Everyone strives towards a goal when setting out on their weight loss journey. While this goal stands as a marker of your success, it is not a finish line.
During the course of your weight loss program you will develop many healthy habits. To maintain your weight loss success you cannot abandon your new way of life. Long after you’ve reached your final weight loss goal, you’ll need to continue your healthy habits and adjust them as needed along the way.
In this section of our guide we will look at the strategies that will help you keep your weight off and stay healthy long into the future.
What does it take to prevent weight from coming back? Various types of weight loss surgery can help you achieve lasting weight loss, but you need to make the choice to continue eating right and exercising after you’ve reached your weight loss goal.
Maintaining your weight loss is the key to ensuring your long-term success. But how exactly do you maintain your initial weight loss?
You need to understand that the lifestyle changes required after weight loss surgery have to be as permanent as the surgery itself. Remember, the surgery can't do all the work for you. Lifestyle changes that you must stick to include:
- Staying away from junk food
- Decreasing your stress level
- Becoming more active
- Committing to exercise daily
After your surgery, watching your body change will be exciting. This excitement will help you stay motivated to eat less and exercise more. Once you lose the weight, or if the weight loss slows down and becomes less dramatic, you may find that you're not as enthusiastic and motivated as you were at the beginning of your journey. It's important that you find ways, either through support group members or trainers, to stay motivated to eat right and exercise.
You are accountable for your own decisions. By making yourself manage your eating and exercise habits and by understanding that, no matter what the weather is like, how the day has been, or what situation you're in, no one is responsible for the choices you make but you, you will likely be more committed to doing the right thing.
4. Realistic Goals
Establishing realistic goals is crucial to losing weight and keeping it off. You need to continually strive to meet or exceed new goals. If those goals are unrealistic, you risk setting yourself up for failure, which can damage your confidence and negatively affect your weight loss.
5. Time Management
One of the major reasons why diets fail is that people stop having time to devote to them. As the months wear on and we become over-committed, we find that preparing meals and exercising have less and less room in our daily schedule. In order to ensure your weight loss maintenance success, you must put your commitment to yourself first. Be assertive about your scheduling and time needs, learn how to manage your time so that you can exercise and prepare healthy foods, and manage your stress so that your obligations don’t seem impossible to face.
Social cues and stress can trigger you to eat when you are not hungry, which can lead to overeating. Learn how to recognize hunger and avoid negative eating cues to prevent weight regain.
There are many cues or signals in our daily lives that we tend to misread. When trying to reach and maintain weight loss success, these cues can completely derail us. Understanding the signals that you often misinterpret and learning how to better understand them can go a long way toward helping you reach your goals and avoid sliding back into old, bad habits.
Physical hunger is the best cue for determining whether or not you should eat. It usually happens about two to four hours after the last meal you ate. It can show itself as a lightheaded feeling, stomach rumbling, or an emptiness in your stomach.
Psychological hunger is more of an emotional need for food than a physical need, and it often tricks us into eating when we don’t actually need to. You can recognize psychological hunger easily, as it brings no physical signs that you should eat. Instead, you become fixated on a certain food. You want it, but your body is not telling you that you need it. These cues can be brought on by emotions, loneliness, boredom, or habit. You must learn to ignore them, distract yourself from them, or find out why they happen and work on eliminating them at the source.
Social hunger strikes when you're at a party, out to dinner with others, or in some other social situation and are offered food or find yourself around other people who are eating. This could make you want to eat also, even if you're not hungry. Assertiveness will really assist you in these situations. If you're not hungry, an assertive “no thank you” when offered food will solve that. If you're hungry, then you need to make healthy choices. If others make jokes about your healthy choices, ask them not to. If they do so anyway, let them know that they need not invite you in the future.
Physical Activity Cues
It's important to understand which outside factors keep you from sticking to your commitment to physical activity. Recognizing external inactivity cues can help you avoid them and subsequently take more opportunities to be physically active. For example, common labor-saving devices like elevators and escalators should signal you to be more active by taking the stairs.
Depending on your personal support system, social cues can either remind you to be more active or encourage you to take the easier, less-active options. Friends or family members who want you to watch television with them instead of going to the gym, or coworkers who encourage you to enjoy snacks instead of taking a walk bring up negative social cues. On the other hand, friends who support and encourage your healthy lifestyle bring up positive social cues. It's important to recognize these signals and ignore the negative ones.
Internal cues are those everyday events, illnesses, and injuries that can interrupt your activity schedule temporarily. Remember that these are only temporary and that, as soon as you are well and able to, you should hold yourself accountable for starting to exercise again. Write down your goals and plans for the re-launch of your physical activity routine and stick with them.
Sources of support are all around you, from family members and friends to others who have undergone various types of weight loss surgery at your bariatric center. Recognize those positive sources of support and use them to your advantage.
After weight loss surgery, it is invaluable to have a support system that includes not only healthcare professionals, but other individuals sensitive to your situation as well. Though your weight loss journey will not always be easy, having a support system for guidance and assistance will help you cope with transitions and difficult times, improving your chances of success.
