Weight Loss Surgery: Maintaining Weight After Bariatric Surgery
This Bariatric Friday, Kemal Erkan, Chairman of American Surgery Center, is accompanied by Dr. Isaias Irgau, President of Christiana Institute of Advanced Surgery to engage in a discussion regarding maintaining weight after bariatric surgery, also known as weight loss surgery.
Dr. Irgau explains how bariatric surgery is the most powerful tool that aids in losing a large quantity of weight. During bariatric surgery, the surgeon removes a portion of the stomach from the body; this is permanent. However, weight gain after bariatric surgery is still possible. The American Surgery Center has a program in place for patients to prepare for not only their surgery but how to manage their weight following the procedure. “This is a tool, we know that you have tried diets hundreds of times and not been successful… we are not saying stop those attempts… we are adding bariatric surgery to those efforts,” Dr. Irgau states.
Food is pervasive in our country; this can lead to poor habits. Food is available everywhere in high caloric density; therefore, it is important to understand calorie consumption. The greater number of calories taken in, the higher the probability those calories will turn into fat and cause weight gain. Dr. Irgau mentions that people should listen to their bodies. If you are feeling full, you should stop eating. It does not matter if you have only eaten half of an appetizer, if your stomach is full, then you should not continue to finish your meal. Biology also plays a significant role for those suffering with obesity. “Everyone will have a propensity to gain weight… as people we have evolved to learn to accumulate and to store calories… all of us have evolved in a biology that is much more friendly to weight gain than to weight loss,” Dr. Irgau explains. Certain people can do all the right things, such as exercising and dieting, but never lose the weight they need. After having bariatric surgery, this biology does not disappear. Thus, educating the patient prior to the procedure is extremely important. It is crucial to understand fullness. The stomach size has been reduced, so the patient should not be overeating once the stomach is full. “For a person who has had bariatric surgery, the difference between fullness and discomfort could be one extra bite… they really have to learn to listen to their body when it tells them it’s full… the danger of pushing it time after time is that the stomach can adjust,” Dr. Irgau states. It is important not to stretch the stomach. The stomach stretching out will counteract the progress made with the surgery. Dr. Irgau states, “That’s why we don’t just do surgery, we have a program where we have to empower people with knowledge beforehand, so they can stay successful in the long term.”
“Our relationship with our patients is not over after the surgery. I am going to make sure the patients are open about their issues so then we can actually provide the appropriate support, Erkan explains. It is important that patients know that the team is always there for them. The support group that they provide allows patients to discuss their thoughts or concerns throughout their journey and receive advice or feedback. “We want to hear of their success stories… but we also need to know when they’re struggling… obesity is a chronic disease… they shouldn’t feel embarrassed, they should always reach out,” Dr. Irgau affirms, “our program is obviously very open to that because we know that's a critically important component for the success of our patients”.
In regard to fitness after bariatric surgery, Dr. Irgau says the foundation of fitness is walking, “walking is the foundation because as human beings we were built to walk”. With the evolution of technology, people are now able to track their steps during the day. “All of us should strive at some point to get to ten thousand steps a day… if we start tracking it, no matter how low we are, we will be able to tweak our routine… whether it’s parking further away, whether it’s taking the longest route in a store,” Dr. Irgau suggests. Walking is critical and it is easy to incorporate into the day. Dr. Irgau reassures patients, “weight regain is not something that happens commonly of course many of them (patients) may have seen friends or family members who had weight loss surgery who drastically lost weight and then they’ve seen them regain some weight… we have to make a distinction between regaining weight and some weight gain… in bariatric surgery, we believe that if a person is able to lose fifty percent of their excess weight and they maintain that long term, that is success”. Erkan concludes by saying , “with proper support and daily discipline, we can actually prevent a lot of the potential challenges… for people feeling comfortable with their body, feeling healthy, living longer, being with their loved ones longer, these are all important things, and we want to be part of that and we want to help our patients”.