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Bariatric Patient's Decalogue

Every patient who decides to undergo surgical treatment of obesity receives information at the beginning of their therapeutic path that they will be responsible for the success of the treatment to the same extent, and maybe even more than the surgical team. This does not result from the desire to shift the responsibility onto the patient, but from the real need to realize that surgical treatment is only the beginning of therapy, and changes in the digestive tract made by the surgeon are only a tool that the patient will use or not. The final effect of the treatment depends on the daily use of a healthy diet as well as on avoiding mistakes which, when often made, lead ultimately to the patient's disappointment.


In order not to be limited only to generalities, I would like to present in points the basic rules of conduct, as well as a list of the most common mistakes made by patients after bariatric surgery.



  1. Drinking water while eating

    Taking water while eating makes the food leave the stomach faster. In this way, space is created to take another portion of food during the same meal. In other words, a patient whose stomach volume is 100 ml, instead of taking 100 ml of solid food during a meal, he will take, for example, 150 or 200 ml depending on how much liquid he takes during the same meal.


  2. Drinking carbonated sweetened drinks.

    Apart from the fact that in the short period after the operation, taking carbonated drinks results in discomfort or even pain caused by the rapid stretching of the small stomach, in the distant period after the surgical treatment, drinking carbonated drinks unfortunately becomes a habit, which results in the regular intake of "empty" calories, which are not lacking in carbonated, sweetened beverages. For example, a 330 ml can, without indicating any manufacturer, may contain from 100 to 140 kcal. For comparison, 330 ml of water always contains 0 kcal! Remember, when we drink we need water, not sugar!


  3. Quality of meals taken

    You don't need to be a dietitian to understand the simple principles on which a healthy diet is based. A portion of fries eaten with a burger is not the same as a fish fillet with a vegetable salad. A portion of strawberry ice cream is not the same as a portion of strawberries, and a glass of 18% cream is not the same as a glass of yogurt.

    The pace of life exposes us to reaching for highly processed products, containing much more calories than we could take during a meal. On the one hand, it is a truism, but if someone reaches for an aggressive form of therapy, which is surgical treatment, they cannot underestimate such truisms. What ends up on our plates cannot be a matter of chance, but of careful tactics that must accompany us every day.


  4. Alcohol

    First of all, alcohol is also calories. The phrase "beer muscle" didn't come out of nowhere. Considering this is the same problem we touched on in the second point. Secondly, every patient after bariatric surgery must be aware that his sensitivity to alcohol is definitely different than before the operation. The liver in the first year after surgery is very sensitive to ethanol. More figuratively speaking, it is not able to neutralize the adopted liquid percentages as quickly as it did before. What's more, in the case of patients who have undergone gastric bypass surgery, alcohol is absorbed much faster from the gastrointestinal tract, therefore its content in the blood increases very rapidly. On a more practical note, if before surgery you could drink 3 glasses of wine while still holding the vertical, after bariatric surgery the vertical can be lost after just one glass of wine. According to some surgeons, alcohol should not be consumed in the first year after the operation at all, but if someone cannot stop himself, he should consume alcohol only in a proven company.

    Psychological research should also be mentioned, which indicates a greater ease of alcohol dependence among bariatric patients.


  5. Supplementation of vitamins and microelements

    It should come as no surprise that the changes introduced by the surgeon in the gastrointestinal tract, resulting in spectacular weight loss, will also interfere with the absorption of vitamins and microelements. This is not a high price, the more so that if not taken in sufficient quantities with food, it can be supplemented in the form of oral preparations. On the other hand, if someone underestimates taking these "banal" preparations, they are exposed to a number of serious consequences that may result in serious neurological, internal or orthopedic diseases. In accordance with the principle that prevention is better than cure, consideration of whether I can stop supplementing with the recommended preparations should not take place at all.


  6. drinking water

    You can live without food for a month or even longer, without drinking a maximum of a few days. The most common ailment with which patients call the surgeon shortly after surgery is a feeling of weakness. The most common cause of this is not taking enough fluid. Therefore, it should be remembered that a bottle of water (non-carbonated!) should be a permanent prop accompanying the patient after surgery. In the later stages of treatment, it is also easier to control hunger by taking water between meals, because the stomach can be tricked in this way. A good state of hydration also allows you to flush out all the toxic metabolites that are formed during the period of intensive weight reduction.


  7. Biting

    The mechanism of action of bariatric surgery is based, among others, on We are able to fill the "new", small stomach with about 100 ml of food, which results in the tension of the stomach walls, and then sending a nerve impulse through the stomach informing us about filling the stomach, which we interpret as satiety. If, on the other hand, between meals our main occupation is snacking on small amounts of anything, we are dealing with a situation when a small amount of food, with a volume smaller than the volume of the stomach, is constantly in it, at no time resulting in a feeling of satiety. We reach for snacks not because we are hungry, but mainly because they are tasty, and even more often because they are. So let's not bring them home, so as not to be tempted, and if we need something to occupy the stomach, let's reach for a water bottle and drink a few sips. It will help for a while, and it will be healthy for sure. If the feeling of hunger accompanies us, it is much wiser to reach for a protein snack, such as an egg or a portion of meat, which will fill the stomach and make you feel full for the next few hours.


  8. Physical exercise

    Bariatric math is simple: "eat less, sleep more". If you want to achieve more spectacular weight loss and improve your physical condition in general, you cannot rely only on changes in the gastrointestinal tract and the amount of calories consumed. Physical exercises will be much easier over time because excessive body weight will no longer be a real obstacle in practicing sports.


  9. Carbohydrates

    "Sugar is white death," says the slogan, and it's not just an empty slogan. An obese patient who eats sweets is more or less the same situation when a person suffering from atherosclerosis continues to smoke cigarettes. I do not want to argue with the fact that each of us is attracted to sweet, but it is worth considering for a moment to realize that fruit, which is also sweet, has on average 10 times less calories than processed sweets, regardless of the form.


  10. Obesity is like alcoholism

    Every person who has become obese must humbly accept one sad fact. You are obese for the rest of your life, no matter how much you weigh. If you ever forget that you weighed 100 kilos or more a few years ago and start slipping back into your old habits, it's only a matter of time before the scale hand passes the magic three-digit number. If you don't want to go back to a time when you weren't the only one who knew about your obesity problem, then you should be as strict as an alcoholic who knows that every cycle starts with the first drink.


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