Bariatric Regain to build resilience

Dawn (00:00):

Hello and welcome to the Gastric Health Show. My name is Dawn Boxell and we are back this week to discuss bariatric regain, but we’re flipping it and really focusing on 10 different ways to build resilience. So I want to show you how to become resistant to regain or at least put the odds in your favor that you can minimize the regain. And it doesn’t mean that you may not experience some that’s pretty typical to go up 15 pounds or for some people 25 pounds if they went way too low.

Dawn (00:30):

I’m not going to say that you will never regain, but we have to put this in perspective. I want you to become resilient to bariatric regain so that you have tools in your toolbox that you can pause and say, Hey, I know what I need to do. I need to fix this or optimize that.

Dawn (01:10):

So that’s what we’re going to dig into. We’re going to basically give you tools so that you can prevent and reverse regain if this occurs. So we know bariatric regain is common but there are ways that you can reverse it and prevent it. So you know what nothing in Life is guaranteed and bariatric surgery is just a tool. And what you do with the tool kind of determines if you’ll be a bariatric regain statistic. And here’s the facts, health requires maintenance and participation.

Bariatric surgery and sail through weight loss

Dawn (02:00):

No one is going to have bariatric surgery and sail through weight loss and all of the different diet and lifestyle changes that need to take place and never experience hiccups or stalls or problems or bariatric regain. So for example if you have type one diabetes, you have to take insulin every day for the rest of your life or death is imminent.

Dawn (02:30):

Same thing if you have celiac disease. You have to avoid wheat and gluten forever the rest of your life, even one crumb can cause intestinal damage. And if left unmanaged, it’ll lead to malnutrition and death. So you have obesity and there are several things that contribute to obesity. And guess what? It does require daily maintenance. It’s no different than celiac disease or diabetes. They all require maintenance. So it’s just, it’s unfortunate. But our past understanding of obesity was flawed. And it was always believed that people were obese because they ate too much and they didn’t exercise enough.

Dawn (03:10):

And it’s just not like that. So although there’s no quick fix, there’s no magic pills, really just the consistency with the foods you put on your plate and your lifestyle choices are really the only ways to create long lasting health. And this is no different with bariatric regain.

Dawn (03:48):

There is no magic pill, but there are some foundations that you can implement and some things you can do to be more resilient to prevent it from going too far. And this requires health ownership. And the only way that you’re really going to put yourself in the best situation is own it. This is where you have to take health ownership and work with a provider like myself who can kind of help get you to the root of what’s happening and why you’re experiencing bariatric regain.

Dawn (04:30):

Something is going on. Something is contributing to the regain. It’s not that the surgery has failed. It’s just that there are things that maybe weren’t corrected, some things that are out of balance in your life. So it’s more than just eating too much and not exercising. There’s more to the story. Those of course, are important and you need to have those in line.

Dawn (05:01):

But there are additional factors that contribute to bariatric regain. So my best advice is don’t accept this from any provider. Don’t feel like, Oh, I need a revision because I’ve started regaining weight. That is unlikely to provide you with the results you are thinking or expecting. And the risks and the side effects that come with it sometimes really outweigh the benefits that come with the small percentage of weight loss. Most will occur. Of course, there are scenarios and reasons why some people have to have a revision. It’s medically necessary.

Dawn (05:40):

But if you’re wanting a revision for regain, I want to challenge you. I want to offer you alternatives. I want to offer you ideas and different strategies that have maybe never been presented to you so that you can maybe look through a different lens and say, Okay, I see there’s some hope. There are some things that I can do and let’s work on it.

10 ways to build resilience against bariatric regain?

Dawn (06:18):

So here, here’s something that I have learned with counseling tens and thousands of you. I do believe you when you say, Hey, I feel like I’ve gained 20 pounds overnight and I feel like I really haven’t changed anything I feel. Like I’m still eating the same and drinking the same and moving my body the same, but yet here I am four weeks later and I’ve put on 20 pounds. I believe you. Because there are things that can cause your weight to shift rapidly.

