Episode 145: How To Overcome Weight Regain

[00:00:00] Welcome back to the Back on Track Achieving Healthy Weight Loss, where I help you get

[00:00:05] on track and stay on track with your weight loss journey.

[00:00:09] I'm your host, Dr. Alicia Shelly, so let's get started!

[00:00:28] Welcome to the Back on Track Achieving Healthy Weight Loss podcast.

[00:00:32] I'm your host, Dr. Alicia Shelly.

[00:00:35] So I've been doing this podcast for about three years in July and the reason why I started

[00:00:43] this podcast was because, well, number one, I've suffered with my weight, but also I

[00:00:50] wanted to help people who were like myself, who have yo-yo diet all their life and

[00:00:56] who was kind of on the other side trying to get right back on track with getting back

[00:01:01] on track with their healthy weight loss.

[00:01:03] And so just for those who may have joined a little bit later on in this podcast, because

[00:01:08] we've had over 140 some episodes at this point, but I just wanted to share with you

[00:01:13] my story.

[00:01:14] So like I said before, I have suffered with weight loss for a long time, since childhood

[00:01:20] I would say.

[00:01:21] And like many people, I've tried all types of diets, eating right, even the extreme diets

[00:01:27] like the lemonade diet where I just drink lemonade, cayenne pepper for like seven days.

[00:01:32] I felt like I was going to die.

[00:01:35] At the end I was so weak.

[00:01:36] I've tried different programs, Ginny Craig, Weight Watchers, a lot of things to help.

[00:01:42] And I'm not saying these programs don't work.

[00:01:44] They do.

[00:01:45] I lost weight.

[00:01:46] But then all of a sudden that weight started creeping back.

[00:01:49] I would remember being in the gym, exercising all the time, seeing such great results, feeling

[00:01:54] great.

[00:01:55] And then life would happen.

[00:01:57] I remember being in med school and now the rotations.

[00:02:00] I had to come in at 5 a.m., leave in at 6 or 7, trying to study and then coming back

[00:02:05] to the hospital.

[00:02:07] And it just got so overwhelming sometimes.

[00:02:09] And I would see where I had such progress and then the weight would come back.

[00:02:13] And so what we describe that as as weight regain.

[00:02:17] And I know a lot of people or many people have similar experiences as far as with that

[00:02:23] yo-yo dieting, as they say.

[00:02:24] Or even just kind of the weight gain.

[00:02:26] Even if it's not necessarily your yo-yo dieting, you're just doing a life change.

[00:02:29] And then a few years later you're like, man, the weight came back.

[00:02:32] I don't know what happened.

[00:02:34] And so today, actually last week, my TEDx talk, which was entitled Three Ways to

[00:02:40] Stop Weight Regain after bariatric surgery, just dropped on the TEDx YouTube channel.

[00:02:46] So there'll be a link if you want to check it out.

[00:02:49] But I wanted to share just some information and just some strategies and how you can overcome

[00:02:56] that weight regain after bariatric surgery.

[00:02:59] For those who may not be aware, I did actually have bariatric surgery in 2015.

[00:03:05] And I was doing great.

[00:03:06] I felt great.

[00:03:07] I lost weight.

[00:03:08] But then all of a sudden that weight started creeping back up.

[00:03:11] And that was over a couple years.

[00:03:13] And I lost 80 some pounds and it had gained 40 of it back.

[00:03:17] You can only imagine just how distraught I felt with having to look at myself and be

[00:03:22] like, oh my gosh, what are you doing?

[00:03:24] What's going on?

[00:03:25] Because to lose the weight and then to gain half of it back, I felt so ashamed.

[00:03:31] And that's when I realized that I had to make this a lifestyle change.

[00:03:36] I had to do this for me.

[00:03:39] I can't just stop all the different interventions that I'm doing.

[00:03:42] Like I have to keep going because for me, when I stop, that's when the weight comes back.

[00:03:48] And especially if things like life gets in the way, stress work, all the different

[00:03:52] obligations that you're supposed to do get in the way, it can make it really easy

[00:03:57] for that weight to come back.

