The focus after gastric sleeve in Mexico is, of course, weight loss. And while it can be a long and winding journey to your goal weight, at least you know where you’re going and how to get there. When it comes to maintenance, many VSG patients feel like they’re tackling a whole new beast—with no end in sight. The good news: A recent Cal Poly study published in Obesity outlines some pretty clear steps to keep weight off long term, and it’s the same things your sleeve brothers and sisters have found to be true.

Tip #1: Get your mind right.
Without the right mindset, you’ll probably regain at least some of the weight you lost after vertical sleeve gastrectomy. Some say that weight control starts in the kitchen, but I’ve long believed that it starts in your head. Results from the Cal Poly study seem to back that up. In their survey of 5,000 people who had lost weight on a popular diet plan and then maintained that loss for several years, they found that successful people stayed positive in the face of a few pounds of regain, focused on past successes, and used other healthy mindset habits. And, even better, these thought patterns got easier over time. Discipling yourself to focus on what you’re doing right and sticking to a plan you know works is a huge factor in maintaining weight loss over the long term.

Tip #2: Keep your diet in check.
One of the most common questions from people in VSG maintenance is, “How much should I eat now?” My general guideline is five to six small meals a day that average out to roughly 1,200 calories total. The study echoes that a healthy gastric sleeve diet remains important during maintenance, mentioning specifically that actions like measuring food and recording food intake are key. Tracy J., who is successfully maintaining a 75-pound loss, says she pretty much follows the same diet as when she was losing. Tracy S. continues to follow what she learned early on, too. “I make sure I eat my protein first and listen to my tool each moment. I still don’t eat and drink at the same time.” Dorothy sums up the number one rule for gastric sleeve diet at every stage: “When I stay on plan, my weight stays stable. When I eat garbage, I gain. Same as before (gastric sleeve surgery).”

Tip #3: Move your body.
Hitting the gym may not play as big a role in maintenance that food does, but there’s no doubt that it helps your body stay toned, burns off some extra calories, and inspires you to adhere to clean eating habits. Exercise is extremely important to Angie’s maintenance plan. “(I hit the) gym three times a week—two days of Body Pump and one day of TRX,” she says. Tracy S. adds, “I’ve maintained for two years; I go for three- to five-kilometer walks two to three times a week.”

Tip #4: Watch your weight.
After years of being glued to the scale to (hopefully) watch the number go down, you might think maintenance will allow you to break up with your scale. But people who are most successful at avoiding regain keep that relationship going strong. “If my weight inches up two pounds, all bets are off and I go strictly back to program no matter what’s going on,” says Virginia, who is still down 100 pounds after three years. “I know that I cannot mentally handle gaining the weight back, so I am fanatic about the two-pound rule.” Catherine echoes the benefit of frequent weight checks. “I weigh myself weekly and keep on top of my weight that way,” she says. “I stay more aware of my weight. No more denial. No more avoiding the scale. It’s working for me so far.”

Studies like the one by Cal Poly are just more confirmation of what successful maintainers know through trial and error: a positive mindset and a no-excuse approach to making good choices are the best tools in your VSG maintenance arsenal.

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