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How Weight Loss Surgery Can Change Your Life

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Weight Loss Surgery: What to Expect the First Year

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

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.

You'll start walking -- even just five minutes at a time, working up to 30 minutes a day, he says. "That can be a huge deal for some people." If you have arthritis, especially if it's in hips and knees, he advises water aerobics.

  • One to Three Months Post-Surgery. At this point, people start trying "regular food" to see what they can tolerate. The timing depends on the type of weight loss surgery. "Try different foods, to see what will go down easily," says Madan. "If it doesn't, just stay away from it for awhile. Wait a month and try again."

Don't set yourself up for disappointment, says Beverly P., a Memphis patient who lost 200 pounds with gastric bypass surgery. "It takes awhile to train your mind not to want much food. Don't fill up a big dinner plate, use a smaller plate. Eating can still be enjoyable -- but you don't need to eat enough to feed several more people."

  • Six Months Post-Surgery. At six months, you'll have lost a lot of weight. If you've had gastric bypass surgery, you will have lost about 30% to 40% of excess body weight. With gastric banding surgery, you lose 1 to 2 pounds a week -- so by six months, you'll have lost 25 to 50 pounds. 
  • Nine Months Post-Surgery. If you had any problems at the six-month visit, your surgeon will want to see you at this milestone, too. Vitamin deficiencies or lack of sufficient weight loss are the typical issues being addressed at this point, says Madan. 
  • One Year After Surgery. Between 12 to 18 months after surgery, you will have lost a great deal of weight, says Madan. With gastric bypass surgery, you likely are close to your goal. If you had gastric banding surgery, you should have lost over 100 pounds. If weight loss has lagged, it's important to find the cause -- like eating too many snack foods.
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What will be your biggest challenge after surgery?