For people living with obesity, bariatric surgery can be the beginning of their weight loss journey. We describe the process as a journey as it requires long-term commitment to real change which can often come with bumps in the road. The rapid weight loss after bariatric surgery brings hope and a renewed vitality, so when you hit a plateau in your weight loss or even regain weight some years later, this bump in the road can be incredibly disheartening. 

 

Today we are going to look at the weight loss plateau after bariatric surgery and when you should be concerned, as well as weight regain following surgery and how to tackle it. 

 

Plateaus are a normal part of weight loss. But if you have noticed that your weight has plateaued for an extended period and you’re no longer losing weight, it might be worth checking in with yourself… 

• Have some unhealthy habits returned, like mindless snacking? 
• Are you sticking to your post-surgery diet? 3 meals a day? Plenty of protein? 
• What are your activity levels like, could you be doing more or trying something different? 
• Should we be considering the addition of Anti-Obesity medications such as GLP-1 agonists to help you get to goal?

If you’re still unsure what’s causing it, it is time to make an appointment with your healthcare team or your doctor, who’ll be able to help steer you back on course if need be. 

If the healthy habits cultivated post-surgery are replaced by old, detrimental behaviours, it can contribute to weight regain and the risk of lesser weight loss. This is why follow-up is so important as the team can guide you throughout this journey, you are not alone. 

Getting Back on Track – 3 Ways to Tackle Weight Regain

1. The Importance of Checking In – regular follow-up appointments with your healthcare team are designed to monitor progress. If weight regain becomes evident or bad habits begin to resurface, these appointments are the ideal platform for discussion and intervention. It’s a team effort. 
2. Taking Responsibility – reflecting on your current lifestyle habits and identifying areas that may have contributed to weight regain can empower you to make positive changes. This may involve being more accountable for what you are eating, being honest about your physical activity levels (and if you can do better), as well as other areas of your life such as sleep quality and stress management. If reflecting on your lifestyle makes you feel uncomfortable or disappointed in yourself, pick up the phone!
3. Reclaiming the Journey – weight regain is a detour, not a dead-end. It’s an opportunity to reassess, realign and reclaim your journey toward health.

Weight regain after bariatric surgery is a challenge that many face, but it’s not a journey to navigate alone. Recognising when to be concerned and taking proactive steps to address weight loss plateaus or weight regain can set you back on course toward a healthier, more fulfilling life. Embrace the journey and stay connected to your healthcare team. 

If you have had bariatric surgery and experienced weight regain, and would like to discuss this with one of our team, you can make an appointment online or call 02 9553 1120.

If you’re considering bariatric surgery for the first time, the information available online can appear quite daunting. Our own website has information booklets, handouts, videos and hundreds of blogs. So today we are keeping it simple. Here are five considerations you need to be aware of when considering bariatric surgery as a tool to aid weight loss and have success maintaining that new healthy weight for the rest of your life. 

2. Support System

Building a strong support system is essential. Whether it’s friends, family or support groups, having a network to lean on during your journey can be instrumental in your success. At Upper GI Surgery, after having bariatric surgery our patients are enrolled on the Fresh Start program (for 2 years), a professional health coaching team to help guide and support you on your journey. While you’ll have ongoing support from our medical team at your follow-up appointments, you should also try spending time with friends and family whose healthy and active lifestyles you admire. People who “walk the walk” of a healthy life will often have tips they can share to help you. 

Post-Bariatric Surgery Recovery

4. Nutritional Changes

After your surgery, you’ll need to follow a specific diet plan for several weeks before you transition to “normal” food and an eating pattern that you will want to try to maintain lifelong. Understand the importance of proper nutrition, including portion control and taking your required vitamins and minerals supplements. Read more here:

What is the pre-bariatric surgery diet? 

What is the post-bariatric surgery diet? 

At Upper GI Surgery, we’re here to support you every step of the way, from your initial consultation to your long-term follow-up care. If you have any questions or are ready to begin your journey, please don’t hesitate to contact us.

Bariatric surgery is a life-changing step towards achieving weight loss and overall improved health. As patients begin this transformative journey, it’s crucial to recognise the significance of post-operative bariatric care, particularly when it comes to vitamin supplementation. Many patients don’t realise that after bariatric surgery they will be required to take lifelong vitamin and mineral supplements, or potentially face serious health consequences down the line. 

 

In this blog post, we’ll delve into the essential role that vitamins play after bariatric surgery and why it’s important to prioritise their intake for long-term well-being.

 

Vitamin B12 – reduced stomach acid and intrinsic factors after surgery can hinder B12 absorption.

Iron – reduced stomach size and changes in the digestive tract can limit iron absorption

Calcium – changes in the digestive system can impact calcium absorption.

Folate (Vitamin B9) – Reduced absorption in the small intestine.

