool. You’ll need to continue doing the right things and making the right choices for any weight loss surgery to be effective over the long run.

Psychological Effect
The ‘whys’ are typically related to the unfortunate fact that old habits die-hard. Food is often used as a psychological fix.  Just because one loses the weight doesn’t mean they have lost the bad habits that may have contributed to their weight gain in the first place. In many cases the reason for eating has less to do with hunger than it does with emotions. Scientists have found that eating a meal alters your mood and emotions, typically increasing calmness and reducing irritability. Studies in Psychosomatic Medicine have confirmed that people with weight issues tend to consume food in order to self-medicate their feelings of anxiety, stress, boredom and depression.  Thus regardless of the reduction in appetite due to a surgical procedure, the need to eat for psychological reasons may still be there.

Why's
This brings us to the all-important question~ how to prevent this from happening to you, post surgery?  The first step is to find your most important ‘whys’.  Why did you want to lose the weight in the first place? What are your deepest and most meaningful or motivating reasons?  List them in order of priority:
1.
2.
3.

How's
Once you can recognize the ‘whys’ the ‘how to’ is much easier to accomplish.  Think about your list of important reasons every day.  Keep them in plain sight.  Better yet, post them right on your refrigerator or food cabinet. 

The next step is to change your eating habits.  It is not just about changing your food, but changing what your food means to you. To quote the author of the ‘The 10 Minute Total Body Breakthrough’, Sean Foy, “food is simply fuel”.  If you think of it as fuel your food choices become clear.  You wouldn’t want to fill your car up with the wrong fuel, the same way you don’t want to fill your body up with poor food choices.  And most importantly you need to release the association of food to the many reasons you might have eaten it in the past… to celebrate, to commiserate, to de-stress, to feel better.  These are not the reasons to eat.  Remember this simple truth,  ‘food is fuel’! 

Eat to function, eat to move, eat to keep your body healthy. 

Use It to Lose It!
Last but not least you need to move more!  Everyday, every way, it doesn’t have to be an organized exercise routine, or set time of day, you simply need to use your body as it was designed.  We are all movement machines, capable of an endless list of physical abilities.  I love the old exercise saying, ‘Use it or lose it’.  Specializing in the area of senior fitness for many years, I am constantly amazed at the difference exercise can make when it comes to maintaining ones functional ability.  On the other hand, you can also say that you have to ‘use it to lose it’.  This is because exercise is an important part of the energy balance equation. We know that those patients who have adopted a more active lifestyle that includes regular exercise burn off more calories per day and have an easier time keeping of the undesirable weight. 

So let’s sum things up: the best way to keep from being one of those people who gain fat weight back after surgery or dieting:

o Write down your ‘whys’
o See food as ‘fuel’
o And ‘move it’ …

Don’t forget to also include the right supplements,liquid calcium & vitamin D3, liquid multivitamin, liquid iron and B-12 sublingual liquid are all most important to help insure your body can function at it’s best.