Life After Bariatric Surgery

How will your life change after bariatric surgery?

Bariatric, or weight-loss surgery can bring about significant changes in your life, both physically and emotionally. While the exact changes you will experience may depend on your individual circumstances, here are some general ways that weight loss surgery can impact on your life.

Improved Physical Health: One of the main benefits of weight loss surgery is that it can help improve your physical health. Losing weight can help reduce your risk of developing chronic conditions such as diabetes, high blood pressure, sleep apnoea, and heart disease. It can also alleviate joint pain and improve mobility.

Increased Energy Levels: Losing weight can also help increase your energy levels. With less weight to carry around, you may find that you have more energy to do the things you love and feel less fatigued.

Better Mental Health: Many people who undergo weight loss surgery report improved mental health, including a reduction in symptoms of depression and anxiety. This can be due to the confidence boost that comes with achieving weight loss goals, as well as the positive impact on health and self-esteem.

Changes in Eating Habits: After weight loss surgery, you will need to make significant changes to your eating habits. This will include eating smaller portions, avoiding certain foods, and eating more slowly. These changes can take some time to adjust to, but they can help you maintain your weight loss long-term. 

Social Life Changes: Losing weight can also impact your social life. You may find that you are more comfortable participating in activities that you previously avoided due to your weight. You may also find that your relationships with others change, as people may react differently to your new appearance.

A Healthier You!

Overall, weight loss surgery can be a life-changing experience that can help improve your physical health, mental health, and quality of life. However, it is important to remember that weight loss surgery is simply a tool – a tool that requires significant effort and commitment on your part to use effectively, to achieve and maintain weight loss in the long-term.

Dr Willingham and his multidisciplinary team can help you to achieve this.

What will your diet look like after bariatric surgery?

After surgery, your diet will undergo significant changes to support your recovery and weight loss goals. Your diet will be different in the first few weeks and months after surgery, and it will continue to evolve as your body adjusts to the changes.  You will need to take bariatric strength multivitamins daily for the rest of your life. Protein powder will need to be used regularly in the early months of your recovery, and in some instances, you may need to rely on protein powder for the long term.

Fluid Stage (Weeks 1-2): In the first few weeks after surgery, your diet will consist of nourishing fluids that are thin enough to pass through a straw (although you should not drink through a straw).  This will include, for example,  shakes, smoothies, soups, and drinking yogurt.  

Puree Stage (Weeks 3-4): You will then progress to pureed foods, such as pureed stews or casseroles made with soft meat and vegetables  You should consume 3-5 meals per day, and your meal portions will be approximately 1/4 cup in size.  You must also avoid drinking fluids the half hour before a meal; during the meal; and the half hour after a meal.

Soft Stage (Weeks 5-6):After the pureed food stage, you will move on to soft foods that are easy to digest, such as scrambled eggs, soft cooked vegetables, and ground meats. You will need to continue eating 3-5 small meals throughout the day and must avoid high-fat, high-sugar, and high-carbohydrate foods. You must continue to avoid drinking fluids the half hour before a meal; during the meal; and the half hour after a meal.

Solids Stage (Week 7 onwards): As you continue to recover and lose weight, you will transition to solid foods, but your diet will still be limited in terms of portion size and food choices. You will continue to avoid foods that are high in fat, sugar, and carbohydrates, and focus on protein-rich foods, such as lean meats, fish, eggs, and dairy products. You must continue to avoid drinking fluids the half hour before a meal; during the meal; and the half hour after a meal.

A year after surgery, your diet will likely consist of small, frequent meals that are high in protein and low in fat, sugar, and carbohydrates.  Most patients will need to avoid foods that are difficult to digest, such as raw vegetables and tough meats. Your diet will also need to be nutrient-dense to support your health and recovery. And you must continue to avoid drinking fluids the half hour before a meal; during the meal; and the half hour after a meal.

It is important to note that your diet will be customised to your specific needs and medical history, and you will work closely with our dietitian to develop a meal plan that works for you. Your diet may also evolve over time as your body adjusts to the changes from surgery and as you continue to lose weight.

