Life After Surgery: Whether you’re in the process of deciding if bariatric surgery is right for you or you’re post-op and would like some helpful tips, knowing what life is like after surgery—and being able to commit to it—are both important aspects of successful outcomes. From lifestyle changes to health transformations that change lives, life after surgery is full of both successes and challenges.

Health Transformation

One of the most rewarding aspects of bariatric surgery is the impact that improved health has on a patient’s quality of life.

Studies have shown that gastric bypass patients:

• Lost an average of 61.6% of excess weight.
• Experienced significant health improvement with resolution or improvement of 96% of co-morbidities, specifically type 2 diabetes, high blood pressure, sleep apnea, depression, and back pain.
• Had significantly reduced rates of developing cancer, cardiovascular diseases, infectious diseases, and psychiatric disorders.
• Experienced 89% lower mortality rates when compared to a control group of people who did not have gastric bypass surgery and were still living with morbid obesity.

Studies also have shown that gastric bypass patients:

• Had dramatically lower hospitalization rates for cancer, heart conditions, and high blood pressure than a control group of people who did not have gastric bypass surgery and were still living with morbid obesity6
• Experienced a 77.3% drop in total cost of diabetic and blood pressure medications compared to a control group of people who did not have gastric bypass surgery and were still living with morbid obesity and these co-morbid conditions.

Recovering from Bariatric Surgery

Recovery takes time and patience. The diet is strict; you may experience discomfort and pain as your body heals; and the length of time to return to normal activities can vary from patient to patient. Some patients are able to return to work within a few weeks and see weight loss soon after surgery. For others, a couple of months go by before they experience noticeable weight loss.

Call Your Bariatric Surgeon If you experience any of the following:

• Pain and/or swelling in your feet, calves, or legs
• Abdominal pain
• Bleeding
• Blood in stool
• Pain, burning, urgency, frequency of urination, or blood in urine
• Signs of infection such as fever or chills
• Vomiting or severe nausea
• Redness, swelling, pain, bleeding, or discharge at the incision sites
• Coughing, shortness of breath, or chest pain
  

Healthy Habits for Success

Healthy habits don’t just happen. They take know-how, time, and commitment. If you’re ready to commit, Trinity Bariatric and Weight Loss Center can provide you with the knowledge and tools to develop healthy habits, eat in restaurants and social situations while following your dietary guidelines, and cope with cravings and emotional eating.

Steps to Developing Healthy Habits:

Many bariatric programs describe bariatric surgery as a tool patients can use to take control of their health. In addition to surgery, goal-setting skills are important tools that can help you achieve healthy habits. The following steps can help you set yourself up for success.

Step One: Do Your Homework

Lifelong habits start with information and knowing yourself. Spend some time researching online and speaking to someone whose diet and fitness habits you admire. Find out why they enjoy their habits and what keeps them going.

     Tips and Action Starters

• Think about your current diet and physical activity habits, your time management skills, your strengths, your weaknesses, and your biggest fears and concerns.
• Research fitness and cooking information, and browse through some magazines for inspiration.

Step Two: See Yourself Succeed

Once you’ve done your homework and grounded yourself with information, write down your objectives, a short description of them, and what you anticipate life will be like once you accomplish your objectives.

      Examples of Objectives

• “After bariatric surgery, I want to lose 100 pounds, eat healthfully, and be physically active. I will take that vacation I have always wanted to go on.”
• “I am going to have bariatric surgery. Before I have surgery, I am going to begin walking and eating more vegetables and whole grains. After surgery, I will follow my bariatric program’s dietary and fitness guidelines. My goal is to lose 100 pounds, and, hopefully, my type 2 diabetes, GERD, and asthma will resolve or improve.”

      Tips and Action Starters

• Is your objective realistic? For example, if you currently weigh 350 pounds, a goal weight of 145 pounds may not be realistic. Our bariatric program will ensure that your weight loss objective is realistic.
• Think about what you need to attain your objective: time, effort, knowledge, and resources.
• Recognize your small successes, too. Sleeping better, going down one belt notch, being able to park further from an entrance—these are all successes!

Step Three: Come Up with an Action Plan

Once you’ve defined some objectives, it’s time to create an action plan. A plan plots your short- and long-term goals on a timeline. A plan should be specific so that you have realistic, but flexible, goals you can attain.