Thiamine (Vitamin B1) – Reduced absorption in the small intestine, especially common in gastric bypass patients. 

Zinc – Reduced absorption in the small intestine.

Copper – Limited absorption in the digestive tract.

Vitamin A – Reduced absorption.

It’s important for individuals who have had bariatric surgery to undergo regular blood tests to monitor their nutrient levels. For our patients, we tailor supplementation plans based on individual needs and recommend specific products designed for post-bariatric surgery patients. For example, as part of our Aftercare Program, our patients are provided with a month’s supply of Bariatric multivitamins.

Thiamine – A Critical Component

One of the key vitamins that demand special attention after bariatric surgery is thiamine. Thiamine deficiency can lead to neuropathy, permanent brain damage and even dementia. To combat this, our nurses regularly check in with our patients, providing reminders about taking bariatric multivitamins post-surgery and emphasising the critical role supplementation plays in preventing long-term complications.

Investing in Your Health

Taking the correct vitamins after bariatric surgery is an investment in your long-term health. For as little as $1 a day, the benefits far outweigh the expense. We encourage patients to explore subscription options online or with their pharmacy, where you may be able to get your supply at a lower cost. 

Dispelling Misconceptions – not just any multi-vitamin will do

There’s a common misconception that any multivitamin will suffice post-bariatric surgery, especially if you haven’t undergone a gastric bypass. During the weight loss period after surgery (first 6-12 months) and during times of stress or illness, standard multivitamins are insufficient and some can contain additional items (such as high levels of vitamin B6)  that can be toxic and cause illness. Bariatric multivitamins are specifically formulated to meet the unique needs of post-operative patients. Opting for standard multivitamins or none at all can lead to unwanted consequences, as the body may no longer absorb certain nutrients effectively.

The importance of taking vitamins after bariatric surgery cannot be overstated. At Upper GI Surgery we prioritise the well-being of our patients – it’s not just about taking vitamins, it’s about investing in a healthier, more fulfilling future. Don’t compromise on your post-operative care.

If you are living with obesity and have been trying to lose weight, it can sometimes feel like an impossible challenge. Diet and exercise alone are often not sufficient or even possible for those who have been living with obesity for a long time. Weight-loss medications have emerged as a beacon of hope for those who have ‘tried everything’ to lose weight. But are weight loss medications a temporary fix or a long-term solution? In today’s blog we’ll find out. 

Weight loss medications come in different forms and work through various mechanisms, from appetite suppression to inhibiting fat absorption, assisting individuals in their journey to a healthier weight. They are not prescribed alone but as part of a holistic approach including a healthy diet and increased activity/exercise levels to be most effective. 

Temporary Triumph

While weight loss medications can produce positive results during their administration, it’s important to acknowledge the transient nature of their effects. Many individuals experience initial success only to find that, when they stop taking the medication, the weight creeps back on. The hard truth is that without a fundamental shift in behaviour, relying solely on weight loss medications may not offer a lasting solution. Despite the fact that no-one wants to regain weight after stopping these medications, on average most people will regain >50% of the weight they have lost within a year.

There is also nothing ‘temporary’ about a medication if you have to take it long-term to achieve and maintain weight loss. These medications each come with potential side effects and risks that need to be considered by the individual to determine if they are suitable candidates. 

The decision is a little easier for patients who have had previous weight-loss surgery. Because their stomach is no longer normal, their risk of weight regain is far less because they are protected against the return of their normal appetite by their previous surgery.

It is also important to note that currently in Australia, there have been supply chain issues with certain medications, meaning fulfilling prescriptions has become difficult for many. This in itself can cause issues because if you do not have access to the prescribed medication, you are at risk of regaining any weight lost. 

Weight Loss Medication – for those who have had bariatric surgery

Even with consistent healthy lifestyle changes (diet and exercise), some weight regain can and does occur in patients who have had bariatric surgery. While in some the weight regain is only minor, in others it is progressive which can be very disheartening. If someone is struggling to lose weight that they have regained through diet and exercise alone and are not having any success, weight loss medication is a potential option to help get them back on track and lose the extra kilos they regained. 

In our clinical experience patients that regularly attend follow-ups with the team tend to regain less weight than those who don’t come back. If you’ve regained weight following your bariatric surgery, booking a follow-up appointment with your specialist is the first step; at Upper GI Surgery our specialists can discuss with you the potential option of weight loss medication as part of your treatment. 

If you would like to discuss your eligibility for weight loss medications, you can make an appointment with our Bariatric Care Specialist Dr Jennifer Matthei who will be happy to give you more information. 

As the Sydney summer ushers in the holiday season, those who have undergone bariatric surgery may find themselves navigating a unique set of challenges. The hot weather, special family or social gatherings, and the abundance of delicious, sometimes less-than-ideal foods can trigger old eating habits or temptations to overindulge. In this year’s holiday-themed blog, we’ll delve into the triggers that might arise and offer some strategies to overcome them, helping you make the most of your summer festivities while staying true to your post-bariatric lifestyle.