Dawn (06:40):

And these are things like high stress, hormones, gut imbalances, your genetics that kind of get switched back on. There are reasons that can make you pack on the pounds really rapidly. So when it comes to bariatric, regain something in your life and body is out of balance. And working with a provider like myself who can help you get to the root of what’s driving it is important.

Dawn (07:25):

So let’s get to the 10 ways to build resilience against bariatric. Regain number one, correct gut dysbiosis. Number two, resolve inflammation. Three, balance blood sugars. Four, take health ownership. Five, optimize genetics. Six, improve sleep habits. Seven, work on stress management. Eight, connect with a supportive community. Nine, be intentional in all areas of living. And 10, do the mind work. So let’s dig into the first one, Correct gut dysbiosis for bariatric regain. You have good and bad bacteria living harmoniously in your gut.

Dawn (08:00):

And when any one of those, the good or the bad get out of balance, that’s when problems arise. And there have been quite a few studies on bariatric patients and gut dysbiosis, and I do have a few blog posts and podcasts on this. So you can find the link in the show notes for that or in the blog post here. Either way that you can learn more about gut dysbiosis.

Dawn (08:43):

Now, a study published in 2019 found that bariatric surgery enables partial rescue of gut microbiota dysbiosis observed during obesity. And some of the gut microbiotic characteristics, modified post bariatric surgery are linked to bariatric surgery, beneficial outcomes such as weight loss and metabolic improvements. So we know that bariatric surgery improves gut dysbiosis, but it doesn’t fully correct it. Now there are many things that can influence gut bacteria that really could have just set you up for bariatric regain.

Dawn (09:30):

So you know, had obesity. So you have gut dysbiosis you have bariatric surgery, it corrects it partially and then life happens. You’re weeks, months, years out and you’ve had to go on some antibiotics. Maybe you’ve had to take some new medications, maybe you’ve had some stressful life events, maybe now you’re experiencing some vitamin and mineral deficiencies. Maybe you’ve gone back to eating some of those refined carbohydrates that really don’t serve you.

Gut Dysbiosis for bariatric regain

Dawn (10:05):

Maybe you’re consuming way too many artificial sweeteners, or you’re not getting enough fiber in your diet, and you lack the polyphenols that can help support your gut microbiome. Personally, in my opinion, I think all bariatric patients need to correct gut dysbiosis after surgery. Ideally it would be prior to surgery or at least start working on it. I know at the bariatric center we would always make our patients at the first consultation. That is where we would have them start a probiotic.

Dawn (10:40):

So it could take six months to a year before they’re actually going to have surgery, but we hopefully are correcting that dysbiosis by adding that probiotic early on so. All patients should correct gut dysbiosis because obesity causes dysbiosis and dysbiosis causes obesity. So if you don’t correct it, regain is highly likely so. That to me, this is just a no-brainer. We have to fix this, we have to correct it fully and not just leave it partially corrected. We need your gut to be in balance.

Dawn (11:20):

Now the next one, minimize your inflammatory response for bariatric. Regain in inflammation can be very sneaky, and in all honesty, it gets blown off. A lot of times as I’m just getting older. Society really in general, we’ve kind of accepted these random symptoms and aches and pains that we have as this is what you’re supposed to experience when you’re in your forties, fifties, and sixties but you really

Inflammatory response and anti-inflammatory properties

Dawn (11:52):

Don’t have to. There are solutions to inflmmation that is going on in your body and those aches and pains and symptoms that you’re experiencing. There are things you can do to minimize and reverse them. We do know that low grade inflammation is at the root of all obesity. We know that obese individuals have a low grade inflammation always. So that doesn’t mean you’re always feeling inflammation. So it doesn’t mean it’s going to present very obviously, and that’s where it can be confusing or you know, may not realize that you’re having inflammation.

