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Approx 60% don't follow the post-op plan



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Hi all,

Im new to this forum and have just started the process of appointments with the dietitian, physiologist, surgeon, etc.

I was told by one of the nurses at the clinic that around 60% of people who get an RNY bypass don't follow the post-op program with varying degrees of consequences including malnutrition.

This is slightly worrying because i imagine each and every one of those people told themselves they'd follow the program faithfully and do everything they were told to do only to end up NOT doing what they knew they should.

Does this mean that the post-op plan is SO hard to follow that the majority of people are prepared to risk their health by not following it or does life just return to 'normal' so much that people just forget to stick to the plan? Or is it something else again?

I'm keen to hear everyone's thoughts and whether or not you still follow 'the plan' regardless of where you are in your journey.

Peace & love,

Joy

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I can only answer for myself and even then, my answer will be askew for the simple reason that I am pre-op and do not have a surgery date yet. However, I have tried to incorporate some changes into my lifestyle so that hopefully the transition will not seem as drastic once it occurs. I have made changes such as replacing two of my meals with a Protein shake and have incorporated a 25 minute daily walk for at least 5 days a week. I also try not to drink carbonated drinks, mainly sodas. Most of my liquid intake comes from plain Water, unsweetened green tea and/or coffee. Albeit, to be completely honest with you, there are days were I falter and I end up having two solid meals instead of one or sometimes I will have a glass of soda. But every time that happens, I have no other option than to just stick to it the next day and make sure I follow through. I don't know that I will have the will power to keep up my post-op program, but that is one of the reasons I am making these changes, so the transition will not seem as huge.

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If the lifestyle changes and healthy choices were easy for us we wouldn't need surgery to begin with. A significant number of people cheat their way into the process and don't use the time preop to overcome behavioral/psychological issues. There's a high incidence of eating disorders, addictions and mental illness too. Many people have an enabling support system, people who support their bad habits or fail to support good habits. I had to work diligently to change habits in advance and did not set my date until all necessary changes had been achieved and successfully maintained. Make use of your resources, set goals and enlist your support system to support those goals. This is an opportunity. Some people will seize it and some will waste it. It's all about choice.

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I told my surgeon before I had surgery that I was going to be the most compliant patient he's ever had. And I *have* been super compliant. I'm sure that's why I've been able to reach a normal BMI. I am NOT going back to where I was, so I'm going to continue being his most compliant patient ever...

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I've actually found compliance over the first 7.5 months post-op to be quite easy. I don't really understand the thought process for people who are non-compliant right out of the gate. I'm not judging, I really just lack an ability to understand where they are in their life/thought process that allows them to do that.

That being said, I worry a ton about maintenance. Being non-compliant there i can TOTALLY get my head around. I think everyone of us who had this surgery had dieted over and over and over. We probably all had some level success, but we pretty much all failed at maintenance - that's why we are here.

So, to me, it's the old demons. I always failed in the past, why will this be any different?

I am almost almost 30 lbs below my original goal weight and if I'm honest with myself, part of why is that I am so worried about transitioning into maintenance (and partly because I can, so hey, why not).

As a last thought, I also wonder if you ever get to a point that you feel "safe". If you maintain for 5 years, will you start to believe you will not regain? 7 years? 10 years?

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If this was said already I apologize, I haven't read all previous comments yet. I believe the issue is not that the post op plan is too hard or impossible but more that many people have serious food addictions and while they start off with the best intentions they lose steam and self sabotage after a while due to not dealing with the underlying issues. Also there are many who think that these surgeries are a quick fix. I know someone who had bypass done around the same time that I had my sleeve done. We had very similar stats to start with but I took this very seriously and her sadly not so much. I have gotten to 156lbs now and she still weighs over 200 lbs even though most people should lose faster with bypass. While I have been sticking to my plan she has been posting a lot a junk food and carb loaded meals that she has been eating on Facebook. She went into it in the beginning with the attitude of I'm having surgery to eat what I want and get skinny.

Edited by reree6898

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My surgery date is November 28th and I have not lost anything, it's hard as hell to remain cigarette free cold turkey since Jan and loose weight at the same time, I'm addicted to Pasta and it has made my AIC (blood work to measure diabetes) go up from 5.8 to 7.8, I'm not happy with that I would like to walk more and eat smaller portions I pray and pray for the strength.

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If this was said already I apologize, I haven't read all previous comments yet. I believe the issue is not that the post op plan is too hard or impossible but more that many people have serious food addictions and while they start off with the best intentions they lose steam and self sabotage after a while due to not dealing with the underlying issues. Also there are many who think that these surgeries are a quick fix. I know someone who had bypass done around the same time that I had my sleeve done. We had very similar stats to start with but I took this very seriously and her sadly not so much. I have gotten to 156lbs now and she still weighs over 200 lbs even though most people should lose faster with bypass. While I have been sticking to my plan she has been posting a lot a junk food and carb loaded meals that she has been eating on Facebook. She went into it in the beginning with the attitude of I'm having surgery to eat what I want and get skinny.

Agreed!

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I am almost 4 months post op and started off with good intentions to stick rigidly to the plan ... not that my surgeon or nut actually gave me a full eating plan, just one for the first 5 weeks and then "guidelines" to help with a healthy lifestyle moving forward.

What I have found since surgery however, is that surgically reduced stomachs don't read nutritional plans. So you may have a plan that states x amount of Protein per meal and x amount of vegies etc, but that doesn't mean your stomach is going to agree with it. Since my surgery I have found Protein is the hardest thing for my stomach to cope with. I try and make sure I have some at each meal, but I doubt if I manage the number of grams that some plans recommend. ( I should perhaps mention I was a vegetarian pre op so that might make a difference to protein tolerance).

Having said that I have had my first lot of blood tests and everything came back normal. My surgeon says my weight loss is on target - whatever that means since he never gave me any solid goals to meet.

I eat healthy, yes once or twice tried something I shouldn't and instantly regretted it and am moving on with an eating plan I find I can cope with on a daily basis. I stick to mainly fresh fruit and vegetables, chicken and fish and a small amount of dairy (limited by lactose intolerance). I don't stress about numbers - not calories nor nutrient grams. I am learning to listen more to my body and finding I feel much healthier for it as well as the weight coming off easily. This suits me and my body ... yours might be different and require different things.

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Pre op was much harder than post op. I've managed to be pretty rock solid at post so far. I am 11 days out.

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      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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      1. LeighaTR

        I hope your surgery on Wednesday goes well. You will be able to do all sorts of new things as you find your new normal after surgery. I don't know this from experience yet, but I am seeing a lot of positive things from people who have had it done. Best of luck!

    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

    • CaseyP1011

      Officially here for a long time, not just a good time💪
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