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Weight Loss Surgery: Beware the Pitfalls continued...

Regular appointments with your surgeon are critical, Madan adds. "Often, complications occur when patients become complacent. They stop making follow-up visits with their surgeon. Then they develop a problem five years after surgery."

With gastric banding procedures, follow-up is directly related to success because frequent adjustments in bands are necessary for weight loss, he says.

"The band can be consistently adjusted as hunger and fullness change over time," Courcoulas explains. "Gastric bypass patients lose quickly, regain a little, then level out. [Gastric banding] patients lose more slowly, but they don't tend to regain."

Weight Loss Surgery: Tips for Long-Term Success

Don’t look at it as dieting. This is a complete lifestyle change -- exercise and food habits -- that should enhance the rest of your life.

Tune in to satiety. "You have to be really conscious of how your body feels when you're full," says Madan. "Learn when you're full and when you're not full."

Get a hobby. Take the focus off food. "For a lot of my patients, their hobby is eating," he suggests. "They need a hobby that keeps them active. Exercise can become a hobby, painting, guitar lessons, art class, scuba diving. Get pleasure from something other than food."

Make exercise a habit. If you can walk a little bit, that's great. Wear a pedometer to track your steps, so you can challenge yourself. Start by walking five minutes a day, then build on that. Park a little further out in the parking lot. Take a flight of stairs if you can. "It's aboutgetting into the right mindset ... establishing new habits that will stay habits," Fernstrom says.

Get a good support system. Join a weight loss surgery support group. "While friends and family are going be supportive, they haven't gone through the surgery,” Madan says. “It's easier to talk about issues with someone who has walked a mile in your footsteps. People who join support groups lose more weight. The group support reinforces lifestyle changes."

See a psychologist. When people are under stress, eating can happen. Seeing a psychologist can be very helpful in breaking that chain, says Madan. "It's important to learn stress-relieving activities. If after surgery you're engaging in stress-triggered eating, you need to see someone. There's no embarrassment in seeing a psychologist."

Discussions with a nutritionist can also reveal barriers to weight loss -- untreated depression, hostile relationships, stress at work, unhappiness in career, self-esteem issues. "All of those have nothing to do with eating -- but they have everything to do with the drive to eat," says Fernstrom.

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