Weight Loss Achieved, But Cholesterol Concerns Persist?
**Context:** Over the last four years, I have embarked on a weight loss journey in preparation for bariatric sleeve surgery. My initial weight was 470 pounds, with a peak at 490 pounds. The program mandates that individuals must weigh under 400 pounds to qualify for the procedure. I committed to this challenge by joining a gym and transforming my eating habits. I delved into nutrition and fitness literature, meticulously tracked my caloric intake to maintain a deficit, engaged in meal prep, and significantly increased my physical activity. I worked out regularly, dedicating two hours, three times per week, and ultimately reduced my weight to 390 pounds before my surgery, which took place in September 2025 when I weighed 370 pounds. Prior to the operation, I carefully planned my post-surgery diet, breaking it down into phases: two weeks of clear liquids, followed by one week of non-clear liquids, then one week of pureed soups, progressing to soft foods, and finally reintroducing solid foods gradually. Since undergoing the surgery, I have maintained a consistent exercise routine that includes swimming three times a week. On days I cannot swim, I switch to gym workouts that incorporate cardio and resistance training. Currently, my schedule involves gym sessions on Mondays, Wednesdays, Fridays, and Saturdays, while swimming takes place two times a week on Tuesdays and Thursdays. I continue to prioritize meal prep and track my calories, and I recently visited the doctor, revealing my weight has dropped to 296 pounds. **My Inquiry:** After undergoing lab tests three months post-operation, the majority of my results were favorable, but my cholesterol levels are concerning. Despite my efforts, not only has my cholesterol remained elevated, but some figures have even risen. This predicament is both frustrating and disheartening, prompting me to seek advice on additional measures I can take. I am incorporating regular exercise, achieving weight loss, and consuming an ample amount of fiber through vegetables, fruits, beans, and even adding psyllium fiber to my protein shakes. Here are my results from 2024 to the present: - Cholesterol: 189 → 210 - HDL (Good Cholesterol): 42 → 45 - Triglycerides: 345 → 147 - LDL (Bad Cholesterol): 101 → 139 - Cholesterol/HDL Ratio: 4.5 → 4.7 - Non-HDL Cholesterol: 147 → 165 Is this a common occurrence? Am I missing something in my approach? I am at a loss regarding what I might be doing incorrectly, and I would appreciate any medical insights. I plan to follow up with my primary care physician and my bariatric team, though I anticipate some delay in their response—a delay that adds to my stress, as I am eager to implement changes swiftly.
Answers (1)
2/7/2026, 11:10:33 PM
OpenHealth AI
It's commendable that you've made significant lifestyle changes and successfully lost weight. However, it can indeed be frustrating to see your cholesterol levels not improving as expected post-surgery. Let’s break down your situation and consider actionable steps you can take to address your cholesterol concerns.
Main Points:
- Elevated cholesterol after weight loss surgery can occur for several reasons, including dietary choices and metabolic changes.
- You've made positive changes, but there might be additional factors affecting your cholesterol levels that we can address.
Explanation:
Cholesterol levels can be influenced by various factors, including genetics, diet composition, and exercise. After bariatric surgery, your body undergoes significant metabolic changes, which can affect how your body processes fats and cholesterol. It's not uncommon for some patients to experience fluctuations in cholesterol levels in the months following surgery.
Key Observations from Your Results:
- Your triglycerides have decreased significantly, which is a positive sign.
- Your LDL ("bad" cholesterol) and total cholesterol have risen, and your HDL (“good” cholesterol) has only slightly increased.
- The Cholesterol/HDL ratio has not improved, suggesting there is still work to be done on optimizing your cholesterol levels.
Next Steps:
-
Revise Your Diet:
- Healthy Fats: Focus on incorporating more sources of healthy fats (like avocados, olive oil, nuts, and seeds). Limit saturated fats found in full-fat dairy and fatty cuts of meat.
- Omega-3 Fatty Acids: Include sources of omega-3s (like fatty fish, walnuts, flaxseeds) to help improve lipid profiles.
- Reduce Sugars and Refined Carbs: Minimize processed foods, added sugars, and refined carbohydrates that can negatively impact cholesterol levels.
-
Increase Fiber Intake:
- While you’re already consuming fiber, consider emphasizing soluble fiber sources even more (like oats, barley, beans, lentils, and citrus fruits) as they can be particularly effective in lowering LDL cholesterol.
-
Stay Active:
- Continue your regular exercise routine but consider incorporating more cardiovascular exercises, such as brisk walking, running, or cycling, which can contribute to lowering cholesterol levels. Aim for at least 150 minutes of moderate aerobic activity each week.
-
Hydration and Weight Monitoring:
- Stay well-hydrated and monitor your weight consistently. Even small fluctuations can sometimes influence metabolic processes.
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Manage Stress:
- Consider stress management techniques, such as mindfulness, yoga, or counseling, which can be beneficial for both mental health and physical health. Stress can impact cholesterol levels as well.
-
Follow-Up with Healthcare Providers:
- Continue working with your primary care doctor and bariatric team, and express your concerns about the cholesterol levels. They might recommend further testing or possible medications if lifestyle changes don’t yield results in the coming months.
Conclusion:
It's understandable to feel stressed about your cholesterol levels, but you're taking significant steps in the right direction. By refining your dietary approach, staying physically active, and effectively managing stress, you can have a positive impact on your cholesterol profile. Keep tracking your progress and maintain open communication with your healthcare team for further support. You're not alone in this journey, and every small step counts.
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