For many living with obesity, bariatric surgery is a critical step toward achieving better health. However, the path to sustained weight loss and lifestyle changes extends beyond the procedure itself. Many patients find that joining a support group is one of the most valuable ways to stay on track and feel empowered. Support groups offer a unique combination of motivation, emotional support, and practical tips that can improve the post-surgery experience.

Let’s explore three important advantages of participating in bariatric support groups, along with research-backed insights on why they play an essential role in post-surgery success.

1. Motivation and Accountability

Staying motivated on the journey after bariatric surgery can be challenging, especially during times of stress or plateaus. Support groups provide a space to share progress, setbacks, and goals, creating an atmosphere of encouragement and accountability for those attending.

• Regular Check-Ins: Meeting regularly with others reinforces accountability, which can help you stick to dietary guidelines and exercise routines.
• Community Encouragement: Listening to others’ stories and achievements serves as a powerful reminder that you’re not alone, which helps maintain momentum.
• Scientific Insight: One study examined the impact of participation in an online support group on bariatric surgery patients. The findings revealed that frequent users of the group experienced significantly higher weight loss up to two years post-surgery compared to infrequent users and a control group. This suggests that online support groups can be a valuable tool for improving postoperative outcomes in bariatric patients.¹

2. Emotional Support and Coping Strategies

The emotional aspects of weight loss and lifestyle changes can be just as challenging as the physical ones. Many people turn to support groups for a safe space to discuss feelings, frustrations, and successes with others who truly understand the journey.

• Shared Experiences: Talking with others who have had similar experiences provides comfort, reduces feelings of isolation, and helps normalize struggles.
• Stress Management: Support groups often discuss ways to manage stress, which is critical for avoiding emotional eating and other setbacks.
• Scientific Insight: A recent study found that psychoeducational support groups significantly improve self-management in bariatric surgery patients. Participants showed better eating habits and emotional regulation, highlighting the importance of these groups for long-term success.²

3. Education and Practical Tips

Bariatric surgery requires lifestyle adjustments that go beyond simple dieting. Support groups often provide valuable educational resources and practical advice on nutrition, exercise, and overall health management.

• Nutrition and Meal Planning: Support groups may offer insights from dietitians or nutritionists, who share meal ideas, portion control strategies, and tips for balanced nutrition.
• Exercise Guidance: Many support groups discuss beginner-friendly exercises and activity modifications that accommodate post-surgery needs, helping members find physical activity that suits them.
• Scientific Insight: Research shows that frequent participation in educational programs after bariatric surgery leads to better long-term weight loss. These programs offer essential tips on nutrition, exercise, and health management, helping patients maintain their weight loss effectively. A study found that patients who frequently attended these programs had greater weight loss and less weight regain 10-15 years post-surgery compared to infrequent attendees.³

Conclusion

The journey after bariatric surgery encompasses more than just physical changes; it also involves significant mental, emotional, and lifestyle adjustments. Attending a support group is a powerful way to navigate these changes. Through motivation, emotional support, and valuable education, support groups can help you stay on track and committed to your goals.

We encourage you to join our upcoming support group sessions. You’ll find a welcoming space to learn, and connect with others who understand your journey.

Join Our Next Virtual Support Group

If you’re looking for extra support to stay on track, we invite you to join our upcoming free virtual support group session. Whether you’re navigating holiday gatherings or just looking for practical tips to maintain your health post-surgery, this session will offer valuable insights and community connection.

Event Details:

• Topic: Holiday Success Post-Surgery: Food, Family, and Post-Surgery Tips
• Presenter: Cassie I. Story, RDN, Director of Nutrition
• Date & Time: Wednesday, November 13th, 2024, at 11 AM PST / 12 PM MST / 1 PM CST / 2 PM EST
• Can’t Attend Live? No Problem! Sign up anyway, and you’ll receive a recording of the session to watch at your convenience. Register now and take a step toward a healthier, more empowered holiday season.