Strategies to Overcome Triggers

Mindful Choices – practice mindful eating by making conscious choices. Prioritise protein options and vegetables while being mindful of portion sizes. Most functions will have low calorie options such as sliced vegetables that you can munch on, this will sort out any hunger but will also help you “blend in”.

Prepare and Communicate – plan your holiday meals in advance. If you’re attending other people’s gatherings, let your host know about your dietary needs and consider bringing a dish that aligns with your post-surgery eating plan.

Stay Hydrated – often, thirst is mistaken for hunger. Keep yourself hydrated, especially in the summer heat. Drinking water can help you differentiate between actual hunger and thirst. But remember to limit your liquid intake at mealtimes. When going to a social event choose water first, especially if you’re planning to have a glass of wine. Drinking alcohol when thirsty or tired is never a good idea.

By identifying and understanding your overeating triggers and trying some of these strategies, we hope we’ve helped you navigate the summer holidays successfully. This season is about celebrating, connecting and creating joyful memories. With mindful choices and support from loved ones, you can enjoy the festivities to the fullest while staying committed to your post-bariatric surgery goals.

The gastric bypass is known as the ‘gold standard’ weight control operation and has been the most frequently performed bariatric surgery procedure worldwide. But did you know that there are different types of gastric bypass surgery? Here’s a brief overview of the differences between the various gastric bypass procedures. 

Roux-en-Y Gastric Bypass

Roux-en-Y Gastric Bypass, commonly abbreviated as RYGB, is the most frequently performed gastric bypass procedure. It involves the creation of a small pouch (15-30ml) which can be long or short (but is always narrow) at the upper section of the stomach that is then connected directly to the small intestine. This restricts food intake, releases neuropeptides that suppress appetite and create taste changes, and leads to substantial weight loss.

Single Anastomosis Duodeno-ileal Bypass (SADI) and Sleeve+ procedures.

Sleeve Gastrectomy with Duodeno-Ileostomy (SADI) is an advanced surgical technique that combines sleeve gastrectomy with a modified digestive pathway. This restricts food intake, limits calorie absorption and leads to substantial weight loss. It is just one of the many Sleeve+ procedures that combine a Laparoscopic Sleeve Gastrectomy with some type of intestinal bypass to try to improve long-term weight loss.

Choosing the Right Gastric Bypass Surgery

Selecting the most suitable type of gastric bypass surgery is an important decision made after a detailed consultation with your bariatric surgeon. Your surgeon will discuss and assess your unique health conditions, weight loss goals and medical history to guide you to the right choice.

Benefits and Risks

Every type of gastric bypass surgery offers common benefits – substantial weight loss, enhanced health and improved overall well-being. However as with any major surgery, it is crucial to be informed about the potential risks and complications of these procedures. An in-depth discussion with your surgeon will equip you with the knowledge required for a well-informed decision.

At Upper GI Surgery, we are committed to guiding you through the decision-making process and ensuring a safe and effective surgical experience. Whether you’re considering Roux-en-Y, Mini Gastric Bypass or SADI, your journey to a healthier, happier you starts with a consultation. 

As part of our Patient Aftercare Program and in addition to appointments with Dietitian Tania, we provide each of our patients with their own copy of Sally Johnston’s ‘Your Complete Guide to Nutrition for Weight Loss Surgery’. Why do we feel this is an important component of your weight loss journey? 

The book is exactly what it proclaims in the title, a complete guide for those who have had any type of bariatric surgery, from the gastric sleeve to a gastric bypass, or those who may just be considering surgery. It combines simple, healthy recipes and food fundamentals, with troubleshooting common complaints, the nutritional impacts of bariatric surgery and the need for supplementation. 

This comprehensive guide combines delicious and uncomplicated recipes, from both colleagues and patients, with over 15 years of knowledge as a dietitian within the weight loss surgery industry.

Recipes for Everyone

The recipes in the book are not only for bariatric surgery patients but are easy to modify for family and friends too. Suggestions to modify serve sizes are included and this works really well for those who are getting family involved in their new healthy diet/lifestyle. 

Living with obesity means that a person’s excess weight poses a serious health risk; bariatric surgery is currently the only consistently effective treatment for severe obesity. For both insured & uninsured patients, there are out-of-pocket costs associated with surgery, which can often stop people from seeking treatment that they need. 

 

Let’s look at bariatric surgery as an investment in your future self, and how many years it will take to get a return on your investment. The return on your investment, through commitment to diet and lifestyle changes, is not just in monetary terms but in your overall quality of life as you transition to a healthier, happier you.

 

But here are four ways that bariatric surgery can save you real money, long-term.

