Metabolic Adaptation & Bariatric Surgery

Bariatric surgery is a very effective way to lose weight. However, it doesn’t always work for everyone. In some cases, patients develop metabolic adaptation—a condition that makes it harder to lose weight after bariatric surgery. If you're trying to lose weight, your metabolism may be working against you. That's because the less food you eat, the slower your metabolism becomes — and the fewer calories are burned by your body.


The bad news: Losing weight requires you to eat less than your body needs for optimal health and physical activity. This can slow down your metabolism, making it harder to lose weight or maintain a healthy weight loss over time.


The good news: With proper planning and support from a Nutrition/Health Coach who is experienced in Bariatric Surgery, this doesn't have to be an obstacle standing between you and reaching a healthy weight goal! Metabolic adaptation occurs when the body stops responding to calories (energy balance). It can happen over time if you chronically restrict calories in an effort to lose weight or when you try to eat more than your body needs because you believe this will help you keep up with dieting patterns or other goals (eg., eating less sugar). This article explores metabolic adaptation and ways we can combat it by changing our thinking about food and exercise.


The term “metabolic adaptation” refers to any change in the way your body processes food. In this case, it's referring to a process that occurs when you restrict calories or exercise regularly and then return to more normal eating habits. While some of these changes may be beneficial (such as increased muscle mass), others can cause problems like:


  • Weight regain after dieting

  • Increased hunger and cravings for unhealthy foods

  • Low energy levels due to dietary changes that shift the balance of nutrients away from consuming adequate calories



Chronic dieting patterns are a problem because it slows metabolism & leads to weight regain.


Chronic dieting is a a sign of an eating disorder, and eating disorders are very common in obese patients who've had bariatric surgery. Eating disorders are also linked to other health problems such as heart disease or diabetes, so if you're struggling with one or both of these conditions post-surgery, talk to your doctor about how they might be interfering with the progress you're making on your own journey towards better health!


Standard advice doesn’t work for everyone.


The standard advice for a person who is trying to lose weight and maintain their new, healthier lifestyle is to eat less, move more. However, this isn't always the case and it's important to understand why.


Some people have metabolic disorders that cause them to store more fat than they need or burn it off at a slower rate than others do (1). These patients will require higher caloric intake and larger meals in order to meet their energy needs. Others may have underlying health issues preventing them from losing weight competently on their own (2). In either case, bariatric surgery can help address these issues by providing an alternative method of managing excess body fat while also improving overall health outcomes such as diabetes management or improvement in blood pressure levels


Energy balance and metabolic rate.


Energy balance is the difference between energy intake and energy expenditure. Energy expenditure is the sum of basal metabolic rate (BMR), thermic effect of food and physical activity. The BMR is controlled by hormones such as thyroid stimulating hormone (TSH) and growth hormone that stimulate or suppress lipolysis, glycogenolysis, gluconeogenesis and lipogenesis. Physical activity also contributes to an increase in total daily energy expenditure which depends on how much you move each day.


Energy intake can be controlled by diet composition but also by altering eating habits such as reducing portion size or increasing meal frequency while increasing physical activity may reduce hunger pangs during eating time.


The problems with metabolic adaptation.


The problem with metabolic adaptation is that it can be confusing and unpredictable. When you lose weight, your body uses a number of different strategies to get back to its normal state.



Lessons learned from bariatric surgery.


Bariatric surgery is a treatment for obesity. It’s not a cure, and it doesn’t work on everyone. If you have had bariatric surgery, you should be prepared for some complications that may arise from the surgery itself or from your overall health status after the procedure.


Bariatric surgeries have also been found to be most effective when combined with other treatments like diet and exercise; however, this doesn't always happen in practice (or at all). Patients should be aware that they will still need to make lifestyle changes outside of just having their weight loss surgery done if they want long-lasting results with their health goals


Re-adjusting your thinking about calories and macronutrients can be quite confusing and overwhelming for new Post Op Bariatric Patients, this is where Bariactive Nutrition can guide & coach you though this portion of your WLS Journey


You may have heard this before and it sounds like a simple idea, but we want to make sure that you understand the importance of this concept: calories are not the only thing that matters.


The human body has an amazing ability to adapt to new environments and situations. When we first went paleo or ketogenic, our bodies responded by changing their metabolism away from carbohydrates towards fat—but then after a few weeks or months (or years), these changes stopped happening. Why? Because our bodies stopped needing those nutrients as much! This is called metabolic adaptation; if something happens in your life for long enough, your body will stop needing it so much that its function becomes less efficient or even goes backwards (like when someone loses weight on purpose).


What else can you do to combat metabolic adaptation?


Exercise. The more you can do physically, the better your body will be at responding to the stresses of metabolic adaptation.


Eat more frequently. Your body needs a steady supply of energy and nutrients throughout the day, so try eating every two hours during meal times (breakfast, lunch and dinner) or more often if you’re feeling hungry between meals (snacks).


Eat more protein. This helps keep blood glucose levels stable while also supporting muscle building—which is especially important if you have lost weight!


Eat more fat than carbohydrates or both together; this will help reduce inflammation in your body as well as help prevent insulin resistance from developing over time due to low-carb diets that are typically high in sugar content such as those found on packaged foods today - even ones labeled "low-fat." It's important not only because they cause inflammation but because they can also lead directly into diseases like diabetes which brings on other complications including heart disease/heart attack risk factors associated with obesity such as hypertension (high blood pressure).


Chronic dieting slows your metabolism and leads to weight regain.


Chronic dieting leads to metabolic adaptation. This means that your body slows down its metabolism, making it harder to lose weight. You’re also more likely to regain weight if your metabolism is slower, you need many more calories than before in order to maintain a healthy weight. To combat this problem, try eating smaller portions of food and increasing physical activity levels.


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Here at Bariatric Nutrition we recommend a “Diet” aka Meal Plan based on Macronutrient ratios customized for the individual. This can be customized for any stage of the Bariatric Journey. Our method always prioritizes protein and use carbohydrates and fats as variables depending on individual goals. The simple truth is adherence to a meal plan is highly dependent on individual preferences. There is no one plan that is going to work for everyone and that’s why BariActive Coaches work with clients to develop their own individual meal plan based on Macros & Activity data. Our goal at BariActive Nutrition is for our clients to be able to achieve their Health & Nutrition goals long term by educating them on nutrition fundamentals and teaching strategies for sustainable success.



Author: Jim Laur


Jim is a successful gastric sleeve patient (09-19-17) as well as a NASM Certified Nutrition Coach and Founder of Bariactive Nutrition .



Certified Nutrition Coaches are not medical professionals e.g. Registered Dietician or Physician therefore BariActive Nutrition Coaching Services are not regarded as medical advice. Coaching Services at BariActive Nutrition are a combination of accountability , evidence based nutrition education , and weight loss processes & strategies that are tailored to the individual that produce results for our clients. Please consult with your Doctor before making any changes to your Meal Plan including but not limited to : Caloric Intake, Macros, Food Volume, Vitamins & Supplements.




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