The Reality Behind Going the Bariatric Surgery Route

"Prior to surgery, I tried everything—Weight Watchers, 500 calories a day with a gallon of water, prescription diet pill, the executive weight-loss program at a local medical center. I lose weight, but I always gained it back," SparkPeople member QUEENDIVA50 shares. "I was first told by an orthopedist surgeon that I should consider bypass surgery about five years before I had the sleeve. I was so scared I went to my car, called my husband and had a good cry."
Weight loss is tricky, to say the least, and when you've tried everything under the sun, a permanent fix to your day-to-day struffle starts to look more and more appealing. This is where weight-loss surgery, or bariatric surgery, comes in.
On paper, it seems like a quick fix. But it’s not like mending your jeans or replacing a button. The surgery is a true lifestyle change that calls for even more lifestyle changes. When used as a tool instead of an answer, weight-loss surgery can reverse the comorbidities of obesity.
But is it the best choice?
Luke*, who had a gastric bypass in 2015, doesn’t think so. This is even after a lifetime of weight problems. At 33, he weighed 335 pounds and could barely make it up the stairs. It was diet after diet after diet, all to no avail.
These days, Luke is still dealing with this life-changing move. "It's nothing like I imagined, and I struggle with my decision every day."
Weight-loss surgery is a big leap. At its core, it’s not a conventional method of losing weight. Different people will make the decision in different ways. The common thread is that there were countless efforts beforehand.
Like Luke, Brianna's* choice to have surgery was driven by a lifetime of weight problems. "At age 15, I weighed 224 pounds. By age 18, I was 305," she says. "Weight issues were not anything I came across later in life."
After years of diet, exercise and Weight Watchers, she would occasionally lose 10 to 20 pounds. But even with these efforts and nutritionist consultations, she still had 80 to 100 pounds to go. In November 2015, she had gastric sleeve surgery.
Julia Holloman, blogger at Miles to Go and author of "Out of Obesity and into the Promised Land," had the gastric bypass done in 2006. Before that, she went through years of constant dieting—30 years, to be exact. Even then, she was 150 pounds overweight. "I’d lose weight, gain it back, plus a few. But I never made it a lifestyle."

What Is It?

Let’s take it back to the basics: There are three common types of bariatric surgeries, each one with pros and cons.
  • Roux-en-Y Gastric Bypass: Simply known as a gastric bypass, this surgery divides the top of the stomach from the rest to create a small pouch. The small intestine is then divided and the bottom end is brought up and attached to this new pouch, while the top end is connected to the small intestine further down. It basically reroutes the food’s path while suppressing hormones that control appetite and hunger. It’s also more complex than other procedures.
  • Vertical Sleeve Gastrectomy: The gastric sleeve removes about 70 to 80 percent of your stomach, making it the size and shape of a banana. Your stomach will also stop secreting hormones that promote hunger. Compared to gastric bypass, the gastric sleeve is simpler.
  • Adjustable Gastric Band: Another way to make a small stomach pouch is to use an inflatable band attached to the upper portion of the stomach. This will boost satiety without the risk of malabsorption. However, this means that you need to keep a foreign object in your body. It’s also linked to a slower rate of weight loss.
Obviously, weight-loss surgery isn’t for everyone. According to Dr. Seun Sowemimo, medical director at Prime Surgicare, co-medical director of Central Jersey Bariatrics and a board-certified bariatric and gastrointestinal surgeon, a patient must fall into one of the following categories to consider surgery:
  • A body mass index of 35 or greater with health problems and comorbidities related to obesity
  • A body mass index greater than 40 or 100 pounds over their ideal weight
Dr. Sowemimo also notes that in very obese people dealing with medical problems related to weight, surgery can improve diabetes, hypertension, high cholesterol, sleep apnea and chronic joint pain. And considering the comorbidities that come with obesity, the operation is considered to be extremely safe.
Beyond the numbers, there’s an even bigger qualification: motivation. Lots of it.
"Someone who may be a good candidate medically must also be very motivated to change," shares Sarah Matharoo, R.D. If there is no determination, the odds of success are slim.
"Surgery is only a tool," adds Denise Roden, a bariatric health coach at Bariatric Center for Success, who got the gastric bypass herself in 2004. "Without lifestyle change, the weight will most certainly come back on."

The Pre-Surgery Prep Work

Much like buying a house or planning a vacation, bariatric surgery needs major preparation. You need to learn about the ins and outs and everything in between. Now is the time to buy a new notebook.
But it’s more than just a crash course. It can take up to a year before surgery happens. After her initial seminar, for example, it took Brianna 11 months to get ready for her operation.
"[Pre-surgery] seminars and consultations will explain options. Your medical history should be discussed, along with a multi-pronged, long-term strategy," says Dr. Sowemimo. "The operation is only one aspect of this strategy."
Aside from education, your body needs to get ready. Matharoo explains that most patients are required to lose some weight before hitting the operating table to enhance the chances of a stellar outcome. This is where a registered dietitian provides guidance on pre-surgery portion control and nutritional requirements.

