Long term weight loss
We all know that bariatric surgery is the most effective treatment for obesity and obesity related health conditions like diabetes, high blood pressure, fatty liver etc… However, we all know some patients who did not lose as much weight as you would expect with bariatric surgery or put some weight back on.
Obviously, there are many reasons for such outcomes; some of which are completely out of the control of the patient (and the surgeon). There is a ‘biological’ interaction between the body, brain and the surgery that determines the amount of weight that people lose.
Beyond biology, there might be some factors that are directly related to the ‘patient’s behaviour’.
When I hear patients talking about it, they normally mention some behaviours that led to ‘stretching of the stomach’. There is no denial that some patients have large gastric pouch after bariatric surgery (either related to the surgical technique itself or to the patient’s behaviour afterwards). Some patients might benefit from their stomachs to be tightened and reduced in size.
When I do bariatric operations, I use calibrating tubes to ensure that stomach is as small as possible (but not too small that the patient cannot eat) to reduce the possibility of such issue.
However, from experience, the main issues that people face are not related to larger stomachs but to three ‘behaviours’.
Having food and drinks that are rich in sugar and/or carbohydrates. Even after bariatric surgery, people are able to consume large volume of such food and drinks. The reason for such ability is that they hardly require chewing (if any at all). These foods down the stomach easily, when within the stomach, the stomach sends minimal signals of receiving food (the stomach has less sugar and carbohydrate receptors compared to protein receptors) and they go very quickly to the bowel without being kept in the stomach. As the stomach is empty, patients can eat more, and they only feel full when eating too much.
Having foods that are soft/liquid. To understand what I mean think about a steak versus a burger. You will be able to eat more burger in weight compared to a steak because it is much softer, require less chewing and fit more easily into the stomach subsequently allowing more food to be eaten.
Reduced physical activity. For several reasons reduced physical activity is associated with less weight loss and more weight gain. You should aim for 30 minutes of moderate intensity physical activity a day (physical activity that makes you sweaty or breathless or preferably both).
If you need help with your weight loss journey and you are looking for effective treatments for obesity, you are very welcome to attend my weight loss information sessions, my monthly support session or book an appointment with me on https://www.spirehealthcare.com/consultant-profiles/zaher-toumi-c6035173/
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