We have learned that Post Ops need a lot of help, but don't always know it until things have gone wrong!
We asked our Facebook bariatric support group members a simple question about handling hunger in early post op months, but were not prepared for the outpouring of post ops who were not even making changes needed to make it through the first year, forget a lifetime. Some insisted that their surgery had failed them but admitted that they didn’t take vitamins, drink water or avoid sugar. While some were eating right and drinking protein, they didn't connect that protein with controlling their hunger. Some who were always hungry didnt make a connection to pretzels and goldfish. Then there were those who do not appear to be even trying.
At two years post op and already this far off path, what happens in twenty years? We can already hear their weight coming back and bones collapsing. What is missing? Responsibility! How this turns out is largely up to us.
No matter how fast or successful you were in initially losing weight, these are the top ten things that can and will sink you!
1.Drinking with Meals
Taking a big glug of sweet tea with a mouth full of food is normal for many. But after weight loss surgery, drinking while you are eating washes the food out of your pouch. This allows you to refill your pouch and eat around your surgery. There are some who do this on purpose so they can eat more, adding a twist of psychological sabotage.
We know that there is one professional who wrote that its okay to drink with meals. So latch on and listen to this one voice rather than the many thousands of surgeons & certified professionals who have told us otherwise. Brilliant.
People come up with the excuse that they have to drink because they are thirsty. Drink a glass of water before you eat. Problem solved. You can drink right up until you take that first bite, but once the food starts, no more drinking unless you are choking. This is critical to long term success. No drinking with meals. Forever. Period. Done.
After bariatric surgery no drinking with meals.
2. Drinking Soda
Having a pop doesn’t do anything as dramatic as explode your pouch or even stretch it, BUT it does take many back to a time when they would drink a twelve pack OR MORE of Mountain Dew a day. There are many people who drank a LOT of soda before their bariatric surgery. It is better to not go back there. Post ops are also more likely to drink their soda with meals and that is a combination that will eventually get you back to pre op weight.
3. Not Making Good Food Choices
We obviously made more bad than good choices or we wouldn’t have needed weight loss surgery. We envy Slim People as genetically blessed and don’t realize they watch their food choices and exercise as their normal. When I would lunch with my naturally slim and fit friend Veronica, I would think ‘She is so thin, why is she eating grilled salmon on a house salad? She can afford to eat the bacon blue cheese burger and fries!’
It never dawned on me that she was slim because she didn’t choose burgers and fries plus she exercised in her living room every single morning. I had it backwards and it took me a long time to own that I ate differently than others. Weight gain and loss is math. Calories Eaten versus Calories Burned. We were 300 pounds because we took in more than we burned. A lot more. If we are not losing after surgery, we are STILL taking in more calories than we are burning. We have a volume restriction, which means we are choosing the Wrong Foods.
Cook fresh food, stop with the processed ‘dead’ food, fast food, convenience foods and surround yourself with better choices. For the rest of your life, ‘Protein First, followed by lower carb Vegetables’ is the plan. Keep repeating it. Stick to it. You chose surgery knowing this was the deal. Why have your stomach removed if you never truly intended to change toxic food choices?
4. Not Understanding Alcohol
Not a drop of alcohol for the first year after surgery. The liver and other organs are already pushed beyond normal limits by massive weight loss detox. Non-negotiable.
Your prior experiences with alcohol are no longer valid as things changed with your bariatric surgery. Without a handbag sized stomach for digestion, the cocktail dribbles directly into the small intestine and is sucked into the bloodstream at almost full proof. You can get deliriously sloppy and dangerously drunk in seconds. With bypass surgery you can additionally become ill from sugar as specialty cocktails can easily contain 50 grams of sugar.
Never drink alcohol unless you are with someone with whom you can trust with your life. Period. Your blind date does not qualify. Things can go very wrong with alcohol and if you are alone or with someone who does not understand your surgery, it may place you in grave danger. Never do a shot or feel pressured to keep drinking as alcohol poisoning can kill you.
There are studies that show a slightly increased rate of alcoholism in the bariatric set that may be due to a transfer of compulsive behavior. Be aware of this. If you find you are drinking more than occasionally or cannot stop, get help. Call your surgeons office, they won’t judge and will know what to do.
There is a strong pull to go out, dance and party after being released from the bonds of obesity and social drinking can be a part of that life. We are not a website that tells you to not drink, just have a plan before that first sip. There was a woman in our Support Group who asked which cocktail she should drink for her wedding as she was one year post op and had not tried alcohol. Not a good idea to have your first post op drink at your own wedding, the office holiday party, or a business dinner with your boss. Common sense should always prevail.
5. Not Taking Vitamins or Supplements
Let’s cut to the chase. It’s ridiculous to think that you could have most of your stomach removed or cut in half with intestines bypassed, or a silicon band choking down the organ to the point where forced malnutrition causes a 100 pound weight drop in a few months and NOT need to take vitamins. Professionals TELL US we must take bariatric supplements, yet most don’t. It is shocking how many wonder why they are sick! They insist they chew ice because they LIKE it, when unbeknownst to them they have a ferritin stored iron level of *3*, that is not compatible with life. If you walked into an ER with a ferritin level of 3, they would give you a blood transfusion, not simply IV iron. Serious iron deficiencies can damage your heart.
