It’s been shown time and time again that the sleeve gastrectomy is an extremely effective treatment for weight loss and improving overall health. If you’ve opted to have one, you’ve already made the first step toward leading a healthier lifestyle.

However, just as with any other journey to a healthier weight, there may be times when you reach a weight loss plateau and discover that it’s difficult to drop further pounds. Experiencing a plateau in your weight reduction can be disappointing and demotivating, particularly if you’ve been strictly adhering to your diet and exercise routine.

The development of a weight loss plateau is rather common, and there are a number of strategies that can aid you in overcoming the plateau and continuing your weight loss journey. Let’s look at a few different approaches that can aid you in breaking through a weight loss plateau after having a sleeve gastrectomy.

These are plans I implement and things I discuss with my own patients. Here are five ways to overcome a weight loss plateau after gastric sleeve surgery and achieve your weight loss goals.

Re-Evaluate Your Diet

One of the main reasons—if not the main reason—for weight loss plateaus after sleeve gastrectomy is a lack of a healthy diet.

Perhaps you’ve fallen back into old eating habits. Maybe you never conquered those habits in the first place. Regardless, anyone who has plateaued after weight loss surgery should always start with diet.

Some experts postulate that diet is responsible for 75% of weight loss. Others suggest it’s 99% responsible for weight loss. The exact number doesn’t really matter, because the take-home message is that diet matters…a lot.

If you’re struggling with a weight loss plateau after a sleeve gastrectomy, spend the majority of your time focusing on your diet. My experience is that improper diet is where the majority of problems occur. So how can you be more deliberate with your diet?

Keep a Food Diary

Maintain a journal of your daily eating and drinking habits. This can assist you in determining areas of your diet in which you may be consuming an excessive amount of calories or an insufficient quantity of protein, healthy fats, or other essential nutrients.

If it goes in your mouth, write it down. I don’t care if it’s a stick of gum or an ice cube. Document everything to see if you’re missing something. Many patients assume they have a healthy diet, when, in fact, they don’t.

Eat Adequate Protein

Every meal should have some healthy protein. Adequate protein intake can help stabilize blood sugar, decrease food intake, reduce food cravings, and help build or maintain muscle mass.

Aim for 60 to 80 grams of protein every day. Make the majority of your protein sources lean. In my opinion, fish is the superior source when it comes to protein. Chicken, turkey, pork, and eggs are also excellent sources of protein. Keep in mind, too, that certain plants—such as lentils, quinoa, and chickpeas—are also great sources of protein.

Eat More Vegetables

I live in the South, so I rarely have to encourage protein intake. I really have to hammer in vegetable intake, though. Vegetables are great for helping you feel full and satisfied since they are low in calories and high in fiber. Accentuate those leafy green vegetables.

Speak to a Registered Dietician

In my practice, we have two full-time registered dieticians on staff. Many bariatric surgeons do the same. Take the time to sit down with an expert and go through your diet journal so they can answer any questions you may have. Ask them to explain the nutritional facts label. Ask about styles of food preparation or healthy recipes. Registered dieticians are a wealth of knowledge that you should exploit!

Watch What You Drink

Soft drinks, sweet tea with sugar, specialty coffees, milkshakes, and alcohol are all ways to gain extra calories.

Watch the Sneaky Calories

I spent nearly a decade in Louisiana. They could ruin a piece of broccoli with a roux, a gravy, or some other delicious topping. Watch the condiments as well—BBQ sauce and ketchup are the biggest offenders in my neck of the woods.

Watch the Preparations

Most food preparations are good, except for frying. Grill, roast, bake, steam—but don’t fry.

Increase Physical Activity

Physical activity is crucial for weight loss, and increasing your activity level can help you break through a weight loss plateau. Here are some different exercise strategies that may be of assistance in losing weight.

Aerobic Exercise

In order to burn more calories, aim to engage in at least 30 minutes of moderate-intensity physical activity per day. Then, try to grow that to an hour a day.

People who struggle with their weight often struggle with joint problems, so you may want to find low-impact exercises. My favorite is walking, but swimming and elliptical training are also good options for low-impact exercise.

Strength Training

I really believe that strength training may be the most overlooked portion of fitness that may have the highest return on investment. Stronger and denser muscles will help you burn more calories, increase muscle mass, decrease body fat, and help prevent injury. A stronger you is a healthier, longer-living you! Don’t hurt yourself, but go pick up a heavy object a few times.


I know someone who had back surgery and could trace their initial injury to reaching for the remote control for their TV. This started a cascade of events that led to back surgery.

When working on your flexibility, focus on your hamstrings, back, and hip flexors. These seem to tighten up the quickest as we age and can become some of the greatest areas of injury.


To prevent a fall, you need a sense of balance. According to the Centers for Disease Control and Prevention, falls are the #1 cause of injury-related deaths in those over 65 years of age. Balance training, yoga, dancing, and sports can all help promote that natural sense of balance that deteriorates with age.

Get Enough Sleep

Your overall health and well-being, as well as your efforts to reduce weight, are directly correlated to the amount of sleep you get each night. Research has shown that lack of sleep can interfere with weight loss efforts, increase cortisol (a stress hormone), and damage your metabolism, leading to weight loss plateaus and even weight gain.

Here are some suggestions to improve the quality of sleep you get each night:

  • Aim for at least seven hours of sleep each night. Six hours should be the minimum.
  • Try to maintain a consistent sleep schedule. It’s okay to not be perfect at it, but try to maintain a consistent schedule as closely as possible.
  • Create a relaxing sleep environment to help you fall asleep faster. Turn off the electronics and try to keep your stress levels low just before bedtime.
  • Try a sleep mask. This has been a game-changer for me—it really helps black out the room and decrease potential distractions.

Stay Hydrated

Drinking enough water is essential for weight loss. It decreases appetite, cleanses the body of toxins, increases the metabolic rate, and allows your workouts to be as effective as possible.

Aim to drink a minimum of 8 cups of water (about 64 ounces) per day. Some experts suggest even more. In fact, the National Academies of Science, Engineering, & Medicine recommends about 90 ounces per day for women and 125 ounces per day for men.

Speak with Your Healthcare Provider

If you have tried the above tips and are still experiencing a weight loss plateau, consider speaking with your healthcare provider about the following:

  • Underlying health conditions. Hypothyroidism, low testosterone, and congestive heart failure are just a few medical conditions that can cause weight gain.
  • Medications. There is a possibility that drugs will cause weight loss plateaus after sleeve gastrectomy. Medication for depression, high blood pressure, and diabetes are all recognized contributors to weight gain.
  • Mental health. Depression and anxiety can also cause weight loss plateaus or even weight gain. Be sure to make your mental health a priority as well.

You Can Break a Weight Loss Plateau After Sleeve Gastrectomy

Weight loss plateaus after gastric sleeve procedures are common, but they don’t have to impede your progress. By re-evaluating your diet, increasing physical activity, getting enough sleep, staying hydrated, and speaking with your healthcare provider when appropriate, you can overcome your weight loss plateau after a sleeve gastrectomy and continue on your weight loss journey. Remember, weight loss isn’t always a linear process, so be patient, stay motivated, and don’t give up!

If you need more assistance with your weight, I encourage you to request an appointment at Arkansas Heart Hospital’s Bariatric & Metabolic Institute by calling (501) 219-7770. We would love to help you on your path to better health.


Call to schedule an appointment with Dr. Bledsoe, today!