Are you a weight loss surgery patient whose weight loss has slowed, stopped, or even started to go in the wrong direction? If so then you may be wondering what is keeping the pounds from falling off. In most cases poor weight loss in weight loss surgery patients (gastric bypass, gastric sleeve, lap band) can be contributed to 1 of 5 factors including:

1) Inadequate protein intake (remember that females need 60gm protein/day and males needs at least 80gm/day)

Within each of our intestines lives a colony of bacteria. In fact, researchers believe that each of us have around 4 trillion bacteria in our intestines. Most of the bacteria are located in the large intestine, while very few microorganisms are found in the small intestine. This is a good thing considering that excessive amounts of bacteria in the small intestine may be correlated with obesity. In fact, researchers have found that excessive bacteria in the small intestine may increase the rate of gastric emptying (and thereby decrease satiety/fullness after a meal), decrease the body’s production of the hormone leptin (a hormone that tells you that you are full and to stop eating), and increase the amount of calories that can be extracted from food. As you can see, excessive microbes in the small intestine make it difficult to get skinny.

Now the good news is that in most people the population of bacteria in the small intestine is kept low by a number of factors including: 1) Hydrochloric acid produced in the stomach kills any incoming bugs, 2) Migrating motor complex/Housekeeper wave sweeps/propels bacteria from the small intestine on a frequent basis, 3) Good digestion and absorption in the upper part of the small intestine leaves little food for the bacteria, and 4)bile acids and pancreatic juices exert an antibiotic effect on bacteria in the small intestine. Unfortunately, small intestine bacterial overgrowth is commonly seen in R&Y Gastric Bypass patients as a result of the decreased stomach acid production and the mild malabsorption that results from this procedure. This increase in small bowel bacteria may contribute to digestive disturbances (gas and bloating) and may make it difficult for gastric bypass patients to lose as much weight as they potentially could have if the bacteria weren’t growing where it shouldn’t.

Are you keeping up with your food logs? If not then you could potentially be hindering how much weight you could lose with weight loss surgery. As mentioned in your education class, food logs can significantly impact how many calories you consume and therefore how much weight you lose.
In fact a recent research study published in The American Journal of Preventive Medicine found that patients who kept food logs while on the anti-hypertensive DASH Diet lost double the amount of weight as compared to the subjects who did not keep food logs while on the same diet.
This study confirms what I have seen in practice, which is that weight loss surgery patients who keep food logs achieve a greater level of weight loss than patients who fail to keep logs.
Food logs can help you lose weight by:
• Opening your eyes to how many calories you are really consuming (most people seriously underestimate their calorie intake)
• Helping you see where you can cut empty calories ( sports drinks, a piece of candy here and there, and high fat sauces and dressings)
• Keeping you honest with yourself
• Helping you track calories throughout the day so that you know when to say “enough already”.
• Helping me help you. If I don’t know what you are doing then I can’t give you good advice that will get you back on track

I could go on and on, but you get the point.
To help you keep a good Food Log I suggest that you implement the following plan:
1. Get a Food Journal. It does not have to be expensive, any notebook will do. You can also you online sites such as www.thedailyplate.com to help you track your intake.
2. Get appropriate measuring equipment. Food scales, measuring cups, and measuring spoons are important because your eyes can deceive you.
3. Read labels closely so that you know what a serving is and how many calories are in a serving.
4. Calorie databases: Use calorie databases such as www.calorieking.com and http://caloriecount.about.com/ when food labels are not available.
5. Log everything

Researchers will tell you that weight loss surgery not only helps people slim down, it often cures their diabetes, high cholesterol and high blood pressure.

These findings will come as no surprise for those who have had weight loss surgery. Unfortunately, many of our friends and loved ones have no idea how overwhelming the scientific evidence is.