How long can someone last when food intake is restricted and they cannot absorb nutrients? Take vitamins. Take vitamins. Take vitamins. If you have bariatric surgery at age 35, what happens to you after 25 years of deficiencies? It does not end well. The numbers of post ops who break a wrist or ankle in minor trip and fall accidents would shock you. A crisp porous bone will CRUSH like a wafer and little can be done about it late in the game. Longterm post ops are horrified that their teeth have loosened because of osteoporotic jawbones. Many need involved dental procedures including bone grafts when the underlying structures won’t support a root canal or implant.
There are serious conditions that can damage you when you are deficient in vitamins, protein and or minerals. There are neurological conditions caused by not taking essential supplements that are irreversible and can lead to death. Yes, death.
The image above is from the surgery report when I fractured my ankle in a motorcycle accident 8 years post op. “The bone was extremely osteoporotic”. That straightens you right up. These stories are common. Wake up and pop a couple of capsules!
6. Not Drinking Enough Water
Dehydration is the number one reason for hospital readmission and is a largely preventable complication. Your surgical team is not kidding when they tell you to keep sipping. Many come out of surgery feeling good and then after the first ten days slide into dizziness, nausea, headache, not being able to keep focus and falling asleep mid sentence. It gets progressively worse and unfortunately lands them in a hospital bed where they are fortunately hydrated with a fluid IV. Stay in front of the problem and drink water on schedule to prevent this.
Adequate water intake will also help flush fat metabolites from your system as you lose weight. Drinking water releases water weight so you will lose more pounds. Even 20 years post op I sometimes get a terrible headache and realize that I have not been drinking enough water.
Plan and eat actual meals. Three meals plus Two small Protein Snacks; this is also called Five Small Meals. Grazing is eating a bite here and a bite there, never really filing up. Your small pouch is the strongest tool and not filling it is giving up a powerful way to control fullness.
Sit down with your plate then slowly and deliberately eat your meal; fullness or satiety will tell you when to stop. Grazing is a behavior that allows you to consume a larger amount of food over a longer period of time as pouch fullness does not happen. If you realize you are grazing, stop it by eating enough solid protein to feel full, a hard cooked or deviled egg, rolled up deli turkey, half a protein bar. Or DRINK AN INSPIRE PROTEIN DRINK… bam, tastes good and you won’t want to eat.
Much of what we call grazing is due to ‘head hunger’ where we think we are hungry or actually just looking for something to do. Take up beading, play online games, read, anything to take attention from food!
8. Not Exercising
Obese people like to believe that people who go to the gym love to exercise. The truth is that people who exercise WANT to look and feel good. Few really like the act of working out, they like the result.
EAT LESS BURN MORE is a mathematical formula to lose weight! The boost provided by even 10 minutes a day of jacking up your heart rate will help you lose weight faster, give you a chance at keeping it off longer, help you LIVE longer and make you look & FEEL better. I cannot believe the energy I now have and I am happy. I wasted so much time feeling tired and sad.
If you are right now formulating silent excuses that ‘you would’ but have bad knees, medical maladies, no money for gym membership and no time, we have BE exercise plans that are done at home, using no equipment, place zero impact on joints and take up just 10 minutes of your day. Poof. Nice try. Excuses gone. If you choose to be a slug, OWN IT! Sorry, but walking around Walmart doesn’t count for squat. Get real.
These short videos feature BJ Gaddour of Men’s Health and StreamFit and show how LITTLE exercise you can do. It will make a difference! This low impact full body movement is called a Ground Zero Jump. Your feet do not leave the floor. Anyone can do it and it can be done anywhere. Stand up and give it a try right now. It will make you feel good to do it.
9. Eating Too Many Carbs
Let’s lay it out there. A big post op problem is HUNGER and many do not get that carbs are the reason.
Eating protein first crowds out the carbs which controls hunger and forces weight loss. Any carbs eaten should be the vegetable or fruit kind. While a Little Debbie cake may have the same carbs as a dish of blueberries, it has zero nutrients. The little cake is a processed or dead food with no nutritional value. Choose the berries for great taste, fewer calories, tons of nutrients and use the energy to burn stored fat! All around a much better deal.
Carbs like pretzels and biscuits burn quickly and leave you hungry for more. Ever notice that eating Goldfish crackers just makes you want to eat more Goldfish crackers? When people are gaining weight and keep a food journal for a few days, it’s obvious that carbs have wiggled their way back into the kitchen. Clean them out, stop buying them and get some fresh lower carb foods that bring nutrients to the party.
10. Assuming Surgery Has Cured Your Morbid Obesity
Calling it a Honeymoon Period is an accurate description. When weight is falling off and suddenly the world is brighter and all is good it is hard to imagine you will ever face the problems of morbid obesity ever again.
Here’s your wake up call. THE WEIGHT LOSS PARTY ENDS. During those first seven months of massive weight loss you are not driving the bus. You will lose the same amount of weight no matter what you do. There are some who don’t catch on to this and happily think that they have somehow cheated the system and are still losing weight while eating french fries. This does not end well in the long run.
It is common for post ops to not lose all the way to goal weight or over the years regain a substantial portion or even all of their weight back if they have not embraced making completely different foods choices. Even those paying attention can get hit with a gain, just like people who have not had weight loss surgery can gain weight. As with most successes, you create a long term plan and follow it. Weight loss surgery is not effortless nor does it last forever without serious commitment to the new way of life you create.
Change is hard, even with weight loss surgery. While we all thought this would be less difficult and more permanent, it turns out that just like in non-surgical life, once out from under the burden of 150 plus pounds it still comes down to diet, exercise and our willingness to change.