I was weeks out of recovery and my target weight was in plain sight. I was enjoying regular exercise, discovering healthy foods and feeling amazing after eating much smaller portions. I had slipped comfortably into my new routine and my new tool seemed to be working beautifully. I felt as if I could go on like this forever, achieving better and better results. When just before reaching my first weight loss goal my progress came to a sudden halt. Needless to say I was completely thrown and had no idea what had gone wrong.

During my first weight loss stall I became obsessed with weighing myself on the scales; I pushed myself harder at the gym, walked further and scrutinised everything I ate but still couldn't shed the pounds. Then I started feeling despondent and felt my surgery had nothing more to offer in the way of success. The last thing I considered was to change my diet and exercise routine which had served my weight loss so well up to this point. But if you need to overcome weight loss stall, change is exactly the right answer.

How to overcome the plateau effect

The best single word of advice is change. 

Change something, change anything, just mix up your routine! Don’t waste your time doing the same things over and over again and expecting the same results. The difficulty, however, is in knowing what changes to make and what you keep the same. Here are a few suggestions to get you feeling motivated and back in control:

Be flexible with your diet: alter your macronutrient intake

Macronutrients are the proteins, carbs and fats which you require in large amounts on a daily basis. There is no need to get super technical about post-op dieting. But if your current diet is higher in carbs then reduce the amount of starchy foods you’re eating and replace with different sources of protein. If you’re snacking on fruit in the afternoon then switch to nuts or yoghurt. Remember: bariatric patients should be eating a minimum of 60g of protein per day, but if you’re exercising more frequently increase your protein intake by around 20 percent. 

Reassess your protein sources

If you’ve been taking protein shakes and bars regularly then switch to different sources like beef jerky, chicken skewers or seafood. Your body needs to work harder to break down and digest whole food sources than it does with shakes and bars, which means burning more calories in the process. Don’t be afraid to eat healthy fats like avocado and olive oil - omega-3 and monounsaturated fats are not the enemy!

Zig-zag calorie cycling

Zig-zag calorie cycling is a method of varying your daily calorie intake while maintaining the same intake over a week. Instead of consuming 1000 calories everyday day you can increase or reduce this number on different days. For instance, take in 1000 calories on Monday then just 700 calories on Tuesday. Achieving this can be as simple as swapping meat for fish or adding a protein shake into the plan.

If your post-op intake is 1000 calories a day then zig-zag calorie cycling over a week will look like this:

DAY OF THE WEEK	CALS
Monday	800
Tuesday	1100
Wednesday	700
Thursday	1000
Friday	900
Saturday	1200
Sunday	700

Strength training and muscle fitness

Soon after recovery patients will be getting their fitness mainly from taking brisk walks which can become a fairly routine exercise. Walking more is a great start to getting fitter, but perhaps it is time to add some muscle resistance into the mix.

If you have not been including strength training in your weekly fitness routine then you should get started. Working your muscles will help to strengthen bone tissue, increase lean body mass, and ultimately boost your metabolic rate.

Have you tried High Intensity Training? It is a great way to boost your body strength and muscle capacity.

Here are some strength training ideas:

• If you haven’t already then join your local gym and ask your trainer to make you a strength training program.
• Follow a bodyweight training program
• Get some some dumbbells at home

Changing your exercise routine

Remember: whatever you are doing consistently try to mix it up a bit. If you’re already walking a lot then crank up the speed and start jogging distances. Introduce swimming or cycling into your lifestyle or any fitness activity that will change the way your body is currently used to working. Change is as good as the rest.

If you are doing low-intensity cardio work then progress to high-intensity work for short durations to start with. For instance, instead of your normal slow jog run as fast as you can for 30 seconds then walk for 30 seconds. Do this four times throughout of your jogging session.

Need more ideas?

• Try a new exercise DVD at home. Some of us happen to like dancing around the room, knocking over coffee tables and falling over chairs!
• A new gym class such as yoga, pilates, spinning or zumba (to name a few).
• Social sports - join a volleyball, football, basketball or hockey team.
• Go hiking with friends.
• Yoga - to help you to relax.
• Get a cool bicycle - don’t leave it in the garage gathering dust.
• Got kids? Get in the playground with them instead of sitting on the bench.
• Video games for physical activity.
• Get a Nintendo Wii or an Xbox with Kinect and some good fitness games. 

The key is to introduce new activities which change your current routine. You need to keep your body guessing and notice how quickly you can adapt to a new exercises or activities.

Change how many meals you eat in a day

Rather than eating three meals a day try the Mediterranean style of eating meals: five to six smaller, high protein meals each day with intervals in between. Eating five meals a day is a well-known technique among bodybuilders who claim the thermic effect of eating helps to burn more fat. 

Energy expenditure takes place in the body as food is processed (particularly protein). The Thermic Effect of Food (TEF) is very real. A recent study of gastric bypass patients showed enhanced TEF after surgery. The rule is to eat little and often. 

Other small ways you can introduce change to your lifestyle

• If you can’t move away from eating three square meals a day then add snacks in between and reduce the portion size of your main meals.
• If skipping breakfast has been your thing then maybe it’s time to change tactics.
• Start a food diary
• Set an alarm or reminders for when to eat.

Still not working? Extra things you can try to kick start weight loss

• Get more sleep. A good night’s sleep can often work wonders for the metabolism.
• Work on your portion sizes. Make sure you stop eating when you're satisfied and don’t over eat at meal times.
• If you have become obsessed with the scales then it might be time to change your goals.
• Rather than getting slim switch your focus to getting fit: train to run 5km, cycle further or lift heavier weights.

We all have different capacities to adapt to new routines and activities. While some patients will lose weight more quickly for others it can take more effort to overcome stalls and reach target weights. Wherever you sit on the spectrum don't become disillusioned with your weight loss tool. It does work! We just need to learn what works for us as individuals and know when to adapt our routines and activities. You will succeed!  

Now I've learnt, my way of dealing with a stall in my weight loss is to chill out and back off from the scales. I’ve come to recognise a plateau as the need to give my mind a body a break. First I start to increase my fluids and gradually increase my cardio fitness levels. I find yoga and meditation really helpful in these periods. When it comes to what and when I eat I prefer to rely on my intuition rather than rigorous planning. We are all different and respond differently to stimuli. This is why it's important for each of us to get into our own rhythms and routines. After surgery we have a period of 12-18 months before weight loss really starts to slow down which is when we need to find our own equilibrium. Your happiness and wellbeing depends on you finding the right balance in this crucial period.