Dawn (12:30):

But I will tell you, most clinicians agree that keeping chronic inflammation at bay is really important to your overall health. And I did do a podcast where I discuss how chronic inflammation contributes to bariatric regain. And actually there are several things that contribute to an increased inflammatory response. Inadequate whole foods that contain anti-inflammatory properties. Excessive intake of pro-inflammatory fats, environmental exposures over or under exercising, inadequate sleep, poor stress management and genetics. Genetically some will require an anti-inflammatory diet lifelong to keep certain genetic SNPs turned off.

Dawn (13:35):

So to build resiliency to bariatric regain will require monitoring. This is where working with a provider like myself who can order those inflammatory marker tests to kind of assess where you are is so important. Now maintain balanced blood sugars that will otherwise lead to bariatric regain. Studies show that although bariatric surgery initially does a fabulous job, in fact nearly 90% of all diabetic patients are in remission at one year post surgery.

Maintain balanced blood sugars to minimize the bariatric regain

Dawn (14:00):

But here’s the thing, diabetes may return if it’s not properly managed. I did a deep dive on why bariatric patients should care about blood sugar, and you’ll have the links on that as well. But where this is where you can learn more about how after the five years after bariatric surgery, they found that more than 30 to 40% of bariatric patients will have diabetes return. So preventing and reversing, regain requires blood sugar balance.

Dawn (14:50):

You cannot have one without the other. So if your blood sugars are out of balance, you are going to have issues maintaining your normal weight, not a normal weight, but your normal weight. So you have been, your weight may have been pretty stable for months or even years and then all of a sudden you started having issues. And it could be because some things have shifted genetically or metabolically or personally that has triggered this to kind of return. In my opinion, blood sugar balance should be step one.

Dawn (15:16):

Whenever you are noticing your clothes are fitting tighter, the number on the scale is rising. Or if you’re having some physical symptoms like shakiness, intense hunger, headaches, difficulty focusing, lightheadedness or dizziness. If you’re starting to have those on a regular basis, that should be a red flag that, hey, something’s up with my blood sugar. Why?

Dawn (15:56):

What is happening? What’s changing that is making my blood sugar fluctuate so much that I feel so poorly. This is where I’d encourage you to work with your provider or I’d love to work with you on something like this but you have to get to the root of what’s driving the fluctuations. And these can be a variety of causes. So I think this is where you’ve got to have that conversation that, hey, I am having these symptoms and I’m noticing that I’m gaining weight in my midsection or the scale is just increasing and I don’t understand what is happening. So that’s where working with someone and helping you kind of sort through why your blood sugar is having such issues.

Take health ownership to prevent from bariatric regain

Dawn (16:55):

The next one is take health ownership to prevent or reverse bariatric regain. And honestly, this is probably the most important thing for bariatric regain in building resiliency or reversing, it doesn’t matter. You have to take health ownership. And I get it, bariatric regain can be quite frustrating. This is where you have to just pause and say, Okay, we can reverse it. I’ve put on X pounds not what I wanted. I don’t like this. It makes me feel uncomfortable. And maybe to some degree fearful. Here’s the facts, you can reverse it. You don’t have to be stuck with what has happened. But what does

Dawn (17:48):

Taking health ownership mean? It kind of means not settling for. Challenge yourself, challenge your healthcare team or work with a provider like myself who’s willing to help you sort through your health story. No matter what. Bariatric regain requires health ownership. Because you are the only one living in your body and your voice matters. And you can’t be afraid to speak up and say, Hey, I don’t like these numbers, I don’t like these labs, I don’t like the scale and I need guidance. I need, I need a detective to go through and put all these things together to help you.

Dawn (18:20):

There’s nothing wrong with asking for that type of health, absolutely nothing. But on the flip side, health ownership requires your participation. So you can’t take your health problems, dump them on your doctor’s lap and say, fix them, and then you do nothing. Health ownership is being an active participant.