References

1. Athanasiadis DI, Carr RA, Smith C, et al. Social support provided to bariatric surgery patients through a facebook group may improve weight loss outcomes. Surg Endosc. 2022;36(10):7652-7655.
2. Shinan-Altman S, Sandbank GK, Katzav HN, Soskolne V. Participating in Bariatric Support Groups: the Effects on Self-management Changes. Int J Behav Med. 2023;30(1):19-29.
3. Bjerkan KK, Sandvik J, Nymo S, et al. The Long-Term Impact of Postoperative Educational Programs on Weight Loss After Roux-en-Y Gastric Bypass. Obes Surg. 2022;32(9):3005-3012.

Losing weight is a transformative journey, especially after bariatric surgery. Procedures like sleeve gastrectomy and Roux-en-Y gastric bypass offer substantial potential for weight loss, improved health, and an enhanced quality of life. The journey doesn’t end with the surgery; rather, it marks the beginning of a new chapter where your active participation plays a crucial role in your long-term success.

It’s important to understand that weight loss outcomes can vary in the long term post-surgery. While many people achieve remarkable weight loss success, others face challenges in losing the optimal amount of weight during the first 12- 18 months post-surgery, a term known as inadequate weight loss.¹

Additionally, other patients experience significant weight regain.

Recent studies suggest that by seven years post-sleeve gastrectomy, only 20% of patients maintain a weight loss greater than 50% of their excess body weight, which is one measure of weight loss success after surgery.² This highlights the importance of effective weight management strategies, including self-monitoring.

Self-monitoring involves tracking various health aspects and behaviors contributing to weight loss or gain. It can include monitoring your calorie intake, physical activity level, and body weight. By keeping an eye on these factors, you become more aware of your habits and patterns, allowing you to make necessary adjustments for improved health.

Maximizing Success After Bariatric Surgery

Understanding the factors that influence bariatric surgery outcomes can help you take proactive steps toward your goals. Successful weight loss after surgery involves following dietary guidelines from your healthcare team, incorporating regular physical activity, and consistently monitoring your food intake and body weight.

Engaging with support systems, such as your bariatric clinic and support groups, also plays a crucial role in maintaining motivation and accountability. To read more about long-term strategies for success, read our blog.

The Power of Self-Monitoring

Self-monitoring is a simple yet powerful tool that can significantly impact your weight loss journey. Here’s why it’s so effective:

• Increased Awareness: By logging your food intake, you become more aware of your eating habits. This awareness helps you make healthier choices and identify patterns that might be impacting your progress. It also ensures you reach crucial nutrition goals, like consuming enough protein.
• Accountability: Tracking your weight and dietary habits holds you accountable. It’s a tangible way to see your progress and stay committed to your goals.
• Data-Driven Decisions: Regular self-monitoring provides valuable data that can help you and your healthcare team make informed decisions about any needed adjustments to your diet, medications, or lifestyle.
• Prevention of Weight Regain: Self-monitoring allows you to catch minor weight gains before they become significant, preventing 5 pounds of regain from turning into 50.
• Motivation: Seeing your progress, even in small increments, can be incredibly motivating. It reinforces your positive changes and encourages you to keep going.

Trusting the Journey

Research shows that individuals who log their meals daily lose significantly more weight than those who don’t. Self-monitoring has also been shown to improve self-awareness, self-efficacy, and self-regulation – all crucial elements for a successful weight loss journey.

A recent paper highlights the impact of food tracking on weight loss outcomes at 24 months post-sleeve gastrectomy.³

• Individuals tracking their food intake most days of the month lost 76% of their excess body weight.
• By comparison, those logging 10 days a month lost 69% of their excess body weight over the same period.
  • This means that those who tracked their meals daily lost 9% more of their excess body weight than those who tracked less frequently.
• On the lower end, sleeve gastrectomy without self-monitoring behaviors tends to result in about 45% loss of excess body weight at 24 months.
• This indicates that people who self-monitor their food intake most days in the long-term post-surgery can expect to lose 40% more excess body weight than those who don’t!

