Bariatric Surgery: What Does It Take to Lose Weight After Procedure?

Number of surgeries skyrocketing as obesity prevalence continues to rise

By Deborah Jeanne Sergeant

The number of bariatric surgeries in the U.S. has increased from 158,000 in 2011 to 216,000 in 2016, based on figures from the American Society for Metabolic and Bariatric Surgery based in Gainesville, Fla. Part of the reason that the figure is rising is that the number of candidates is increasing.

According to the Centers for Disease Control and Prevention, obesity increased in the U.S. adult population from 30.45 percent in 1999-2000 to 35.65 percent in 2009-2010, the most recent statistics available.

It’s easy to see why more and more people want to lose weight. Obesity raises the risk of more than 40 health conditions.

“Obesity is associated with a 50 to 100 percent increased risk of premature death compared to healthy weight individuals,” states the Office of the Surgeon General.

Bariatric surgery, which uses surgical procedures to reduce the amount of food a person can hold at a time, doesn’t equal lasting weight loss for some patients.

Among other stipulations, surgeons may require patients to begin a healthful eating plan and exercise regimen before surgery, but sticking with it can represent a barrier to lasting weight loss.

“As many as 50 percent of patients may regain a small amount of weight (approximately 5 percent) two years or more following their surgery,” states the American Society for Metabolic and Bariatric Surgery. “

The organization further stated that “successful” weight loss following bariatric surgery is described as losing at least 50 percent of excess body weight.

To achieve better success in losing weight after bariatric surgery, patients need a great deal of support before and after surgery, according to Kelly Springer, registered dietitian and owner of Kelly’s Choice, LLC in Skaneateles.

She recalled that when she first started in bariatrics, she sat down with patients the day before surgery to tell them what they could and could not eat after surgery.

It took years for bariatric program managers to understand that dietitians need to meet with clients multiple times before and after surgery to help educate patients.

Springer is working on back-on-track programs for people who did not receive that education and regained weight after bariatric surgery — or those who struggle to follow their new healthy lifestyle. Some patients have no idea they were supposed to begin taking multivitamin supplements for life.

Unlike a fad diet or abandoned exercise regimen, the changes must be lifelong to lose weight and to avoid the weight piling back on once it’s lost. Patients should also address the reasons why they gain weight.

Some obese people use food as a coping mechanism for stress or to help them handle emotions.

“What we’re finding is a lot of emotional eating, the weight gain is from other sources in life,” Springer said. “We found there was a lot of abuse or neglect from childhood or domestic violence as to why that person has had disordered eating. This piece is just as important as nutrition. If that’s not addressed, the person is still going to use food to try to overcome that emotional hardship.”

To become successful in weight loss, patients need to develop healthful ways to manage stress and emotions.

Accountability also makes a big difference, too. Journaling food and activity can help track progress in how the patient is eating.

By not adopting new ways to look at food, the old impulses can lead bariatric patients to continue to fall back into overeating eventually. Immediately post-surgery, patients can eat very little food at a time, about half a cup.

“Over time, you can stretch that out, like a uterus when having a baby,” said Barb Goshorn, bachelor’s level registered nurse, has a master’s in applied clinical nutrition. She operates Goshorn Wellness Center in Webster. “If they go back to old behaviors, the weight does go back on.”

“It’s a lifestyle change, not a diet that ends in November. People who think of it as such can have tremendous success.”