success after bariatric surgery

10 Keys to Success After Bariatric Surgery

April 3, 2017

Taking the journey of weight loss surgery (WLS) is a rewarding gift thousands of people choose to take. One of the most enjoyable aspects of my role as a Bariatric Registered Dietitian is hearing patient success stories. I often have patients report post-surgery they have an overall increase in energy levels and are able to run and play with their children again. Simply put: they’re living without pain.

The period from the first year to 1-1/2 years after surgery is considered the “Active Weight Loss Period.” You often don’t hear the bariatric community discuss keeping the weight off or what we call weight maintenanceFrom my experience working with bariatric surgery patients, there are 10 tips that promote keeping the weight off; enjoying a lifestyle centered on health and wellness.

10 Keys to Success After Bariatric Surgery

1. Surround yourself with a circle of support

Bariatric surgery is more common than you think. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), approximately 196,000 bariatric procedures were performed in the year 2015 and is rising.

Your support system can come from a variety of sources: attend your local support group, plan regular outings with peers who have had surgery and are doing well, and most importantly to follow-up regularly with your bariatric clinic. Support groups are an opportunity to develop personal relationships with other bariatric patients while staying on track. I encourage my patients to have a meal with other successful patients so they can observe food choices, portions and eating behaviors.

2. Get moving

I see post-operative patients daily in our clinic ranging from a few months out of surgery to 10+ years post-op. A patient who is doing well in weight maintenance is most likely doing some form of exercise. Exercise is motivating! Patients who put time and effort into their workouts are less likely to make unhealthy food choices. It’s a domino effect. Always receive medical clearance from your physician before starting an exercise routine.

When choosing an activity, find something you enjoy. Think about activities such as Zumba, hiking, water aerobics, yoga or walking. Consider using the “buddy system.” Having a friend or family member attend organized exercise with you increases accountability and can keep you motivated. Some find fitness trackers are a great way to evoke a healthy competitive spirit. Set a goal and aim for our National Health Initiative’s 10,000 step per day goal. Lastly, work activity into everyday life. Take the stairs, park further way, or a lunchtime stroll in the park. Exercise does not have to be in the gym!

3. Know your body's signals

One of the best parts about bariatric surgery is its ability to provide a tool for restriction. We spend a lot of time in our clinic discussing what these signals look like. The body’s sign of fullness is the best place to start. I ask all of my bariatric patients to be mindful of what “full” feels like post-operative. Most patients describe bariatric fullness as the sensation of a slight pressure right below the sternum.

Being in tune with your body’s sensation of fullness with help determine appropriate food portions, especially the first year post-op. It’s also important to determine your body’s sign of overfilling; and, food coming up the throat, pain or uncomfortable pressure. Often, negative sensations after eating are not food-related but more behavioral in nature. Working with your dietitian on the appropriate behavior changes to make pre and post-operative is key to improved food tolerance.

4. The three P’s to meal prep: Plan/Purchase/Prepare

  1. Plan – Plan bariatric-friendly meals for the week to stay on track. A written or electronic meal plan works. I have my patients choose two bariatric-friendly dinner meals each week. Leftovers can serve as lunch for the next day. When going out to eat for a special occasion, glance at restaurant menus beforehand to make your shortlist. When traveling, always carry snacks with protein. Consider using small packs of nuts, protein bars, protein shakes or packs of tuna. Lastly, many of my patients have started experimenting with mail-order meal services. Bariatric-friendly options are available, and for a busy lifestyle, it’s hard to beat.
  2. Purchase – Choose one day out of the week to go to the grocery store. Don’t shop hungry and stick to the list. Most patients would agree that staying on the outside aisles of the grocery store works for avoiding packaged or processed foods.
  3. Prepare – Choose one day to prep your ingredients. Prepare chopped vegetables for your snacks and lunches, then put them in storage containers for each day of the week. Consider preparing a crockpot meal on your day off to use for the week. Prep quick protein and vegetable based meals and snacks, such as bean salads, chicken or tuna salad, soups, and chilis.

5. Avoid grazing throughout the day

Grazing or “picking” on small portions of food throughout the day is a common style of eating pre-op. When bariatric patients are asked to slow their eating speed to 20-30 min per meal, post-surgery eating may mimic grazing. For a successful post-op course, work with your Registered Dietitian to build an individualized meal plan with small, frequent scheduled meals every 3-4 hours.

6. Follow-up with your dietitian

Regular follow-up with your dietitian is essential for the safe transition back to regular-textured foods as you lose weight. Beyond year one post-op, a dietary consult is helpful when the goal is weight maintenance. The dietitian can provide an in-depth meal plan catered to your schedule, promote food variety, review vitamin and mineral requirements and keep you up-to-date on the latest best practices. Many of my patients schedule nutrition follow-up appointments simply to stay accountable and motivated throughout their journey.

7. Schedule non-food treats to stay motivated

Non-food related “treats,” scheduled throughout the week can help you to stay on track while creating a mental outlet. Consider treating yourself to a massage, pedicure, walk at your favorite park or night out at the movies. Reward yourself for sticking to your bariatric plan!

8. Remove negativity/potential sabotage.  Period

9. Regular tracking

There are hundreds of free phone applications that aid in tracking food and fitness. Most patients report that tracking food intake helps target hidden calories. Also, tracking protein and fluid intake as a bariatric patient are crucial. Find a tracking device that works for you!

10. Stay in the know

Keep things interesting. Stay up-to-date with new bariatric products. Consider a rotating menu to add variety, change up your workout routine to keep things interesting.

Surgery day is only the beginning of your weight loss journey. Life after surgery involves deeply rooted lifestyle changes.

Healthy habits that you adopt along the road should be integrated into your lifestyle, not disregarded once you reach your goal weight. Those are the keys to success for years of long-lasting health and wellness.



Kristin Kelly, RD, LDN, got her start working with child/infant and maternal nutrition in addition to private counseling for adult weight and diabetes management. Kristin’s guiding principle is to enjoy what you like in moderation and mindfulness. She works at Bariatric Specialists of North Carolina and helps to provide realistic and long-term solutions for better eating in the midst of our demanding lives.