Dietary sensitivities prevail even with weight-loss surgery

Although the bar for pre-surgical education has been raised for bariatric patients seeking obesity treatment with weight-loss surgery, some nonsense prevails among patients and the public suggesting that surgery is the easiest way to lose weight. The popular perception of surgical weight loss suggests that lifestyle changes, including diet and exercise, are not necessary to lose weight; surgery does all the work for the patient by restricting caloric intake.

The truth is, to lose weight and maintain healthy body weight resulting from weight-loss surgery (gastric bypass, gastric band, gastric sleeve) significant lifestyle changes must be made, including following a diet high in proteins, eliminating carbohydrates and carbonated drinks, and avoiding or at least controlling snacks or mindless meals. More patients must perform daily physical activity beyond the physical movements of the routine day. Patients must exercise. A lapse in meeting the dietary or activity requirements of bariatric surgery will cause weight loss to cease and possibly cause weight gain.

The notion that simply eating less of the things we ate at the height of our obesity as a means of losing weight is absurd. However, I have heard the hearty laugh from a post-surgical patient more than once when he explains, “I can still eat the same things I used to, just less!” Okay, how about we check back with that person in a year or so and see how it’s working out? The last thing they want to talk about, much less laugh about, is likely to be weight loss surgery. Patients and the public who want to believe that weight loss surgery is easy weight loss don’t want to hear this simple truth: if the food you ate before surgery made you gain weight, then you will continue to eat the same food, even less. , after surgery. to keep you fat. It’s that easy.

Most bariatric programs explain to their patients that the surgical stomach bag is “just a tool” for weight loss, and some programs have patients sign a contract stating that they will use their tool correctly. To use the tool correctly, the patient must follow the prescribed diet and exercise program. Not just for a few weeks or until the goal weight is achieved. Surgery is a permanent alteration of the human digestive system, so the patient must make a permanent alteration of her behaviors in a conscious effort to use the control tool of the metabolic disorder that we call obesity.

Even with surgery, patients must diet and exercise to lose weight. To maintain that weight loss, they will continue to follow the high protein diet and exercise requirements for the rest of their lives. Patients who do this are happily successful with their “easy” weight loss surgery. Patients who in the first place ignored these requirements in the hope that surgery would do the job for them don’t laugh much now as they try to disappear into the background doing the same things they’ve always done hoping for different results. .

In my work I counsel weight loss surgery patients who often ask me if it’s okay to eat this or that. My job is not to feed these people with forks, my job is to give them the power to rule their own fork. So I answer this question this way: “When you’re looking at or longing for that fried food at the county fair, use your dietary sensibility and remember that if it made you fat before surgery, it will surely make you fat after surgery.” .