Sony09

Imagine this. You and your doctor agree that you need to lose weight. You tell your doctor you’ve been thinking about weight loss surgery. Your doctor lets you know his or her thoughts about WLS, and they’re very negative.
You may not need to imagine it because it may have happened – or be happening – to you. What should your next step be when your own doctor is not supportive of WLS?


Doctor’s Orders: Lose the Weight
Almost all Weight Loss Surgery patients and nearly everyone who’s considering getting WLS had a similar experience to the following. You go for a routine visit to your primary care physician, endocrinologist, or regular doctor, and you get the news you’ve come to expect: you’ve gained a little weight since the last appointment and you’re developing obesity-related problems. Bottom line, your doctor says, is that you need to lose weight.
It’s no secret that you need to lose weight. You’ve probably tried a thousand different diets. They may have worked, but only for a time. Then any weight that left came right back, with a few extra pounds. You recently started thinking about weight loss surgery, and you bring up that idea to your doctor.
“Weight Loss Surgery Is the Wrong Choice”
Some doctors are against weight loss surgery. They have the same reasons as anyone else who may be against weight loss surgery. They say it’s the easy way out, or you can lose weight on your own, or you might have complications. It’s great for them to express their concerns to you since that’s their job. But it’s not okay to deny you the opportunity to lose weight just because they don’t like the idea of WLS and may not have ever done any research into it.
The Ideal
Doctors are supposed to be compassionate, understanding, and competent. If that sounds like a tall order, it is. But it’s not unrealistic. You need to feel comfortable discussing your health and health decisions with your doctor without your doctor making you feel like a failure for not losing weight already and for considering Weight Loss Surgery.
You Come First
Your doctor should put you first. Putting you first means taking into consideration your future health, your dieting and weight history, and your own beliefs about whether weight loss surgery is right for you. Your doctor should put you ahead of any personal beliefs or biases about weight loss surgery, or lack of knowledge about it.
Seeking a “Second Opinion”
You’re always entitled to a second opinion when it comes to your health and healthcare decisions. You may not need an official “second opinion” on whether you should get WLS if you’ve already decided you’re going for it. What you do need is an opinion from a doctor who will support you.
You can consider switching your primary care doctor if it’s important to you that your PCP be supportive of your WLS journey and during it. You may even want to find a doctor with some understanding of WLS and how to help you prepare for and recover from it. That’s not always possible, for insurance and logistical reasons. It may not be desirable if you like your PCP otherwise and don’t want to jump ship.
A Supportive Bariatric Surgeon
Whether or not your family doctor approves of Weight Loss Surgery, your surgeon absolutely needs to be on your side. While you can expect bariatric surgeons to be supportive of you getting WLS, that’s not the only thing to consider. Consider whether the surgeon makes you feel confident you’ll get the support you need and that you will succeed.
Whether because of their poor bedside manners or lack of attention to detail, some surgeons will keep you in doubt about your decision. Those are not the right surgeons for you! You may need to have initial consults with one, two, three, or even more surgeons before settling on the one that’s going to boost you up.
A Personal Decision
Ultimately, weight loss surgery is your decision. You can decide to get it, or not to get it. It should be a decision based on what you think will help you lose weight, how much risk you’re willing to take by going “under the knife” (although it’s laparoscopic these days!), and how you think it stacks up against your other options.
It should NOT be a decision based on what your doctor thinks or how uncomfortable you feel talking to your doctor or surgeon about it. It’s up to you.

Is your weight loss history standing between you and your current success after weight loss surgery? If you’re not getting the results you want, there’s a good chance it is. In Part 1 of the series, we brought up the idea of learning from your past, not running from it. Now, we take a look at a few more ways your past might have brought you down, and what you might be able to about it.


Problem: Depending on Others
This one’s not always so obvious, but it may be keeping you from reaching your full potential in weight loss and, frankly, in life. Of course, it’s normal and healthy to depend on others for some things. Maybe you rely on your spouse to pick up the kids from school, and you depend on your parents to parents to take care of your house when you’re on vacation.
But what about the important things? What about your health? Do you take full responsibility for it? Or do you do what you did as a kid – depend on someone to make sure you had the food you needed and expect your parents or the doctor would make you better if you got sick or hurt?
You’re still living in the past if you have not taken control of your health. You are the one who needs to purchase and prepare healthy food; set aside time to work out; eat the right foods to avoid complications from surgery. Others can help, but you need to be in charge.
Problem: Looking for the Quick Fix
If you look for a quick fix, you’ll probably find one. You can lose weight quickly using any number of strategies, and you’ve probably used them all from juicing to low-carb to low-fat. The problem with quick fixes is they’re quick to break, as you’ve found out when you went off the diets and gained the weight back. After WLS, don’t look for the quick fix. Be patient, and know you’re in it for the long haul.
Looking for the quick fix can be something obvious that you recognize in yourself, but it is not always. Looking for the quick fix can be as subtle as subconsciously thinking of what and how much you eat as a temporary diet or thinking of your exercise program as something with a start and finish.
You may be subconsciously looking for the quick fix if you’re unwilling to sign up for a long-term gym membership, or to invest in a kitchen scale or bariatric surgery recipe book. If you feel these things aren’t worthwhile, think about why. Is it because you don’t honestly see yourself needing them for long because you’re not really invested long-term into weight loss surgery success?
Problem: Not Building Your Support System
Many obese people struggle with late-night eating. Even if they are able to make it through the rest of the day eating reasonably healthy, night-time binges can strike furiously. If you weren’t able to overcome them previously, it may have been because you did not build enough of a support system.
This time, don’t underestimate the power of your support system. Include people, such as friends and family, as well as alternate plans. You can set up many layers of protection against late-night overeating. Don’t store junk food at home, and don’t drive home past trigger spots like drive-through burger joints. Have two or three friends or family members whom you can call or talk to if you’re about to make a bad choice, and choose a pre-determined activity to do before eating, whether you decide to blog, sew, or take a walk. Also, have plenty of ready-to-eat healthy food around so it’s easier to grab than any junk.
Problem: Lack of Self-Confidence
Have you ever heard of a self-fulfilling prophecy? You think something will happen a certain way, so you act as though it will happen that way, and then it does.
For weight loss, that can be a bad thing if you let it. “I know my diet’s going to fail, so I’m not going to bother weighing my food.” Then, guess what – you don’t lose weight! “I knew I wouldn’t lose weight.”
But self-fulfilling prophecies can be just as positive as they can negative, especially if you have self-confidence. “I know WLS will work for me, so I’m going to hit my protein goals and weigh my portions every meal.” When you don’t even let doubt creep in, you can be more empowered to follow the behaviors that lead to success.
Weight loss surgery can be a fantastic tool for weight loss, but it’s only as good as you make it. To make it more powerful, don’t run from your personal history. Recognize your past, identify what went wrong, and fix it. Make sure this time really is different.