Post-Surgery Life

So, the operation is under your belt—literally. What next?
Dr. Sowemimo explains that the few days after operation can be uncomfortable, as with any surgery. It shouldn’t be markedly painful, though. On average, the hospital stay is one to two days. Your doctor will see you at least twice daily during this time. He’ll also have you come in for an in-office follow-up one week after you leave.
For SparkPeople member QUEENDIVA50, who had her surgery in April 2008, the first few weeks after surgery were rough. "I did wonder if I had made an awful mistake. But once I healed up, I could eat a little."

The days that follow are crucial. As your body heals, you’ll need to meet specific protein, fluid and vitamin requirements. This can be done with the help of a registered dietitian or nutritionist, who will guide you through liquid diets, protein shakes, portion control and temporary elimination of certain foods. 
The goal? Staying healthy while losing weight rapidly. It will also prevent post-surgery complications like protein-calorie malnourishment and vitamin deficiencies.
It’s also the first step in warding off long-term problems. According to The Journal of Clinical Endocrinology & Metabolism, it’s possible to develop nutritional deficiencies after surgery. Unsurprisingly, the best way to prevent this is to follow your registered dietitian's guidance. Your future self will thank you.
As time goes on, you’ll shed a ton of pounds, which means that your work here is done—right? Not quite.
Roden refers to the first year after surgery as the "honeymoon phase." During this time, you can’t help but lose the weight because of the size of your stomach. But when the weight loss slows down, there’s more room for old habits.
Cue the health coach. "The surgery might have taken care of the weight loss, but it doesn’t take care of maintaining it," explains Roden. "After that 'honeymoon phase,' it would be a good time to hire a coach to help you change the way you think and feel about food and exercise."
Your surgeon won’t be out of touch, though. Dr. Sowemimo says he’ll see a patient every three months in the first year and every six months in the second. After that, appointments continue yearly. More frequent appointments can be made if there are issues.
Seeking out a therapist is another option that many surgery recipients find beneficial. Due to your reduced capacity to eat, it’s not uncommon to develop anxiety around social events and food. For some, dealing with the adjusted lifestyle can be overwhelming. A therapist can help you through these psychological complications of weight-loss surgery.
As for the most important member of the post-op team? That would be you.

It’s Just the Beginning

From now on, everything you do will make a huge difference. Sure, you already made a life-changing choice, but it won’t be the only one you make. With the drastic change of surgery comes the drastic change of lifelong habits.
"You think when you have the surgery that you will never have to think about dieting again, but that's not true," says Roden. "If you eat poorly—even in small portions—the weight will slowly start to creep up. Without lifestyle changes, the weight will most certainly come back on."
Let’s say it again, friends: lifestyle changes. The importance doesn’t change after surgery, emphasizing again its role as a tool.
Holloman adds, "It is a life-changing surgery, but it isn’t an easy way out. You have to work to make sure you don’t fall back into old habits."
Take a tip from Brianna, who lives a busy lifestyle like many of us. Despite working two jobs, spending time with her husband, caring for her pup and maintaining a social life, she treats healthy habits as a non-negotiable component.
"[All of] this makes meal prep very important. Eating fast food can’t be my go-to anymore, so I have to have snacks and meals with me when I leave the house," she explains. "I use my 30-minute lunch break to take a walk, and have worked the gym into my regular routine." Reevaluating those old habits that led to your weight gain in the first place is paramount in refocusing and realigning your life for post-surgery success. Without a shift in your mindset and daily routine, you're no better off than you were before the surgery.

How to Set Yourself up for Success

A support team is essential, but it starts with yourself.
QUEENDIVA50’s approach is the perfect example. "One of the reasons I’m so successful is that I see my doctor every six months, just to check in and keep in touch. That was a decision I made early on in my weight-loss journey." And when she needs an extra boost? She visits the nutritionist, who helps her stay on track.
Being an active member on SparkPeople is also a gamechanger. As a team leader of the Gastric Sleevers team, she’s been interacting with other bariatric patients for years, which helps her check in with herself. It proves how powerful support and community can be.
Asking questions is right up there with support. It doesn’t matter if you’re in the pre- or post-op stage—just ask questions.
Luke, who is still coming to terms with his procedure, understands this concept well. "Now, I see that I needed more counseling before surgery. The team was great, don’t get me wrong. It was me. I never really asked questions or expressed concerns, and I’ve been struggling with compliance for the past two years [since surgery]", he says. "I constantly don’t feel well, but I know it’s on me to focus on habits. Sometimes, I wonder if I should have just waited first." 
Once you decide to have surgery, you’ll have to work harder than ever before. And as long as you put in the work, it can be a life-saving tool in the face of the comorbidities of obesity.
"Long-term weight loss for any of us will only come from changing our habits and the way we think about food and exercise," explains Roden.  "Eat to live, not live to eat!"
Brianna echoes a similar thought. "Having a smaller stomach won't keep your car from driving to a fast food restaurant or eating absolute junk. It won't wake you up at 5:45 a.m. to go to the gym, and it won't portion out your food for you." That’s all on you.
* Names changes for privacy
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Member Comments

