Dealing With Stalls and Plateaus After Bariatric Surgery


You probably know this already – bariatric surgery is designed to help you rapidly lose weight, but it does not directly lead to weight loss (unlike liposuction, for example). [mfn][/mfn] When you choose to undergo bariatric surgery, the entire process requires a very high level of commitment from you, including sticking to a diet plan and optimizing your nutrition.

The surgery itself is effective and safe, but many bariatric patients experience hurdles in their weight loss journey later on. In this article, we’ll take a look at some of the common reasons for weight loss plateau after bariatric surgery and how to handle it.

What are plateaus and stalls after bariatric surgery?

Most people undergo rapid weight loss after bariatric surgery. However, sometimes the body weight plateaus.

Stalls are defined as maintaining the same weight for three weeks, or longer, despite following the recommended diet and recovery procedures correctly.

Why do stalls occur?

After surgery, the body is adapting to a changed anatomy (stomach), a new diet, and alternative ways of burning energy stores. The water weight is the first to go, followed by muscle and fat. It’s normal for the metabolism to slow down through successive phases, which is what causes a stall. There are other reasons for plateaus after bariatric surgery, including additional life stressors or failing to adhere to dietary recommendations.

What should I do if I plateau after bariatric surgery?

First, know that you are not alone. Everyone hits a stall at some point. The important thing is to identify it and handle it properly. Understand that your BMR (basal metabolic rate) will vary throughout the process. The BMR is the minimum calories your body uses for basic functions at rest. As you lose weight, your BMR and the calories you burn at rest decrease.

Don’t be alarmed if you hit a stall – it’s your body adapting. Be mentally prepared for weight loss plateaus. Give your body a chance to readjust to the drastic changes it is undergoing. Don’t be demotivated by the lack of weight loss and return to unhealthy habits or negative thinking. Stick to your new lifestyle and diet as you ride out a stall. You’re undergoing a huge transformation and there are going to be ups and downs in the journey.

Bariatric Stalls

Anticipate Early Stalls:

Plateaus are common after bariatric surgery. Do not be alarmed if a stall occurs early on in the process; first 3-4 weeks post-op. For most patients, there is nothing that they are doing “wrong”. The body needs to adapt.

The purpose of the preoperative diet is to shrink your liver and reduce any chance of complications through surgery. The reason why the liver shrinks is because the body is using up glycogen stores within the liver for energy. For most patients those glycogen stores have not been used in years. This is a shock to the body and system.

Through the process of bariatric surgery and immediately after; the body is adapting to a new diet and burning alternative energy stores. Water weight is usually lost first, then the body turns to muscle and fat. As the body is burning muscle, the metabolism starts to slow resulting in a stall.

In addition, having bariatric surgery is a distressing experience to the body. Due to this, the body is trying to do its best at adjusting to the new restricted caloric diet and trying to establish a new normal or homeostasis. While all this is going on inside the body, it often leads to a stall in weight.

Many patients do not realize all the biological functions happening during the entire process, and they automatically jump to “What am I doing wrong?

Be prepared to go through weight loss plateaus. It will happen to everyone, perhaps multiple times, during their weight loss journey. Give your body a chance to re-adjust and push through the drastic changes it has undergone recently. Stay mentally and emotionally strong to stick with new lifestyle modifications, and not to let old habits or negative inner dialogue interfere.

Bariatric Patients have generally lived a different type of lifestyle previous to surgery, usually unhealthy.

Do not expect a huge transformation within the first month postoperatively. Weight loss will take time. The first month’s weight loss is commonly a loss of all three; water, muscle and fat. Further long term fat loss may be a slower process that requires consistency.


  • Take the time to enjoy the journey, not just becoming consumed with a goal weight. There are many reasons why people choose to have Bariatric Surgery including; increasing energy, traveling more comfortably, decreasing medications or reversing diagnosis etc. Remind yourself of these daily and reward yourself when you have accomplished a goal.
  • Do not compare yourself to others; patients are on different journeys and develop individual goals. Weight loss can be impacted by age, medications, gender, hormones, level of activity, diet and total excess weight.
  • Keep your expectations about weight reduction realistic.
  • Weigh yourself once a week or twice a month. Choose a specific day, time and wear the same clothes or none at all to get a more accurate reading.