These findings emphasize the critical role of consistent self-monitoring in achieving weight loss goals. By adopting consistent self-monitoring habits, you equip yourself with a powerful tool for achieving your weight loss goals.

Overcoming Barriers to Self-Monitoring

Despite the compelling evidence supporting self-monitoring, it is natural to feel hesitant or overwhelmed by the idea of tracking your daily activities. Let’s address some common barriers and how you can overcome them to make self-monitoring an integral, manageable part of your routine.

1. Time Constraints: One of the most frequently cited barriers to self-monitoring is the belief that it takes too much time. However, with various user-friendly apps and tools, logging your meals, exercise, and weight has never been easier. Devoting just a few minutes each day can yield substantial long-term benefits. Consider it an investment in your health and well-being.

2. Fear of Judgement: Many people fear being judged about their food choices or weight. Remember, self-monitoring is a private and personal tool meant to help you; it is not about perfection. It’s about staying informed and making gradual improvements. Judgment has no place in your journey; focus on self-compassion and growth.

3. Forgetfulness: Establishing a new habit can be challenging. To combat forgetfulness, set daily reminders on your phone or incorporate tracking into a specific part of your routine, such as after meals or during your evening wind-down. Consistency will eventually lead to a habit.

4. Emotional Triggers: At times, the act of recording everything you eat might feel like a constant reminder of challenges, which can be emotionally taxing. Acknowledge these feelings without judgment.

5. Perceived Complexity: The self-monitoring process might seem complex or intimidating at first. Start small. Begin by tracking one impactful aspect, like your daily meals, before gradually expanding your efforts. Simplifying the process makes it more approachable and sustainable.

By recognizing and addressing these barriers head-on, you can transform self-monitoring from a daunting task into a fundamental component of your success strategy.

Addressing Emotional and Psychological Aspects

Weight loss is not just a physical journey; it’s also an emotional and psychological one. Many people experience feelings of guilt and shame around their food choices and/or body weight, leading them to avoid self-monitoring, which can hinder their weight loss progress.

Addressing these aspects is essential for long-term success. Some helpful strategies include:

• Working with a therapist or joining support groups to address underlying emotional and psychological factors surrounding weight.
• Building in ways to cope with emotions such as physical activity, journaling, meditation, deep breathing, or practicing mindfulness.
• Being kind and patient with yourself throughout the journey. Create an empowering mindset by practicing positive self-talk. Remind yourself of your strengths and achievements, and focus on the progress you’re making rather than setbacks.

Everyone’s journey is unique, and it’s essential to personalize your approach to self-monitoring. The key is to find a balance that works for you, ensuring it integrates seamlessly into your lifestyle rather than feeling like a chore. Some days you may feel more motivated than others, and that’s perfectly normal. Remember, it’s not about being perfect; it’s about consistency and making progress over time. Use self-monitoring as a flexible tool to support your goals, celebrate your victories no matter how small, and learn from the challenges without self-judgment.

There’s an App for That, Baritastic!

Now that you understand the importance of self-monitoring, it’s time to introduce you to a tool that can make this process even easier and more effective: Baritastic. This comprehensive app is designed specifically for individuals on a weight loss journey after bariatric surgery, and the best part is it’s free to use!

Here’s how it can help:

1. Easy Food Logging: Baritastic makes logging your meals simple and convenient. You can quickly record your food intake and track your nutritional values. You can even scan food items directly from the package for easy entry!

2. Regular Weigh-Ins: The app allows you to track your weight regularly, providing visual progress charts that motivate and encourage you.

3. Connectivity with Your Clinic: Stay connected with your bariatric clinic for ongoing support and guidance. This feature ensures you have access to professional advice whenever you need it.

4. Comprehensive Tracking and Reminders: Beyond food and body weight, Baritastic helps you track your hydration, vitamins, and more, and allows you to set up alerts to help you remember these crucial tasks.

Ready to Start?

