Weight Loss Surgery - Gastric Bypass/Sleeve Gastrectomy: 18 Month Follow-Up

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PODCAST – 18 Months


Hi – this is Debbie, your registered dietitian. Congratulations on making it to 18 months out from surgery. Hopefully you have had some great weight loss following your gastric bypass.

At this point out from surgery, weight loss has basically stopped. By now, the gastric bypass has done what it can in helping you achieve dramatic weight loss. From this point forward, the primary goal is weight maintenance. Fifteen percent of bypass patients regain some or all of the weight they lost. We don’t want that to be you!

Here are some tips for keeping your weight off:

First, Eat Breakfast, Everyday. “Breakfast” is any nutrition you can get in within two hours of waking up. It doesn’t have to be a 3 course meal. Try to include a protein like egg or cottage cheese but please avoid breakfast meats like sausage and bacon. Breakfast doesn’t have to be breakfast foods. Leftover lean dinner meats or beans are fine too. If you aren’t hungry for breakfast, you may be eating too much in the evening.

Next, continue to limit your starches. Our most successful patients keep their ½ cup starch servings to 2 per day, and they make sure that the starchy foods they eat are high in fiber and whole grains. Avoid starches at lunch by choosing a protein-topped salad or wrapping your sandwich in lettuce and avoid using crackers or chips as “carriers” for foods like peanut butter, tuna salad or salsa – use fresh veggies, cucumber slices or a spoon instead! At snack time, choose apples, carrots or string cheese instead of popcorn, crackers or cereal.

The purpose of gastric bypass is to create fullness after eating small portions of solid foods but if you snack or pick on food throughout the day, you are not allowing the surgery to work for you the way it was designed to. You may not need to eat as many times per day as you did right after surgery. Be sure you are not eating if you are not hungry and think of every eating occasion as a “meal” that includes a lean protein and perhaps a vegetable or fruit. Using the word “snack” allows for poor food choices – just remove that word from your vocabulary. Also, to maximize the benefit of your new anatomy, avoid, slippery, slidey foods like protein shakes and even yogurt. Those foods pass through your pouch too quickly and keep you from having that prolonged sense of fullness. Continue to separate eating and drinking - drinking too soon after eating will flush the solid food through your pouch too quickly, allowing you to get hungry sooner.

It is also important that you maintain an aggressive exercise routine. Exercise is more critical for weight maintenance than weight loss. And now that you weigh less, you don’t burn as many calories doing the same activities as you did when you were heavier. Additionally, research shows that you need to do more exercise than a person that weighs the same as you, because you used to weigh more. The 2005 Dietary Guidelines and the National Weight Control Registry state you must do 60-90 min DAILY to prevent weight regain after significant weight loss. While that fact may be overwhelming, the bottom line is strive to do more every day.

Research also shows that if you write down everything you eat, you will be more successful at weight maintenance and weight loss! Food journaling makes you accountable for every bite that you take. Now, it doesn’t matter how you choose to do this: paper and pencil, an excel spreadsheet, or even any of the websites available. Just jotting it down keeps you honest and shows you what to work on. While you’re at it, write down your exercise and vitamins too!

If you are at 18 months and are not at your personal goal weight, you can still lose more. But at this point, the dramatic, rapid weight loss that occurs right after gastric bypass is behind you and now it is a matter of eating less and moving more.

For the long haul, remember that you are different. You cannot tell from the outside that you had bariatric surgery. Once you lose the weight, many will never know you ever struggled! Surround yourself with people who can identify what life after surgery is like in order to keep your eye on the ball! Use these podcasts and your bariatric surgery support groups, to stay connected with others who have been there and done that!

It is important that you see us at your 18 month mark and then every year around the anniversary of your surgery. During these visits, we can discuss your personal weight loss and diet, as well as review your supplement intake, exercise routine and do lab work on you.


Your MUSC Bariatric Surgery Team wants you to be successful and stay in touch.  If you need an appointment, call us at (843) 792-7929 or visit us at www.muschealth.com/weightlosssurgery   


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