Each year around 20,000 Australians have bariatric surgery, with thousands of people sharing information about their experiences on social media. If you’ve read some of these posts, you’ll notice across the bariatric community everyone has a slightly different story to tell. This may leave you feeling a bit confused about what to expect on your own journey. Read on to discover more about the stages people travel on this lifelong journey.
Claudia, Debbie and Lindy have kindly shared a little about their lived experiences. It is hoped their stories will provide some useful insights about the realities of this lifelong journey.
The Crossroad – a place of hope
The crossroad is a metaphor for the place where hope is born. Hope of living a different life. You begin to believe that surgery could improve your health and well-being. Finding yourself at The Crossroad may be triggered by a significant family health event, a conversation with a trusted health care provider or inspiration from observing someone else’s transformation.
So, you start seeking more information. You search the internet, talk to more people and learn a bit more about bariatric surgery. Hope grows and thoughts begin to morph action. You sound out your supporters, you re-gig your finances, you might join a private health fund or check your policy, consult with your doctor, arrange a surgical referral, have blood tests, and attend specialist appointments.
You use all this information and support to make a decision. You may find there’s more preparation to be done, or perhaps all is straight forward, and you progress to the next step.
A conversation with Cathy in a casual setting was a big turning point for me and the main reason I decided to go ahead with the surgery. We were at a 30th birthday of a mutual friend and we got chatting. I invited her to re-join the committee of the Newcastle Triathlon Club but she said she couldn’t commit as she was working on her PhD. Being a bit of a sticky beak I asked her about her study and learnt obesity was her area of interest. So began a life changing conversation.
Something Cathy said triggered me to think seriously about surgery. I talked about my years of yo-yo dieting, and although I don’t remember her exact words she said something like “the percentage of morbidly obese people who have success with weight loss and then manage to successfully keep that weight off is like 5%”. This got me thinking seriously about surgery. I also started meeting people who had success with gastric sleeve surgery. I met one person after another. This kept my interest sparked I started to believe that surgery was the right answer for me.
It took me time to book an appointment with my GP to get a referral to see a surgeon. Doubts circled my mind. Let’s face it, when you’re morbidly obese you are aware about your lack of health. I was thinking am I fit enough to make it through, will I die in surgery, what about complications. But then I thought what if I don’t have the surgery? What quality of life will I have moving forward. The pro’s were outweighed the cons, and I booked my appointment.
I kept my decision to have surgery all very private. I only shared it with my immediate family and closest friends. I was worried about being judged. I thought people would think I had taken the easy way out. I felt embarrassed that I couldn’t fight the weight without the surgery. I also felt ashamed about how heavy I was. Outside of that circle I spoke with 2 friends who had previously had the surgery and they both gave me positive feedback. They said surgery was the best decision they had ever made. One of those friends added me to a Facebook group of Gastric Sleevers, I was grateful at the time, but later I blocked the group from my feed. I’d seen a post from a lady who was 2 weeks post op. She wrote about how she walked past a Michel’s patisserie, craved a sausage roll so bought it and ate what she could. I just felt that was negative behaviour and I didn’t want to be a part of it.
My story started a long time before I made the final decision to have surgery. I was 49 years old and I had been seeing a counsellor ( “one” of the most important things I did). I went to see my surgeon and he asked me a simple question, “Why do you want to have surgery?” Daaah, I weighed more than 168kg. I said I no longer wanted to embarrass my children and husband. I thought I nailed it. Bump ba, nope WRONG ANSWER! He told me to go and see a counsellor (already was) and a dietician, then come back in 3 months. I walked out thinking he could stick the surgery where the sun don’t shine, I WONT BE GOING BACK!!!!! After a few visits with my counsellor I realised the reason I wanted surgery was actually in fact for myself, to allow me to LIVE LIFE not watch it, something I had dreamt of for a very long time.
When I went back (yes I “ate my words” lol) I realised that HE actually knew what he was doing. He said he would do my surgery because I now knew I was doing this FOR ME!!!!! Fancy him being right lol.
My weight loss journey started after being diagnosed with severe sleep apnoea, needing pain killers daily for a sore back, and then starting to see my blood pressure rise. I had been on a diet for 45 years. Something more had to be done. On the horizon I could see grandchildren and retirement, but I feared not being actively involved. I was already sick of hearing “we won’t do that cause mum can’t do it” when the family planned for travel and activities. So I started taking action.
First, I got my health insurance increased to be sure it would cover the costs. Over the next 12 months I researched and spoke to people to locate the perfect surgeon. I got a referral, booked the appointment, and undertook all his requirements (psychologist, dietitian, gastroscopy and colonoscopy). My surgery date was set for a few weeks after my health insurance waiting period was over.
