Preparing for Bariatric Surgery

Are you emotionally and mentally prepared for surgery?

Preparing for weight-loss surgery involves not only physical preparation but also emotional and mental preparation. Here are some tips to help you prepare emotionally and mentally for weight-loss surgery:

Understand the benefits and risks: Before you undergo surgery, it is important to understand the potential benefits and risks involved. Talk to your GP. Talk to Dr Willingham, his specialist bariatric practice nurse, and the dietician. Talk to family and friends who have had surgery.  These people are all important resources that can help you understand what to expect before, during, and after surgery.

Address emotional eating: Emotional eating can be a common issue for many people – whether they struggle with obesity or not. It is important to try to address any emotional issues related to food before undergoing surgery. Consider working with a therapist, counsellor, or psychologist to address emotional eating and develop healthy coping mechanisms.  We can help you with this process by referring you to an appropriately qualified person, should you feel that it could be of benefit to you.

Seek support: Having a strong support system can make a big difference in your emotional and mental well-being during the weight-loss surgery journey. Consider your friends, family, church, work circles – find and surround yourself with people who can provide encouragement and support.  Consider joining a support group. We are linked to local Facebook support group who has much to offer our patients and meet monthly.

Practice mindfulness: Practicing mindfulness can help you stay present and focused during the weight-loss surgery journey. Consider starting a mindfulness practice, such as meditation or yoga, to help you manage stress and anxiety. Consider your eating habits – focus on your food at mealtimes, minimise distractions, slow down, pay attention to when you feel full and stop eating at that point.  Often, we eat in front of the TV and lose sight of the point in time when we reach fullness and consequently, we overeat.  Start paying attention to your habits – practice mindful eating.

Manage expectations: Weight-loss surgery is not a magic solution, and it requires effort and commitment to achieve and maintain weight loss. It is important to manage your expectations and be patient with yourself during the journey. Start considering the changes you might make in your life after surgery.  Consider your physical activity and what you might like to try as you lose weight. Swimming? Gym? Sport? Keep it simple – if you did not take regular walks before surgery – that is where you might consider starting after surgery.  Give these things some thought before surgery.

Celebrate milestones: Celebrating small milestones along the way can help you stay motivated and positive. Consider setting small goals, such as walking for 20 minutes a day.  Or reducing the amount of soft drink you consume.  Or reducing the amount of sugar in your tea or coffee. And celebrate these small victories when you achieve them.  Every small change in your life counts on this journey and better prepares you for long-term success. 

Be kind to yourself! Understand that this is a life-long journey, and you will not succeed at doing the right thing, every single time.  Some days you will manage well, and some days will not be your best.  Shrug it off and try again tomorrow.  Remember, preparing for weight-loss surgery is a journey, and it requires both physical and emotional preparation. By taking the time to address emotional and mental health issues, seeking support, and practicing mindfulness, you can set yourself up for a successful and fulfilling weight-loss surgery journey.

You CAN take some positive steps before surgery ...

Before bariatric surgery, a patient can take several positive lifestyle steps to prepare for the procedure and improve their changes of success.   These steps include:

Make dietary changes: Bariatric surgery requires changes in diet after the procedure, so it’s a good idea to start making changes beforehand. Begin to incorporate more nutrient-dense, high-protein foods and reduce or eliminate the consumption of sugar and processed foods. This can help you to adjust to your new diet after surgery and make the transition easier.

Engage in regular exercise: Exercise is an important component of a healthy lifestyle, both before and after bariatric surgery. Exercise can help increase muscle mass, improve cardiovascular health, and aid in weight loss. Think about your current fitness level and any medical conditions you have and consider where you might begin.  Keep it simple!

Stop smoking: Smoking can increase the risk of complications during and after bariatric surgery, so you should try to quit smoking before the procedure. Smoking cessation can also improve overall health and reduce the risk of other health problems in the future. Speak to your GP about this – there are medication that can help you quit.

