Resources and support for weight loss surgery

Weight loss surgery may be the next step for people who are looking for a permanent weight loss solution after trying nonsurgical approaches, or for people who have an obesity-related disease. You may be a candidate for surgical weight loss if you:

• Are 100 pounds or more above your ideal weight or have a BMI of 40 or higher.
• Have a BMI of at least 35 and are diagnosed with at least one or more serious obesity related conditions such as high blood pressure, diabetes, or sleep apnea.
• Have no severe medical, psychological or emotional conditions that would render surgery too risky.
• Have no dependence on drugs or alcohol or have been sober for a year.
• Have tried and failed at previous efforts to lose weight
• Understand the seriousness of the surgery and the necessity for a lifelong personal commitment to a healthier diet and lifestyle
• Have obesity-related physical problems that interfere with employment, walking or family function

Remember: There are no guarantees for any method, including surgery, to produce and maintain weight loss. Success is possible only with maximum cooperation and commitment to behavioral change and medical follow-up -- and this cooperation and commitment must be carried out for the rest of your life. Sentara offers personalized support following weight loss surgery, including support groups, counseling, and nutrition and fitness programs to help achieve a successful weight loss goal.

• How can I benefit from surgical weight loss?
• In my current health condition, what are the best options for me?
• Am I a candidate for a particular surgical procedure?
• What other health considerations should I have regarding surgery?
• What are the other steps I should take to prepare for the operation?

• After gastric bypass, most patients can expect to lose 60% to 70% of their excess weight within the first year. Sixty percent to 70% of patients can expect to maintain their weight loss in the long term.
• After undergoing the gastric sleeve procedure, approximately two-thirds of patients can expect to lose 30% to 50% of their excess weight within the first year.
• After gastric banding, approximately two-thirds of patients can expect to lose 50% to 60% of their excess weight within the first two years.

Most obese people have medium-to-large body frames (bone and muscle). Reaching a so-called "ideal" body weight is unrealistic and may even be dangerous. Fortunately, most people look and feel good at a 60% loss of excess weight. More importantly, they are much healthier.

Most patients experience significant improvement or completely resolved obesity-related medical conditions, such as high blood pressure, diabetes and sleep apnea. All of these factors help to increase self-esteem and improve quality of life.

We help patients recognize that having obesity is a complex problem, one that is not cured solely by surgery, but a medical condition that will require lifelong dedication to keeping up with better eating habits and staying active. Maintaining weight loss requires ongoing dietary, exercise, and behavioral changes, as well as long-term participation in the program.

• Make the primary source of nutrition protein-containing foods, fruits and vegetables.
• Eat and drink very slowly (small bites and sips).
• Separate liquids from meals (do not drink for at least 30 to 45 minutes after each meal).
• Drink at least 64 ounces of water every day.
• In addition to water, sugar-free, caffeine-free, non-carbonated beverages may be used.
• Avoid concentrated sweets and high fat foods.
• Take daily supplements of multivitamins, calcium citrate, vitamin B12, protein and iron (generally for menstruating women).
• Slowly increase physical activity; begin walking immediately following surgery.
• Maintain regular follow-up with your surgeon and dietitian.
• Attending support group meetings.

Our registered dietitians will help you create a personalized eating plan to prepare for and recover from surgery. Your eating plan will focus on the following types of foods:

• Protein-rich foods, such as meat, fish, cheese, or soy-based products like tofu
• Vegetables
• Fruits
• Small amounts of high-fiber starches, such as whole wheat wraps or bread

Adopting a new eating plan is a life-long commitment, not a “diet.” We provide support for our patients to make a permanent change in how and what they eat. 

Although dietary restrictions after surgery may initially appear more rigorous than any other dietary program tried in the past, most patients find it easier to adopt these new changes thanks to their altered anatomy and education about new ways to eat.

Weight loss surgery is a powerful tool--but long-term success depends on the changes you make afterward. Here’s what to expect and how to give yourself the best chance for success:

• Get ready for a fresh start: Achieving your goals will take major, lifelong changes in how you eat, move and even socialize.
• Stay committed: Adopting new habits - nutritionally, emotionally, and socially - will help you maintain your progress and enjoy a healthier lifestyle.

Examples of how to achieve long-term success:

• Dining out mindfully: Instead of meeting friends for a heavy dinner, some patients suggest meeting for a walk, a movie, or a light meal where healthy options are available. Planning ahead by checking menus and choosing protein-rich meals can make social outings easier.
• Making movement a routine: One patient started with 10-minute daily walks and gradually built up to group fitness classes. The key wasn’t perfection--it was consistency and celebrating small milestones.
• Building a support system: Many people find that joining a support group or connecting with a therapist helps them stay accountable and manage emotional eating or lifestyle shifts.

Having a strong support system can significantly impact your success after weight loss surgery. It’s hard to stay on track when tempting foods are always around or when others don’t understand your goals.

• Talk with your loved ones: Let them know how important this journey is to you, and ask for their support, especially when it comes to keeping unhealthy food out of the house or choosing restaurants with healthy options.
• Get help if you’re struggling emotionally: If things like stress, anxiety, or depression have made it harder to manage your eating habits in the past, talking to a therapist can be a helpful step toward lasting change.

Examples of support:

• Ask your partner to keep snacks in a separate cabinet so they wouldn’t feel tempted throughout the day. It helped reduce stress and made healthy choices easier to stick with.
• Have your family join you on walks after dinner a few nights a week, use this time to catch up with one another while staying active.

Even after successful surgery and significant weight loss, some patients ultimately regain some, most or all the lost weight. A medical evaluation usually reveals pouch enlargement from overeating and/or unwise dietary choices. Weight loss surgery can help you reach your goals, but long-term success depends on your willingness to make lasting changes to how you eat and live.

Even after surgery, it’s possible to regain weight, especially if you return to old habits like overeating or making poor food choices. That’s why showing strong motivation and readiness to stick with a healthier lifestyle is so important before moving forward with surgery. Your surgeon and weight loss team may choose not to continue your surgical path if you do not demonstrate a strong motivation or commitment to modify your eating habits and lifestyle.

Examples of strong commitment:

• Keep a food journal before surgery to track eating patterns and identify habits to work on.
• Start an exercise routine, like walking daily or joining a fitness class, even before the procedure.
• Attending nutrition classes, meeting with a dietitian, or joining a support group to build healthier habits.
• Make gradual changes to prepare for life after surgery. Changes include steps such as cutting back on sugary drinks or eating smaller portions.
• These small but steady steps show you're ready to make the changes that will help you succeed, not just after surgery, but for years to come.