Your weight loss journey is unique, and you have the power to shape it. By embracing self-monitoring, you’re taking an active role in your success. The Baritastic app is here to support you every step of the way, making it easier to stay on track and achieve your goals. Download Baritastic today and take the first step toward a healthier, happier you. You’ve got this!

References:

1. Doğan S et al. Residual Gastric Volume Relationship and Weight Loss After Laparoscopic Sleeve Gastrectomy. Obes Surg. 2020;30(5):1929-1934.
2. Lind R et al. Long-term outcomes of sleeve gastrectomy: weight recurrence and surgical non-responders. Obesity Surgery.2023;33(1):3028-3034.
3. Story et al. The Impact of Self-Monitoring Behaviors and Connectivity to a Bariatric Clinic via a Mobile Application on Long-Term Weight Loss Outcomes after Sleeve Gastrectomy [White Paper]. https://www.baritastic.com/white-paper/ Accessed 6/7/2024.

Bariatric surgery is a life-changing procedure often leading to significant weight loss and improved health outcomes. However, achieving long-term weight loss success depends on several factors, some of which rely on you and your choices – while others are due to surgical failure or a change in your medical status.

This is why following up with a bariatric health care provider every year after surgery is important to ensure you maximize this valuable and lifesaving tool.

In this post, we’ll explore the reasons behind weight regain after bariatric surgery and highlight strategies to build and maintain healthy habits. Then we’ll review three popular, evidence-based weight loss diets along with their pros and cons so you can choose which one will work for you!

Understanding Weight Regain

Weight regain after bariatric surgery is a common and concerning issue that affects many individuals. If you’re experiencing this, it’s important to know that you’re not alone. The reasons behind this can be complex and include both biological and behavioral factors.[1]

Factors Associated with Weight Regain After Bariatric Surgery

Lack of dietary planning: Not sticking to dietary recommendations post-surgery is one of the most common predictors. This includes the types of food eaten, meal timing, and frequency.

The most significant contributors seem to be:

• grazing (eating small to moderate amounts of food throughout the day)
• unplanned snacking
• drinking with meals
• regularly consuming sweets or high-fat foods
• not eating enough protein

Sedentary lifestyle: A lack of regular physical activity can contribute to weight regain. It’s important to incorporate regular exercise as part of a balanced lifestyle.

• Weight Loss Tip:
  • Aim for a minimum of 150 minutes of planned activity per week
  • 300 minutes per week is suggested for those trying to lose weight

Psychological factors: Mental health issues such as depression, anxiety, or unresolved eating disorders can affect post-surgery weight management. Emotional stress can also trigger unhealthy eating habits, which may contribute to weight regain.

• Weight Loss Tip:
  • If you are experiencing any mental distress, please schedule an appointment with a mental health provider.
  • Plan time for healthy self-talk each day. Each morning, sit with your eyes closed and acknowledge what you are grateful for in your life. Then, visualize yourself as your healthiest self.
  • Throughout the day, as you catch yourself speaking unkindly or negatively to/or about yourself, stop and remind yourself of the things you are grateful for.

Surgical factors: Sometimes, the type of bariatric surgery or complications arising from surgery can influence weight regain. It’s important to discuss these factors with your health care provider.

Lack of follow-up care: Regular follow-up appointments with your health care team are essential to monitor progress and make necessary adjustments to your diet and exercise plan. Lack of consistent follow-up can increase the risk of weight regain.

For more information on this, and specific recommendations for lifestyle changes after bariatric surgery, read our blog Top Strategies for Success After Bariatric Surgery.

Dietary Plans for Weight Loss After Weight Regain

There are 15 different evidence-based dietary approaches to consider for adults who are trying to lose weight.[2]

All of these dietary approaches have been proven to be safe and effective when it comes to losing weight. For some people, this can create frustration as many just want to be told what to eat. However, we want you to see the freedom that this offers you.

You don’t have to follow a specific dietary plan to achieve weight loss after weight regain following bariatric surgery; there are several options to choose from.

