How Diet History Affects Weight Loss Surgery Success

In my last blog entry, I discussed one of the most common questions patients have as they start their weight loss surgery journey: Why does the process take so long? The answer is more complex than you may think.

Last time, I touched on the insurance limitations placed on patients before surgery. In this column, I will talk about my favorite subject, food, and why it is important for patients to be thinking about it before surgery. The topic of food is important. It has everything to do with what is best for the patient and what maximizes the patient’s chances of long-term success with weight loss surgery.

Getting used to “Eating Right”

One of my favorite phrases to use with patients is this: It takes a while to get used to “eating right.” This phrase embodies the philosophy that lifestyle changes take time. Before your surgery, you must learn to eat small meals frequently (every 3 hours or so during the day). Eating the right foods this way will boost your metabolism, which will help you lose weight (yay!).

Eating small meals frequently also helps patients get used to life after surgery because all of the operations involve limiting how much food patients can eat. Small, frequent meals mean you are eating before you get hungry and minimizing the risk of overeating. Overeating after surgery almost invariably leads to pain and/or vomiting. Learning how to eat right takes a little practice, and I usually recommend patients spend about three months in our nutritional program before undergoing surgery, irrespective of what their insurance company says.

How Weight Loss is a Predictor of Long-term Success

One of the best predictors of how well patients will do with losing weight and keeping it off is how much weight they lose before the operation. When a new patient comes into the office to meet me for the first time, I look at diet history very closely. If a patient lost a lot of weight (regardless of whether they gained it back or not) in previous attempts, whether that was Weight Watchers, NutriSystems, Atkin’s Diet, or something similar, those patients have already demonstrated that they have a pretty good metabolism, and one that will respond well to being taught to eat right.

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Even if a patient hasn’t demonstrated good weight loss in the past, if they can lose at least 5% of their total body weight before the operation, they are far more likely to lose good weight after surgery and keep that weight off long-term. It shows that patients are dedicated to making a lifestyle change, and it also predicts that patients will be more compliant with the changes to their diet that are necessary to successfully transition to a weight loss operation.

In my next blog entry, I will discuss the third part of the answer to why patients have to wait before they can have bariatric surgery. That means exercise, so make sure you stretch out real well and get your best fitness clothes on!

mccullough-headshotDaniel McCullough, MD, has been a bariatric surgeon for the past 10 years. Prior to joining ProMedica Physicians in July 2016, Dr. McCullough practiced in Maryland, Delaware and Virginia. He completed a Bariatric Surgery fellowship at The University of Virginia, residency in General Surgery at The University of Toledo Medical Center, and medical school at the Medical College of Ohio (UTCOM). He is a native of Toledo, Ohio.