Dawn (19:02):

You are the only one who can implement the health strategies that can reverse the regain or prevent it. You are the only one. No one can do this for you. And I’m going to repeat, like I said earlier, there is no quick fix or a magic pill. Consistency with the foods you put on your plate and your lifestyle choices are the only ways to creating long lasting health. Now I get it, your genetics may suck, which means you have less room for error and the cards may be stacked against you.

Dawn (19:40):

But this is where you may have to kind of have a badass attitude and speak up, ask questions, and fire a practitioner and hire someone else who will listen. Health ownership is about you. You have to claim it, own it and live it. And although it doesn’t require perfection, there are no shortcuts. So hopefully you will see that.

Dawn (20:09):

I can pause and look at a perspective of where my health is. And maybe you’re just in a position that you’re like, Oh, I’m so upset because I’ve put on 10 pounds. And it really won’t take much to shift it. Or maybe your perspective or your goals are not in line with your health and your genetics and your abilities to maintain a certain level of exercise or meal prepping or cooking. Those things take time and maybe your life isn’t designed for that.

Dawn (20:40):

So this is where taking health ownership, but demanding from your practitioners the best they can offer. And if they are, they have nothing left, then you find someone else who can help you. Then..but you have to do your part, you have to put in the work on what is recommended. Because it’s not gonna happen without effort. The next one is genetics.

Genetics the ultimate roadmap against bariatric regain

Dawn (21:28):

The ultimate roadmap against bariatric regain. Now genetics are your personal health roadmap and your genes tell the story of you and only you. And no one else has your genetic makeup. So kind of cool. But instead of using what works for most, you can actually do what works best for you. And with bariatric regain, it’s no different. The answers are already inside you. The clues and the cues to better health are in your genetic code.

Dawn (22:00):

And this is why I love the 3 x 4 genetic test because it decodes your genetic story and . When it comes to bariatric regain, it is highly possible a gene has been switched back on or a protective one has been switched off and. This is why working with a practitioner like myself can be helpful, because even if you don’t have a genetic test to reference, I’m trained in how to go upstream based off of symptoms and disease presentation.

Dawn (22:35):

So although a 3 x 4 genetic test is the only way to get the personalization. And to really dial in what’s going on or what’s driving something a lot can be done by just focusing on foundational principles. So that’s where I would say I would love to work with you on this piece. Because I don’t think it’s offered much. And this is one thing that this area of genetics is something that I’m super excited about. And as it continues to evolve, I think there’s going to be more opportunity there for people to really excel at their health. The next one is improved sleep habits.

Dawn (23:10):

The almighty power of rest, your body needs adequate sleep for healing, restoration and energy. And when it comes to bariatric regain, there was a study published in 2019 that found that a lack of a good night’s rest increased your desire for high fat, sweet foods changing your behavior towards sweet and savory foods.

Manage the sleep habits to prevent from bariatric regain 

Dawn (23:45):

The Sleep Foundation states that healthy adults should sleep between seven to nine hours nightly with no less than six hours for optimal restoration. And they do even find that some people really don’t require more than six hours. So if you don’t get seven, that’s okay, but if you can at least get six consecutive hours of sleep, your body is going to benefit very much from that. I actually did a podcast and I go into detail regarding sleep. So if you want to listen to that that may be helpful. But to become resilient or to reverse regain getting adequate sleep is necessary.

Dawn (24:00):

The next one is work on stress management. Now, in my opinion, stress is probably the most under-recognized cause of bariatric regain. I mean, let’s face it, life is stressful. And although you cannot control the stress you are given, you can control how you react to it.

Dawn (24:52):

And I did do a post, in depth on stress and how it can really derail your health. And personally, I can’t tell you the number of times I’ve counseled patients who’ve had a stressful life event occur and then months later experience weight gain. So this is why it’s so important to build stress, resilience and learning stress management tools or strategies is so important. And if you want to build stress resiliency this only happens if you reflect on your life and remove what’s no longer serving you. And actually this is probably a good practice that everyone should do every year.