Tips for healthy eating behaviours ...

While bariatric surgery can be an effective tool for long-term weight loss, it also requires significant lifestyle changes to maintain a healthy weight. Healthy eating behaviours are key to successful weight loss after surgery. Here are some tips for healthy eating behaviours after weight-loss surgery:

Do not skip meals: You should aim to eat al least 3 meals each day, as well as have a couple of snacks either side of those meals.  You are unlikely to feel much hunger  in the early months following surgery.  Don’t let yourself forget to have your meals, or be tempted to skip them – set alarms if necessary. Skipping meals may lead to excessive hunger building up, resulting in eating so quickly that it causes you to feel discomfort. You may also find yourself reaching for less nutritious food, or easily available foods like takeaways. 

Eat small portions: Purchase appropriately sized bariatric plates and bowls and USE them to help you control your portions.  It is easy over time to increase portion sizes without being aware of doing so. Persistently overeating can lead to stomach stretching. 

Slow down and chew thoroughly:  Eating too quickly or not chewing your food thoroughly can lead to discomfort, nausea, and vomiting after weight-loss surgery. Take your time when eating and chew your food thoroughly to aid digestion and prevent these problems. Eliminate distractions.

Seperate your food and fluid: Drinking and eating at the same time will overfill your stomach, leading to discomfort. It may also ‘flush’ your food into your bowel too quickly, leading to increased feelings of hunger, and potentially, leading to symptoms associated with ‘dumping’ – sweats, nausea, even diarrhoea.  Avoid this by separating your food and fluids!  Try to always maintain the 30-30 rule – don’t eat or drink within 30 minutes of each other.

Ensure adequate water intake: Sip sip sip throughout the course of the day. It’s easy to become dehydrated if you don’t drink regularly as it is hard to catch up if you forget.  Aim for a minimum of 1.5 litres, and on hot days, push beyond 2 litres.

Focus on protein: Protein is important for building and repairing muscles and tissues, and it also helps you feel full for longer periods of time. Be sure to include high-quality protein sources in your meals, such as lean meats, fish, eggs, and low-fat dairy products.

Avoid sugary and high fat food: After weight loss surgery, it is important to avoid sugary and high-fat foods as they are high in calories and can lead to weight gain. Focus on nutrient-dense foods that provide the vitamins, minerals, and other nutrients your body needs to function properly.

Vitamins and protein powder: Take your vitamins and use your protein power, PLEASE!  These, together with a good diet, will ensure that you maintain not only your weight loss, but good energy levels and in the longer-term – your HEALTH! 

Practice mindful eating: Stop and think before you eat – try to eat to satisfy hunger not because of boredom or emotions.

Food Journal: Consider keeping a food journal. It can help you track your progress, identify problem areas, and stay accountable to your weight loss goals. Write down what you eat, when you eat it, and how you feel afterwards to help you make healthier choices in the future.

How do you maintain weight loss in the long term?

The fact is, that this cannot be achieved without commitment and effort!

While bariatric surgery is a very effective tool for achieving weight loss to begin with, maintaining the weight loss in the long term can be challenging without commitment and effort. It's a simple as that.

Following surgery, you will experience rapid weight loss.  It is normal after dropping to your lowest weight to then regain a few kilos before your weight stabilises. After this point, it would be a good idea to monitor yourself and set a weight range that you are comfortable at.  Should your weight increase by about 3kg or more,  you would be wise to take action to get yourself back to your preferred weight.  The longer that you leave it before taking action, the harder it will be to maintain your preferred weight, and the higher the risk of continuing to gain weight – a very slippery slope!

Some practical tips to maintain weight loss in the long term ...

Follow the recommended dietary guidelines: Dietary guidelines are based on research and evidence.  Following these guidelines after bariatric surgery can initially help your stomach and digestive system heal and prevents complications.  In the longer-term, following dietary guidelines can help you establish healthy eating habits, reach your weight-loss goals, and prevent nutritional deficiencies.  Consistently following dietary guidelines in the long-term will also help you to maintain your weigh loss and prevent regain.

