Who Sets the Set Point?

Written by Nancy Sayles Kaneshiro


There are many advantages to my having made friends with my surgeon over the past six years. We’ve written a couple of books together and I’ve become the world’s most annoying expert on the subject of weight loss surgery. Ask me anything.

So while one advantage is learning a lot about a subject that is near and dear to my heart (not to mention my liver, kidneys and upper arms), one distinct disadvantage is learning a little too much about that subject. There’s some stuff I just don’t want to know about. For example, the dreaded plateau. Did you know that your body can decide when it has lost enough weight? It goes into starvation mode, slowing the metabolism down to a crawl, no matter how few calories you eat and how many thousands of steps that irritating little activity tracker records. It’s your body’s “set point,” my learned surgeon explained. It’s the body protecting itself against starvation.

Oh, I swear to God, doctor, I won’t starve. But I’ve followed your recommended post-operative diet to the letter, I exercise like a son-of-a-gun and I dropped more than 20 pounds during the first month after gastric sleeve surgery.Then, for the past couple of weeks…nothing. My body is telling me where IT wants to be? Hey, what if my body and I disagree? Don’t I get a vote?

Aw, c’mon, doc, give me a break. It’s true, my face is much thinner and I had to send all my jeans to Goodwill. But that scale won’t budge. Having had weight loss surgery before, did I ever experience a prolonged plateau? Yes. And did you warn me that because I’ve already had a significant weight loss, I might not lose as much as other people do after this procedure? Yes, you did. And did I listen? Well, no.

Diabetically-speaking, (yes, I know diabetically isn’t a word, but you guys know what I mean) I’m in great shape. It doesn’t take a huge weight loss to zap a type 2’s blood sugar back into normalcy. Many of my friends have had immediate reduction of diabetic meds after this surgery. Some, like me, have been able to go off medication entirely, at least for the time being.

So when I whine to my friend the doctor, when I complain about the sagging skin that used to hold nearly 90 pounds of fat, when I tell him that last year’s Super Bowl “deflategate” reference is nothing compared with how I now look in a T-shirt, when I say that I’d give my eyeteeth for a Snickers, he says something professorial like, “What do you want, egg in your beer?”

I can’t compete with the declarations of a brilliant man, so I’ve made my own plan. I’m upping the level on the elliptical a little bit, I’m gradually increasing the reps on the weight machines and I am continuing to add gym time to my day as my post-op fatigue abates. In other words, very slowly. I’ll increase the protein and watch the carbs as I drag my (much smaller) butt into the gym, going from three days a week to four, and eventually five, as I was doing before surgery. No more excuses to limit physical activity (even though I convinced the doc to tell my husband I couldn’t vacuum for six months!).I’ll let you know how I do.

Take THAT, you stupid set point!

Stay well, see you next time!