In essence, weight loss surgery is one of the toughest roads you could ever choose to go down; emotionally, physically and socially.
Over the past 6 years I have been in the incredibly privileged position of working alongside hundreds of people going through the process of weight loss surgery. To be there throughout the entire process from assessment to post surgery discharge was indeed, a rollercoaster. I shared the highs and the lows, felt the frustrations and the liberation, I felt the despair and the sheer happiness, and usually all in one afternoon! Because weight loss surgery is like that; about as far from a smooth and steady journey as you can possibly imagine.
More and more individuals are being offered weight loss surgery and this, I am certain, is only going to increase.
Because it works.
But let me rephrase that slightly, because it can work and can work brilliantly. However, it can also be a complete disaster. It can be the hardest, most traumatic, heart breakingly disappointing procedure. It can shatter dreams and hope, wreaking havoc with an existing, rock bottom self-esteem.
So what have I learnt about navigating weight loss surgery to make sure it works and works brilliantly?
You can never be 100% certain that it will work. Despite high motivation levels and a good level of understanding, there will always be people for whom weight loss surgery will never work. The reasons for this are multiple and complex and I doubt even that individual will really understand what is holding them back from success.
Timing is everything. The vast majority of people will come for an assessment hoping to be put forward immediately and, in an ideal world, have their surgery within weeks. This would be a disaster. I have learnt so much about the importance of providing people with at least 6 months of pre-surgery preparation. This time is SO important to start accepting the reality of weight loss surgery, to realize the changes that you will need to make and to reflect on the harsh reality of the hard work required to succeed. For some 6 months is enough and for others a period of 18 months works perfectly – everyone is different.
Weight loss surgery is no magic wand. Weight loss surgery or no weight loss surgery…
In order to lose weight you need to make significant, sustainable and positive changes to your diet and lifestyle.
To lose weight with weight loss surgery you need to reduce portions, cut out or reduce the empty calories, concentrate on plenty of fruit and vegetables, lean protein and complex carbs. Just as you need to do without the surgery. It is not a way of eating what you like and still losing weight. You have to work at it.
The complete team is so important. Having a multidisciplinary team with a dietitian, psychologist, pharmacist, specialist nurse, endocrinologist, surgeon, anesthetist and a radiologist is crucial. The team need to communicate effectively and have sufficient funding to offer appropriate levels of care to patients. This is a big one and fairly political at the moment but nonetheless very true.
There is no one-size-fits-all surgery option. I have seen people succeed and fail with all types of weight loss surgery and the choice of surgery needs to be a joint decision, informed, considered and chosen for the right reasons. Many people have seen friends or family fail or succeed with a certain type of surgery and then choose to avoid or select it accordingly. Be open and consider all types.
Accept that after the sunshine comes the storm. The hardest part for many is accepting that post surgery weight loss is slowing and then stopping and then worse, they start to gain weight. This is normal. It happens to everyone and is part of the process. Just as normal weight loss without surgery will come in waves; you lose, you maintain, you gain, you lose….and the cycle continues. Relapse and weight gain is a normal part of the process so expect it at some point, embrace it and use it as a valuable learning opportunity. Look at why it has happened? Which habits have crept slowly back in? (this happens to everyone!) Learn from it and decide how you plan to avoid it happening again? Your weight loss curve will look more or less like a rollercoaster – expect this and you won’t be as disappointed.
To all those who have had surgery – ignore everyone who puts you down, thinking that you have chosen the easy option. Hold your head high, know that deep down you are mustering the same strength, determination and resilience that anyone else trying to lose weight without the surgery, has to do. Criticism is often borne out of resentment and jealousy. Try to rise above it however hard this might be. There is a growing number who realise how hard you are working – focus on these individuals.
Surgery can change the way that you eat forever. Sometimes surgery can have unpredictable effects and you might end up unable to tolerate or digest certain types of food. This can be hugely restrictive and impact on every aspect of your life. Sadly this is a risk, one of the many that those undergoing surgery will have to take. However, be mindful of the choices that you make in terms of foods. Some foods will be easier to eat, however this although tempting is not the way forwards. A good working relationship with your dietitian is the best way to avoid falling into this trap.
Choosing to undergo weight loss surgery is a brave option and it is often the last option available for people. A last resort after years of struggling. Summoning up enough courage to attend an initial appointment is a huge achievement, it takes so much strength to face up to discussing food and eating and these individuals deserve a truck load of respect. I admire each and every patient with whom I have worked. I learn from them every day and I never cease to be amazed by the commitment that they show.
Losing weight might not make you as happy as you think it will. For many, weight loss surgery carries a heavy burden or responsibility – it is supposed to make you happier, improve your relationship, help you to get a job or be better at the one you do, be a better friend, have more confidence, make you do more exercise and so on. A long list of responsibilities for any one ‘thing’ to bear. Unfortunately, the harsh reality of weight loss surgery is that it often fails to deliver on one or all counts. I think this is something that everyone needs to think about. It is all too easy to live in the ‘if only’ land. ‘Life would be better if only I was thinner’, I would have a job if only I was thinner, I would have a relationship if only I was thinner….believe me when I say, that losing weight is not a guaranteed for ‘happily ever after’. In fact, it can have the opposite effect. It can be hard to adjust and you need to be aware of this, if you find yourself in this situation. You are responsible for your own happiness, and that starts from within, not from a gastric band. So reset the expectations that you may have about your slimmer self, when you go for surgery or about others who are doing so. Don’t feel entitled to a new mindset.
That’s not to say you can’t be happier, of course you can but that is down to you and the choices that you make and not a piece of silicone or a few stitches.
I hope that his article makes you think, perhaps about judgments that you have made or about choices that you might make in the future if you are thinking of weight loss surgery as an option. It can be a truly wonderful and life changing tool, but it is just that, a tool, and without the team, the personal commitment and the necessary resilience within your tool kit, the surgery alone is a very small part of a large and complex jigsaw.
The Author – Faith Toogood
Faith is an experienced Dietitian, specialising in weight management and weight loss surgery. She has a breadth of experience spanning the NHS and the private sector. In addition to running a busy private practice, she is a regular on our TV screens, appearing on ITV’s ‘The Biggest Loser’ and other weight loss shows. Faith is passionate about helping everyone to feel empowered around food and cooking, and is well known for her practical, no-nonsense and warm approach in helping others to drastically improve their diets through simple, sustainable and affordable changes.
Faith is a fantastic dietitian and one of the nicest people I have had the pleasure of working with so check her out, on her website and social media links above. A huge thank you for writing this guest blog post Faith, it really highlights the highs and lows of the weight loss surgery journey for the patient and that its not the plain sailing procedure, as its often perceived.
Have you or anyone you know embarked on weight loss surgery?
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Do you have any advice for others considering weight loss surgery?