2. Medication Costs

Losing weight is an effective treatment for the medical conditions that obesity causes. The majority of the significant diseases that people living with obesity suffer from, such as diabetes, hypertension, high cholesterol, sleep apnoea and depression are either controlled or significantly improved by weight loss. 

Bariatric surgery is an effective way of putting type 2 diabetes into remission. People with type 2 diabetes have twice the medical expenses as a person without diabetes (CDC), and the costs only increase as things become more complex. This example is just one of many that demonstrate the medication savings that the one-off cost of surgery will have in a person’s lifetime. 

4. Employment opportunities

People with significant weight problems take more sick days, are more likely to retire early because of illness, and are more likely to be “locked out” of jobs because of physical constraints or because of insidious obesity stigma that reduces employment prospects and promotions for many. Adding years to your life also means adding years to your “working life”, be it in a career where you are paid, or in active, busy years 

Why you should invest in bariatric surgery – investing in your future

Bariatric surgery is life-changing and life-saving – can you really afford not to have surgery? Whether you take the first step today or arrange for your surgery 12 months from now, the real cost of not having surgery is the increased risk to life. Not just the length of your life, but the quality of those days/weeks/years/decades. 

At Upper GI Surgery our obesity treatment is patient-centred. Our expert team can discuss your options in full, from weight loss medication to different bariatric surgery procedures, complete with how much this will cost as an investment into your future. How much could you save if you were living your new, healthier, happier life? 

The Mediterranean diet has long been established as the ‘gold standard in preventive medicine’ (Mediterranean diet and life expectancy; beyond olive oil, fruits and vegetables). It’s true that people who live in the Mediterranean and embrace the diet and lifestyle live longer lives, free from many of the diseases that other places face such as heart failure, strokes and diabetes. 

The diet is based on the traditional foods found in the countries that border the Mediterranean Sea, such as Italy, Greece, Spain or France. It’s not complicated to follow, as it includes such a wide variety of foods with endless combinations, preferably flavoured with herbs and spices instead of salt. 

The focus is on fresh fruit and vegetables, seeds, whole grains, legumes, fish and seafood, whilst not forgetting olive oil. Also poultry, yoghurt, cheese, eggs or even red wine, but these food groups are consumed more moderately while limiting (or avoiding altogether) red meat, highly processed meat or food, refined grains, sugar-sweetened drinks or alcohol.  

Mediterranean diet for bariatric surgery patients – do’s and don’ts

Rather than thinking of it as a diet (which are often restricted and not sustainable), think of it as a new Mediterranean way of life. Here are some do’s and don’ts to help you follow the diet as a weight loss surgery patient. 

Do

• Eat lots of plant foods, i.e. fruits, vegetables, legumes and nuts/seeds. They can be fresh, dried, canned or frozen (just check that they don’t have any added sugar or high salt content). 
• Include seafood in your diet at least twice a week, whilst aiming to reduce meat (red or processed) in your diet. Poultry and eggs are a great source of protein. 
• Switch to wholegrains for your rice, pasta or bread to follow the Mediterranean diet. 
• Have a healthy source of fat in your diet, from using extra virgin olive oil in your cooking to avocados, nuts/seeds, tahini or milk (within reason). It’s important to use extra virgin olive oil, as not all olive oils are considered high in antioxidant phytochemicals. 
• Get creative and use fresh herbs such as basil or rosemary, garlic or spices to keep your dishes tasting delicious. Don’t forget an important part of the Mediterranean lifestyle is sharing food and enjoying dishes together, embrace this. 
• Drink plenty of water, and maybe even enjoy a small glass of red wine with your meal! But remember, as a bariatric patient we don’t really want you to drink while you are eating, so this should be an occasional treat. 

Eating out on the Mediterranean Diet

It’s even easy to eat out on the Mediterranean diet. Choose a fish or seafood dish, which is usually accompanied by vegetables or salad (and if it isn’t you can always order that). Opt for grilled rather than fried wherever possible, you could always ask your waiter what the options are. Not forgetting to choose whole grains over refined grains if you have bread to choose from.

Benefits of the Mediterranean Diet for Weight Loss Surgery Patients

1. Easy to follow and includes a huge variety of foods, making it sustainable for long-term weight management. A quick Google search will lead you to countless recipe ideas to try at home.
2. As it includes foods that are high in fibre and protein, you are more likely to feel full for longer and less likely to snack. It’s the combination of different food groups that make the diet so effective.
3. Studies have suggested that the diet can help to maintain healthy blood sugar levels, improve cardiovascular health and brain function. It has also been shown to decrease the risk of some cancers. 

Bariatric surgery can be a step towards a longer, happier, healthier life, the rest is up to you. A diet like the Mediterranean diet provides an easy blueprint to follow that provides enough variation to never become boring, and could be a key to long-term weight management for bariatric patients.