Dawn (25:30):

So evaluate, maybe you do it at the end of the year or the beginning of the next year, you evaluate what am I doing on a regular basis that is serving me? How am I doing managing my stress and what’s causing my stress? So if you want to have some stress management practices in place these things could be like meditations, exercise, sitting in nature, hiking, hobbies, volunteering deep breathing, anything that brings you pleasure.

Work on stress management

Dawn (26:19):

If you don’t have enough of that built into your life you’re likely to have a lot of issues with stress. So if you want to be resistant to regain, you have to find ways to turn off your sympathetic nervous system, the fight or flight, and turn on your parasympathetic or rest and digest. It’s not hocus focus, but I will tell you it does kind of feel magical when you actually learn how to turn off fight or flight. I went through an eight week training course on stress management and I did it personally for myself and I just wanted to learn how to manage my stress better.

Dawn (27:00):

And it was awesome. When I was taught all the different strategies with stress management and what shuts off that fight or flight. It was so wild when you could.. want practice one of their strategies and you just felt the tension of leaving your shoulders and your neck and you were just like, Ah. And it was with a word or a sound for me, it was. Or you could visualization you can do it with that. So gosh, there are so many ways that you can turn off that fight or flight. Because I mean let, let’s face it, We are not going to get away from stress. It is here. And I feel like for most people it has only increased. So it’s imperative for your overall wellbeing, your physical and mental wellbeing to practice some type of stress management on a daily basis.

Connect with a supportive community

Dawn (28:16):

The next one is connect with a supportive community. The power of community. People heal in community, not in isolation. Matter of fact, if you surround yourself with people who are striving for more in their lives and are dedicated to consistency and their diet and their lifestyle and they’re taking ownership of their health, it’s contagious.

Dawn (28:40):

So this is why you have to stay connected. You have to be connected to a group of people. And there are so many out there for different bariatric patients to join. Find one that you connect to find your people. Find the ones that you relate to or that think like you or that believe like you and that want to prioritize their health.

Dawn (29:16):

You don’t have to have it all together to join one. Actually, it’s not required at all. All you need is a desire to learn and a willingness to consistently show up for yourself. So if there is a group. Show up. Even when you don’t feel like it. Even when you don’t want to show up. Or watch the recording, if it’s something that is recorded. This will keep your head in the game and keep you connected. And this is why I created the gastric health membership. This is something new and that we’re excited about and we want a community to support you where you’re at.

Dawn (29:50):

And just to help nurture you along the way. And the gastric health membership is something that is super important to me to offer, because you need a place where you can cultivate your routines, and challenge your choices and correct those insufficiencies or restore that balance that is not there. But also to kind of nurture your self belief and increase your resiliency and have the encouragement to go for it.

Be intentional in all areas of life

Dawn (30:40):

So health takes time. No one changes overnight. And I think bariatric surgery is a great representation of that. In order to make consistent change. And feeling hopeful and optimistic and excited and capable. Is part of it. And this also kind of goes to your mindset and confidence because you have to believe that you can change your health in order to become convinced to continue taking action. So if you don’t believe that you can control your blood sugars, you are unlikely going to accomplish that. You will likely struggle with imbalanced blood sugars.

Dawn (31:20):

So you have to believe in yourself to do that. And that takes time. You are not going to grow that belief in yourself overnight or even just in a few months after bariatric surgery. These things take sometimes years to nourish into existence. You might have a lot of history that you have to work through.

Dawn (31:59):

So it doesn’t mean you have to be perfect with your diet, it just means believing in yourself enough to prioritize consistency and discipline and grace. So we would love for you to join our gastric health membership. The links will be in the show notes so that you can check it out. We have lots of fun things planned and we are growing slowly and excited to have more of you join. The next is be intentional in all areas of life. \

Dawn (32:00):

And when it comes to bariatric regain, you may have lost sight of being intentional and present. And matter of fact, when life hits, sometimes it’s easier to just check out and coast and you kind of lose that desire to be intentional about meal prep and moving your body and mindfully eating or spending time with the people you care about or managing your finances or cultivating your faith or just plain out having fun.