      Example of a Diet Plan

• “For the first two weeks, I am going to record what I eat. I will use that to examine opportunities for eating more healthfully.”
•  “After the first two weeks, I will begin eating healthfully by incorporating 25 grams of fiber per day in my diet. I will start by eating a bowl of oatmeal or a serving of yogurt sprinkled with high-fiber cereal for breakfast.”
• “The third week, I will substitute five lean meats and low-fat versions of the foods I usually eat. Each week, I will introduce a new healthy choice.”
• “I will measure portion sizes for the next six months.”

      Example of a Fitness Plan

• “I am going to begin by walking for five minutes, five times each week.”
• “After I am able to accomplish this goal for two weeks, I am going to add two minutes to each walk for the next two weeks.”
•  “After four weeks, I am going to walk for 15 minutes, five times each week.”
• “After two months, I am going to walk for 20 minutes, five times each week.”
• “After three months, I am going to walk for 30 minutes, five times each week.”

      Tips and Action Starters

• Be flexible about your plan. If it isn’t working, you will have to fine-tune it.
• Plan upfront: Schedule your exercise time in advance, and plan your meals at the start of the week.
• Be sure to include rewards throughout to recognize your accomplishments—big and small.

Step Four: Keep It Up

Developing a habit takes practice. For the first few months, you will be stress-testing your plan. Whenever you start a new habit, you are likely to encounter some challenges. When you do encounter a challenge, you will need to figure out a way to work through it.

       Example of Coping with a Diet Obstacle
       You and your friends meet up at restaurants for get-togethers, and you’re not sure what to order.

• Check the restaurant’s website to get a jump start on ordering.
• Restaurant appetizers are often closer to an appropriate portion size than the entrées.
• If you order an entrée, ask your server for a to-go box when it comes out and put half of your entrée in it immediately.

        Example of Coping with a Fitness Obstacle
        You schedule a 30-minute fitness activity for Tuesday afternoons, but find that you consistently miss it or do         not have enough time for the full 30 minutes.

• Exercise an additional 15 minutes two other days of the week or 10 minutes three other days.
• Split your Tuesday physical activity into two sessions: Exercise for 15 minutes in the morning and 15 minutes in the evening.

       Tips and Action Starters

• Use a planner or calendar as a food and fitness journal to help you visualize your progress.
• Help yourself with reminders: Keep your sneakers out, and chop up fruits and vegetables to snack on.
  

Emotional Health

Postoperative Blues
It is not uncommon for some patients to experience a brief period of “postoperative blues” during the first weeks after bariatric surgery. This often occurs when patients begin to feel better, but before they experience a return in energy and stamina. Some patients even begin to second-guess their decision to have surgery.

Coping with Emotional Issues
Postoperative blues are often temporary and are gone within a few days. If you experience these feelings for more than a few days, you should contact your bariatric program. The program’s support groups and mental health professionals can help you cope with these emotions. If you live far away from these resources, ask about resources closer to you or about online resources.

Bariatric Program Support Groups
Support groups often are led by a dietician, nurse, or mental health professional with experience in bariatric surgery. Support groups provide an opportunity to get together with other patients who share common experiences. In a support group, you can talk about experiences your family and friends may not understand.

Other Support Groups
Sometimes, bariatric surgery patients will start their own support groups, which meet in person or online. These groups can be very helpful, but there are things to keep in mind:

• One important consideration is that there is no healthcare professional moderating the group, which can increase the likelihood of misinformation.
• Some patients use these groups to tell others how to “cheat” the surgery.
• Some patients in these groups are negative and use the groups as an avenue for venting. If this bothers you, tune them out and identify others in the group who are more helpful and who are good role models.
  

Preventing Weight Regain

A good strategy is to pick an upper weight limit, and weigh yourself once each week, on the same day and time. An upper weight limit is a good red flag to see abnormal increases, which may help you prevent significant regain.

Example of a Weight Cap and a Red Flag
Let’s say you currently weigh 210 pounds, and you do not want to exceed 215 pounds. You weigh yourself weekly and, as long as you weigh less than 215 pounds, you continue your current diet and exercise routines. If you weigh more than 215 pounds, then it’s time to make some changes. You get a bit stricter with your diet and exercise routines, and you bring your weight back down.

Tips

• If you stopped or have not started, begin keeping a food journal to help you track your diet. It’s one of the best predictors of weight loss and, as found in the National Weight Control Registry, one of the best ways to maintain weight loss.
• Start paying close attention to your diet and physical activity level. If you’ve stopped measuring portions, pick up the measuring cup. If you’re exercising less than you thought, take a walk in the park with your kids or friends.
• If you notice an increase in weight for a few weeks in a row, call your bariatric program. They’d much rather see you sooner than later.