Dr. Ellner shares the typical habits of a successful weight loss patient.
The typical habits that I see in my very successful bariatric patients are number one, eating behaviors. Knowing when to start eating and when to stop eating. Sometimes this is the hardest part for any human being to figure out when they are using either a gastric banding or a gastric bypass or a sleeve operation.
Patients need to learn what their first signal is of a low blood sugar feeling, which is hypoglycemia. That is a solid black and white signal that each of our bodies send to us when we need food in the system. A patient can’t be led astray by cravings or emotional eating if they are just following their low blood sugar signal as their only indication to start eating.
The second part of that comes with knowing when to stop eating. I tell my patients that they need to eat every bite, let every bite settle nice and slow in their system, and then they need to ask themselves after every single bite, “Did my low blood sugar feeling go away?” In most cases it’s a sense of dizziness or maybe a headache, and if with that bite, the headache went away, that’s the body saying, “You’ve just filled my tank; I don’t need anymore food.” And that’s a good black and white signal so patients know when to start and when to stop eating.
One of the most common mistakes that I see people making sometimes two or three years out of the gastric bypass is that they are still relying on their stomach to make them feel ill if they eat too much. Over time, the stomach muscles and nerves re-coordinate and they start to move food through faster over the second half of the first year than they did during the first half of the first year.
So the people that have the surgery will naturally be able to eat more food in the second six months and into the second year. So, that stomach will not necessarily make that person feel sick or vomit if they eat too much. Over time, this chronic overfilling can lead to pouch or stoma stretch. That leads to less satiety, which is a decreased sense of fullness with a given amount of food. That leads to increased volumes of food being eaten in a given period of time. That leads to weight regain, and that’s what brings patients in wanting a revision.
About Dr. Ellner, M.D.:
Dr. Julie Ellner, M.D., is a bariatric surgeon and medical director of Alvarado's Surgical Weight-Loss Program at Alvarado Hospital.