Exercise regularly: This is an essential element to your success in the long-term and you are typically advised to engage in at least 30 minutes of moderate exercise every day.  Benefits of exercise include:

  • Burning calories – this helps create a calorie deficit and promotes weight loss. By burning more calories than you consume, you can maintain the weight loss achieved through bariatric surgery.
  • Increases metabolism – this is the rate at which your body burns calories. A higher metabolism means that your body will burn more calories even when you are not exercising, which can help you maintain weight loss.
  • Building muscles – regular exercise, especially strength training, can help build muscle mass.  Muscle burns more calories than fat, even at rest, which means that building muscle can help increase your metabolism and burn more calories throughout the day.
  • Improving metabolic health – regular exercise can improve metabolic health, including insulin sensitivity and blood sugar control. This can help prevent weight gain and maintain weight loss
  • Reduces stress and improves mood – exercise can help reduce stress and improve mood, which can help prevent emotional eating and promote healthy habits.

Maintain a consistent sleep schedule: This can help you stay on track with your weight loss goals after bariatric surgery by helping to regulating hunger hormones, improving mood and energy, motivating you to increase physical activity, and improving insulin sensitivity. You should aim for at least   7-8 hours of sleep per night and to maintain a regular sleep schedule by going to bed and waking up at a similar time each day.

Manage stress: It is important to manage stress levels after bariatric surgery by developing healthy coping strategies. Stress can cause changes in hormones that can lead to weight gain, particularly in the abdominal area. Additionally, stress can cause people to engage in unhealthy behaviours such as overeating or not exercising, which can also contribute to weight gain. Managing stress through techniques such as mindfulness meditation, deep breathing, yoga, or regular exercise can help prevent weight regain. These practices can help reduce cortisol levels, a hormone that contributes to stress, and promote relaxation.

Engage the support of your family and friends: Engaging the support of family and friends can be very beneficial in maintaining weight loss after bariatric surgery both in the short and in the long term. Some reasons why:

  • Accountability: Having a great support system can provide a sense of accountability that can help individuals stay on track with their weight loss goals. When family and friends are aware of an individual’s weight loss goals, they can help provide motivation and encouragement to stick to a healthy diet and exercise routine.
  • Emotional support: Bariatric surgery is a significant life change that can be emotionally challenging. Having the emotional support of loved ones can help individuals manage stress, anxiety, and other emotions that may arise during the weight loss journey.
  • Positive role modeling: When family and friends model healthy behaviors, such as exercising regularly and eating a balanced diet, it can help to both encourage and reinforce healthy habits for individuals who have undergone bariatric surgery.

Attend long-term follow-up appointments: Follow-up appointments with the bariatric team are critical for long-term weight-loss maintenance and health after bariatric surgery. Here are a few reasons why:

  • Identifying and addressing challenges: Weight loss after bariatric surgery can be challenging, and patients may encounter obstacles along the way. During follow-up appointments, the bariatric team can identify these challenges and provide guidance and support to help patients overcome them.
  • Addressing emotional and psychological concerns: Bariatric surgery is a major life change, and it can be challenging to adjust to the physical and emotional changes that come with it. Follow-up appointments with the bariatric team provide an opportunity to discuss any emotional or psychological concerns you may have and get the support you need.
  • Providing ongoing education and support: Bariatric surgery is not a one-time fix, and long-term success requires ongoing education and support. Follow-up appointments provide an opportunity to learn more about nutrition, exercise, and other lifestyle changes that can support your weight-loss goals in the long-term.
  • Monitoring progress: During follow-up appointments, the bariatric team can monitor patients’ weight loss progress and adjust their treatment plan if necessary. This helps patients stay on track with their weight loss goals and make necessary adjustments to their diet, exercise, and lifestyle.
  • Monitoring health: Bariatric surgery can cause significant changes to the body’s digestive system, which can lead to complications if not managed properly. Follow-up appointments allow the bariatric team to monitor your health and catch any potential complications early on.
  • Adjusting the treatment plan: The bariatric team can adjust your treatment plan as needed based on your progress and any complications that may arise. This could include changes to your diet, exercise regimen, or medication.

