Losing weight after weight loss surgery is not difficult, but keeping it off is

Weight loss surgery requires a lifestyle change, and if there are no changes, then years later bariatric surgeons see these patients when they want a revision of their surgery—because they have regained their weight. These individuals will show the doctor pictures of a much slimmer view of themselves years before, usually about a year after their surgery. They say that they regained weight because “something” happened to them in the last few years that caused the weight gain. Usually they blame a yet undiagnosed technical problem with the surgery that has caused the weight regain instead of taking responsibility for what they eat.

Sometimes there is a technical reason, but most of these individuals did not follow the principles listed on the previous page. Instead, the original operation allowed them to lose weight without working for it, and as the years passed and they regained weight, they came back to a bariatric surgeon and again wanted the “magic” of surgery.

Surgery isn’t magic; surgery for weight loss is the start of a lifestyle change

 In summary, people can lose weight doing most anything—strange diets, and even surgery; but it is a commitment to simple lifestyle changes that makes a dramatic difference in their ability to lose weight and keep it off.

The figures vary, but somewhere between 25 and 40 per cent of patients who have the Roux-en-Y gastric bypass begin to regain weight after about 18 months. Long term it might be more. It is clear, however, that those who make the necessary changes in their life will not regain their weight. The “golden period” or “window of opportunity” is truly never shut, unless the patient shuts it by eating junk.

In the old days, there was a weight loss surgery that caused severe malabsorption

 Patients loved it. They could eat whatever they wanted to, and would not absorb much. There were two problems with this surgery – first, some developed liver failure – not a good thing. Second, the small bowel learns to absorb better, so these patients became, after a few years, obese again. These patients were left with 18 inches of small bowel to absorb food, contrast that with an operation called the duodenal switch, which leaves 50 inches of small bowel. Some patients who have the RNY and do not lose weight think they need more malabsorption, a longer bypass, or a shorter common-channel – in fact, what they need is to change their lifestyle.

Weight loss surgery is often referred to as a tool

The weight loss tool works by restricting the amount of food that they eat. Some say that the tool is the “easy way out.” It is not. A tool makes a job doable. Try to pound a nail in without a hammer—you could get a rock, but it won’t work as well, but no one says using a hammer is the easy way out. Try digging a hole with your hands. A shovel makes the job far more doable but no one says using a shovel is the easy way out. The tool of weight loss surgery is designed to take the patient to one level. This book was designed to take patients to the next step in order to get to a reasonable, healthy weight and stay there. But like any tool, it doesn’t work by itself—and like any tool, if it is abused you can break it.

For those who have not had surgery and have thirty pounds to lose, you do not need an operation. That tool is not required. Instead, some simple principles, practiced over the long-term, incorporated in your sub conscious, will lead to permanent weight loss.

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