As long as there is a calorie reduction from your current intake, any of these diets can help you lose weight. This allows you the freedom to try a plan you haven’t considered before.

Let’s review three of these diets together.

Meal Replacement Diet

The Diet: A highly restricted calorie intake that primarily uses meal replacement products for a short duration.

Who May Benefit: Those who want a “jump-start” to rapid weight loss, who want to stop thinking about what to eat for two weeks, and who enjoy meal replacement products.

Who Should Avoid: Individuals with a history of eating disorders or those unable to tolerate extreme calorie restrictions.

A very low-calorie diet (VLCD) is often used before surgery to prepare patients, resulting in a 10% preoperative weight loss and a 15–20% reduction in liver volume.[3] It has also been found to have a positive impact on improving cardiovascular risk factors in diabetic patients.

VLCDs gained popularity in the 1970s, but they started being used as early as the 1920s, making them one of the longest-studied diet plans for weight loss.[4] Initially, these diets emerged as a drastic solution for severe obesity, often lacking nutritional balance and consisting simply of water, lemon juice, and broth. Over the years, advancements in nutritional science have led to the refinement of these diets to ensure they meet the body’s essential needs while significantly reducing caloric intake.

Studies over the years have consistently shown the effectiveness of VLCDs for short-term weight loss outcomes.[5]

It’s important to note that these diets are not just about calorie restriction but are carefully designed to provide all necessary vitamins, minerals, and fatty acids, ensuring nutritional adequacy. We’ve created a free resource for you for following this specific type of diet if it resonates with you. Download it now, Back on Track.

Keep in mind that while VLCDs have proven to be effective for short-term weight loss, if used for longer than two weeks, they are typically utilized under medical supervision to manage potential risks and safeguard the patient’s health throughout the weight loss journey.

High Protein Diet

The Diet: Emphasizes protein-rich foods to promote satiety and muscle retention.

Who May Benefit: Individuals looking to preserve lean body mass while losing weight.

Who Should Avoid: People with kidney or liver problems, or those who struggle to digest dense protein foods like beef or poultry.

If you’ve had bariatric surgery, you’re no stranger to prioritizing protein. What can often happen is people struggle to consume dense protein sources like chicken or steak immediately after surgery, which can lead to a long-term aversion to those foods.

Unfortunately, consuming too little protein after surgery can impact your weight loss outcomes. Studies continue to show that patients with higher protein intake after bariatric surgery are less likely to experience weight regain.[6] Low protein intake has been associated with a loss of lean muscle mass, which can negatively affect metabolic rate and result in less effective weight loss and a higher likelihood of weight regain.

The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends a minimum protein intake of 60 grams daily post-surgery to minimize muscle loss and optimize weight loss outcomes (Mechanic), with the preference being individualized protein goals based on ideal body weight.

However, it is estimated that only about 40 percent of patients can achieve adequate daily protein levels.[7] According to a recent long-term observational study, individuals who prioritized protein intake over lipids and carbohydrates after undergoing bariatric surgery demonstrated improved weight maintenance even after 10 years.[8] This finding suggests that making protein a focal point of postoperative nutrition may play a crucial role in long-term success, especially if you have experienced unfavorable weight regain.

In addition to promoting weight loss and lean muscle mass retention, high protein diets have been linked to improved satiety levels, making them a beneficial option for those looking to manage hunger and cravings.

If you’re looking for high-protein recipes, check out our blog 5 High-Protein Recipes for Bariatric Patients. Also, go to the recipe section on Baritastic for more than 100 dietitian-approved bariatric recipes!

Mediterranean Diet

The Diet: Centers on plant-based foods, whole grains, nuts, and healthy fats like olive oil with moderate consumption of fish and poultry.

Who May Benefit: People looking for a heart-healthy diet, improved mental health, and weight management.

Who Should Avoid: Those preferring a low-fat diet or anyone allergic to nuts, seafood, or specific grains commonly consumed in this diet plan. It can also require more frequent trips to the grocery store to keep fresh produce on hand.