What if I regain weight after bariatric surgery?

If you have had bariatric or weight-loss surgery and have regained weight, please know that you are not alone. Weight regain after surgery is not uncommon, and it’s important to remember that this setback does not define you or your journey towards better health. The fact that you took the step to have weight-loss surgery shows that you are committed to improving your health and well-being, and that determination and motivation is still within you. Remember that weight-loss surgery is just one tool in your weight-loss journey, and there are still many things you can do to get back on track. Reflect on your current lifestyle and habits, identify areas for improvement, and take small steps towards a healthier lifestyle. Don’t be too hard on yourself, celebrate your successes, and keep moving forward. With the right mindset, support, and guidance, you can regain control of your weight and health.

Ask yourself some important questions about the reason for your weight regain ...

  1. Am I following my dietary guidelines? Have I strayed from my recommended diet or portion sizes?

  2. Am I getting enough physical activity? Have I been skipping workouts or reduced my physical activity level?

  3. Am I managing my stress effectively? Stress can impact weight loss and weight gain, so consider whether you have been managing your stress levels effectively.

  4. Am I eating mindfully? Am I eating when I am hungry, or am I eating due to emotional triggers or boredom?

  5. Am I snacking frequently? Are my snack choices healthy, or am I consuming high-calorie, high-fat snacks?

  6. Am I staying hydrated? Am I drinking enough water throughout the day?

  7. Am I taking any medications that could be affecting my weight?

  8. Have I been drinking alcohol regularly? Alcohol is high in calories and can contribute to weight gain.

  9. Have I had any significant life changes that may have affected my weight, such as a change in job, a move, or a relationship change?

By asking yourself these questions, you can identify areas that may be contributing to your weight gain and take steps to make positive changes in your lifestyle. Many patients will recognise patterns of eating from their days before surgery.  Often times, simply identifying these patterns will help you to get back on track.  However, sometimes the struggle is too great and the weight gain continues. Don’t ignore this – you do have options – reach out for help! Re-engage your support systems such as your GP, your dietician, a therapist or psychologist, Dr Willingham and his team, our facebook group, your family and your friends.  Try to remember to be kind to yourself if you are struggling as it is normal for people to get off track at times. The important thing is to recognise this, and take steps to get back on track before too much weight gain.

Some practical tips to reclaim control of your weight gain

Don’t panic: Some weight regain is normal after bariatric surgery, and it does not mean the surgery was a failure or that you can’t lose weight again.

Talk to us – the sooner the better: Schedule an appointment with our dietician and bariatric practice nurse to discuss your weight regain.  We can help you to identify potential reasons for the weight gain and can help you to develop a plan to get back on track.  

Start a food diary: Writing down what you eat or using a food tracking app can help us to help you identify areas where you may be overeating or making unhealthy food choices

Review diet and exercise habits: Let’s help you reassess your diet and exercise habits. A healthy, balanced diet and engaging in regular physical activity is essential to long-term success – let’s help you get back to basics.

Identify triggers: Are there triggers that may have led to weight regains,s much as stress, emotional eating, or a busy lifestyle? We can help you come up with strategies to address these triggers and avoid slipping back into unhealthy habits.

Seek support: join a support group or find a weight loss buddy to help you stay motivated and accountable.

Seek psychological support: Regaining weight after bariatric surgery can be emotionally challenging. It may be helpful to seek psychological support from a therapist who specialises in bariatric surgery to help address any underlying issues that may be contributing to the weight regain. We can suggest someone for you to see.

Consider revision surgery: This is a last resort.  We can help you decide if this is a viable option for you or not.

Disclaimer

The information herein is not intended as medical advice. It should be considered as a reference only, or a starting point for further discussions with Dr Willingham and his team about weight loss surgery. Please be aware that results may vary from person to person