Bariatric surgery is not a magical cure for weight loss, or to eliminate comorbidities, but it is definitely a foundation for a longer, healthier life. Considering the many health consequences associated with obesity, bariatric surgery is a wonderful option. It not only can change a life, it can save it.
The biggest challenge patients face after surgery is breaking old habits and establishing new ones. Habits formed over time, regarding diet and exercise, can make a difference between a positive or negative outcome. Quality of life after surgery requires a lifelong commitment by the patient.
Some patients will continue to put weight on, mostly because they can’t break old dietary patterns. Following surgery, I recommend five small meals a day consisting of one-half-cup of food per serving. The foods must be high in protein, with an intake of 60 to 90 grams of protein per day. Protein provides energy, and a sense of “fullness” for longer periods than carbs or sugar.
In the long term, medical conditions related to weight loss subside, but the alteration in eating habits is permanent and requires a lot of dedication. In the beginning, chew each bite of solid food thoroughly, waiting two to three minutes between bites so the stomach can adjust. It is important not to drink fluids with meals because fluids—even water—because this can flush the food through the stomach too quickly. Avoid desserts in large amounts (if they contain more than three to five grams per serving); high-calorie nutritional supplements; milk shakes, and drinks without nutritional value. Also, limit alcohol, and snacking between meals. A proper diet is essential for long-term weight loss. The goal is to restrict the amount of food consumed while still eating a nutritionally balanced diet.
Since post-bariatric patients will eat less, there is the potential for vitamin and mineral deficiencies. The majority of vitamin and mineral absorption occurs in the upper portion of the intestine, and that’s the portion bypassed in gastric bypass and loop duodenal switch surgeries. Multivitamins, vitamin D, B Complex, vitamin B-12, calcium, and doses of daily iron are recommended.
One of the many benefits of bariatric surgery is that it enhances the chances of pregnancy if a patient has been suffering from infertility.
Obesity may cause infertility, and weight loss surgery is proven helpful for women wishing to conceive. It is vital to wait a full year after surgery before trying to conceive to avoid risks of birth defects and medical issues for the child. Rapid weight loss during pregnancy deprives a growing baby of vital nutrients. If pregnancy occurs, it’s important that woman be tested regularly for any vitamin or mineral deficiency. Those that follow up regularly tend to do the best in losing weight, keeping it off, and regaining their quality of life.
Following surgery, engage in moderate to intensive exercise activity for about 30 minutes a day, five days a week. For maximum weight loss, a regime of 60 minutes, five days a week is recommended. Prior to beginning any kind of activity, seek your physician’s approval.
Exercise, combined with a healthy diet, can maximize weight loss and improve quality of life. A cardio exercise, combined with lifting light weights, is a great way to get your body on the road to recovery.
There will be a period when the body adjusts to its loss of weight and lifestyle changes. A loss of appetite and cravings will also take place as chemical changes continue to occur within the body. Most patients report that some hunger for food starts to return within six to nine months. Since the body underwent a change, it is important not to rush back to work. Patients with desk jobs return normally within five days, others with more physically active jobs take between two and four weeks. In general, most wait a minimum of two weeks.
Maintaining a healthy weight is a journey, and patients play a key role by scheduling appointments, attending support groups, weighing in regularly, and keeping food and exercise logs. Unhealthy weight gain disrupts emotional wellbeing. Bariatric surgery alleviates the physical problems, but psychologically, patients thrive when they’re able to talk to other patients about common issues, so support groups are important.
Bariatric surgery is not a quick fix. In fact two to three decades ago it was considered a risky procedure. In its developmental stages, the negative side effects sometimes offset the promising, positive results. With enhancements in technology and science, the complication rates are very low. Historically successful operations, like the gastric bypass, are highly refined for improved outcomes. In summary, while weight loss surgery has theoretical risks, it is very small compared to a life of obesity.
To learn more about your weight loss options from the UHealth – University of Miami Health System, call 305-689-1910 or visit UHealthMedicalWeightLoss.com.
Dr. Nestor F. de la Cruz-Muñoz, M.D. is the chief of the Division of Laparoendoscopic and Bariatric Surgery Department; co-director of the Center of Excellence for Laparoendoscopic and Minimally Invasive Surgery; and Professor of Surgery in the DeWitt Daughtry Family Department of Surgery at the University of Miami Miller School of Medicine. In addition, he is the medical director for Bariatric Surgery at UHealth Tower, formerly the University of Miami Hospital, part of UHealth—University of Miami Health System. His practice focuses on general, bariatric, and advanced laparoscopic gastrointestinal surgery.
Dr. de la Cruz-Muñoz earned his medical degree from the University of Miami School of Medicine, after graduating with a Bachelor of Science in Biology from Duke University in Durham, North Carolina. He completed his residency in general surgery at Jackson Memorial Hospital in Miami, and became chief resident in 1999.
Renowned nationally and internationally, as a bariatric and general surgeon, Dr. de la Cruz-Muñoz has received numerous awards and has been the keynote speaker at many presentations.