Reduce stress: High levels of stress can have a negative impact on both physical and mental health. Consider ways in which you could reduce stress, for example, by practicing relaxation techniques, such as meditation or yoga, and engaging in stress-reducing activities like spending time in nature, reading, or listening to music.

Develop a support system: Support from friends and family can be invaluable during your weight loss journey. We encourage you to talk with your loved ones about your plans for surgery and ask for their support. You may also want to consider joining a support group or seeking counselling to help you cope with the emotional and lifestyle changes that come with the surgery.

About the pre-op diet ...

A very low calorie diet (VLCD) is often recommended in the TWO WEEKS leading up to bariatric surgery. The purpose of this diet is to help you lose weight prior to surgery, which can improve surgical outcomes and reduce the risk of complications. Some of the reasons for a VLCD include:

Reducing liver size: People living with obesity often have fatty and enlarged livers which can make surgery more difficult and increase the risk of complications. In some cases, an oversized liver makes it difficult for Dr Willingham to safely access your stomach during surgery. A VLCD can help reduce the size of the liver, making surgery safer and more effective.

Improving overall health: Losing weight before surgery – even just a few kilograms – can improve overall health and reduce the risk of complications during and after the procedure. This can include reducing your blood pressure, improving insulin sensitivity, and decreasing the risk of heart disease.

Easing the transition to a post-surgery diet: After weight loss surgery, you must follow a strict diet to ensure proper healing and weight loss. By starting a VLCD before surgery, you can get used to the types of foods you will need to eat after surgery and begin making healthy habits a part of your lifestyle.

Most frequently, Dr Willingham’s patients will be commenced on either the Optifast  or the Formulite diets, consisting of shakes, desserts, soups and bars. You will need to consume three products each day.  In addition, you are required to eat a minimum of 2 cups of a variety of low carbohydrate vegetables, along with a little oil.  Your dietitian will tailor this stage to suit your circumstances and maximise your nutrition.

Managing the pre-op diet ...

The first few days are the most difficult!  Your body is switching into fat burning mode (called ketosis) and it can make you feeling miserable to begin with. Most patients will experience headaches, fatigue, and irritability.  You may be really hungry and obsess about food in the first 24-48 hours.  Fill up with low-starch vegetables. Hang in there … this will subside after a few days.

The key is variety: Be adventurous in your eating habits and food choices. Experiment with the timing of your meal replacement products.  Look for recipe ideas online – for example the Optifast Facebook groups.

Keep your fluids up: They make you feel fuller – aim for 2 litres per day.  Make your shakes with icy cold water – they are usually much more palatable and easier to drink than tap water.  Again, variety is key – have a diet cordial, or tea or coffee (with only a splash of skim milk and an artificial sweetener if necessary).

Some common problems with VLCD products include: Lactose intolerance that can lead to flatulence or diarrhoea.  Ask your chemist for Lacteze tablets to help with this. Tony Ferguson has a lactose-free variety of products, should you continue to have problems. 

Reach out for help: If you find the struggle too much for you – reach out to us. We have many more tips and tricks up our sleeves to help you get through these tough couple of weeks.

Your medications before surgery ...

Most regular medications may be taken as usual, including on the morning of your surgery. However there are a few exceptions:

Blood thinners and antiplatelets: These reduce your ability to form blood clots, which increases your risk of bleeding during and after surgery. These medications usually need to be stopped 1-10 days before surgery. Examples of these medications include Plavix, Xarelto, Warfarin, Aspirin and Fish Oil. Please do NOT stop taking blood thinners without further discussions with Dr Willingham.

Non-steroidal anti-inflammatory drugs (NSAIDs): These medications can also increase the risk of bleeding and should be stopped before surgery.

Diabetic medications and insulin: If you take medication to control your blood sugar, you should avoid doing so on the day of surgery since you fast on this day, meaning that your blood sugar levels could drop very low during surgery.  Speak to Dr Willingham if you have any questions about this.

If you are unsure if you should take a particular medication or not, please discuss with Dr Willingham or his team prior to surgery.


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