Success After Weight Loss Surgery- Show Up

Author- S. Bledsoe, M.D.

“What can I do to improve my chances for success after my weight loss procedure?”  As a bariatric surgeon, I am often asked this question.  Of course, success is dependent on many factors, most of which are widely understood.  I don’t think anybody would argue with me that a sensible, protein-based diet plan is a major predictor for success.  Regular exercise would be high on any reasonable list of things to do post-procedure.  But I want to highlight two things that I think are critical to long-term success after weight loss surgery that don’t get a lot of press.  I can summarize both of them into two words- “show up.”


The first thing that you need to “show up” for would be your appointments with your bariatric surgeon.  During the honeymoon phase after your procedure, most people are very diligent about seeing their surgeon.  As time continues, the novelty wears off, your weight loss has stabilized, and the idea of waiting to see you doctor has lost what little appeal it had in the beginning.  Let me encourage you, regular follow-up with your physician is very important to your success and your long-term health.


Researchers from the University of Pennsylvania recently published an article in Obesity Surgery.  In their report, they analyzed 313 gastric bypass patients and demonstrated that weight loss was significantly increased with increasing numbers of clinical visits with their physician.  In fact, patients were almost 3 ½ times more likely at 12 months and almost 3 times more likely at 24 months to have lost more than 50% of their excess body weight as their attendance at follow-up appointments increased.


So, why are people more likely to lose weight if they follow-up with their physician?  It’s hard to say, but I suspect that part of the answer lies with accountability.   They know that when they walk in the door to see their doctor that they will be queried about their weight gain and applauded for their weight loss.  That’s the doctor’s job.  I have had patients tell me that they really start paying attention to what they are eating and start working out more as their appointments get closer.   That’s the power of accountability.


But, I think there’s another reason why people lose more weight if they go to their physician’s appointments.  Complications of all varieties are identified earlier.  Vitamin deficiencies will make you feel lethargic or sickly.  Who wants to work out when you feel exhausted?  Big problems are avoided, because they are found when they are irritations as opposed to emergencies.


Your doctor is there to head off problems and to be a resource to you.  They want you to succeed.  You are their walking billboard.  You should take advantage of their knowledge and expertise.  But, you should “show up” to one more thing in addition to your doctor’s appointment.


The second thing that you need to “show up” for would be your support group meeting.  Hopefully, you live in an area with a robust and stimulating support group.  If you don’t, consider starting one.  It is a great way to connect to others, find new friends, get new ideas, and achieve success after your bariatric surgery.  The idea of support groups for weight loss surgery patients has been around for years and is gaining in popularity, but we’ve known for decades that support groups help cancer patients.


Perhaps the most common cancer support groups are those for victims of breast cancer.  Breast cancer support groups began in the 1970’s and have become commonplace in most communities.  While support groups do not increase survival of women with breast cancer, support groups will improve the mood, improve the perception of pain, and decrease anxieties.  This improvement in mental well-being can be attested to by thousands of breast cancer survivors.  This improved quality of life extends to other cancer patients when they become involved in support groups, and there is no reason that bariatric patients should not capitalize on this to help them with their weight loss.


A 2011 systematic review from UCLA was released by Obesity Reviews.  They compiled 10 studies that included 735 patients to determine if attendance at support groups increased the likelihood of weight loss.  Let me quote the study itself.  “Support group attendance after bariatric surgery is associated with greater post-operative weight loss.”


Why do support group attenders lose more weight?  There is no doubt in my mind it’s because of the wealth of knowledge found in other patients.  As much as your doctor tries, they cannot identify with your struggles like another patient.  The person next to you may be able to give you exactly the advice that you need at exactly the right time.


That being said, one day you may be the beneficiary of the knowledge, and the next day you may be the dispenser of the knowledge.  No matter how far down the path you go, always be willing to help a fellow traveler.  You will benefit greatly from these interactions.


So, there you have it.  Just show up.  When you have a doctor’s appointment, show up.  When there is a support group meeting, show up.  If you will do just these two simple things, I have no doubt that the odds of your success will increase substantially.

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