Support after bariatric surgery can come from many places, including:
Family and Friends
It’s important that your closest friends and family members are supportive of your efforts to develop a healthier way of life. As you prepare for weight loss surgery, have a frank discussion with those who regularly influence your decisions. Tell those close to you what you will need to be successful and let them know what they can do to help.
Your diet will be significantly different from your family’s after weight loss surgery. Though you should plan ahead to ensure that everyone’s dietary needs are taken care of, your family can help you maintain your weight loss diet by limiting your access to unhealthy foods. Stock your pantry with the foods that will fill your post-surgical diet and ask that junk food be kept out of sight.
Even the most supportive friends and family members will have trouble understanding exactly what you’re going through. At a bariatric surgery support group, you can speak with weight loss professionals and other patients of bariatric surgery who have endured the same changes. This makes a support group the perfect place to find practical advice and valuable weight loss allies. Our bariatric support group meets on the second Tuesday of every month and features a variety of speakers and others who can aid you in your weight loss journey.
Signs of Non-Support
Unfortunately, the family members and friends who are already in our lives aren’t always the most supportive. If anyone in your support system exhibits the following signs, you should no longer consider them a source of support and should work to remove their influence.
- The Tempter. This person pushes you to eat when and what you shouldn’t. These people are sometimes called “food pushers,” and you should firmly let them know that eating unhealthy foods or large quantities of food is not what you want to do. Be very clear, and make your seriousness come through in your voice, eyes and body language.
- The Critic. Someone who is critical of your weight or the weight of others is perhaps the last person you need to be around. At this point, it’s particularly important to be surrounded by positive, motivational people who understand that you’re going through a major transformation and who are already proud that you’ve made the decision to get healthier. Avoid people who try to make you feel ashamed or guilty about your weight.
- The Reducer. It’s common for people who have never struggled with a major weight problem to oversimplify the solution. These people seem to think that obesity can be easily cured by eating less and working out. In theory, these things are simple, but they’re difficult in practice and don’t necessarily lead to success.
- The Partner-in-Crime. This person doesn’t think you have a weight problem, or may be struggling with his or her own weight. People like this may enjoy having someone to eat with them so that they’ll feel less alone or less like they’re doing something wrong. While it’s not your job to point out everyone else’s flaws, it is up to you to ensure your own weight loss success by avoiding their influence.
- The Watchdog. It’s important to have a solid support system, but you don’t want to feel like your progress is being monitored by the people you’re counting on. Sometimes when trying to help, people put undue pressure on us, as if the struggle to lose weight wasn’t hard enough without trying to please other people. Remind these people that it’s your life and your health and that you are accountable for it.
Weight regain is frustrating, but can be prevented and reversed. You didn’t lose weight overnight and you won’t regain it overnight. Learn how to detect the early signs of weight regain and take steps quickly to reverse its effects before it gets out of control.
Unfortunately, some people who have weight loss surgery will experience post-surgery complications. There are many physical complications possible, but one of the most frustrating is weight regain. You might think that weight loss is the only possible result after weight loss surgery, but this is not always the case.
Post-Surgery Weight Gain
Often, weight loss surgery patients think that the surgery itself guarantees weight loss. In reality, the surgery can't make you lose weight all on its own—your weight loss is contingent upon how you eat after you've had the procedure. If you don't follow the post-surgery eating instructions provided by your doctor or other clinician, such as eating small meals, eating nutritious foods, and avoiding snacks, then you might actually gain weight after surgery. The reduced size of your stomach is meant to make these lifestyle changes easier; just don't forget that it's these very lifestyle changes that help you lose weight.
Here are a few tips to help you avoid gaining weight after surgery:
- Exercise daily. Once you're out of your recovery period and can take on an exercise schedule, do it! It's best to strive for 10,000 steps each and every day. If you work in a few weight training sessions each week, you'll increase your weight loss results and decrease your chances of weight gain significantly.
- Use your support group. Many times, the eating habits that create the need for weight loss surgery are rooted in emotion, and they unfortunately don't just disappear after surgery. If you feel anger, sadness, intimidation, or any other emotion that makes bingeing sound appealing, talk to your support group. They can help you avoid this costly mistake.
- Visit your doctor often. He or she will want to keep tabs on your weight loss progress and make sure it's happening at a healthy pace. Make appointments often and keep them.
- Eat right. Eat nutritious foods, appropriate portions, and avoid snacking.
Getting any sort of surgery puts you at risk for certain complications. After weight loss, you’ll have to follow strict dietary guidelines and remain active to avoid weight gain and other uncomfortable potential side effects.
As with other major surgeries, bariatric procedures come with a risk of complications. Though we will take every step possible to reduce your risk of developing complications after surgery, in a small percentage of people these complications will occur.