When I learnt that a dietitian was going to be part of my care I was ecstatic. Actually, it was one of the essentials I looked for when selecting my surgeon. I think it is amazing to have someone to guide me through this process. The paperwork Cathy provides is thorough and tells me all I need to know to survive.
As I prepared for surgery, I did have some worries. I worried, what if it doesn’t work. What if I pay all this money and do everything right and still can’t lose weight. My failure to lose weight over my life has me so entrenched in feelings of failure. To prepare I spoke to friends who have already had surgery, joined Facebook groups, downloaded bariatric cookbooks from Amazon (introductions were helpful), met with my dietitian and started buying listed items. With Facebook I was mindful about how it could be both productive and counter-productive. I was mindful to avoid the negative posts to focus on the positive posts.
Prior to meeting with Cathy to learn about my pre-op diet I thought I was just on shakes, 3 times per day, based on conversations and FB posts. So to learn that I was allowed to other Optifast options (bars, desserts, soups) plus protein extras (chicken, meat, vegetables) was amazing. I tracked my pre-op diet for a few days, till I got into the rhythm of my preferred schedule. I found it easy, and the added bonus was a 4 kg loss. My advice for others is stick to foods on the list, be flexible with what and when you have meals and work out your bad (snacky) times of the day and save food for then. I had a shake for breakfast, a soup for lunch, protein and vegetable stir fry for dinner. My bad time of day is afternoon 3.30pm ish so I would use by third ‘Optifast’ option then, I used the dessert and added fruit from the ‘free’ list. It filled me up, got me through hump hour and after dinner I was full of my stir fry so didn’t need it.
Looking back I just wish I had taken some pre-op body measurements.
Excitement or regret?
I was actually looking forward to my surgery just to get off the optifast. I had to do it for 2 weeks, and I knew it was a short term thing so you can get yourself through it. I got through it by mixing it up as much as I could – I tried the different flavours and foods available and increased my water intake. I knew it was a necessary part of the process. You stay focused and you get through it. It’s not that it tastes bad, it’s just that you get a bit bored.
After my surgery I focused on getting in my protein and water. Again, it was boring. I tried to get my daily protein in over breakfast and lunch with protein drinks so that I had covered it by dinner time and could then introduce some non protein flavor like pumpkin soup. Cathy was a good guide. When I got to soft foods I got excited by cottage cheese and scrambled eggs. But again you get past the next stage and you begin eating a more rounded diet.
Good advice I got from Cathy was serve yourself a plate, then stop when you’ve had enough. Walk away if you have to. So if you’re being social and there’s a cheese platter, serve yourself the amount you think you can handle on a plate and when it’s gone it’s gone. Grazing isn’t a good idea.
At this point I was thinking about food as fuel. I was trying to eat to fuel my body. At special occasions I still wanted the piece of birthday cake, or morning tea with everyone in the office. So I worked not to beat myself up. I knew if they are ‘sometimes’ foods then it’s ok. But I started to struggle everyday with the fear of putting myself through the surgery and regaining weight.
I started my journey with a different dietician (not Cathy) who told me the things I had to do, which I did. I did learn how to eat the things I should, when I should, but it was a very clinical experience and not a journey that I felt was right for me. I did as I was told and by my surgery date I was in fact down from 168 to 140 kg. When I left hospital I didn’t feel I had the support I needed. Yeah, I had been given a sheet but I felt as though I could not ask questions AT ALL. So I stopped going to my dietitian appointments pretty quickly.
Straight after surgery I tried to manage my expectations. I knew not to expect to lose 1kg / day like the lady on FB did. But it is hard not knowing what is a realistic weight loss. I reminded myself everyone’s journey is different and there will be highs and lows. I told myself follow Cathy’s instructions not FB. I tracked my intake for a few days to make sure I was getting my required protein levels. Just till I got into the groove. I bought a water bottle, filled it in the morning and made sure it was empty at bedtime.
Something I didn’t know about my recovery that would have been helpful was that I’d only be drinking 60mls of water per hour. Then the next day 180ml per hour. Then when you go home increase intake as you can – don’t expect to start drinking everything on Cathys list day 1. It took me all day.
You may feel like someone is sitting on your chest – but it is the gases and will pass in a day or two. Reflux after drinking even a little bit was quiet painful and regular for several days.
My recommendations are:
Learning to adjust
Adjusting to the the reality of living with surgery takes time. The time needed to adjust is more than just a few weeks. The surgery dramatically changes your ability to eat and drink, that is an integral part of everyday life. So learning to adjust can consume a lot of your early post-op life. Keep an open mind about what to expect and seek the support you need, as even the most prepared person can encounter unexpected challenges. Life after bariatric surgery can also be a time of personal growth, and mental health support may be helpful.
