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Three Components of Success After Bariatric Surgery

By Carl A. Weiss, III, MD PhD FACS


One of the most important concepts that is often overlooked is the importance of behavioral change that must occur to have success after bariatric surgery. Regaining health and improving quality of life are the general goals of most people who have discussions with surgeons about choosing to have bariatric surgery However, change must occur in three main areas of daily behavior to ensure success.

We emphasize first and foremost protein-based nutrition. Minimizing carbohydrates seems to be a predictable way to achieve a significant weight loss in the first 6 months after surgery. This takes education, awareness and commitment to be successful on a daily basis. Patients with insight and motivation are generally able to make significant changes in the daily food choices. To think that safe and successful weight loss will occur WITHOUT real changes in eating behaviors is unrealistic.

Eating technique must also change. Obviously, portion size is a key component to healthy eating habits. Chewing thoroughly, eating slowly and avoiding dry foods is especially important for both adjustable gastric band and gastric bypass patients. Rich and high fat foods are often accompanied by uncomfortable feelings. The dietician’s role in patient education cannot be underemphasized.

Finally, the role of exercise must be emphasized. Weight loss after bariatric surgery can come in different varieties and flavors. Some patients lose muscle mass and notice weakness while others can see changes in the color of their skin and hair loss. These changes are most characteristic of rapid weight loss after gastric bypass and much less common during the slower weight loss associated with the adjustable gastric band. A vigorous aerobic exercise plan in our opinion effectively corrects for the sometimes seen “unsafe” or “unhealthy” weight loss. Exercise helps to improve strength by enhancing body composition through the maintenance of muscle mass. Endurance is improved and overall quality of life changes are more noticeable when exercise is part of the daily behaviors. Patients who learn to love exercise seemingly have the best outcomes after bariatric surgery and as a result see dramatic improvement in both their health and overall quality of life.

Bariatric surgery for most patients is a life saving intervention. To get the most out of this opportunity, the above mentioned principles need to be put into practice every day for long term success.