This feature could easily be called ‘what’s the best things to do after WLS?’ because essentially they tell the good story about ideal behaviours that bring about success and the sorry tale of those that don’t.
We’ve covered this before when we have asked past patients what they do to get great results (here and here) and also checked out those behaviours that side-line and stall us (here). But here we have some solid evidence about those behaviours that optimise outcomes.
I’m not surprised to see weighing yourself regularly and logging it (see here) and stopping grazing (see here) as aids and culprits respectively but stopping eating when full I thought would be lower on the list.
Now a paper by James Mitchell and colleagues, published in JAMA Surgery, reports on the postoperative eating behaviours and weight control strategies that are associated with differences in body weight seen at 3 years after bariatric surgery.
The study looks at self-reported data from over 2000 participants in the The Longitudinal Assessment of Bariatric Surgery-2 (LABS-2) study, a multi-center observational cohort study at 10 US hospitals in 6 geographically diverse clinical centers in the USA. Participants completed detailed surveys regarding eating and weight control behaviours prior to surgery and then annually after surgery for 3 years.
The researchers assessed 25 postoperative behaviours related to eating, weight control practices, and the use of alcohol, smoking, and illegal drugs.
The three key behaviours associated with poor outcomes were lack of weekly self-weighing, continuing to eat when feeling full more than once a week, and eating continuously during the day.
Thus, a participant who post-op started to self-weigh regularly, stopped eating when feeling full, and stopped eating continuously during the day after surgery would be predicted to lose almost 40% of their baseline weight compared to only 24% weight loss in participants who did not adopt these behaviours.
Other behaviours that had negative influences on outcomes included problematic use of alcohol, smoking and illegal drugs.
Thus, as one may have suspected all along, helping patients adopt and adhere to behavioural changes that include self-monitoring and mindful eating behaviours can be expected to substantially affect the success of bariatric surgery.
The message to take away from the research above is thankfully what we try and encourage everyday – weigh yourself regularly; don’t graze; portion your food and eat until full (but not stuffed) over about a 20 minute period (and don’t go back for more until the next meal); watch your alcohol consumption; and ditch the smoking and drugs for your best chance of weight-loss success and maintenance. Not easy we know … but we’re here to help each and every step, each and every day.
Feature courtesy of Dr. Sharma’s Obesity Notes