In fact, one of the most difficult lifestyle changes after bariatric surgery is psychological and depriving ourselves of everything we enjoy can actually be detrimental to our psychological and physical health. While we do not suggest that patients indulge in a great deal of dessert, we do understand that once a while there is a place for a sweet treat.

Our suggestion is to set a day once a week where you allow yourself a small indulgence, whether it be a dessert or other enjoyment. Be mindful, however, that while you can indulge, it is not a reason to eat excessive amounts of dessert. For example, rather than having two scoops of ice cream in a cone, one scoop in a cup should be plenty to satisfy your sweet tooth.

Patients can work with our dietitian after surgery to determine when they can “schedule” their indulgences. It may be once a week or once a month and the dietary plan can and will change over the course of your weight loss journey.

Always remember that moderation is the key to success after bariatric surgery. Eating far too much or far too little; overindulging or under indulging are all detrimental to your long-term success. Getting just enough at just the right time is the key to enjoyment and consistent weight loss over the long-term.

During the gastric banding (Lap-Band® or Realize® Band) procedure, a small disc shaped injection port is attached to the abdominal wall right under the skin. This port is connected to the band with soft thin tubing and it acts as a vessel for injecting or removing saline into the band. Additional saline tightens the band while removal of the saline loosens the band – this allows for a greater or reduced rate of weight loss, respectively.

The amount of restriction correlates with how much food you can eat, and how quickly food passes through the band. The weight loss is a result of eating the right foods, and less of them.  Adjustments are a very simple and a necessary process to ensure optimal and safe weight loss. Band fills and adjustments are performed right in our office and they will occur approximately every few months until an ideal restriction is found. The adjustment process takes about 5 minutes and your surgeon uses specially made needle to inject or remove the saline. From a pain perspective, the procedure is only slightly uncomfortable and rarely is it painful.

In order to help us during the process, patients are encouraged to let us know when the band feels too tight or if they do not believe they are getting enough restriction. Both may be a sign that the band needs to be adjusted. Patients will receive complete post-operative instructions and guidelines on band adjustments however any questions patients have about their adjustments should be directed to our office.

This addictive behavior starts to take over our lives, not only causing us to gain weight, but possibly causing obesity. Our diets are significantly curtailed as a result of weight loss surgery. Some people, especially those with a tendency toward addictive behavior, may feel a void in their lives as a result. This void then has to be filled – this may be alcohol, drugs or another addictive substance.

The way we approach this addiction substitution is to try to prevent it in the first place. We require each of our patients to participate in a thorough psychological evaluation before undergoing surgery. Further, we encourage our patients to spend time with our licensed psychologist after surgery in order to ensure that their progress is smooth and free from the possibility of addiction substitution.

From the patient’s perspective, the best way to identify the potential for addiction and prevent addiction substitution is by speaking up. There’s no shame in telling friends, family members, coworkers and especially your surgeon that you may be feeling the need to consume other substances to fill a void. While addiction transfer is not common, it is something every patient should look out for.

You can always contact our office to learn more about this destructive behavior and figure out if it may be affecting you or one of your loved ones.

Negative feelings can unravel our progress or they can be the motivation we need to keep going. It’s all in how we look at them and how we manage them. Of course it is worth noting that depression, and even addiction after weight loss surgery, can be very dangerous.

Effectively managing bad days is the key to success. First we must recognize what triggered the bad day. Was it stress, was it peer pressure or maybe just being tired? No matter the cause of the negative feelings, identifying them can allow us to effectively deal with our bad feelings and eventually prevent them when we see them coming on.
Another strategy to manage bad feelings is to take advantage of the support of family, friends, support groups and our office. Each group is an important component that can work together to help you overcome those bad days where negative feelings seem to get the best of us.

The bottom line is that bad days are common, and they can be destructive or can be spun into an opportunity for growth. Your success depends on which path you choose in dealing with these feelings. Remember, use those around you and take advantage of the love and support of those that care about you.

It’s not easy to follow a highly modified lifestyle plan immediately after surgery. Even over the long-term, patients can “fall off the wagon,” so to speak and revert to previous lifestyle choices. That’s why the aftercare programs offered by your surgeon and surgical practice are so important. These programs may include:

• Support groups, during which patients will be able to connect with others who have experienced the same ups and downs of life after surgery.
• Access to dietitians and psychologists to counsel the patient and reinforce the dos and don’ts of lifestyle modification. These changes are a significant physical and psychological challenge, especially in the first few years after surgery.
• Finally, aftercare may also include using tools and online resources to track caloric intake and weight loss goals. These online tools may be offered by your surgeon, by the medical device manufacturer or you may find them on your own.