Okay, it sounds cute, but it’s a serious question. If you want to lose weight or keep it off and get healthy, you need a plan. The old saying, “Fail to plan, and you plan to fail” could have been intended specifically for weight loss surgery patients. Fail to plan after Weight Loss Surgery (WLS), and you’re planning for plateaus or regains and possible complications.
What should you be planning? You don’t want to become fixated on planning, but there are a few key areas to be aware of. These are some of the questions you might ask yourself to make sure you’re planning enough. Each question is followed by the pitfall you might fall into if you don’t think ahead.


Where are you shopping, and what are you buying?
Possible pitfall: Finding an empty fridge and opting for McDonald’s or pizza delivery, or going to the supermarket without a list and buying whatever looks good – which usually doesn’t include lettuce and chicken breast.
A solid answer identifies when you’ll shop, and it includes a list of proteins and other essentials, such as vegetables, fruit, healthy starches, and healthy fats. Check the list to make sure it has enough healthy foods for the meals and snacks that will get you through to the next shopping trip.
What are you having for breakfast tomorrow?
Possible pitfall: Being so rushed you grab a pair of Pop-Tarts on your way out, get a bagel at the coffee place, or get to work so hungry you sneak in a doughnut from the reception area.
A solid answer is realistic, so if you know you’ll be in a rush, it doesn’t involve a lot of preparation. You may want to get your breakfast ready the night before, even if it’s as simple as putting some cottage cheese and a few slices of turkey in a portable container with a tight-fitting lid.
What are you ordering for lunch?
Possible pitfall: Going out with the gang and ordering what they do…anything from a burger and fries to pasta primavera.
A solid answer considers where you’re likely to find yourself at lunch and what’s on the menu. Identify your source of protein and a vegetable beforehand and stick to your pre-made decision when you order. If you end up going out unexpectedly, look for salads, grilled chicken and fish, and sides of vegetables and fruit.
What are you making for dinner?
Possible pitfall: Ordering in or getting take-out, or falling back on a high-calorie, low-nutrition quick fix such as macaroni and cheese or taco kits.
A solid answer identifies your source of protein and vegetables so you can figure out what you need to buy and how much preparation is necessary.
When, where, and what is today’s workout?
Possible pitfall: Running out of time if you haven’t scheduled it into your day, or chickening out of the workout if you haven’t quite made the commitment to a specific exercise.
A solid answer says when you’ll work out, whether you’ll do it at home, at the gym, or somewhere else, and what clothes, shoes, and other equipment you need to bring with you, if any. Your answer should also include what you’ll be doing, whether it’s 30 minutes of walking on the treadmill plus 15 minutes of lifting weights, going to a Zumba class, or pulling weeds and sweeping the driveway.
What will you snack on at the party?
Possible pitfall: Eating whatever happens to look good, and ending up with not enough protein, too many calories, too much fat and sugar, and possibly nausea or dumping syndrome.
A solid answer doesn’t depend on what the host may serve. Your plan may be to bring some hard-boiled eggs or beef jerky for yourself, plus a large green salad, vegetable skewers, or fruit salad for you and the rest of the guests to enjoy.
How will you answer your mother when she offers you a freshly baked chocolate chip cookie (your favorite) or the entire batch?
Possible pitfall: Feeling guilty for refusing or being caught off guard, and accepting the cookie or batch.
A solid answer includes a polite refusal, possibly with an explanation, such as, “No, thank you. My doctor has advised me not to eat cookies.” If you can’t avoid taking the batch home as a “gift,” don’t be afraid to throw it out. Nobody likes to throw away food, but if you’re going to, better to throw it away in the trash can than in your body.
How are you going to feel at the end of the day?
Possible pitfall: Let doubt creep in, and you may be setting yourself up for bad decisions with eating and exercise.
A solid answer is positive and confident with no room for self-doubt. At the end of a day of good eating and a bit of exercise, you may be tired, but satisfied, proud, and a little lower in weight. Staying positive and optimistic sets you up for good decision making without even thinking about it.
You always hear about the importance of planning for weight loss surgery success, but that advice may seem confusing if you’re not a natural planner, or even if you’re just not used to thinking so much about your WLS-related habits. Know the answers to these questions, and your planning skills can help you lose more weight and stay healthy.