Why do we lose weight after bariatric surgery?
Weight reduction in the first 2-3 months after surgery is rapid, but slows down over time. You will reach your lowest weight about 9-12 months after surgery. During this time you will reduce approximately 70-80% of your excess body weight.
However, weight gain is possible after the initial weight reduction, and the amount of weight gained depends on the individual. Some patients will regain some of the reduced pounds and the weight will stabilise at a loss of 60-70% of the excess body weight.
Bariatric surgery is a laparoscopic surgical procedure for the treatment of obesity in which the stomach is reduced by 80% of its original volume. The new organ looks like a small banana and holds about 150ml of liquid food. It resembles a sleeve, hence the procedure is called sleeve gastrectomy. During the operation, the part of the stomach that is responsible for the production of ghrelin is removed. Called the "hunger hormone", ghrelin stimulates the hunger centre in the brain, stimulates the feeling of craving and "encourages" food intake.
The new stomach has a significantly smaller volume, which effectively makes it more difficult to eat large portions of food. Thanks to the combined effect of less hunger hormone ghrelin (reduced appetite) and a smaller stomach (reduced portion size), patients who have undergone sleeve gastrectomy successfully reduce their excess body weight.
How can I keep losing weight?
People who have successfully and permanently reduced weight have applied several important principles to their post-operative management. Four important habits that are associated with successful and long-term weight loss.
- Eating behaviours and food choices
Patients need to understand what their food consists of and avoid heavily processed and partially prepared foods. The easiest way to achieve this is to cook their own meals from unprocessed foods. This is not always possible, but even then choices should not include fasy foods or sweets. All foods should be of high quality.
Regular exercise helps maintain weight loss. Patients who are successful in maintaining weight loss are more physically active. Exercise should be done for at least 200 minutes a week and should be spread over at least three sessions.
Weight loss improves sleep quality and can alleviate sleep disorders (such as sleep apnoea). The most common causes of sleep problems after bariatric surgery are insufficient sleep and disrupted diurnal rhythms (e.g. night shifts).
- Keeping your body and mind healthy
Respecting your body, monitoring your weight and fitness regularly, going to recommended follow-up appointments after surgery, attending age-appropriate screenings, getting vaccinated, not smoking, avoiding alcohol. These are some of the activities and habits that will definitely help you maintain a healthy lifestyle and contribute to weight management.
What behaviours can cause weight gain?
- Chaotic eating - Lack of an eating pattern to follow and return to. Lack of a rhythm for eating meals. Eating low on daily priorities.
- Skipping meals - Long periods without eating, which can result in overeating later. Ineffective meal planning and following a plan, with appropriate snacks or easy and healthy options to prepare.
- Poor food choices - Highly processed, fried and fast food; reverting to previous habits that caused the initial weight gain.
- Snacking, or eating frequent small portions of food - Small portions of food eaten chaotically and uncontrollably, can lead to increased nutrient intake. It is a good idea to prepare portions of a certain volume and consume the meal prepared in this way.
- Night eating - a large part of energy is consumed after the evening meal. Ensure that your meals are planned, try to eat regularly starting with breakfast.
- Too large a portion - Overeating, continuing to eat despite feeling full. Try to keep to a set meal size, eat slowly and chew each bite thoroughly.
- Alcohol consumption - After bariatric surgery, alcohol is rapidly absorbed, which can cause an increase in appetite and a lack of satiety. It is a good idea to limit or even exclude drinking alcohol. People who have had bariatric surgery may develop alcohol problems even if they have not previously experienced any symptoms of alcoholism.
- Insufficient protein intake - Protein is the most important ingredient on the plate, it should give the feeling of satiety, but is also extremely important for maintaining muscle mass. Building skills to compose meals with correct nutrient ratios.
- Mixing liquids and foods - This can increase stomach volume and contributes to early emptying. Avoid liquids in the immediate period before and maintain a 30min interval after a meal.
When can the result of surgery be considered good?
The success of a treatment should not be judged solely in terms of weight loss or weight gain - changes in health and quality of life should also be considered.
Examples of positive changes, in addition to weight reduction, include overall improved physical and mental performance, increased self-esteem, higher energy levels, reduced physical pain, better sex life, more successful social behaviour and improved emotional health.
Satisfaction with the outcome of surgery begins with setting realistic goals and realising your active role in achieving and maintaining the outcome.