Regaining some of the weight you’ve lost after vertical sleeve gastrectomy can be frustrating. Most of the time, it’s pretty easy to pinpoint where you’re going wrong, especially if you’re regularly diving into a box of cookies or skipping the gym. But there are some not-so-obvious things you’re doing—or not doing—that can impact your long-term VSG results.

A recent study by University of Pittsburgh Graduate School of Public Health found that the amount of time post-op patients spent zoning out in front of the TV or playing on the computer can predict weight control results as well as, or better than, traditional actions like counting calories.

The study was specific to Roux-en-Y Gastric Bypass surgery, but the same principles can likely be transferred to vertical sleeve gastrectomy. So let’s look at possible takeaways a little more in depth:

• How you unwind is important. The study specifically looked at recreational activities—not work-related stuff. Meaning that if your job requires long hours in front of the computer screen, there’s no need to press the panic button. The key seems to lie in how you blow off steam after hours.

• Some “red alert” behaviors aren’t correlated to regain. Many patients are hesitant to eat out or have “too many” meals, for fear of gaining weight. But neither frequency of meals nor eating at restaurants (other than fast food joints) seemed to impact whether patients regained pounds after bariatric surgery.

• Don’t skip proven weight maintenance activities. It’s still important to address disordered relationships with food such as binging, eating when full, and feeling out of control when eating. It’s also essential to keep weighing yourself, eating healthfully (ie: not fast food), and exercise, according to the study. In other words: Keep doing what we know helps prevent regain.

In addition to the usual methods of maintaining your weight loss, consider adding some protective measures to your VSG routine.

• Redefine relaxation. At the end of a long day, few things sound better than plopping down on the couch for mindless web browsing or serious television time. But if your bag of relaxation tricks contains only sedentary options, you could be sabotaging your long-term results—especially if your lifestyle, outside of dedicated gym time, is pretty sedentary. If you want suggestions on some new options, I suggest doing some yoga, as studies have shown that even 20 minutes both relaxes and recharges you. Or give yourself permission to work on an engaging hobby you rarely have time for. And working in a garden not only beautifies your environment, but edible gardens can help you add more produce to your diet.

• Reward yourself in new ways. In an effort to avoid using food as a reward, many people view activities like binge-watching a TV show or getting lost in a marathon video game session as a calorie-free win. But again, they’re both associated with regain after bariatric surgery. Instead, reframe your idea of what constitutes a reward. When’s the last time you got to catch up with your partner or a dear friend? Do it over a brisk walk in a beautiful area. Being in nature is a wonderful way to reward yourself, so grab your kids or a four-legged baby and head outside for a romp in the yard. Love to shop? Even if you don’t have a lot of disposable cash, window shopping can still be a treat—and great inspiration to stay on track with your gastric sleeve diet.

Working more activity into your day is always going to be a good thing, and when you swap those activities for time you would normally spend in front of a screen, you’re on the right track to preventing pounds from creeping back on.

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“Changing lives…one sleeve at a time”.