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Life After Surgery

The following identifies areas that will be important for patients to follow after weight loss surgery.

Diet

The modifications made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for successful weight loss. Post-surgery dietary guidelines will vary by surgeon. You may hear of other patients who are given different guidelines following their weight loss surgery.

It is important to remember that every surgeon does not perform the exact same weight loss surgery procedure and that the dietary guidelines will be different for each surgeon and each type of procedure.

What is most important is that you adhere strictly to your surgeon's recommended guidelines. The following are some of the generally accepted dietary guidelines a weight loss surgery patient may encounter:

  • When you start eating solid food it is essential that you chew thoroughly. You will not be able to eat steaks or other chunks of meat if they are not ground or chewed thoroughly.
  • Don't drink fluids while eating. They will make you feel full before you have consumed enough food.
  • Omit desserts and other items with sugar listed as one of the first three ingredients.
  • Omit carbonated drinks, high-calorie nutritional supplements, milk shakes, high-fat foods and foods with high fiber content.
  • Avoid alcohol.
  • Limit snacking between meals.

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Going Back to Work

Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity and the type of weight loss surgery you had. Many patients return to full pre-surgery levels of activity within 6 weeks of their procedure.

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Birth Control & Pregnancy

It is strongly advised that women of childbearing age use the most effective forms of birth control during the first 16 to 24 months after weight loss surgery. The added demands pregnancy places on your body and the potential for fetal damage make this a most important requirement.

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Long-Term Follow-Up

Although the short-term effects of weight loss surgery are well understood, there are still questions to be answered about the long-term effects on nutrition and body systems. Nutritional deficiencies that occur over the course of many years will need to be studied. Over time, you will need periodic checks for anemia (low red blood cell count) and vitamin B12, folate and iron levels. Follow-up tests will initially be conducted every 3 to 6 months or as needed and then every 1 to 2 years.

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Supplementation

Bariatric surgeries create a small pouch that reduces the amount of food one can consume at one time. This can affect the amount of micronutrients that you receive. In some surgeries there is malabsorption of specific nutrients that can also compromise your nutrition.

Regardless of which type of surgery you choose, vitamin and mineral deficiencies can occur. These are quickly corrected using over-the-counter supplements. You should expect to take a combination of vitamines and minerals for life. Though there are a number of bariatric vitamins on the market, we recommend the Celebrate formula.

Celebrate does a great job of meeting the metabolic needs of the bariatric patient by creating a formula specially designed for patients who have had adjustable gastric band or gastric bypass surgery. Your dietitian will work closely with you to ensure that you find an optimal combination for a healthy body.

Should you decide to choose a different supplemental brand please ensure that you still meet the recommended doses of the required nutrients. Also, be aware that, due to the small nature of your pouch, large, solid pills are usually difficult to tolerate. You are encouraged to use chewable or liquid supplements for your lifetime to prevent any possible problems.

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Emotional Challenges after Bariatric Surgery

Preaparing for weight-loss surgery is a very exciting time. Anticipating the resolution of dibilitating health problems, increased mobility, and possibly the emergence of a brand new body, can be exhilarating. Most people view weight-loss surgery as a positive, life-altering event. What they don't anticipate, are challenges in places of their lives that they had previously thought were rock-solid; such as marriage, family and friends. With a little careful preparation and thoughtful consideration, you can avoid experiencing many of the emotional challenges that often impact the post-surgical Bariatric patient. Now is the time to cement your support system with people who want to see you succeed, will meet you at the finish line, and then bask in your glory when you're standing in the winner's circle. Read on to heighten your awareness of behaviors that could be symptomatic of something more serious.

Transfer Addiction

For many of us, food is a source of pleasure, comfort and control in our lives. After weight-loss surgery, the question becomes, "If I don't have food, then what DO I have?" Many people turn to food in order to fill emotional voids, especially in times of turmoil. This dependence on food can be seen as addictive behavior. After weight-loss surgery, because food is no longer an available coping mechanism, many transfer this addiction to other unhealthy options such as alcohol or drugs. If you think you are an emotional eater and feel yourself slipping into unhealthy consumption patterns with alcohol or drugs (including prescription drugs), you should consult with your primary care provider or a mental health professional for evaluation.

Challenges with Interpersonal Relationships

Each person has their own established role with family or their circle of friends. A surprising struggle for weight-loss surgery patients is driven by an unexpected change in their role within these groups. This could be a person who was previously withdrawn and insecure, who becomes a person who is outgoing and sure of themselves. Or, there is the patient in a family of over-weight family members, who becomes the "skinny" one and induces jealousies. At any rate, patients may experience a wide range of reactions from friends and family as they begin to lose weight post surgery. Most reactions are positive and supportive, but there are a select few that experience negative interactions from the ones closest to them. Jealousy can lead to friends or family trying to sabotage a patient's success. An example of sabotaging behavior would be keeping foods in the house the weight-loss patient is not allowed to have, or making them feel guilty for not eating that birthday cake. New found competition may develop as the patient begins to lose weight and friends or family members remain over-weight. Healthy relationships will be able to work over these struggles with proper communication, but if patients are in an abusive or unhealthy/unhappy relationship emotional challenges could ensue.

Body Image Distortion

Bariatric patients can suffer from the same body image disorder (Body Dysmorphia) as anorexia nervosa patients. This usually develops as a coping mechanism established during the years of weight gain. Before surgery, Bariatric patients were able to convince themselves that they really were "not that big." After Bariatric surgery the opposite occurs, and once patients lose the weight they only see themselves as "fat" even though they are now down to an appropriate size. Patients become overly judgmental of their new bodies, focusing on all of the imperfections, adn they have to learn to accept themselves as a thinner person. In some cases, a severe fear of regaining weight or body dysmorphia can lead to the development of anorexia nervosa if not addressed by a professional counselor.

Emotional Instability

Emotional ups and downs are very common during the rapid weight loss phase after surgery. One scientific cause of emotional instability in women is the release of female hormones into the body's system. These hormones were previously stored in the fat tissue, and as the fat stores are burned up, these hormonse are released into the bloodstream, causing an emotional roller coaster. Men and women both may experience many ups and downs after surgery while they learn how to live with and accept their new body, new diet regimes, and how the world responds to the "new" them. A strong support system and attending monthly support meetings will help patients express and work through these emotions.

It is our hope that by increasing awareness of potential road bumps after surgery, our patients will be able to take the steps needed to make a difference. We are thrilled that you have chosen Rockwood Bariatric Specialists to take you on your weight-loss journey, and we will do everything along the way to ensure you have the most positive results possible.

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Support Groups

The widespread use of support groups has provided weight loss surgery patients an excellent opportunity to discuss their various personal and professional issues. Most learn, for example, that weight loss surgery will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on their emotional well-being. Most surgeons have support groups in place to assist you with short-term and long-term questions and needs. Most bariatric surgeons who frequently perform weight loss surgery will tell you that ongoing post-surgical support helps produce the greatest level of success for their patients.

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