Avoiding Weight Regain
Weight regain is a common concern for bariatric patients. For most, their struggles with weight have been life long. Countless diets, programs and pills that all lead to gaining all your lost weight back, and more. Statistically, bariatric surgery is very different from the pattern most dieters are used to. ASMBS, a leading bariatric medical society, has reported that roughly 50% of weight loss surgery patients will regain a small amount of weight in the years following their surgery. This small amount falls around 5-10% of excess weight being regained. When looking at the bigger picture, even 10% regain when over 100 pounds have been lost, is by no means a failure. But seeing the number on the scale move up can be anxiety inducing.
The Problem With Pride
I am firmly convinced that one of the biggest obstacles to successful weight loss is PRIDE. Pride keeps people from asking for help even when they are drowning. Pride keeps people from being helped even when help is offered. It is an attitude of the heart that says “I can do it on my own” and “I know better how to deal with this”. I have been as guilty of this as anyone.
The Importance of Lifestyle Changes
You will hear it said time after time, bariatric surgery is only a tool. While many believe it is, or wish it were, a quick fix, success with weight loss surgery is highly dependent on committing to important lifestyle changes. The mechanisms of surgery create restriction and in some cases change the digestive tract to limit absorption of calories. This still means that, following surgery, a bariatric patient can sustain themselves on “cheat” foods. Of course, the long term result is that improved health and weight loss success isn’t likely. So what lifestyle changes are important for bariatric patients?
Snacking After Bariatric Surgery
As you undoubtedly know from your research about bariatric surgery, the postoperative lifestyle is very different from the eating and exercise habits you had before. And while it may seem like a diet – and it is in the early parts of recovery – the long-term maintenance diet is actually very similar to what we would consider a healthy, normal diet for anyone, bariatric surgery or not. But before we get into the details of how and when to snack, let’s discuss the idea of snacking and how we may have been looking at it all wrong, probably for our entire lives.
Addressing Anxiety Before Bariatric Surgery
Anxiety before any surgical procedure is perfectly normal. There are many unknowns and that can be scary. Bariatric patients may feel even more anxious because the results do not become apparent on the day of surgery – they have months and years of weight loss to pursue and maintain. Patients are often concerned about the safety of the procedure and potential complications after surgery. Of course, they may also worry about the long-term results. While all of these concerns are justified, they are also very manageable and the team here at Advanced Bariatric and Surgical Specialists makes it our goal to ensure the smoothest surgical process for each of our patients. So, let’s jump in and see how to best manage the anxieties and fears we may have before surgery.
What I’m learning about addiction lately…
Many of us have at least one addict in our family….food, alcohol, work, gambling, drugs…they’re all legitimate addictions. Addicts tend to blame others for their bad behaviors. They tend to justify their actions even though they may be wrong morally and legally. Many addicts bend the truth or flat-out lie to cover their actions. This is just what addicts do. If you refuse to allow the addict to continue the bad behavior, they may call you a bully or intolerant. They may play the victim card…for example…”I can’t believe my parents made me move out after doing a little cocaine (again).”
It’s really easy to see these behaviors in our family members. The bigger question is can you see any of these behaviors in yourself? Can I see any of these behaviors in myself? We often see others as “toxic”. But can I see that I’m toxic sometimes? PS…if you don’t think you’re the toxic person at all…you’re probably the toxic person most of the time.
If I’m really honest with myself, I realize that I have lots of negative traits and actions that are offensive to other people and my Creator. The question then becomes…will I own the things I’ve done wrong? Will I release my pride and allow others to help me do better the next time?
~ Dr. Chang
Courage…One reason why bariatric surgery isn’t “taking the easy way”
It takes a great deal of courage and humility to ask for help with your weight. Weight is very personal and patients must “swallow their pride” and admit that their way of managing isn’t working. Oftentimes, patients have tried for years to manage their weight and have failed more often than they have succeeded. If they were successful, they wouldn’t be asking for anyone else’s help!
Success rates with bariatric surgery
We have recently been able to extract data from our bariatric society (American Society for Metabolic and Bariatric Surgery). Our report showed that patients from our practice entered into bariatric surgery 3 BMI points lower than…our patients were smaller on the day of surgery. However, they lost weight at a faster pace than the comparison group (the rest of the patients done elsewhere). At 2 years post-op, our patients were 5 BMI points lower than the comparison group.
Why most medical weight loss will fail…
I’ve heard that quite a few patients are doing medically supervised weight loss plans.
- When patients do temporary plans, they have temporary weight loss.
- When the diet stops, the patient is largely destined to regain weight. although this sounds like #1, it’s different. When you have to purchase foods or shakes or meal replacements, NO ONE will do this lifelong. Therefore they will only have temporary weight loss. The average American cannot afford the additional expense for a lifetime.
- Protein shakes as meal replacements don’t work. the feelings of fullness are partially generated by chewing your food. You will not get this from drinking a smoothie or drinking a protein shake.
- If the stomach is not properly filled, the patient stays in a starvation state. Studies of contestants from the Biggest Loser showed that their basal metabolic rate (BMR) went down by 25%. However, the same studay also showed that the BMR decreased with gastric bypass. The differences are the following…there was a smaller decrease with bypass and the calorie intake was lowered so much with bypass that patients were much more likely to keep weight off.
- Most patients I see for bariatric surgery have tried some gimicky medical weight loss plan…usually with Phentermine. If this really worked well, they would not be considering bariatric surgery!
Does The Gastric Sleeve Cure Diabetes?
Before we start, it is important to understand the difference between a cure and remission of type-2 diabetes. There’s a big difference and we try to discuss results in terms of remission. After all, type-2 diabetes is a chronic disease that must be managed even if symptoms have disappeared and blood sugar is normalized. There is no cure.
We have known for years that bariatric surgeries have shown great promise in improving type-2 diabetes. This was largely due, we thought, to weight loss and patient lifestyle changes after surgery. However, the gastric sleeve and gastric bypass have been particularly effective in this regard, with many patients improving or going into remission before losing a significant amount of weight.
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