Noted for its health benefits, such as reducing risks of cardiovascular diseases and promoting longevity, this diet is accepted globally.[9] The emphasis on variety, flavor, and the enjoyment of food makes this diet appealing to many.

With an abundant use of olive oil, high in monounsaturated fats, the Mediterranean diet contributes to better heart health by lowering levels of cholesterol and blood pressure.[10] The diet’s rich content of antioxidants and anti-inflammatory properties also make it a compelling choice for individuals with chronic conditions, such as rheumatoid arthritis. This diet offers a sustainable approach to eating, focusing on moderation and balance rather than excluding major food groups.

Although there is limited research on the application of this diet specifically to post-bariatric surgery nutrition, its underlying principles can align with the recommended dietary guidelines for long-term maintenance after surgery and can assist in weight loss after weight regain as long as a reduced calorie intake is achieved.

As with all reduced-calorie dietary plans, you should consult with your healthcare provider, or dietitian, to tailor the diet to your specific nutritional needs and health conditions.

Body Weight is Not the Only Measure of Success After Bariatric Surgery: You are More than A Number on the Scale

The benefits of bariatric surgery extend far beyond weight loss, as it brings significant and long-term health improvements. For example, it can lead to profound improvements in diabetes, reduced cholesterol levels, normalized blood pressure, and decreased medication needs, all contributing to an improvement in health.[11] It can also improve or resolve conditions like sleep apnea.

These positive impacts show that success is not just about body weight but about overall health and well-being. Remember to focus on all the positive changes to your life after surgery, not just the number on the scale.

To learn more about other areas to focus on beyond a simple number, check out our blog 30 Ways to Look Beyond the Scale.

Conclusion
Long-term success after bariatric surgery requires specific strategies and lifestyle patterns to produce the greatest results. By understanding the reasons behind weight regain and following proven strategies for success (link to Top strat for success blog once live), you can optimize your chances of achieving lasting weight loss results.

Additionally, exploring different diets and tailoring them to your individual needs and preferences can be a valuable tool in the journey toward a healthier and happier life. Remember, bariatric surgery is just the beginning; the real journey lies in embracing a lifelong commitment to your health and wellness, and learning how to make this tool work for you!

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[1]Noria SF, et al. Weight Regain After Bariatric Surgery: Scope of the Problem, Causes, Prevention, and Treatment. Curr Diab Rep. 2023;23(3):31-42.

[2]M Morgan-Bathke, et al. Medical Nutrition Therapy Interventions Provided by Dietitians for Adult Overweight and Obesity Management: An Academy of Nutrition and Dietetics Evidence-Based Practice Guidelines. J Acad Nutr Diet. 2023;123(3):520-545.

[3]Colles S et al. Preoperative weight loss with a very-low-energy diet: quantitation of changes in liver and abdominal fat by serial imaging. Am J Clin Nutr. 2006;84:304–11.

[4]Herrington G et al. Obes Sci Pract. 2022;8(4):510-524.

[5]Brown, A, & Leeds, AR. Nutrition Bulletin. 2019;44(1):7-24.

[6]Moizé V et al. Protein intake and lean tissue mass retention following bariatric surgery. Clin Nutr. 2013;32(4):550-555.

[7]Moize V et al. Obese patients have inadequate protein intake related to protein intolerance up to 1 year following Roux-en-Y gastric bypass. Obes Surg. 2003;13(1)23–28.

[8]Sherf Dagan S et al. Do bariatric patients follow dietary and lifestyle recommendations during the first postoperative year? Obes Surg. 2017;27(9):2258–2271.

[9]Finicelli M et al. The Mediterranean diet: An update of the clinical trials. Nutrients. 2022;14(14):2956.

[10]Widmer RJ et al. Am J Med. 2015;128(3):229-238.

[11]Gulinac M et al. Long-term effectiveness, outcomes and complications of bariatric surgery. World J Clin Cases. 2023;11(19):4504-4512.