10 helpful tips with bariatric surgery 2

10 Tips for Success With Bariatric Surgery

May 9, 2018

Whether you're researching weight loss surgery, a pre-op, or post-op patient, helpful tips with bariatric surgery are good to have to keep in mind. Even for new or long-term post-ops, I hope these tips will support you as reminders for your journey.

10 Tips for Success With Bariatric Surgery

1. Focus on making your meals smaller and eating slower

Both the sleeve gastrectomy and gastric bypass bariatric surgeries result in restriction. The sleeve is a restrictive only procedure and the gastric bypass combines a restrictive component with a reconfiguration of your small intestine that results in malabsorption.

It takes 20 minutes after activation of gastric stretch receptors before your brain senses satiety.

The restrictive component allows you to not be hungry with a small meal but you are in control of food volume and food composition. Choosing the wrong foods can torpedo your weight loss. Eating too fast without measuring your food volume will set you up for failure. Eating too fast without measuring food volume can lead to overeating. Slow down your meals. If that is not physically possible for you, then you must measure your meals to make sure you do not overeat.

2. Protein will be your friend

Protein is a more complex part of your meal. It takes your body longer to break down and absorb protein.

As a result, you can remain satisfied with a 4-ounce protein meal for 4 to 4.5 hours, long enough to make it to your next meal. A carbohydrate meal is broken down faster and you get hungry much sooner. In addition, because protein is broken down more slowly, you do not get the jump in your blood sugar that you do with a carb meal. Consuming 80-90 grams of protein daily in the first six months also helps to reduce hair thinning.

3. Take your vitamins

Following sleeve gastrectomy and gastric bypass, you will be shrinking your meals down to 4 ounces so you need to take supplemental vitamins as you will not be eating a large range of food you do today. With gastric bypass, you will have difficulty absorbing B vitamins (B1, B6, B12) so vitamin supplementation is critical to long-term health and wellness.

4. Work on strength training in the early phase of weight loss

With sleeve gastrectomy and gastric bypass, patients will lose 50-60 pounds in the first six months. Studies have shown that 20% of that weight is lean tissue or muscle. Loss of muscle leads to a lowering of your basal metabolic rate which can be an issue at 1-2 year after surgery.

Exercise research has shown that aggressive strength training (3 times weekly with a trainer) can preserve 90% of the lean tissue you might otherwise lose.

5. Aerobic exercise should be high-intensity interval training

Almost 5 years ago, the AMA recognized obesity as a disease. The reason for this recognition was all of the metabolic changes that occur in your body once your body mass index (BMI) rises above 30. One of those changes is a change in the composition of your muscles with weight loss. This change means that you burn fewer calories with low impact and moderate aerobic exercise.

One way to partially overcome this change is to use HIIT (High Intensity Interval Training) as a big part of your aerobic exercise. You can use a HIIT protocol with almost any type of aerobic exercise. HIIT pushes the intensity of your workout to a maximum level for a short period of time followed by a period of less intense activity, you cycle through this pattern for 4-5 cycles. Due to the intensity of effort, you usually will exercise for a shorter period of time.

6. Focus on habit change for long-term success

The key to long-term success in weight loss surgery is how you make the necessary changes to your lifestyle that promote long-term success. Controlling food volume, focusing on protein, increasing activity, tracking your weight and intervening when it pops up are all habits that help you maintain long-term success.

The National Weight Control Registry is a registry of 10,000 patients who have lost at least 50 pounds and kept it off for at least 5 years. It is a great resource for you to help identify and use the new habits to help you keep your weight off. Trying to change habits with a buddy is another great way to help you be successful. A buddy helps you remain accountable for your new habits.

7. Focus on what has improved in your life not what is missing

Frequently, patients mention things they used to eat that they cannot eat now. Success following weight loss surgery is dependent on developing and maintain new eating habits. Habit change is hard and we all struggle to incorporate into our lives those habits that lead to long-term success.

Your weight loss will totally change the way you look and the clothes you will wear. You will be able to do activities like running, skydiving, zip lining, etc that you were not able to do before surgery. Focus on all these wonderful improvements in your life. Put a picture of the new you on the fridge doing one of your new activities. Keeping front and center what is new and wonderful in your life will help not look back at what you have left behind.

8. Look for a program with strong on-going follow-up

Programs that closely follow and push their patients have better long-term success. When selecting a bariatric surgery program, look at how much support they provide their patients after surgery.

9. A comprehensive program with medical weight loss & weight loss medications

All weight loss surgery patients will have periods where they struggle to maintain weight loss. When selecting your weight loss surgery program, look for a comprehensive program that can support you with medical weight loss and weight loss medications if needed. A comprehensive program will be able to help you in multiple ways to maintain your hard-fought weight loss.

10. Look for a high-volume bariatric program in an MBSAQIP Accredited Center

Success in weight loss surgery does depend on the program you select. Look for a surgeon with a high volume. That surgeon will have a lot of experience navigating anything that can occur after surgery.

You want to have surgery in a hospital that has an active MBSAQIP accreditation. MBSAQIP is a joint effort between the American College of Surgeons and the American Society of Bariatric and Metabolic Surgery. The program is reviewed by a board-certified surgeon who is actively practicing bariatric surgery. An MBSAQIP program will have better outcomes and higher volumes.



Dr. John Angstadt is a board certified and fellowship trained surgeon with vast experience in general surgery, transplant surgery, as well as minimally invasive and bariatric surgery He founded and developed the only bariatric surgery program in South Georgia. Dr. Angstadt has expertise in various weight loss surgeries and is also the director of the comprehensive and multidisciplinary medical weight loss program at New York Bariatric Group.

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