You can reduce your risk of surgical complications by:
- Not smoking
- Staying physically active before and after surgery
- Carefully following our instructions on pre and post-surgical diet
- Following proper wound care
If you believe that you are experiencing any of the complications below, please contact us immediately so that we can find a solution and help you feel better.
Gastric Band Slippage
Patients of LAP-BAND will rarely experience a complication known as slippage. This happens when the gastric band moves down the stomach, while the pouch above the band may also stretch out over time. This can slow down weight loss and cause symptoms like abdominal pain, bloating, vomiting, acid reflux and heartburn. A slipped band will require surgery to correct the problem.
A stomal ulcer is an open sore between the bowels and stomach pouch that fails to heal over time. Because stomal ulcers are most often caused by smoking, quitting tobacco is the first step in avoiding them. If you’re not a smoker, or if quitting doesn’t stop the development of stomal ulcers, you may need to stop using anti-inflammatory medication and take a medication that combats acid reflux and indigestion.
When the outlet of your stomach pouch narrows, it is known as stomal stenosis. Though this condition is rare, it can cause nausea, abdominal pain, bloating and vomiting. Because stomal stenosis can lead to dehydration and malnutrition, it will be important to be examined for the condition if you notice symptoms like those above. Stomal ulcers often lead to stomal stenosis, so steps that prevent stomal ulcers can help you avoid both problems.
Because laparoscopic surgery uses small incisions, the risk of infection is low. When an incision becomes infected it may look like a large pimple. Risk of abdominal abscess is low, but an abscess can usually be corrected by draining the pus without surgery.
Patients of bariatric surgery also have a low risk of developing pneumonia or an infection with C. difficile colitis. Pneumonia can usually be avoided with breathing exercises and a quick return to physical activity, but smoking will raise your risk of this condition. C. difficile colitis can usually be treated with antibiotics and may require surgery in rare cases.
This complication occurs when layers of the surgical wound begin to separate. This is highly unusual with laparoscopic cases but can occur with traditional surgery. Dehiscence can be caused by a variety of factors like infection, injury at the incision site or pressure on the sutures. If you notice bleeding, pain, swelling, redness, broken sutures or any other evidence of an open wound, you will need to contact us immediately for treatment.
Dr. Ayoola will advise you to take certain vitamins and supplements after surgery. This is not temporary. Ceasing vitamin use could result in nutritional deficiencies.
Because you’ll need to eat smaller quantities of food after bariatric surgery, it will be difficult to provide your body with the nutrients it needs through diet alone. To keep your body healthy as you lose weight, you will need to take supplements that help you maintain adequate levels of key vitamins and minerals.
Gastric Bypass and Sleeve Gastrectomy
After gastric bypass and sleeve gastrectomy, you should:
- Take two calcium citrate tablets (300 mg each) every morning
- Take a multivitamin at lunch
- Take two more calcium citrate tablets in the afternoon (at least two hours after multivitamin)
Your supplemental calcium citrate intake should total 1200 mg in two daily doses of 600 mg. Calcium-rich foods like cheese and yogurt can also be included in your diet to provide further assistance in reaching adequate levels of this important nutrient. Be sure that you are taking calcium citrate and not the similar-sounding calcium carbonate. We recommend Bariatric Best Calcium Citrate with Vitamin D.
Your multivitamin will provide many other important nutrients that may be lacking in your diet. Be sure to avoid chewable children’s multivitamins, as these will not provide the nutritional value you need. Patients of sleeve gastrectomy and gastric bypass can use any supplement designed specifically for bariatric patients, but we recommend the Bariatric Best Multivitamin.
Because patients of duodenal switch have different nutritional needs, Dr. Ayoola will provide you with a supplement formulated specifically for DS surgery. This supplement is not like anything available over the counter and is designed to help you avoid nutritional deficiencies after duodenal switch. These will need to be taken once in the morning and again in the evening.
Duodenal switch patients will also need to take 600 mg of calcium citrate each morning and evening for a 1200 mg daily total. Calcium citrate should not be taken at the same time as your multivitamin, as this can interfere with your body’s absorption of iron and calcium. Wait two to three hours between taking your calcium supplement and taking your multivitamin.
Each day, patients of duodenal switch will also need to take:
- One vitamin A supplement
- One vitamin D supplement, which can also be provided in a yearly injection at our offices
The following is an example of a good timetable for supplement use after duodenal switch:
- 7 AM: Multivitamin, vitamin A and vitamin D (unless you received the injection)
- 10 AM: Two calcium citrate tablets (300 mg each)
- 1 PM: Multivitamin
- 4 PM: Two calcium citrate tablets (300 mg each)
Taking supplements at their recommended intervals and values will help you avoid nutritional deficiencies like anemia, which can lead to a variety of uncomfortable symptoms like:
- Brittle nails
- Cold hands or feet
- Irregular heartbeat
- Shortness of breath
If you begin experiencing issues like these, schedule a check-up so that we can assess your nutrient levels and discuss solutions. We will be happy to help you find nutritional supplements that your body can tolerate if you are having problems finding them on your own.