[00:03:59] So let's first talk about why does weight regain happen?

[00:04:03] And there's a theory called the set point theory.

[00:04:06] In this theory, it says that a majority of us, our body has a certain weight that it wants

[00:04:11] to be.

[00:04:12] And this weight for me usually is a lot higher and a lot less healthy.

[00:04:17] And so what happens is, is that when I start to do the lifestyle interventions, exercise,

[00:04:24] eat differently, maybe take medications, my weight will start to go down.

[00:04:29] But my body still wants to be at that set point.

[00:04:32] And so it works against me by increasing my hunger hormone called ghrelin or decreasing

[00:04:38] my metabolism so that the weight will start to creep up again.

[00:04:43] And so a lot of times you see that when you lost weight and then all of a sudden things

[00:04:48] get in the way and you may not necessarily be doing the same intervention that you were

[00:04:52] doing before, you can see that weight just kind of slowly creeping up going back to

[00:04:56] where that set point is.

[00:04:58] And it can be very frustrating at that set point.

[00:05:01] And later on I'll talk about some strategies to overcome that.

[00:05:04] But there are other reasons why people can regain their weight.

[00:05:08] Most commonly you can regain your weight due to medications.

[00:05:12] There are certain medications that can promote weight gain, such as steroids.

[00:05:17] So being on steroids chronically can regain your weight.

[00:05:21] Even certain antidepressant medications can regain your weight.

[00:05:25] Not to mention even like anti-seizure medications like Gabapentin, like you regain your weight.

[00:05:32] And then there are certain diabetes medications like Gallipoli and Glamiparide that can cause

[00:05:38] some weight gain as well.

[00:05:40] So there's many different medications that can promote weight.

[00:05:44] And so if you've been put on that to help treat a different condition sometimes

[00:05:48] even weight you start to see your weight come up.

[00:05:51] I forgot about this one.

[00:05:52] But a big one is the Depo Medraw shot.

[00:05:55] Or that progesterone for birth control can definitely regain weight.

[00:05:59] I've had several patients who are on that gain like 20, 30 pounds.

[00:06:04] And I know for me when I was on birth control I gained weight too.

[00:06:08] So it just depends on what your body is more sensitive to.

[00:06:11] Also a couple of other things that can cause you to regain your weight.

[00:06:15] It may be if you're going through a tough time, if you're going through depression

[00:06:19] or worsening anxiety, sometimes these mood disorders can really affect you.

[00:06:26] And it can affect your motivation.

[00:06:27] It can affect you whether you want to go outside and exercise or eat right.

[00:06:31] Or if you just want to stay indoors and just lay in bed all day.

[00:06:34] Like it can really affect your momentum and your motivation.

[00:06:38] And so it can make a difference too.

[00:06:40] Some people who experience those conditions some people don't eat.

[00:06:44] Some people do eat or overeat.

[00:06:47] And when it comes to weight, people think, oh, I let me not eat enough and I'll lose weight.

[00:06:52] But actuality your body goes into starvation mode when you're not eating enough calories.

[00:06:57] And that can cause you to gain weight.

[00:06:59] So I've had patients that have gone both ways as far as with overeating or not eating enough.

[00:07:06] Also sometimes the lack of physical activity and just the time to kind of have that eating healthier foods can also play a role when it comes to weight regain.

[00:07:15] I know when I had lost weight in medical school and then when I got to the wards and I was eating the hospital food or wasn't eating the food I brought.

[00:07:24] And I didn't have time to exercise because I was studying so I can go back and still perform.

[00:07:29] My weight just increased.

[00:07:31] And by the end of residency, I did not recognize that woman who had graduated residency from where I was as a second year med student.

[00:07:40] So it definitely played a role on my weight kind of coming back.

[00:07:45] And so let's talk a little bit about strategies or ways that we can overcome.

[00:07:51] And the first thing I realized is that when it came to the forefront that, oh, my gosh, I had gained back 40 pounds after losing 80 with bariatric surgery.

[00:08:00] That really hit me kind of hard.

[00:08:02] Like I said before, I felt so ashamed.

