Why Some Patients Fail to Lose Weight after Surgery – My Bariatric Life

My Bariatric Life Health Guide
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    Bariatric surgery requires significant on-going behavioral changes and adherence to dietary and activity recommendations. In this regard, life following bariatric surgery is no different from the life of participants in traditional non-surgical weight loss programs.


    Research indicates that there are a number of behaviors that are associated with successful weight loss and patients should be encouraged to engage in as many of these as possible:

    • Attend post-operative support groups
    • Increase physical activity
    • Keep a food journal
    • Stimulus control (e.g. no junk food in the pantry)
    • Substitute behaviors for eating (e.g. take the dog for a walk)


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    In particular, researchers indicate it is imperative to make modifications to the environment in which we live so as to control stimulus, or eating triggers. In the toxic food environment in which we live we find ourselves faced with an onslaught of unhealthy processed foods that are rich in fat, sugar, and other ingredients that promote obesity. Post bariatric patients will be particularly vulnerable to such cues.


    The restrictive component of bariatric surgery alone is not responsible for weight loss. While it is not fully known how the surgery works, the resulting reduced caloric intake and absorption helps with weight loss. So patients who engage in certain eating behaviors that circumvent the effects of the surgeries are at greater risk for weight regain. Maladaptive eating following bariatric surgery includes grazing, sweet eating, and consuming an excess of liquid calories.


    Grazing refers to consuming a large amount of calories by eating small amounts of food over an extended period of time. Those patients whom were binge eaters prior to bariatric surgery may instead resort to grazing on foods that are more easily consumed in larger quantities, such as high calorie liquids or foods that melt like ice cream and chocolate.


    A significant number of bariatric patients report a past history of emotional eating. This can be dangerous as bariatric surgery does not teach patients alternate methods to cope with emotional distress to substitute for eating. If they are emotional eaters they may resume eating in a manner similar to their behavior prior to surgery.


    These maladaptive eating patterns are addressed specifically as behavioral issues with treatment focused on breaking unhealthy eating patterns and developing healthy ones. For example, grazing is replaced with controlled eating by way of planned meals and snacks. Patients keep a food journal to document all food consumed and learn specific coping behaviors.


    Similarly, patients who’ve learned to use food as a universal emotional cure-all need to participate in programs that will teach them alternate methods of coping with emotional distress.


    Patients who undergo bariatric surgery may believe that there is something wrong with them because they are morbidly obese. Additionally, they may have irrational beliefs about an incurable addiction to food. So for some patients to be successful after weight loss surgery it is essential that these maladaptive beliefs be addressed so that they may be at peace.  


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    My Bariatric Life


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Published On: October 18, 2013