Dawn (33:10):

So you have to be intentional, not perfect because they’re going to be seasons in your life that it’s going to be hard to be intentional. And you’re only going to be able to focus on maybe one area tops two. So you might have to just be okay with that because some life events are pretty.. they take time. And you need that grace and you need that community and that support to have that connection with others so that you can move through this season and get back to really that full health picture.

Dawn (33:40):

And in our gastric health membership we discuss this very topic. We work on finding balance that works with every season of life that you’re in. Because they do occur and we have a gastric health will of life evaluation tool that we use and it kind of helps you identify what area is lacking or needs attention.

Dawn (34:20):

And it can really help you just say, Whoa, wow, I can see how I got off track, how this stressful event has really taken me into a place of isolation and how I’m really not taken care of myself. And I’m not doing the things that can nurture my health and keep it in a good place. So that’s maybe why you have had some bariatric regain is because of this. So we’d love for you to join our gastric health membership for that so that we can help you be intentional and kind of protect your intentions along those different seasons of life.

Do the mind work

Dawn (35:00):

And lastly, do the mind work. Bariatric regain takes a lot of mind work, and at some point you have to do the work and deal with the things that are holding you back. This could be past traumas a dysregulated nervous system from things that happened in your past or even just a negative mindset or just flat out fear.

Dawn (35:37):

You just have a fear of regaining weight and just a fear of anything. So what you meditate on eventually comes to pass. So what are you meditating on? That’s where you have to work on that mindset and do that mind work. Just because bariatric regain is common, it does not mean that you have to participate. This is why taking health ownership is so important and shifting that mindset to how can I help myself or what is no longer serving me. Having those conversations with ourself of okay…kind of taking the blindfolds off and saying, Okay, what is going on and what is causing this?

Dawn (36:30):

Why am I having regain and what has shifted in my life? And that, again, this is why being connected in a community is such an important piece because this is what can keep you consistent. Staying connected is what can keep you consistent. So if you show up in a group and get connected with others, even if you kind of disappear, we can check on you. We can find out, Hey, is anything going on? Are you doing all right? I’m concerned you haven’t been at a Zoom meeting lately and we want you back. So that’s where being connected and finding your people are so important.

Dawn (37:12):

Additionally, there are some books that are helpful in shifting your mindset. I love the books What Happened to You by Oprah Winfrey. Believe it by Jamie Kern Lima. Girl Wash Your Face by Rachel Hollis. You are stronger than you think by Joel Osteen. And The body keeps a score by Bessel a Vander Kolk and. Building resilience against reversing regain starts in your mind. And this is why it’s so important to have a supportive community because life ebbs and flows and without adequate support, it’s super easy to revert back to old behaviors when you get stuck.

Conclusion

Dawn (38:00):

And don’t let this be you. Find your people. So to kind of wrap this up you don’t have to be a bariatric regain statistic. You can build resilience against and reverse bariatric regain. And as you can see, taking health ownership is important so you can feel empowered to correct the gut dysbiosis, optimize sleep and stress management, balance blood sugars and reduce inflammation.

Dawn (38:31):

But most importantly, to empower you to find a supportive community to do the mind work and be intentional in all areas of your life. So don’t settle for a dismissive practitioner. I hope you’ll check out our gastric health membership and consider joining our community as we continue to grow. And I hope you will join us and . I hope this has helped and given you some insight to maybe some areas that you can work on and, I want you to know that I believe in you . And I know that even if you have experienced regain or if you’ve regained all of your weight.

Dawn (39:00):

I promise you, if you just get in a community like our gastric health membership and you work with providers like myself, I will listen and I will help give you the guidance and insight and sometimes some tough love that you may need to hear. So it can help get you out of this position that you’re in. So you guys have a great week and we’ll see you next time. Bye-bye.
Your future health awaits…