People who have bariatric surgery for weight loss take big steps towards a healthier life. The pounds they shed after their procedures lower their risk for obesity-related health conditions. However, they also need to be prepared to make significant lifestyle changes that will make their surgery successful. In fact, having bariatric surgery requires a lot of preparation and planning.
“Patients need to make a real commitment to appropriate diet and exercise before they have a bariatric procedure,” says John Paul Gonzalvo, DO, FACS, bariatric surgeon at the AdventHealth Bariatric Surgery at Tampa. “I ask my patients, ‘Are you committed enough to have surgery? You need to be able to follow the diet you will need to eat for the rest of your life before your procedure, or you’ll be fighting against your surgery afterwards.’”
Bariatric surgery should not be seen as an easy way to lose weight. Rather, it’s a tool for people for whom diet and exercise do not work well enough on their own. People who want bariatric success need to get ready for it physically and psychologically.
A New Diet Before a New Life
“It’s important to start eating differently before surgery by eating the same diet you will need to eat after surgery,” Dr. Gonzalvo advises. This means eating smaller portions and meals with fewer carbs and more protein. Patients should practice this diet so it’s not new to them as they recover from their bariatric procedure.
Dr. Gonzalvo and his colleagues, Michel Murr, MD, FACS, and John A. Dietrick, MD, FACS, also bariatric surgeons, often see patients who are addicted to carbs, which give the body an easy source of energy in the form of sugar. Bariatric Surgery at Tampa helps educate patients about the differences between macronutrients – carbohydrates (“carbs”), fats and proteins – so they know how to improve their diets. When people stop eating high-carb diets, they often experience withdrawal in the form of cravings, headaches and feeling “blah.” Dr. Gonzalvo advises patients to get over this withdrawal before surgery so that recovery is more comfortable. However, the benefit of replacing carbs with proteins and modest amounts of healthy fats generally results in more energy.
Mom Was Right: Eat Smaller Meals and Chew Your Food
Eating smaller meals can also be tricky when our modern portion sizes have been distorted. However, Dr. Gonzalvo says that patients’ new stomach sizes will be equal to that of a D-cell battery (for a gastric bypass) or two, C batteries lined up (for a sleeve gastrectomy). Going forward, they will need to eat a third or maybe just a quarter of a restaurant-sized portion of food.
Besides eating smaller meals than they’ve been used to, patients need to practice chewing their food much more thoroughly than before. That’s because after surgery, the opening between the esophagus (food tube) and stomach will be smaller than the size of a quarter.
“At some point after surgery, everyone challenges their new stomach,” says Dr. Gonzalvo. “They stop thinking about their surgery and eat something like a large piece of chicken – which comes right back up.”
All of these dietary and eating changes constitute a “major mind shift” that Dr. Gonzalvo says patients should make before moving forward with surgery.
The Need for Real Exercise
Beginning an exercise routine is also an important part of preparing for surgery. Dr. Gonzalvo says that many people think they get enough exercise simply by walking from their car to their office when that’s not the case. Most of his patients have a limited exercise capacity at first, but this quickly improves as they stretch themselves physically in concentrated efforts that work their muscles and increase their heart rate.
After surgery, exercise will be important for burning calories and building muscle – which burns calories at rest.
“Most weight loss will occur in the first year after bariatric surgery,” says Dr. Gonzalvo, “after which it becomes very hard to lose weight.” Therefore, it’s important that patients take advantage of that first year as much as possible so they do not miss their chance to lose the weight they desire. Exercise is a big part of that formula, and the team members at Bariatric Surgery at Tampa help educate patients about how they can start safely exercising.
Gaining a New Mindset to Set Yourself Up for Success
Patients at the AdventHealth Bariatric Surgery at Tampa also see a psychologist before surgery to help redefine their relationship with food. Emotional eating – using food and calories as an outlet for depression, stress or anxiety – is common. People who have bariatric surgery will need to find new, healthy ways to cope with negative emotions.
Dr. Gonzalvo also says that he sees many mindless eaters, who eat simply because they are watching a movie rather than because they are hungry.
“You need to find ways to diffuse this by focusing on what you’re eating and savoring it. Don’t eat while seated in front of a TV,” he advises. By being more mindful of what they are eating, people are less likely to overeat.
COVID-19: An Opportunity to Prepare for Bariatric Surgery
For people interested in bariatric surgery but also concerned about the COVID-19 pandemic, now is a good time to start preparing, especially because getting ready for surgery takes several months.
“For most patients, insurance companies require that they attempt a diet supervised by a physician or a dietitian for three to six months before their bariatric surgery will be approved,” says Dr. Gonzalvo.
AdventHealth Bariatric Surgery at Tampa is making this process easier during the pandemic by offering telemedicine appointments. Much of the preparation for bariatric surgery does not need to be done in a doctor’s office. Surgeons will need to see their patients in person at least once before the procedure, but they can provide most of the other care through telemedicine.
If you are interested in learning more about whether bariatric surgery is right for you, schedule a consultation at the AdventHealth Bariatric Surgery at Tampa. Call Call813-971-2470 for an appointment.