Maintaining Weight Loss After Weight Loss Surgery

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A little more than two years ago, Judy Simes weighed 347 pounds. She couldn’t walk up a flight of stairs or tie her own shoes. Her body mass index (BMI) was 57, which qualified her as morbidly obese. She spent her days sitting in one room, one chair, doing nothing.

Then, Judy chose to have bariatric surgery. Two years later, she has lost more than 133 pounds—“about a person”—and now weighs 174 pounds. Her BMI is down to 32, and where she used to be unable to get out of her chair, she’s now “out and about doing everything.”

For any bariatric approach to weight loss to truly succeed, lifelong changes in diet and lifestyle are necessary. Judy’s weight loss success is not due simply to her bariatric surgery, but to the fact that she has continued to work with her bariatric treatment team to develop and sustain balanced, healthful diet and exercise plans.

“The long term management is a team approach starting with the patient,” notes Dr. Caroline Apovian, Director of Nutrition and Weight Management Center at Boston University Medical Center. “The patient is the number one member of the team.”

Exercise is Key

Under the guidance of her surgeon and health-care team, Judy started a regular exercise program as soon as she was approved to following her surgery. The most commonly recommended activity for behavior-based weight loss is to “get a good pair of shoes and start walking.” Judy Simes now walks 10 miles a day.

And while Judy’s dedication is exemplary and has brought her great results, health experts agree that any kind of movement helps, and even short bouts of activity can add up to promote long-term changes.

Diet and Nutrition

Before weight loss surgery After weight loss surgery

Sustained success through bariatric surgery does require permanent changes in your diet. But Judy Simes notes “you can eat almost anything you love,” as long as you are careful about consuming too many sugars and fats and “don’t drink your calories.” It’s important to eat smaller amounts with sufficient time in between, and not to eat and drink at the same time.

At the time of surgery, the bariatric treatment team provides patients with guidelines that are designed to decrease their risk of complications. After surgery, frequent follow-up visits with their bariatric team will be required for at least a year, and annual visits will be called for after that. “We have to see our patients frequently to make sure that they’re not getting vitamin deficiencies,” notes Dr. Apovian. The medical team is particularly alert for any signs of dehydration and vitamin and mineral deficiencies. Patients may need to get supplementary iron, vitamin D, vitamin B12 and folate.

A Transformational Experience

“You have no idea of the difference in my life,” Judy Simes tells Dr Apovian.

Judy’s refrain is echoed by a number of practitioners. Terrence Fullum, M.D., Medical Director of Bariatric Surgery at the Upper Chesapeake Bariatric Surgery, explains “As the weight comes off you get stronger and not weaker.” Dr. Alan C. Wittgrove of the Wittgrove Bariatric Center concurs—“Patients look at this as transformational…Many patients look at this as a new birthday…the beginning of the rest of their lives.”

The patient can’t make transformation alone. As Dr. Apovian says, “This is a procedure that will change the rest of your life. Remember that the bariatric surgical team is there to help you.”

You can watch the relevant video here.

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