“Ultimately whether a person wants to lost weight with or without bariatric surgery,” says General and Bariatric Surgeon, Dr. Paul Stanish, M.D., F.A.C.S., who is the Medical Director for the Healthy4Life program at Community Hospital in Munster and St. Mary Medical Center in Hobart, “they will need to make lifestyle changes.”
Stanish, the co-founder of Healthy4Life, a program designed as a comprehensive team approach to weight loss. To accomplish this, group’s team of professionals, each with specialized skills and expertise in a multitude of areas including nutrition, exercise physiology, diet, internal medicine, surgery and psychology, are able to work with each patient and address their individual needs.
According to Stanish, even those who are prime candidates for weight loss surgery still need to be in good shape before proceeding to surgery. That’s why the team approach emphasizing education and lasting lifestyle changes is so important.
“Changing eating habits is the most important step,” says Stanish. “We live in an extremely toxic food environment where there’s food everywhere. Much of our fast food is easier to get and cheaper to buy and not good at all for you.”
While most people can county food calories, they aren’t always aware of liquid calories—the amount of sugar in what we drink. Consider this, the largest size Starbucks Caramel Flan Latte with whipped cream has 450 calories; a 16-ounce Coca Cola classic at McDonald’s has 410. And those are empty calories, they don’t fill you up so you’re still hungry. Pile that on with a cinnamon roll at Starbucks (420 calories) or a Big Mac at 540 calories and you have half your 2000 calorie allotment for the day.
But there’s further bad news. Forget about working it off.
“You have to be a highly trained athlete to exercise you way out of a bad diet,” says Stanish. “That’s why education and food journaling where we keep track of what we eat are so important.”
Weight loss surgery is a life-changing procedure requiring many changes before and after surgery says Lori Granich, Registered Dietitian at the Midwest Bariatric Institute at Franciscan St. Margaret Health in Dyer.
“Not only will the surgery center that you choose require you to make changes, but your insurance company also has requirements that must be completed before they approve your surgery,” she continues. “With the help of your bariatric team, you will be asked to start making changes before surgery.”
According to Granich this may include starting a vitamin regimen, increasing fluid intake, quitting smoking and regularly exercising.
“One of the best ways to improve health before surgery is to lose weight,” she says. “Even a small amount of weight loss will decrease the risk of surgery, improve breathing and increase ambulation.”
Kristal Markovich, a registered dietitian at Methodist Hospitals, suggests that prior to surgery it’s important to start a diet that includes low fat or fat free dairy options, lean cuts of meat, whole grains as well as consuming more fruits and vegetables.
“Bariatric support groups allow you to meet people who have had surgery or are preparing to have surgery just like you,” says Markovich. “They are great places to practice your new healthy lifestyle in a positive and supportive environment.”
There’s also a psychological component to why we eat.
“When we do the surgeries, they’re very measured,” says Stanish noting that it’s the patients not the surgeries which vary, making it important to get to the underlying food pathology.
“Meeting with a psychologist is also a prerequisite for most programs,” says Granich. “The psychologist can evaluate if you are ready to make the changes necessary for weight loss surgery and can also help you deal with other issues you may have related to food, stress or family. Most bariatric centers have information seminars and support groups that can educate you and your family on bariatric surgery.”
Often patients are asked to keep a food journal.
“People think of it as a chore,” says Stanish, “but I want people to think when they’re about to eat and ask themselves, why am I eating? Am I eating because I’m hungry? Depressed? As well as the time of the day and what they’re eating”
Bariatric isn’t the end of healthy lifestyle changes.
“It is extremely important to continually stay in touch with your bariatric team,” says Granich, “and attend all preoperative and postoperative appointments.”
When they recognize the signs of patients who aren’t fully committed, Stanish and his team work with them.
“We know what phases they are in and whether they are or are not following the diet and exercising,” he says. I tell them I’m like Santa, I know if they’ve been good or bad.”