No matter what aftercare resources are used, it is important that patient have a dedication to changing their life after surgery. There’s a direct correlation between the amount of effort that is put into changing and maintaining a new lifestyle and how much weight is lost. And we know how hard this can be. We encourage any of our patients to contact us if ever they have questions about their aftercare program or sticking to the plan.

However, the BMI calculation cannot be used as a precise be-all and end-all guide to qualify for weight loss surgery. Indeed, the BMI calculation leaves out several very important factors that can affect the final number including: age, gender, muscle tone and build frame. Each of the aforementioned can influence the body mass index number significantly. The BMI was created as a guide for an average person of average height, average build and average age.

After a patient decides that bariatric surgery is right for them, their BMI is only one of many factors that we take into account before we clear them for surgery. A number of tests are performed on each and every patient in order to make sure that bariatric surgery is a medical necessity – that the procedure is needed for medical and not aesthetic reasons.

So what can we take away from this? Well, we should continue to use the BMI to generally estimate our eligibility for weight loss surgery until we have a better tool. However, we should not focus too strongly on the BMI alone, as it would obscure other factors that are very important in deciding whether bariatric surgery is right for us.

The band has become a very popular alternative to stapled weight loss surgeries including gastric bypass, mostly because it is fully adjustable and reversible and does not require any cutting or re-routing of the stomach or small intestine. And just as it has its benefits, so too does it come with considerations including slower and lower weight loss potential.

The gastric band is placed around the top of the stomach and tightened to form two stomach chambers. The upper chamber is much smaller, becoming the primary receptacle for the food that the patient eats. Once the food passes through the small opening formed by the band, it is digested as normal. The entire procedure is performed in a minimally invasive manner, which means that the large single incisions of years past are no longer needed. Rather, five small incisions are made in the abdomen to access the surgical field.

After surgery, banding patients will visit their surgeon on a regular basis to adjust the tightness of the band in order to help them lose more or less weight. Adjustments will continue for up to two years after surgery or until a good level has been established.

For all of the benefits that the gastric band offers, not least of which is disease improvement and resolution, it also comes with various risks, including the inherent risk of any surgical procedure such as infection. There are also risks specific to abdominal surgery and the gastric band such as slippage or erosion of the band, which may require additional surgery to correct.

Learning more about the gastric band is easy – you can navigate through our website and you can attend a free weight loss surgery seminar at one of several locations in Northern New Jersey.

Obesity and morbid obesity is dangerous and can affect anyone regardless of age, gender or socioeconomic status. As such, weight loss surgery can be considered for certain adolescents whose obesity is uncontrollable and life-threatening. However, just as adults have to control their diet, exercise and lifestyle after surgery, so to do adolescents. Their relative immaturity may make it more difficult for them to follow the prescribed diet and exercise plan that is crucial to success.

The effects and results of adolescent bariatric surgery are, as yet, largely unknown and unproven. Unproven too is the idea of whether or not an adolescent can effectively self-motivate. As we learn more about the options available to the young and obese, it will be clearer as to whether weight loss surgery is an acceptable option for our younger population in the fight against morbid obesity.

• A seemingly healthy piece of grilled fish or grilled chicken, which actuality may have been prepared with plenty of butter slathered on it to make it moist and taste better.

• Chinese cooking that may have a significant amount of sodium or MSG, which can hurt hydration. It can also raise blood pressure.

• The list goes on and on.

Ultimately, the trick to eating out is moderation, just like everything else after bariatric surgery. We don’t pretend to think that you will always stay at home and make only the healthiest dishes – that is certainly not a realistic expectation. However, understanding the food that you may be consuming at a restaurant and learning how you can make it healthier, can be a great way to enjoy eating out while following your post bariatric surgery diet.

It is easy to automatically assume that when a post bariatric surgery patient loses up to 85% of their excess body weight, the result would be sheer ecstasy. Those who don’t understand bariatric surgery however may not realize that the lifestyle changes that are necessary after bariatric surgery are strict and difficult. Also, many don’t understand the difficulties that post bariatric patients have in adjusting their new lifestyle and maintain their new lower weight – maintenance is a challenge in and of itself.

To be sure, losing weight is a very exciting thing. However, because the patient will have enjoyed, possibly even been addicted to, certain unhealthy foods over many years, even decades the loss of that “comfort blanket” can allow depression to set in. Depression, even in its mildest forms, can interfere with the patient’s daily life after surgery. The results can be debilitating and progressive if left untreated.

How does a patient fight depression? They can do so in much the same way as they deal with other issues after their procedure – excellent support and asking for help. Hopefully with the help of their surgeon, they will have developed a strong support system that may include family, friends, support groups and online resources. Further, practices such as ours will have trained psychologist offering the ability to discuss any problems that they may be feeling after surgery.

When addressed immediately, depression and other psychological issues after surgery can be warded off before they become severe.