ARTICLE BY GINA FOURIE: DIETICIAN
To prevent weight regain after bariatric surgery, one needs to make lifestyle and behaviour changes that stick, as bariatric surgery is only one tool in the toolbox for long-term success. Here are some tips to help make the weight you lose permanent:
Ensure you stay connected with a team of experts or health team who can guide you through the process. Frequencies of follow-up visits after surgery are inversely related to weight regain – based just on this, I believe patients should commit to long term follow up programmes. Your therapist will help you to navigate emotional eating and help you to attain greater psychological strength and stability (lower levels of depression are correlated with less chance of weight regain). Registered dietitians provide support and answer vital questions, while holding you accountable in preventing old eating habits from creeping back. With the help of your healthcare team, identify the emotional connections you have with food and work to change those patterns before and after surgery for the best chance at success. Replace those ingrained patterns with new patterns or eating habits. Give nutrient dense foods the priority they deserve. Years down the line, when you feel some hunger has returned and your portion sizes are no longer so petite, incorporating low-calorie, high-volume foods like vegetables can be key to preventing weight regain. In addition, the physical therapist in the team will help you to make physical activity a big part of your life. There is some evidence that an increase in exercise volume is linearly related to weight loss post-bariatric surgery. Ultimately aim to be physically active most days of the week and incorporate cardiovascular and resistance exercise to preserve and build muscle mass. This will stand you in good stead to maintain all the weight that you manage to lose.
Take advantage of a support network and support group. Friends, family, and other patients walking a similar path can offer insight the bariatric team cannot. Bariatric surgery is an emotional roller coaster – surround yourself with people who have understanding about what people with obesity struggle with and can offer unique ideas to overcome barriers, or just offer emotional support.
Reach a self-determined goal weight – it is so important to be realistic about this goal. Don’t wait until you have reached your goal to be proud of yourself. Be proud of every step you take towards reaching that goal.
Maintain a regular meal rhythm or eating pattern, paying special attention to avoiding snacking, picking, or grazing.
Self-monitoring behaviour i.e. keeping a diet journal and weekly weighing to improve focus on the healthy eating process and remaining mindful of what, how and how much you are eating.
It is important to have an internal motivation to lose weight. You need to be doing this for yourself and experience the benefits of the weight loss.
With the help of support or therapy, an improved and constructive ability to handle stress i.e. better coping strategies can also improve weight loss maintenance.
A sense of self-efficacy, autonomy and assuming personal responsibility are also key components to long term wellness.