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How to Succeed After Bariatric Surgery
Follow-Up Appointments
Follow-up is extremely important with bariatric surgery. Lifelong follow-up
appointments are expected and need to be scheduled with the office staff. Of course,
visits with other specialists are encouraged, should you have any problems. Initially
you will have many appointments during the first year, especially if you have had
the Lap-Band® procedure. Long-term, your surgeon will expect to see you once
a year. It is probably a good idea to have your annual physical exam scheduled with
your primary care physician before your annual surgical appointment. The primary
care physician can have testing done which can then be reviewed with you by your
bariatric surgeon.
Expected Weight Loss
Roux-en-y Gastric Bypass
Gastric Bypass patients experience rapid weight loss in the first 12-21 months following
surgery. Studies suggest that patients lose an average of 60 to 80% of excess body
weight. After 21 months, the stomach pouch has stretched to hold more food. This
stabilizes the weight loss. At this time, is critical to adhere to the low fat,
low sugar diet and exercise recommendations to maintain the weight loss.
Laparoscopic Gastric Banding
Lap-Band® patients will have progressive weight loss for the first
2-3 years following surgery. The patient can, however, continue to lose excess body
weight up to 6 years. Studies show that banding patients lose an average of 50 to
60% of excess body weight.
Research has shown that bariatric surgery patients who exercise 3 or more times
per week for a minimum of 30 minutes each time lose an additional 12% of their excess
weight in 6 months compared to their peers who do not exercise as strenuously.
Lifestyle Changes
You cannot lose weight without having a healthy lifestyle. Here are some
simple things you can do right now to keep yourself, your friends and your family
on track:
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Get rid of all the junk food in your house. (No, the kids don't need junk food).
Restock your cupboards with healthy snacks your whole family can enjoy.
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Set aside time for fun and outside play.
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Have a daily schedule to ease the chaos and decrease some of the stress in your
life. This may mean taking some activities out of your schedule or your kids' activities.
Often, we plan to do more than we have time for.
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Cut the time you and your family spend each day watching TV or using the computer.
Spend more time doing more active things such as playing outside with the kids or
going for a walk.
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Plan your social life with activities that do not include food, such as going out
dancing rather than going out to dinner.
Maintaining the Weight
We have been referring to bariatric surgery as a tool to help you lose
weight. The goal of the surgery is to allow you to lose weight with the fewest possible
restrictions to your diet. It is not automatic, and your behavior after surgery
plays a very large part in your outcome. How you use the tool will affect your weight
loss.
Gastric bypass works in part by making the stomach much smaller so that you feel
full sooner. It also works to curb the appetite because the food goes quickly into
the small intestine, and chemical messages are sent to the brain telling the satiety
centers that food is present. The surgery will give you a full feeling on a much
smaller meal, improve the sense of self-control and help many avoid sugary foods
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The lap-banding patient will feel full sooner also because the pouch above the band
is smaller than the stomach below it. This, in turn, will restrict the patient from
ingesting more food than necessary.
By eating only at mealtime and only until you feel full, your daily food intake
will be decreased enough to provide weight loss. The weight loss will vary from
week to week and may plateau for days and up to two weeks at a time. If you are
at a plateau during the first 6 months post-op that lasts longer than two weeks,
please call the office.
Gradually, the rate of weight loss will decrease and your weight will stabilize.
Your responsibility is to avoid snacking and grazing (continuous nibbling); and
to choose healthy foods, become more active and exercise regularly and nurture the
process of recovery from obesity. Participation in group meetings will help you
through the surgery process and the years to follow. Also be sure to keep your regular
office appointments so that your weight loss can be maximized and your health monitored.
Again, surgery is a tool, something to help you accomplish your health goals. There
will be adjustments that you will need to make. The bariatric team will be glad
to guide, support and motivate you. We know that you can do it!
The 8 Rules of Weight Loss
There are eight rules that we have found helpful for weight loss success. All successful
patients have these things in common.
- Consumption of an adequate amount of liquid, preferably water, is crucial. You should
consume a minimum of 64 oz. of liquid each day. This can only be done slowly, sipping
fluids throughout the day. Gastric bypass patients should never drink more than
2 ounces of liquid quickly. On very hot or humid days, or when exercising, you should
drink additional water. This is necessary in order to prevent dehydration.
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Only eat at mealtimes. Between-meal snacking or “grazing” on small amounts
of food throughout the day will sabotage your weight loss and result in the inability
to lose an adequate amount of weight.
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The primary source of nutrition should be protein. 70 to 75% of all calories consumed
should be protein-based (eggs, fish, meat, etc.) Carbohydrates (bread, potatoes,
etc.) should make up only 10 to 20%, and fats (butter, cheese, etc.) only 5 to 15%
of the calories that you eat. A diet consisting of 600 to 800 calories and 75 grams
of protein should be the goal for the first 6 months.
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Never drink liquids when eating solid foods. Liquids should be avoided for a period
of 30 minutes before and 30 minutes after eating meals.
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Avoid foods and liquids which contain sugar or high fructose corn syrup. Not only
will they slow down your weight loss, but they may make you sick! Sugar may cause
“dumping syndrome” in patients who have had the gastric bypass procedure.
"Dumping", in short, is when sugars go directly from your stomach pouch into the small
intestine causing heart palpitations, nausea, abdominal pain and diarrhea.
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Stop eating and drinking when you begin to feel full. Listen to your body's signals.
Do not think about the food that is left on your plate. Overeating and overfilling
your stomach pouch will cause your pouch to stretch and may prevent weight loss
success - or worse - cause long term problems and complications.
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It is essential that, within the first 6 weeks after surgery, you begin a regular
exercise program, like walking, swimming, bike riding or etc. Research indicates
that this will increase your overall weight loss by 12% in 6 months.
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Attend support group meetings and workshops. They will help you stay focused and
motivated and help you work through the changes that weight loss brings. Plus, you
might just make a few new friends!
Changes
As you lose weight, you may notice other changes in your body. You may
experience increased energy levels and you should be able to sleep better at night.
You can anticipate resuming a more normal life soon after recovery. As your weight
decreases, more physical activity will be possible. Ongoing exercise will be important
for calorie burning, muscle tone, and a sense of well-being.
Long term, you can anticipate doing things you were not able to do before. Traveling,
eating in restaurants and other pastimes will be more enjoyable. You may also experience a more positive self-image.
Reconstructive/Plastic Surgery
Patients who lose more than 100 pounds may also face another challenge – excess skin. You may notice excess skin folds and wrinkles where the greatest weight loss has occurred. This is especially noticeable on the face, upper arms, chest and abdomen. Reconstructive surgery can correct these issues if needed, but it should be delayed until your weight loss has stabilized for at least one year.
We will be glad to discuss this with you and recommend an experienced surgeon.
Patients who lose more than 100 pounds may also face another challenge – excess skin. You may notice excess skin folds and wrinkles where the greatest weight loss has occurred. This is especially noticeable on the face, upper arms, chest and abdomen. Reconstructive surgery can correct these issues if needed, but it should be delayed until your weight loss has stabilized for at least one year.
We will be glad to discuss this with you and recommend an experienced surgeon.
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