The Bariatric Surgery Journey: Successful Weight-loss after Surgery

Bariatric (weight-loss) surgery is a complex journey to improved health that varies from person-to-person. I spoke previously about “Changing Your Mind” and I believe that is a process too. I do better with that some days than others. However, it warrants working on daily so that the rest of the journey will fall into place.

Rome was not built in a day!
Immediately after surgery you will experience weight-loss. The most successful patients interact regularly with their multidisciplinary team (physicians, bariatric nurses and coordinators, dietitians and nutritionists, etc.). Your multidisciplinary team will educate you on the proper use of your new tool and guide you through the process that first post-operative year.

It is important to take advantage of this first year to change your relationship with food and to get healthy. It is perfectly fine to call your dietitians, bariatric coordinators and exercise physiologists for advice and to clarify instructions as often as needed. Pitfalls I have seen include failing to have a healthy diet, not treating obesity-related conditions (the diseases associated with obesity like diabetes, high blood pressure, obstructive sleep apnea and depression) and inactivity.

A healthy diet is most important of all. I like to say that “We cannot out-exercise what we can eat!” Think about the fact that a candy bar has about 240 calories, which equals about 2 ½ miles on a treadmill! A healthy diet will provide a foundation for a healthy body. I say foundation because there are very real nutritional consequences of the operations that are performed for bariatric surgery that cannot be overcome with diet alone. That is where vitamin, mineral and protein supplementation comes in (see the clinical practice guidelines from the American Association of Clinical Endocrinologist, The Obesity Society and the American Association for Metabolic and Bariatric Surgery). Vitamin and mineral deficiencies can be life threatening. Patients who follow the recommendations actually feel better and have more energy. It is imperative that you stay up-to-date with all blood work to avoid deficiencies. Remember that protein is always your best choice instead of carbohydrates. My most successful patients continue to use protein supplements (shakes, bars etc.) in addition to regular foods for the rest of their life.

Your multidisciplinary team will also be able to help you with treatment for other medical obstacles such as depression, and obstructive sleep apnea (OSA). If these conditions are not adequately treated, it may interfere with your weight-loss. I find both of these conditions in greater than 70 percent of my patients! Depression leads to inactivity and snacking on “comfort foods.” Those high carbohydrate-containing foods are the bane of weight-loss attempts and must be avoided at all costs. OSA, if untreated, also leads to failed weight-loss. Patients with untreated OSA have higher circulating levels of the hunger promoting hormone ghrelin, which leads to an increased appetite. Untreated OSA also leads to daytime fatigue and therefore inactivity.

“Sweat is Fat Crying!”
Activity (exercise) is important too. You have to start where you are, but you must have daily movement. I always recommend starting with walking and slowly increasing the speed and distance. Many studies have shown that regular moderate activity is important for the maintenance of weight-loss. That is so important because weight regain is, I believe, my patient’s greatest fear and must be avoided at all cost, so KEEP MOVING! “No matter how slow you go, you are lapping everyone on the couch.”

Surround Yourself with Positive People!
Support is an essential element of success after bariatric surgery. This may be family, friends, or a well-run support group. Successful patients seek support and knowledge from positive sources. Hopefully you have friends and family members who will be a source of encouragement for you during your journey. I encourage all my patients to become involved in a local support group and attend meetings regularly.

A note about negativity: We have all had those people in our lives that are supposedly in our corner but seem to sow seeds of doubt or are sometimes openly negative about attempts to improve ourselves. Usually their negative comments speak more about themselves than the truth of our situation. Seek out people and forums that make you feel good about yourself when you are interacting with them!

Change is always difficult. You are starting on the journey of your New Life and if you are successful, change will be inevitable.

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About the Author
Dr. Stephen Boyce obtained his Bachelor of Science and Masters of Science from Texas A&M University, College Station, before beginning medical school in Dallas, Texas at the University of Texas Southwestern Medical School where he received his medical degree. Surgical Residency was performed at Parkland Memorial Hospital in Dallas where he completed his general surgery training and was introduced to weight loss surgery under the tutelage of Dr. Otto Wilbanks, a pioneering father of weight-loss surgical procedures. With more than 24 years of experience performing bariatric surgeries, Dr. Boyce has completed more than 4,000 weight-loss surgical procedures, has special training in advanced laparoscopic surgery and has also completed a Masters Certification in Bariatric Surgery. He started his own practice the New Life Center for Bariatric Surgery in Knoxville, Tennessee in 2002, which shortly after became one of the Nation’s first Centers of Excellence (7th in the Nation) in 2005.  He is the Medical Director of the Tennova Center for Surgical Weight Loss in Knoxville, TN.  His special interest in bariatric nutrition led him to develop Bari Life Bariatric Supplements, specializing in custom multivitamin formulas for the weight loss surgery patient. Additionally, he is an active educator for Ethicon-Endo Surgery and he was the first physician to be awarded by the Obesity Action Coalition (OAC), “Outstanding Membership Recruitment by a Physician Award.”

Disclaimer: This blog post does not reflect the views of the OAC, the National Board of Directors or staff. Information contained in this blog post is not based on scientific research and has not been validated. The OAC does not endorse any merchandise mentioned in this blog post.

3 Comments for this Post
  • Pingback: Obesity Action Coalition » The Bariatric Surgery Journey: The Beginning

  • Lauren Korman
    February 17, 2014 at 5:19 pm

    I am a post gastric surgery patient I have lost 420 pounds I need to lose another 20 to reach goal. I have a tremendous amount of excess skin and am worried I came this whole way to not be able to get this skin off and I will not look normal. When you call plastic surgeons offices that do post bariatric patients they have financing but it is crazy what they expect. I have documented eczema an d had to go through abdominal reconstruction for a huge inguinal hernia. My breasts hurt from the pulling of the skin from weight loss. What do I do? Can you please advise? I will have Blue Cross Blue Shield PPO until October and then I will have Medicare due to my other forms of disabilities. I thank you in advance for any help you can give me.


    Lauren Korman

  • Steve Boyce
    February 17, 2014 at 5:53 pm

    Dear Lauren,

    Congratulations on your great success! Many bariatric surgeons are doing limited body contouring for their patients because of the high cost of plastic surgeons. All insurance companies have codes that cover tummy tucks, brachioplasty, and even thigh lifts. These are handled just like bariatric surgery in that they will have specific criteria for when these procedures will be covered. I would recommend following up with your bariatric surgeon to see if they perform any body contouring procedures. If they do not perform these procedures themselves, then you can ask them if they know of any plastic surgeons that participate with your insurance. I would actively continue to research this while your BCBS PPO is in place.


    Dr. Boyce

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