What Makes Some People More Successful than Others Post-Bariatric Surgery?
Bariatric surgery is the most effective treatment for severe obesity, resulting in significant weight loss and the improvement, prevention, and/or resolution of many related diseases, including type 2 diabetes, heart disease, hypertension, sleep apnea, and certain cancers1. Bariatric surgery is as safe or safer than some of the most commonly performed surgeries in America, including gallbladder removal, appendectomy, and knee replacement surgery1.
By one year post-op, patients may lose as much as 77% of excess body weight*, and on average, five years after surgery, patients maintain about 50% of the excess weight lost1. *The excess weight % is calculated based on the Ideal Body Weight (IBW) tables, not to be confused with total body weight.
So what is it about those people who are successfully keeping the weight off long term, versus those who experience some weight regain? As a bariatric dietitian with 10 years of experience, I have seen a lot of recurring trends with my patients in those who do well, and those who struggle to lose as much as they wanted or who experience weight regain years later after their surgery. I’m going to share with you some of the insights I have seen, as well as things that are demonstrated in research that help people be successful with long-term weight loss, so you too can be a success story!
- If You are Pre-Surgery Start Making Healthy Changes TODAY. This is one of the biggest contrasts I see between patients. Those who take their health seriously and start right away making improvements to the way they are eating, working to manage stress, prioritizing sleep, and starting an exercise routine tend to be more successful than those who wait until the last minute before or after surgery to begin to make any changes at all. Start out with small, manageable goals instead of making drastic overhauls overnight that will make you feel overwhelmed. Your bariatric dietitian will help guide you with goal setting at your initial clearance appointment.
- Have Realistic Expectations. Weight loss after surgery is not a perfectly linear, downwards sloping line. There will be ups and downs and periods where weight loss will slow down and then pick back up again, and this is completely normal. Weight can fluctuate by several pounds on a day-to-day basis depending on several factors: sodium intake, bowel movements, sleep changes, fluid intake, sweating, muscle soreness, and exercise, as well as menstrual cycles. Weight loss stalls will happen to everyone at various points throughout the post-op timeline, and it is nothing to panic about. It is more important to pay attention to the week-to-week and monthly trends with your weight, and not the daily fluctuations.
- Don’t Ignore Your Mental and Emotional Health. Bariatric surgery is not just a physical transformation; it’s an emotional one too, and many people underestimate that. Neglecting your mental and emotional well-being can hinder your success or sabotage your efforts. Seek support from friends, family, and mental health professionals, and be sure to attend bariatric surgery support group meetings regularly to help you to navigate the emotional aspects of your journey. Meeting with a psychologist/psychiatrist can help you find healthy ways to manage stress, prevent emotional eating or food addiction, identify barriers to change and ways to overcome them, and change unhealthy habits that are preventing you from achieving your goals.
- Avoid Having an “All or Nothing” Mindset. You don’t need to be doing everything perfectly all the time in order to be successful. Aim to have an 80/20 balance when it comes to your diet. If you make healthy choices 80% of the time, that will allow you 20% flexibility for fun foods that bring you joy that you may have at special occasions and celebrations or those moments that you were caught unprepared.
- Get into a Consistent Exercise Routine. In the first couple months following surgery you will be losing weight quickly and not feeling hungry, which can give people a false sense of security that the surgery is going to do all the work for you, and that you don’t have to put in much effort. This is a common mistake! Do not underestimate the importance of regular physical activity. Not only does it help aid in the weight loss process, but exercise also helps promote overall well-being mentally by reducing stress and anxiety and helping improve sleep quality. Set exercise goals that are specific and realistic based on your current fitness level to help guide you and keep you on track. 10 minutes is better than 0 minutes and we all have to start out somewhere! Incorporate both cardio and light resistance training into your exercise routine to prevent loss of lean muscle tissue as you are losing weight. See previous blog posts regarding exercise for further information.
- Don’t Compare Yourself to Others. Everyone’s journey is different, and everyone’s bodies and health backgrounds are different. Some people lose weight faster than others, and some people are slower losers; and that is perfectly okay! Slow and steady wins the race. Faster weight loss is not always better, and can result in losing lean muscle mass in addition to fat mass. Nothing will rob you of joy faster than comparing yourself to other people. Focus on how far YOU have come, thinking back to where you started and celebrating where you are now!
- Keep up with Follow Up Appointments. Regular check-ins with your healthcare team are crucial for monitoring your progress, addressing concerns, checking vitamin levels to screen for deficiencies, and ensuring you’re on the right track. You will receive follow-up phone calls from your bariatric dietitian (me!) post-operatively at 2 weeks, 2 months, 4 months, 8 months, and 18 months following your bariatric surgery. These calls are in between the dates of your follow-up visits with your surgeon/nurse practitioner, which are 1 week, 1 month, 3 months, 6 months, 9-12 months, and once per year thereafter. Consistency is key to a successful bariatric journey. Life happens, and things come up unexpectedly sometimes. if you have to cancel a follow-up appointment, be sure to call back to reschedule!
References:
1. American Society for Metabolic and Bariatric Surgery