How to beat stalls?

It can be discouraging when your weight hits a plateau after bariatric surgery. Here’s what you can do to beat a stall.

Enjoy the journey and don’t focus too much on your weight loss goal. Look at the bright side – How much weight have you already lost? How has your health improved? Did you get off some medications? Can you do things now that you couldn’t previously?

Remind yourself daily of what you’ve accomplished and celebrate your successes.

Don’t compare yourself to others. Everyone’s body and bariatric journey is different. There are a lot of factors that impact weight loss, such as total excess weight, age, gender, hormones, diet, and exercise.

Be realistic about your weight loss expectations. Don’t be consumed by the number on the scale. Weigh yourself at most once a week or twice a month. Get an accurate reading by weighing yourself at the same time of day in the same clothes.

Make sure you’re on track with your diet. Are you tracking your food with an app? Are you tracking your diet in real-time and honestly? Are you exceeding the recommended daily calorie intake? Is there enough lean protein and other nutrients in your diet? If your diet is off course, that could be the reason for a stall or plateau in weight loss.

Stress is another potential reason for stalls after bariatric surgery. You cannot avoid some stressors in life but you can manage stress in healthy ways. For example, if you turn to alcohol to relieve stress, you’re giving your body empty calories.

However, if you choose to go for a run to manage stress, you are burning calories while managing stress. Make sure you’re staying well hydrated and getting enough (7-9 hours) of sleep every night.

Take Action:

Commit to the following to support weight loss and/or to bring yourself out of a plateau.Follow the checklist and start with the basics such as water, sleep, protein, and stress.


  • Aim for a minimum of 64 oz each day. As patients progress through the post operative phases, start to increase water up to, ½ of your body weight in oz. (example: weight = 200 lbs., water = 100 oz. per day.) Water will help keep you hydrated and control hunger. It will also boost your metabolism, cleanse your body of waste and increase the number of calories you burn each day.
  • It is important to incorporate adequate amounts of protein before and after bariatric surgery. Your goal should always be 60-80 grams of protein each day, now and forever.
  • Protein’s role in the body is to preserve lean muscle mass, provide energy and fuel, aid in growth and maintenance of hair, skin and nails, and is essential for cell growth and maintenance.
  • Aim to consume protein at every meal
  • Consume protein first, before other foods
  • Protein will keep you fuller longer
  • 8 FULL HOURS should be the goal, each and every night. Sleep is significantly essential in one’s overall health and cannot be understated. Getting enough sleep will reduce food cravings, stress and it will also allow your body to burn calories efficiently.
Track Diet:
  • Measure and weigh portion and track your diet. Track diet in real time and document everything consumed including liquids. 
  • Having this information at your fingertips can help you identify if you are in a plateau or slipping into old habits, that are preventing you from losing weight.
Change Diet:
  • Cut back on carbohydrates and add more lean protein. Aim for natural protein over supplements like;  raw and fresh food options over protein bars.
  • Bodies can adjust over time, and it may be that your body has adjusted to the new bariatric diet. Try swapping out carb snacks for ¼ cup of plain nuts, go back to lean protein options like chicken and tuna, and reach for healthy fats. (Olives, Avocados, Flaxseed and Chia seeds, Salmon, cook with Olive oil or Coconut Oil).
  • Start and continue a, exercise program after bariatric surgery. Regular exercise will help maintain lean muscle mass and boost metabolism. Work at making physical activity exciting and challenging. After time change up either the duration, frequency, intensity or all three. To capitalize on maintaining lean muscle mass, use free weights, gym machines, and resistance bands.



Weight loss can happen in multiple ways; it is not just measured by the number on your scale. You may be losing in inches and losing in dress sizes. So, take measurements of your body once a month to compare how far you have come. Noticing these changes in inches can help you recognize your overall success.

Weight loss surgery is a difficult process that begins with surgery. Adopting a sustainable healthy diet, physical activity and a positive outlook will help obtain the body and life you are looking to achieve.

Bariatric surgery is a powerful tool, but it is a tool nonetheless, one that you have to use for it to be effective. The surgery itself is just the beginning of a challenging process. By being aware of stalls and plateaus after bariatric surgery and their causes, you can handle them with a positive outlook and obtain the body and health you deserve