Many potential bariatric patients erroneously think that bariatric surgery is a magic bullet and that the procedure alone will correct their excess weight and obesity-related health problems. Patients who go into the surgical process thinking that all their issues will be handled in one fall swoop are unknowingly perpetuating the stigma that we try to fight – that bariatric surgery is the easy way out. Let’s talk about why patients may believe that surgery will resolve all their issues. The reason for this is simple:
About 90% of obese patients who try to lose weight through diet and exercise alone fail to do so. They may lose 50 or even 100 pounds, but in time that weight often returns, and they can sometimes gain even more. On the other hand, patients who have bariatric surgery see the flip side of those results. About 90% of patients can maintain significant weight loss over the long term. It must be the surgery, therefore, right? Not exactly.
Bariatric surgery is simply a tool that creates a framework for the patient to take on the responsibilities they have for their health after surgery. Bariatric surgery often catalyzes physical, emotional, and psychological changes; some procedures also offer hormonal benefits. However, without strict compliance, patients can “cheat” their way to weight regain.
It is up to the patient to limit what they eat and exercise according to their postoperative plan.
Success Starts Before Surgery
Before undergoing bariatric surgery, patients must understand that success is mainly in their hands. That means patients must be willing and able to change their diet, exercise, and lifestyle. This lifestyle change is critical to recognizing the full effects of the surgical procedure. While a complete lifestyle change may seem daunting, patients should receive solid support from their bariatric team, as most high-quality bariatric programs will offer significant post-operative care. With proper planning, this support can also come from close friends and family. Enlisting those closest to the patient helps the journey to weight loss and disease resolution and can be a powerful tool to ensure they remain on track. Some patients even decide to have bariatric surgery around the same time as their spouses (we suggest about 1-2 months apart) for added support.
Patients can and should ask questions and learn tips and tricks to help them through their post-surgery life changes. These opportunities are available through a myriad of online and practice-based support groups. Here are a few to consider:
- Be open and communicative with those closest to you. While bariatric surgery will make it easier to lose weight, it doesn’t mean you won’t experience the ups and downs of any lifestyle change. There will be times when you’re frustrated, and these are the times when your progress is most at risk. By including family and friends in both the wins and losses of your postoperative life, you create an inherent support system that challenges you when needed, cheers you on when appropriate, and picks you up when you fall. It can be hard to open up and trust someone else, but you did so with your decision to have bariatric surgery, and you can do so again.
- Right size your expectations. One of the biggest frustrations we, as bariatric surgeons, have is when patients set incredibly lofty goals that can’t be achieved today or in a year. This doesn’t mean we don’t believe in you – we’ve seen patients achieve what we otherwise thought was impossible. But that doesn’t mean it should be your goal from the outside. Evidence and our experience show that setting many small intermediate goals eventually build to allow you to reach those more prominent, seemingly unattainable achievements. We will be rooting for you along the way, but we don’t want you to set goals that aren’t achievable right now and push yourself into a state of frustration that ultimately makes it far easier to derail from your plan.
- Give yourself some grace. We all have bad days and times when frustrations get the best of us. We’ve beaten ourselves up over the years for our excess weight and inability to maintain the weight loss that we achieved. The same happens after bariatric surgery too. Our patients often don’t realize how far they’ve come, even with incredible weight loss progress. It’s tough to look in the mirror and see imperfections six months or even a year after surgery. But these imperfections are far less imperfect than at the beginning of the process, and these achievements must be recognized. While we don’t suggest celebrating with food, there’s nothing wrong with standing in front of the mirror and pointing out all of the achievements you’ve accumulated. Is your blood work looking great? Is your waist size significantly smaller? Are you able to enjoy activities that you couldn’t before? Telling yourself that you’ve made progress, even if you haven’t reached your goal, is a great way to overcome your negative thoughts during your weight loss process.
Ultimately, with dedication and an eye on health, patients can achieve excellent weight loss and disease resolution results no matter what bariatric procedure they undergo. Patients should remember that weight loss surgery is a tool to help them change their lives, but they have the ultimate responsibility to achieve their goals. That responsibility is physical – how we treat our bodies through diet and exercise – and mental in how we think about ourselves and our achievements. To that end, we must take responsibility for our actions and inactions and implement changes to get us to our goals.