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    With bariatric surgery, the most dramatic changes happen in the first year. Here's what to expect.

    If you're considering weight loss surgery, prepare to make changes that last a lifetime.

    "When you're seriously overweight, it affects your social life, your health," says Atul Madan, MD, chief of bariatric surgery at the University of Miami School of Medicine. "This surgery helps people get past their cravings. They're much healthier, their social interactions get better. It affects them in so many ways."

    But bariatric surgery is only one tool to help achieve weight loss. You’ll still need to make many lifestyle changes to stay healthy and keep the weight off.

    "The most successful people do not look at this surgery as a quick fix," says Madelyn Fernstrom, PhD, director of the University of Pittsburgh Medical Center's Weight Management Center and a frequent contributor on NBC's Today Show. "It does not replace lifestyle. You've got to be willing to face lifestyle changes that last forever."

    To make those changes successfully, it helps to understand the milestones you can expect three months, six months, or a year later. To learn about these, WebMD talked to the professionals, and to people who had bariatric surgery.

    Preparing for Weight Loss Surgery

    Well before having bariatric surgery, patients begin taking steps in the right direction. Most insurance companies now require six months of presurgical patient education to prepare them, says Fernstrom.

    You must come to grips with eating patterns that have doomed you in the past, she explains. "Every severely obese person says they eat because it's fun, they're bored, they're at the movies and it's a social thing. They eat when they're happy, they eat when they're sad."

    There is also the commitment to eating very small portions. If you overeat, you risk vomiting. Also, too frequent overeating can eventually stretch the new stomach pouch, which means you won't lose weight -- and could regain weight, explains Madan.

    "It's not a punitive lifestyle ...You simply become a taster of many things," Fernstrom tells WebMD. "You find that you're perfectly full with one egg, maybe a couple of strawberries for breakfast. It's just enough."

    • Immediately After Weight Loss Surgery. For the first two weeks after surgery, Madan prescribes a liquid protein diet. Then, patients start eating pureed and soft food -- food the consistency of scrambled eggs.

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