[00:08:05] But what happened was I took that moment, even though I did feel ashamed, I addressed that moment.

[00:08:10] But then that's when I kind of realized that I needed to do something different.

[00:08:14] And I was in that mindset and I was ready to do something different.

[00:08:19] After that, I realized I do a lot better with a personal trainer or with somebody who can be my accountability partner.

[00:08:26] And so I started working out with her.

[00:08:30] I started actually eating healthier.

[00:08:33] So I made sure I, you know, the days I couldn't cook, I actually would get a meal prep.

[00:08:38] I would meal prep on the weekends so that I had food for the week and I bring my lunch.

[00:08:43] That's another thing in our office.

[00:08:45] We're so blessed to have pharmacy reps that come and bring lunch, so we don't always have to worry about it.

[00:08:50] But it's never really that healthy.

[00:08:52] I mean, sometimes you have some healthy lunch like, oh, this is great.

[00:08:55] Oh, my gosh, it's a great lunch.

[00:08:56] Other times it's like pizza and you're like, OK.

[00:09:00] But I find that when I am on top of that meal prep, I feel so much better because I'm eating healthier,

[00:09:06] high quality foods and healthier foods as well.

[00:09:10] So the first thing is number one strategy is to take a moment, assess where you are,

[00:09:15] assess if you're ready to start a lifestyle intervention because some of us are not ready,

[00:09:20] especially if you're going through a depression and anxiety and you're still in that space.

[00:09:25] You may need to try to first work with somebody, getting to a better place

[00:09:30] until you're ready to kind of put that time in.

[00:09:33] I know sometimes I have patients and we talk about the lifestyle intervention

[00:09:38] and they're like, nope, I don't have time.

[00:09:39] I can't do this.

[00:09:40] I can't do that.

[00:09:41] And you know, I ask them, I'm like, is this a good time for you right now?

[00:09:45] Or do you want to wait until it's better?

[00:09:48] And usually when I ask that question, then that kind of helps people to kind of be like,

[00:09:53] well, I'm ready.

[00:09:55] I am ready to do this.

[00:09:56] And so we kind of work through how we can implement healthy habits in their current lifestyle.

[00:10:02] But sometimes you have to actually take that moment and assess where you are.

[00:10:06] Are you ready?

[00:10:07] Do you have the bandwidth to do it?

[00:10:09] If you don't, then work on getting there.

[00:10:12] If you're going through depression, work with somebody to help you get out of that depression,

[00:10:16] whether it's with a psychologist, psychiatrist or your primary care,

[00:10:20] a trained specialist to kind of help you get through that depression.

[00:10:24] Is it if you're just overwhelmed and you have so much stuff,

[00:10:26] so many obligations on your plate, you may need to say no to something

[00:10:31] so that you can say yes to your health.

[00:10:34] And that's okay to tell people no because in order for you to continue to do the things

[00:10:39] that you need to do for others, you got to address you.

[00:10:43] You got to take time for you.

[00:10:45] And so sometimes you got to say no to other things so that you can say yes

[00:10:50] to what's most important to you.

[00:10:52] And then once you're ready and you're like, yes, I'm ready to go for it,

[00:10:56] then the strategy number two is start with a lifestyle habit that you would like to start with.

[00:11:02] Like it just has to be one, start with one.

[00:11:04] And that may be, hey, I want to start exercising a little bit more.

[00:11:08] I'm going to make a time in my schedule so that I make sure that I'm exercising

[00:11:13] three to four times a week.

[00:11:14] Or it may be, you know what, I really want to be healthier,

[00:11:17] so I'm going to eat healthy.

[00:11:19] I'm going to start with meal prepping or I'm going to get somebody a meal service

[00:11:23] so that I can eat a little bit more healthier throughout the week.

[00:11:26] Or it may be something as simple as I just want to drink more water.

[00:11:29] You know, I just want to decrease the sodas that I'm drinking and the different beverages.

[00:11:34] You decide what that lifestyle goal is.

[00:11:37] I would say, and you know how much you can handle.

