Bariatric surgery is an excellent tool for managing obesity, but it is not be effective alone. It takes continued hard work and dedication as well as lifestyle changes in order to realize and maintain substantial weight loss and to avoid or control chronic diseases, such as diabetes, high blood pressure or cancer. Regardless of where you are in your bariatric surgery journey, stock your toolbox with these tools:

Nutrition

Bariatric surgery will help you feel more satisfied with less food. Committing to a diet full of nutritious options is the best choice for getting the building blocks that your body needs after surgery. Choose nutritionally-dense foods — foods that are rich in protein, supplemented with non-starchy vegetables — to form the basis of your meals and snacks. Serving sizes after bariatric surgery are much smaller, so you will also need to consistently take your bariatric vitamin and mineral supplements to ensure that you are getting adequate nutrition. Don’t forget your support team: schedule an appointment with your bariatric dietitian to check in early and often.

Fitness

One key to long-term weight maintenance and chronic disease management following bariatric surgery is exercise. This does not mean that you must start marathon training (unless you want to), but it does mean that you should look for ways to be more active. If you are the kind of person who does not love exercise, consider other ways you can be more active: dancing, walking and hiking are great options. Consider trying something new since a prior negative experience may have had more to do with the setting or type of training than you may think. Are you interested in power lifting, ballroom dancing, yoga, softball, kickball or martial arts? Are you the kind of person who likes to take a solo walk on the greenway, or are you more motivated by being part of a class? Are you interested in more one-on-one or small group training environments? Don’t forget your support team: schedule an appointment with the WakeMed Bariatric Fitness Specialist, Joelle Sevio, to create or further develop your fitness plan.

Sleep

According to the CDC, some research has found that a shortened sleep duration results in metabolic changes that may be linked to obesity. Furthermore, information from the American Heart Association indicates that people who do not get enough sleep actually eat more than people who sleep adequately. How much is enough? Information on CDC.gov indicates that adults need a minimum of 7 hours of sleep per night. Nationally, greater than 33% of all adults are not getting at least seven hours of sleep each night. There is some really interesting work that has been done in this area, including evidence that your food choices may be driven by lack of sleep. If you want to learn more about how sleep effects weight, WakeMed surgeon Dr. David Pilati recently wrote a blog post about the topic which can be read here.

Mental Health

The relationship status of obesity and mental health issues should be described as “it’s complicated.” Evidence supports a correlation with the onset of depression and obesity AND obesity with the onset of depression. It’s a classic chicken-or-egg situation. Depression predicts reduced success with weight loss. There is also a reduction in depression symptoms associated with weight loss. At the same time, there are links between anxiety and PTSD with weight gain. The biochemical mechanisms at play here, some of which we understand and some of which we don’t, make the relationship between weight management and mental health very complicated. But what we do know is that when we improve our mental health, improvements in our physical health often follow. Seeing a therapist or psychologist or having a spiritual leader who is trained in counseling can be hugely beneficial. Remember your support team: talk with your primary healthcare provider or bariatric provider for community resources that may help. Take time to tend to your mental health and look for ways to incorporate people that support your mental well-being into your life.

About Stacy Kropp, MPAP, MPH, PA-C, RD, LDN

Stacy Kropp is a certified physician assistant who specializes in surgical weight loss, nutrition, and wellness. Before attending physician assistant school, she practiced as a registered dietitian helping people improve their health through nutrition.

Stacy joined the WakeMed Physician Practices General Surgery team in 2017 and continued working to improve the health and wellness of patients as a physician assistant. With the WakeMed Bariatric Surgery and Medical Weight Loss team, she is focused on helping patients prevent, slow, and/or reverse weight-related medical problems.