The Reality Behind Going the Bariatric Surgery Route

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"Prior to surgery, I tried everythingóWeight 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 itís 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, doesnít 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, itís 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 dietingó30 years, to be exact. Even then, she was 150 pounds overweight. "Iíd lose weight, gain it back, plus a few. But I never made it a lifestyle."

What Is It?

Letís 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 foodís path while suppressing hormones that control appetite and hunger. Itís 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. Itís also linked to a slower rate of weight loss.
Obviously, weight-loss surgery isnít 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, thereís 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 itís 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 beltóliterally. What next?

Dr. Sowemimo explains that the few days after operation can be uncomfortable, as with any surgery. It shouldnít 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. Heíll 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, youíll 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.

Itís also the first step in warding off long-term problems. According to The Journal of Clinical Endocrinology & Metabolism, itís 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, youíll shed a ton of pounds, which means that your work here is doneóright? Not quite.

Roden refers to the first year after surgery as the "honeymoon phase." During this time, you canít help but lose the weight because of the size of your stomach. But when the weight loss slows down, thereís more room for old habits.

Cue the health coach. "The surgery might have taken care of the weight loss, but it doesnít 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 wonít be out of touch, though. Dr. Sowemimo says heíll 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, itís 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.

Itís Just the Beginning

From now on, everything you do will make a huge difference. Sure, you already made a life-changing choice, but it wonít 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 poorlyóeven in small portionsóthe weight will slowly start to creep up. Without lifestyle changes, the weight will most certainly come back on."

Letís say it again, friends: lifestyle changes. The importance doesnít change after surgery, emphasizing again its role as a tool.

Holloman adds, "It is a life-changing surgery, but it isnít an easy way out. You have to work to make sure you donít 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 canít 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.

QUEENDIVA50ís approach is the perfect example. "One of the reasons Iím 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, sheís 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 doesnít matter if youíre in the pre- or post-op stageójust 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, donít get me wrong. It was me. I never really asked questions or expressed concerns, and Iíve been struggling with compliance for the past two years [since surgery]", he says. "I constantly donít feel well, but I know itís on me to focus on habits. Sometimes, I wonder if I should have just waited first."†

Once you decide to have surgery, youíll 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." Thatís all on you.

* Names changes for privacy
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Member Comments

Wow, I kind of forgot I had the band surgery and lost before starting to gain again requiring another surgery. What a waste but my husband kept pushing food (and still does) so it's hard to lose and harder to keep it off. Mad at myself. Report
i think id rather lose weight the really old fashioned way. Follow a healthy eating plan and exercise Report
I was seriously considering bariatric surgery, but at the encouragement of my bariatrician, tried a very low calorie diet (around 800 calories per day) under close supervision first. For me, it was the right choice. Doc was quite right that it was worth a shot since I was only barely qualified for surgery (just over the line for Type lll or ďmorbidĒ obesity). I know others for whom surgery ended up being the right choice - in their cases, because of much higher weight or co-morbidities, and/or issues that made the non-surgical route more difficult for them. Neither path is a quick fix - but the end result is worth it! Report
I have two friends who did the stomach surgery, Both gained the weight back! They kept eating the way they did before surgery. Waist of money without change of heart and eating habits. Report
ELRIDDICK
Thanks for sharing Report
ELRIDDICK
Thanks for sharing Report
Bariatric surgery changed my life. I'm two years post op, and although it's been the most rewarding thing I've ever done for myself, it's also been the most challenging. I would never go back. I'm a different person today, and I love my life! Report
Good information but more needed. Side effects, eating habits and learning the healthy lifestyle are a must to learn and know. Report
Love cures people - both the ones who give it
and the ones who receive it.
- Karl A. Menninger Report
I wish the article had talked about some of the side effects of the procedure - hair loss, having to taking vitamins for the rest of your life. Having to sip water throughout the day because of the stomach being so much smaller. I heard this from a doctor who does these procedures as well as people who have gone through it too. For me, the thought of the doctor cutting out 2/3's of my stomach and never getting it back, I couldn't do it.

For all the people here on SP who have done gastric bypass surgery - more power to you! It's just not for everyone - The path to a healthier lifestyle is different for everyone. One journey isn't necessarily better or worse than the other, just what works best for the individual. Report
Really makes one think. Report
Interesting! Report
Such a serious topic. I have thought about this many times and always come to the conclusion that I don't have the money to have the pain to go through it. Report
I met a woman who is very thin who had bariatric surgery 20 years ago at least. She had complications, required other surgery because of it, and now suffers from osteoporosis. I also knew a woman who wasn't prepared for a lifestyle change and was looking for a quick fix who had this surgery, but I lost track of her. I do have serious doubts that her weight loss was effective, knowing her personality. I don't need this myself. I know there must be people who need this but it seems so risky to me. Wouldn't exercise and changing the way you eat do the same thing with less cost and less physical stress. I am thinking of the famous Richard Simmons. It won't happen over night, a change, but wouldn't it be a better choice? Report
It's a great article with lots of things to consider. The biggest thing that jumps out at me is 'lifestyle change'. Out of the 29 family members & friends that have had the surgery only one of these has been successful in losing the weight & keeping it off, these are people that failed to make the lifestyle change before surgery and continued to fail make it a lifestyle change after. Unfortunately, 28 of the 29 are either still morbidly obese, with little little loss or some that have lost nearly all the weight only to see it pile back on because of their habits & refusal to adapt.
All of my Dr's for years had told me "have the surgery", "it's the only way to lose weight", "it's a guarantee that everyone loses the weight"...no, it's not. Clearly, it's not. I knew if I could lose the weight with surgery I could lose it without. So began a long search for another Dr. She looked me square in the eye & told me the blatent, unkind, but much needed truth, "this is your fault & I'm going to show you how to fix it, but it's up to you"..and there you go. I couldn't blame my genes, my family, estrogen dominance...nothi
ng. It was literally what & how much of what I poked into my mouth. With her incredible help, the many links to studies she emailed, the scientific proof of why 'this' works..160# pounds down, 25" off my waist all confirms that yes, it's a lifestyle change. Not prepared for that? Then even a drastic, often unnecessary surgery isn't going to offer a solution. After all, our stomachs & intestines aren't the problem, they work fine..fix what doesn't work fine and the weight will come off. 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.
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