[00:11:40] A lot of times we have to change everything all at once.

[00:11:43] You do not have to do that.

[00:11:45] You can start with just one thing that you want to change

[00:11:48] and then go from there and then keep moving forward.

[00:11:51] So it does not have to be this whole complete change

[00:11:54] because you can start with one goal, master that, go on to the next goal,

[00:11:59] master that, go on to the next goal.

[00:12:00] And then before you know it, you've changed so much of your aspect of your lifestyle

[00:12:05] that you don't recognize the person where you are.

[00:12:08] And so I see it a lot when people come back after working with me

[00:12:12] and they're just like, hey, I see the weight has gone down.

[00:12:16] I see that it has gotten better.

[00:12:18] And sometimes it's just because, first of all, they keep putting one foot forward.

[00:12:22] They keep moving forward.

[00:12:23] They keep tweaking things, improving things

[00:12:26] because when it comes to the lifestyle, it's kind of a, like I said, it's for life.

[00:12:32] So you may not get it all at once, but just as long as you keep moving forward,

[00:12:36] it will get easier.

[00:12:37] It will get easier.

[00:12:38] And so with those lifestyle goals, it can include incorporating, eating healthy,

[00:12:43] exercise, drinking more fluids, getting sleep,

[00:12:47] sleep, sleep, getting enough rest, reducing your stress,

[00:12:51] all important principles to help with losing weight.

[00:12:55] And then the last strategy I would say is find your accountability partner,

[00:13:00] whether it's a partner, whether it is a group,

[00:13:03] whether it is an app that you're utilizing,

[00:13:07] a partner, whatever it may be, find how you can stay accountable.

[00:13:11] Because sometimes we have so much going on

[00:13:13] that we need somebody to be that appointment where we're going to meet them at a certain time

[00:13:18] so we can exercise or we are going to join this class at a certain time

[00:13:23] and we know we're going to get that in because we enjoy it.

[00:13:25] So finding how do you keep yourself accountable?

[00:13:29] And the last thing, once you keep somebody accountable,

[00:13:32] you can be able to be consistent.

[00:13:33] So stay consistent.

[00:13:35] And then the last thing I would say, the last strategy would be

[00:13:38] have your, give yourself some grace on the days that it doesn't work out for you

[00:13:43] because there are some days when it just, things just aren't going great.

[00:13:47] Give yourself grace and then start again.

[00:13:50] I was talking to a client, a patient, and they were talking about how they were going on a cruise

[00:13:55] and I'm like, well that's great.

[00:13:56] But do you have a plan for that cruise?

[00:13:58] Are you going to stay the same lifestyle or are you doing a change?

[00:14:01] Give yourself a little bit of leeway.

[00:14:03] What are you going to do?

[00:14:04] And they hadn't thought about it.

[00:14:05] And I'm like, well, first of all, you're going on a cruise,

[00:14:07] you're on a vacation.

[00:14:08] Doesn't mean you have to go all crazy and eat everything,

[00:14:11] but have a plan, have a small plan and give yourself a little bit of grace to enjoy that

[00:14:16] vacation and that time so it's not overwhelming.

[00:14:19] So needless to say, as far as the strategies,

[00:14:22] number one, just take a moment to assess where you are.

[00:14:26] Make sure you're ready for that lifestyle intervention.

[00:14:29] And if you don't have the bandwidth or you're in a different space,

[00:14:33] go ahead and work on that to get to that place where you do have the bandwidth

[00:14:36] to start a lifestyle change.

[00:14:38] Start with a small goal and then kind of taper up and work your way up.

[00:14:42] Number two, number three, incorporate eating healthy,

[00:14:45] incorporate exercise.

[00:14:47] Number four, the number five is have more of an accountability and stay consistent.

[00:14:52] And the number six is give yourself some grace.

[00:14:55] Well, I thank you so much for joining us today on the back on track,

[00:14:59] achieving healthy weight loss.

[00:15:00] I hope you liked this episode.

[00:15:03] Please feel free to share it with others, like it and subscribe.

[00:15:05] And don't forget to leave a five star review and we will see you next time.