8 Strategies For Success After Weight Loss SurgeryAugust 11, 2017
As a bariatric psychologist, I meet daily with patients who are looking to have “success” with their weight loss surgery (WLS). They may have tried other ways to lose weight, and nothing is keeping the weight off. I put “success” in quotes because this term means something different to everyone. From meeting with many bariatric patients, I recognize that success is defined as much more than just weight loss. In fact, let's break it down so you can celebrate your own WLS success.
I think it’s most beneficial not to see “success” as a finite goal, but as an ongoing improvement in and commitment to your health and wellbeing. When you think about your own WLS success, what does that look like?
If you have a specific goal of losing an exact amount of pounds from WLS, then you may not think you’ve “succeeded” if you lose any less than your goal. You may wonder if it was a waste of time for you to have undergone surgery.
However, if you see “success” as being an improvement in your health conditions, then you may be very pleased that your diabetes improves and you no longer need to take high blood pressure medicine. If you see “success” as a reduction in pain, improvement in range of mobility, or more energy to play with your kids, then you may also be pleased.
8 Strategies For Success After Weight Loss Surgery
1. WLS Is Not A Quick Fix
Some patients I evaluate are looking for a quick fix. They may know that their weight is inhibiting their daily life, but they think, “Oh, if I get this surgery, I will lose all of this extra weight and keep it off.” What people don’t realize is that the process is much more interactive than that.
The stomach is a muscle. It can stretch. When individuals become bariatric surgery candidates, they have to limit their food intake, specifically by eating smaller portions. If the individual does not, and eats larger portions than the stomach can hold, the stomach can stretch and the individual can regain all the weight they've lost and even more on top of that. This is not a quick fix surgery. A huge life change such as this takes your participation, and can’t be expected from the surgery itself. Which leads me to…
2. Work With Your WLS As A Tool
WLS will not work on its own. It requires a commitment to behavioral change. Changing behavior, our own and most definitely others’, is difficult, if not sometimes impossible. If you approach WLS as a tool to help you achieve your goals or expectations, I think it will empower you and make you a real partner in the quest.
If you expect the surgery to do all the work for you, you might be in for a rude awakening. You will have to work with the surgery to change your eating behaviors, incorporate physical activity into your life, if you don’t already, take vitamins to prevent malnutrition, if prescribed, and keep your appointments at your bariatric clinic. A big commitment, but not one you cannot achieve if you work with the surgery.
3. Take Care Of Your Whole Self
This can’t be understated. Your whole self will be going through a dramatic life change before, during and after your surgery. Not just your body. Not just your brain. Not just your digestive tract. Your whole human self. Take care of yourself by getting enough sleep, minimizing stress, finding ways to manage stress which don't involve eating (this will be important post-surgery to avoid emotional eating), spending time with social support, and resting when you feel you need to.
4. It Is Very Difficult To Change Behavior…Be Patient With Yourself
Above all else, recognize that this is a process. It doesn’t start and end the day of the surgery. Days, weeks, and months before, practice making small, realistic changes little by little. That will eventually make it easier to incorporate the changes into your daily life. Be kind to yourself. Recognize that any change is difficult, so be patient with yourself. You’re not going to change all of your eating habits, exercise habits, and coping strategies at once. Perhaps try some coping self-talk: “I will take this a step at a time, “Change is hard, but I am committed to this for my health.” Any phrase that works for you. Nobody knows how you feel but you.
5. WLS Won’t Stop You From Eating Certain Foods; You Have To Exert Control
People mistakenly think that just because the bariatric surgeries will reduce the size of the stomach, they will automatically switch to foods that are compliant with the bariatric diet. The notion of behavioral action and behavioral control doesn’t seem to play into their understanding. Even though your stomach is the size of an egg, that won’t automatically make you comply with the food/eating requirements. You have to want this change in your lifestyle. You have to commit, as best as you can, to the changes it requires. Therefore, you'll have to deliberately think about what you're eating, how much, when, and all the other circumstances around eating. Your stomach won’t do it for you. But it will give you signals, so…
6. Listen To Your Body
Before your surgery and especially afterward, your body will be giving you signals. Ask yourself “Am I full? Wait, I feel stuffed. Am I hungry? Wait, I hear my stomach growl.” If you listen to your body, and begin that as a practice weeks, if not months, before your surgery, you will become more attuned to noticing when you’re full, hungry, and maybe when you’re just eating because you’re bored, angry or stressed. These cues are essential to pay attention to. They are your internal guideposts to understanding your body. For example, you want to be careful about eating when emotional, for comfort, because you may lose control over how much you eat or what you eat.
7. Seek Support, People Who Will Be There For You When You Are Stressed
One of the questions I ask people is, “What kind of social support do you have before, during and after this surgery process?” I want to make sure patients understand that a life-changing surgery such as bariatric surgery will, no doubt, bring up times of stress. Stress is the body’s response to change, could be positive changes like being promoted or moving to a new home or negative changes like a loss. It is more than beneficial to have people there to support you with a) the day-to-day changes you’ll have to make, which include changes to what you eat and how often, and b) people to lean on to help you navigate these big changes, to listen to the challenges you may face. Social support is essential.
8. Recognize Your Body Will Go Through Changes…That’s To Be Expected
Once you’ve had your bariatric surgery, your digestive system will have changed. You will no longer be able to hold the same amount of food in your stomach. You may need to take daily prescribed vitamins.
Sometimes, and this concern comes up quite often with patients, people have to deal with “extra skin.” It can happen when a person loses a lot of weight, they may have extra or hanging skin. Being prepared mentally for this change, so it doesn’t surprise you, may help you adjust to this. Some people are more bothered by the extra skin than others. It can affect you emotionally in how you see yourself and your body image. I think it’s important to prepare for these body changes mentally, so you can do what is needed to maintain your own self-esteem and motivation.
Success means different things to each of us. The measure of success isn't limited to the scale. Recognize the changes you've made and celebrate your own definition of success.
ABOUT THE AUTHORDr. Randi Dublin is a Bariatric Psychologist at Harlem Hospital Center, Physician Affiliate Group of New York serving the Greater New York City Area. She is a licensed clinical psychologist with dedication to physical and behavioral health integration via research, writing and clinical work. She has experience with evaluation of readiness and promotion of health-behavior changes and extensive training in evidence-based psychological interventions for anxiety disorders and depression.