As a result, there has been a race to craft solutions, some medical others plain insane, to deal
with obesity. This has seen the rise of special diets, weight loss medication and metabolic
surgery all designed to help people lose weight. Some, like the diet fad, have been discredited by
the scientific community while others, especially metabolic surgery, have grown in popularity.
Metabolic surgery, or obesity or weight loss surgery, involves bariatric surgery which, in turn,
involves a variety of surgical procedures. It is the preferred obesity intervention for people with a
BMI of 40 kg/m2 or more and where other interventions have failed.
Obesity surgery has proved very popular: over the 2003-2008 periods, the number of these
procedures increased by 133%, while over the 1998-2008 period, the rise was 761%, from
40,000 procedures in 1998 to 344, 221 all over the world in 2008.
However, despite this surgical intervention, patients still experience weight gain. This
is for a number of reasons such as poor diet and lifestyle modification and secondary
hyperparathyroidism, a major culprit in weight gain.
Below are a number of tips that will help to keep off the weight after weight loss surgery
Tip 1- Post-operative Dietary Counseling
After bariatric surgery, absorption of iron, vitamin B 12, foliate, calcium and vitamin D is
diminished. As such, patients develop anemia- your doctor may recommend multivitamins on
top of regular blood metabolic tests. Stick to the prescribed mineral and vitamin supplements.
The doctor is obligated to provide advice on an appropriate diet. This means a new approach to
food and nutrition. A common mistake is to lose vigilance on your diet in the false belief that
following your surgery, gaining weight will be far much difficult- remember, the surgery only
corrects the amount of food your body can digest and not the metabolic processes that led to
obesity in the first place.
Tip 2- Post-operative Exercise Counseling
It is, generally, easier to exercise after bariatric surgery due to a reduced body mass. In addition,
jobs that involve sedentary schedules lead to weight gain- in fact, standing burns more calories
(50% more) than sitting.
As such, don't be such a potato couch and task yourself to stick to an exercise regime.
Tip 3- Lifestyle modifications
Obesity risk factors such as smoking are as influential after bariatric surgery as they are before.
Quit smoking and stop drinking as these will quickly set you back to weight gain.
Tip 4- Follow-up
Secondary hyperparathyroidism is an adverse effect that affects a number of obesity surgery
patients and is related with post-operative weight gain. Precaution demands that you schedule
regular thyroid and metabolic checks such as vitamin checks and metabolic hormone analysis. In
addition, avoid over the counter iron pills as they have different side effects such as constipation-
instead, go over your doctor's prescription advice.
Pregnancy is another challenge in the post-operative period. Usually, pregnant women
experience fluid loss and, therefore, require IV fluid replacement which leads to pooling of body
fluids and weight gain. Even after parturition, associated weight gain is particularly difficult to
deal with. Sometimes, it is advisable to avoid pregnancy in the first year after obesity surgery
and be disciplined in your prenatal visits once pregnant.
Tip 5- Weight loss medication
For the severely obese, bariatric surgery and post-operative surgery is usually not sufficient.
For these patients, weight loss is a long term affair designed to accomplish significant weight
loss immediately after the operation and avoid a relapse in the future. Medication, and only that
which has been approved, is prescribed to assist towards this end. Self-medication should be
avoided at all costs- specialist knowledge is an asset that should not be overlooked.
Tip 6- Addiction Control
Sometimes, patients replace their food cravings with other items or preoccupations such as
alcohol, cigarettes or a predominantly sedentary lifestyle. This should be avoided- counseling has
demonstrated effective solutions in this regard.
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