Some common challenges that weight loss surgery patients experience include:

• Bad food habits: Even after having surgery, it can be difficult to break habits you’ve practiced for years. You may have a habit of emotional eating or living a sedentary lifestyle, and these habits can prevent you from getting the best results from your weight loss surgery.
• Becoming complacent: Many people lose weight very quickly after weight loss surgery and then find that their weight loss slows or stops completely. This may be because you’ve become complacent after achieving some immediate success and have begun to revert to old habits.
• Insufficient follow-up: If you’ve experienced a few setbacks, you may cancel follow-up appointments with your surgeon in order to avoid feeling judged or embarrassed. You might also stop checking in with other support systems, including bariatric surgery support groups or online forums you frequented shortly after surgery.

Overcoming common challenges

These challenges are common, which means that there is nothing inherently wrong with you if you find yourself faced with them. Avoid being overly harsh with yourself, and resolve to move forward. Remind yourself that weight loss is a long-term commitment, and you may experience setbacks along the way, but making the right decisions over time will produce results. You should also stay plugged into a support system, even if you begin to feel you no longer need support because you’ve started to lose weight. A good support system can help keep you on track for years to come.

The simple truth is that your caloric intake and your physical activity determine your weight. Metabolism, the process that your body undergoes to convert what you consume into energy, is generally balanced to meet your body’s needs. Even when you rest, your metabolism is creating energy for all of the resting functions of the body, including breathing, blood circulation, and cell repair.

Every person has a base metabolic rate (BMR), which is the number of calories that your body needs to carry out your basic bodily functions. Your BMR is determined by several factors, including:

• Body size
• Body composition
• Gender
• Age

Your metabolism accounts for about 75% of the calories that you burn every day and is very difficult to adjust. Physical activity, however, is a major factor in the amount of calories that your body burns every day that you can directly affect.

Except when resulting from a metabolic disorder, weight gain is most commonly directly correlated with eating more calories than you burn. Instead of relying on quick-fix supplements that do not have FDA approval but claim to increase your metabolism, the most effective way for you to lose weight is to reduce the amount of calories that you eat and increase your physical activity. Even increased activity during your normal life, such as taking the stairs instead of the elevator, parking farther from the door, cleaning the house, or walking your dog, can burn calories and help with weight loss.

The Department of Health and Human Services’ Agency for Healthcare Research and Quality has discovered that on average, complications relating to bariatric surgery declined 21% between 2002 and 2006. Much of this improvement is attributable to an increased use of vertical-banded gastroplasty and lap-band surgery over gastric bypass surgery, more use of laparoscopy, and increased technical experience among surgeons performing said procedures. As an additional benefit, hospital payments for bariatric surgery patients also dropped, partially due to the reduced need for hospital re-admissions from complications.

“Recent Improvements in Bariatric Surgery Outcomes,” published in the May 2009 Medical Care, detailed that the complication rate among bariatric surgical patients dropped approximately 24%, mainly occurring due to a significant decrease of 58% in the rate of post-surgical infections. Additionally, complications like staple leakage and abdominal hernias, among others, decreased by between 29 and 50%.

The research found that even with an increase in the number of older and sicker patients having bariatric surgery, the complication rate still declined. The Director of the Agency for Healthcare Research and Quality, Carolyn M. Clancy, MD, said that people “considering an elective procedure need unbiased, science-based evidence of its benefits and risks . . . all surgeries involve risks, but as newer technologies emerge and surgeons and hospitals gain experience, as this study shows, risks can decrease.”