Yes I had the Gastric bypass surgery 11 years ago. It was the best thing I did for myself. I lost 145 pounds and managed to keep the weight off. Yes it is very easy to regain back your weight just as it is easy to regain the weight losing the old fashion way. Do I cheat absolutely but it is so much easier for me to stay on track. I continue to get my protein in and continue to do daily exercising. Prior to my surgery I was sleeping in a recliner. I had a hiatal hernia that was repaired during my weight loss surgery. It save my life. Report
I know a nurse who ate through her gastric bypass...and ruptured her stomach. Report
Just read through the comments posted in the last year. I'll say it again: those of you who dismiss weight loss surgery as just another gimmick or a ploy on the part of the medical establishment to induce people into paying for expensive procedures did NOT read this article thoroughly and are missing the point.

1) This surgery is a "last-ditch" option for MORBIDLY obese individuals for whom diet and physical activity have not worked. It is NOT a "quick-fix" for people who have the ability to lose weight through traditional means. Not everybody can.

2) Patients are ALWAYS screened ahead of time, and most are required to lost between 5-10% of their weight, through following a strict, doctor-supervised diet, before they can be considered for surgery.

3) Weight loss surgery is ALWAYS combined with medical supervision and weight-loss counseling, and it is made abundantly clear to prospective patients that this procedure DOES INDEED involve a lifestyle change.

4) Statistically, although some individuals do regain weight, the majority have maintained most of their weight loss 5-10 years later. The one or two individuals you may know personally who regained the weight are ANECDOTES, not empirical data. I can cite just as many examples of individuals who I know personally who've kept the weight off. Personal acquaintanceship proves nothing.

5) Yes, there are sometimes complications; no, not everyone is going to experience an optimum outcome. That is true of EVERY medical procedure, not just weight loss surgery. Side effects and complications still pale in comparison to those caused or exacerbated by obesity: heart disease, diabetes, stroke, cancer, arthritis. Report
Every one I know of who has the surgery gains the weight back. I weighed 250 pounds and had Type 2 Diabetes and I just did it the old fashioned way, exercise and food tracking (sparkpeople helped ALOT! As did OA and stuff like meditation). I see this surgery as another way the medical system has thought up to make money no matter how much it puts people at risk. The bottom line is, if you will gain back the weight unless you change your dietary and exercise habits, then you can lose the weight without the surgery by making those exact same changes!!!!!!!!!!
!!!!!!!!!!!!!!! Report
That's scary. Thanks. Report
This is a very interesting article. I thought that there would be more positive outcomes and replies. Report
Great info. Thanks. Report
I have had friends who had the surgery. Without fail, they all gained the weight back after the honeymoon, losing, period. It was not the surgery’s fault that they saw a “quick fix” solution and figured the smaller stomach would equate to being able to eat whatever I want.

I was morbidly obese when I started my journey. The doctor suggest gastric options but I declined. I won’t do elective surgery when there are other ways to achieve the results. This is MY opinion. It has been a very slow weight loss journey. It has taken me 3 years to lose 70 pounds but I did it. I focused on creating a healthy lifestyle. One to do for life, not just to lose. More important than losing, I am keeping the weight off. Sure it takes work but you are worth the effort.

I don’t knock surgery but if the mindset doesn’t change, surgery or not, success will not follow, Report
I had the full gastric bypass and I regret it. Not the surgery but I chose the wrong doctor. He has since switched his profession. There wasn’t a support system in place and I gained my weight back after my honeymoon period. I thought that was impossible. That is my fault from not researching more thoroughly. Bottom line, you still have to work just as hard when it is done Report
I've seen people have these surgeries only to see them gain the weight back. You have to have the right psychological attitude Report
Excellent article, good need-to-know information, thanks! Report
My sister got the surgery done and she had a lot of problems related to it. I feel like for people who are at the end of their rope it might be an option but yes you still have to make those same lifestyle changes that you would have to make to lose the weight on your own Report
Very informative article . I like how it explains the good and the bad , helps people make informed decisions. Nice that there’s a spark group too , good luck everyone 🌸 Report
This really is a great article--I have seen so many people regain all the weight back after surgery---keeping the weight off is a life-long battle--always--- Report
Great article, I have been thinking about having surgery, now I have more to think about! thanks for sharing! Report


About The Author

Kirsten Nunez
Kirsten Nunez
Kirsten Nunez is a health and lifestyle writer, editor and author. She has a Master of Science in Nutrition and is currently based in New York. Kirsten spends her days writing articles and dreaming up healthy recipes.