Anyone who knows me is aware how grateful I am for all the knowledge I have gained from our patients over the years. That said, it has recently been brought to my attention that not everyone feels thoroughly prepared for the bariatric “long haul,” even patients who successfully lose weight. After a lot of thought, I would have to agree that the 3-6 months of pre-op medical and nutrition appointments, the 2 week pre-op diet, the 5 post-op weeks of transitional diet stages, the rapid weight loss period, and the mindfulness and vigilance that accompany all these periods, are really just the beginning of a very long process. As I thought about how to better prepare patients for the long-term aspects of this journey, an old children’s song drifted into my head;
The bear went over the mountain,
the bear went over the mountain,
the bear went over the mountain
and what do you think he saw?
He saw another mountain,
he saw another mountain,
he saw another mountain
and what do you think he did?
(Repeat verse 1)
(Repeat verse 2)
And so on and so on…
If you remember this song, you know that once the bear got over the first mountain he/she was confronted with another mountain and another mountain and the song never really ends. If you don’t know the song, you get the idea. After bariatric surgery, you must keep learning and growing, modifying behaviors and gaining self-confidence, by moving on to the next metaphoric mountain.
To reaffirm that your support team does understand the depth and breadth of this journey (even if we don’t always express it), I have tried to identify the Bear(iatric) mountains that you have already conquered and those that may lie ahead:
Insurance clearance following multiple pre-op medical and nutrition visits.
Ten days on pre-op diet for liver shrinkage and 48 hours on clear liquids to empty stomach.
Five weeks on post-op transitional dietary stages with early establish- ment of new food-related habits and mind- body adaptation to changes in hunger and satiety signals and taste.
Further reinforcement of new eating patterns and behaviors during major weight loss period with gradual adjustment to actual physical changes and body image and other’s reactions to your physical changes.
Weight loss slow down and confidence building that your personal food-related decisions are further evolving and will support healthy weight maintenance.
Weight maintenance and focus on fine tuning your healthy lifestyle, including mind (mental health) and body (diet and fitness).
Acceptance of the need to call on supports when life stressors threaten your new lifestyle. –
Continue to climb every (bariatric) mountain “till you find your dream.”
Nancy Murphy RDN, CDE
