Completing the puzzle for bariatric patients

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When I was researching bariatric surgery for myself, I was initially given very little guidance from the referring doctor. Pinterest became my friend, and I discovered a few valuable resources, namely Reeger Cortell’s Weight Loss Surgery Podcast, which I recommend for anyone considering bariatric surgery and for post-surgery patients at any and every stage. I have links to a few other resources on my personal blog. I also joined a number of different Facebook “support” groups.

On these groups, you’d see questions like:

I’m six weeks out from surgery. When can I eat pizza again?

No joke. This is the one that I always cite as an example of a SMH moment. You’ve undergone major surgery, with many risks, and you’re thinking about pizza? I see people making taco shells out of cheese or pizza with wonton wrappers — basically continuing the same eating patterns that resulted in the need for surgery.

A few things about bariatric surgery: whether you choose a sleeve gastrectomy or Roux-en-Y gastric bypass, the surgery is on your stomach, not your brain. Your sleeve or bypass is just a tool and part of the equation. And it’s a very powerful tool! To some degree, the weight loss will continue over the course of 12-18 months. Some people lose with easy, while some people have to follow the dietary guidelines to a T (that’s me — more on this later). And incorporate exercise immediately post surgery. Behavior change is key. And building healthy habits needs to happen before surgery.

Some bariatric programs have amazing support. Orientations, nutrition classes, guidelines for supplementation following surgery, meetings with psychologists and nutritionists, and active support groups. It’s obvious, however, from observing the conversations in these Facebook groups that people are not researching this surgery prior to permanently altering their bodies, nor do they receive proper pre-surgery education or post-surgery follow-up. This education and support is something I see as a gap in the bariatric surgery process.

I’m one of the most fortunate patients. Not only am I a rule-follower who thrives on structure and rules, but I also had a fantastic surgeon who provided excellent guidance both before and after surgery. She teaches the nutrition classes herself, and is far more knowledgable about nutritional needs, malabsorption, quality of supplementation, adjusting for stubborn metabolisms, and other guidance following surgery. Her practice now has a private support group ( which I’ll add that I helped start up and function as an admin), and she is actively participating in the discussion.

As a health coach, I can help close that gap by coaching from experience. I am still working on reinforcing the positive lifestyle changes required for being an obesity ass-kicker. The most important thing I have learned is that everyone has their own unique journey. People lose weight at different rates, people have difference medical co-morbidities that may change how their bodies’ metabolism functions, and people react differently to certain foods. Guidelines are just that – guidelines. Everyone has a unique prescription for unlocking their optimal health, even bariatric patients. They just need to discover what that is. I still have more discovery to do in order to hit that sweet spot, but I am enjoying what I am learning from the process.

And the answer to the question “when can I eat pizza again?” — for me, it’s never. However, the exploration of more appropriate options is all part of the fun.