Long Term Success

Follow-up

Follow-up is extremely important with gastric bypass surgery. Read this surgery guide carefully before going to office visits, so that you can have some questions ready for the staff. Lifelong follow-up appointments are expected and need to be scheduled with the office staff. Of course, visits with other specialists are encouraged, should you have any problems. Long-term, the surgeon expects to see you once a year. It is probably a good idea to have your annual physical exam scheduled with your primary care physician before your annual surgical appointment. The primary care physician can have testing done which can then be reviewed with you by your surgeon.

Expected Weight Loss

Most patients experience a fairly rapid weight loss in the first 3 to 6 months following surgery. The greatest weight loss will occur in the first three months after the gastric bypass procedure. Most studies suggest that patients lose an average of 65 to 80% of excess weight the first 12 to 18 months. After 18 months, the stomach pouch has stretched to hold more food. This stabilizes the weight loss. At this time, it is critical to adhere to the low fat, low sugar diet and exercise recommendations outlined in this guide to maintain your weight loss. After 24 months post-op, studies have shown that most patients keep off at least half of the excess weight over 5 to 15 years. Thus, there may be some weight regain. However, patients are much less obese even long after surgery than before the surgery. Advanced Laparoscopy Center has shown that weight loss surgery patients who exercise 3 or more times per week for a minimum of 30 minutes lose an additional 12% of their excess weight in 6 months compared to their cohorts who do not exercise as strenuously.

Lifestyle Changes

You cannot lose weight without having a healthy lifestyle. Do you have an unhealthy lifestyle? Here are some simple things you can do right now to keep yourself and your friends and family on track:

• Get rid of all the junk food in your house. (No, the kids don’t need junk food). Restock your cupboards with healthy snacks your whole family can enjoy.
• Have allotted time for fun and outside play.
• Have a daily schedule to ease the chaos and decrease some of the stress in your life. This may mean taking some activities out of your schedule or your kids’ activities. Often, we plan to do more than we have time for.
• Cut the time you and your family spend each day watching TV or using the computer. Spend more time doing more active things such as playing outside with the kids or going for a walk.
• Plan your social life with activities that do not include food, such as going out dancing rather than going out to dinner.

Maintaining the Weight

Gastric bypass works in part by making the stomach much smaller so that one feels full sooner. It also works to curb the appetite because the food goes quickly into the small intestine, and chemical messages are sent to the brain telling the satiety centers that food is present. The surgery will give you a full feeling on a much smaller meal, improve the sense of self-control and help many avoid sugary foods due to dumping syndrome.

By eating only at mealtime and only until you feel full, your daily food intake will be decreased enough to provide weight loss. The weight loss will vary from week to week and may plateau for days and up to two weeks at a time. If you are at a plateau during the first 6 months post-op that lasts longer than two weeks, please call the office. Gradually, the rate of weight loss will decrease and your weight will stabilize. Your responsibility is to avoid snacking, grazing (continuous nibbling), to choose healthy foods, be active and exercise daily, and nurture the process of recovery from obesity. Participate in group meetings and continue to use this guide to help you through the surgery process. Be sure to keep your regular office appointments so that your weight loss can be maximized and your health monitored.

Again, surgery is a tool, something to help you accomplish your health goals. There will be adjustments that you will need to make. Our staff will be glad to guide, support and motivate you. We know that you can do it!

The 8 Rules of Weight Loss

There are eight rules that we have found helpful for weight loss success. All successful patients who have had gastric-bypass have these things in common.

1. Consumption of an adequate amount of liquid, preferably water, is crucial. You should consume a minimum of 1 1/2 to 2 liters of liquid each day. This can only be done slowly, sipping fluids throughout the day. Never drink more than 2 ounces of liquid over a 10 to 15 minute period. On very hot or humid days, or when exercising, you should drink additional glasses of water. This is necessary in order to prevent dehydration.

2. Only eat at mealtimes. Between meals snacking or “grazing” on small amounts of food throughout the day will sabotage your weight loss and result in the inability to lose an adequate amount of weight.

3. The primary source of nutrition should be protein. 70 to 75% of all calories consumed should be protein based (eggs, fish, meat, etc). Carbohydrates (bread, potatoes, etc.) should make up only 10 to 20%, and fats (butter, cheese, etc.) only 5 to 15% of the calories that you eat. A diet consisting of 600 to 800 calories and 75 grams of protein should be the goal for the first 6 months.

4. Never drink liquids when eating solid foods. Liquids should be avoided for a period of 30 minutes before and 30 minutes after eating meals.

5. Avoid foods and liquids which contain sugar or high fructose corn syrup. Not only will they slow down your weight loss, but they may make you sick! Sugar may cause “dumping syndrome” in patients who have had the gastric bypass procedure Dumping, in short, is when sugars go directly from your stomach pouch into the small intestine causing heart palpitations, nausea, abdominal pain, and diarrhea.

6. Stop eating and drinking when you begin to feel full. Listen to your body’s signals. Do not look at the food that is left on your plate. Overfilling your stomach pouch will cause your pouch to stretch and may prevent weight loss success – or worse causing long term problems and complications.

7. It is essential that, within the first 6 weeks after surgery, you begin a regular exercise program. Our research indicates that this will increase your overall weight loss by 12% in 6 months.

8. Attend support group meetings and workshops. They will help you stay focused and motivated and help you work through the changes that weight loss brings. Plus, you might just make a few new friends.