I expected surgery to be hard and it was hard. Each day was a struggle to consume all of the protein required on top of all the water you need to ensure you stay healthy. But each week things got a little easier and as the body started to heal and the food variety increased, the weight was literally falling off and my weight loss expectations were being met.
The reality of the food changes was not something I really mentally prepared for. As time went on and the food variety increased, I remember the exact moment I realised that my mind had to adjust. My stomach was full but my mouth, tongue, tastebuds wanted so much more but I had to tell my brain to walk away. It’s not easy.
I also remember the first time I was really active and I desperately wanted to skull a glass of water but you can’t because your stomach doesn’t have capacity to handle that. Also for me drinking anything fizzy is difficult depending on the timing around when I’ve eaten. But I’m not sure that’s necessarily a bad thing though.
The reality of surgery was definitely so different to my expectations. I was one of those people that didn’t read too much about what I was doing. I just knew I couldn’t live a full life being 168+ kg and I wanted to fix it. I knew a couple of people who had surgery, but I also knew that they hadn’t really followed the guidance of the professionals. They are the professionals, they know what is right for you in the long run. How can you know? You haven’t been there before, you don’t know what to do, so I ate and drank what I was told to. I thought I was prepared but in hindsight I wasn’t. What made it easier was that I knew I had support and it was up to me to use it AND I DID.
I was on social media pages and read all the comments, even the negative ones and they did help me to learn. But it was my journey, my choices, my outcome, and I got down to 107 kg after my sleeve. Still sitting at obese class II and then I did get back up to 113kg.
To be updated soon…
A new normal
For me surgery was magical. The weight loss in the first 12 -24 months was amazing. It falls off without even trying. I remember my surgeon telling me the surgery is a tool to assist with weight loss, and early on it was THE tool. In saying that, I was following the instructions from Cathy to the letter and was very focussed on my goals.
By my 3rd anniversary of surgery I was feeling amazing with absolutely no regrets. I wasn’t a size 8, far from it, but I was happier and healthier than I’d been for 30 years. I regained mobility, being able to participate in normal activities, being able to shop in a ‘normal’ size clothing store, being around and active with the family – all excellent benefits. The first time you fly and don’t have to ask for a seat belt extender – there’s no feeling like it.
I know I’m a foodie. I always have been and probably always will be, and so I committed to having a life-long relationship with my dietitian. I’ve now been seeing Cathy regularly for over 7 years.
For me the pros of surgery FAR FAR FAR outweigh the cons. After my first surgery (sleeve) my new normal was that you just can not have JUST ONE MORE MOUTHFUL. Lucky I learnt quickly.
After my SADI I got down to 73kg at my lowest weight. At this point came all the comments: “don’t lose any more weight”, “are you eating enough?”, “you can’t possibly be healthy losing all this weight”. But you know what, I had no control over how much weight I was losing it just came off. But when I had doubts about how I was going there was definitely comfort in knowing that I had my backstop (Cathy) to help if I needed. I remember asking Cathy what do I do “if it doesn’t stop”. Her reply was “there are things we can do” (we did not have to use them). I knew I was eating enough because I was entering it on an APP that Cathy gave me which was awesome. It showed how much protein I was having. And last but definitely not the least I KNEW I was healthy (healthier than I had EVER been) because I was under a dietitian that guided me as to the right and wrong things to do. Yes my choices but the guidance was there.
The honeymoon is over
A year or two after surgery you may find your surgery isn’t working as powerfully as before. Meal size and hunger have both increased. Some aspects of self-care may have decreased, such as taking your recommended multivitamins, having your annual blood tests, attending all your specialist appointments etc. You may feel a little lost about what is best. You worry you are slipping backwards. You feel you should be doing more. But what?! Wasn’t surgery the last resort. Nobody has surgery intending to let a better life slip away. Deep down you know surgery is not a miracle cure. It does not cure your family genetics, or physiology or lifestyle. So when the honeymoon is over it becomes even more important to keep going with what works best for you. Stop and reflect to ensure you are doing all that you can to look after your health and well-being. Find the gaps and plan to stay on track with positive self-care. When the honeymoon is over the next task is not to give up. Nothing good comes from giving up.
As time passes you start to realise that having something ‘naughty’ here and there is okay. Your weight is still falling off and so a little nibble doesn’t hurt, or so you think. It’s when the ‘naughty nibble’ turns in to a habit that the damage is done.
For me the honeymoon was over exactly 2 years after my surgery date. I had my first re-gain of 0.6 kg. My focus wasn’t as strong and the poor choices started to creep in more regularly. I wasn’t overly worried as I still felt great, and I knew that a small re-gain was expected and part of the process. So, the habits didn’t change and the bad ones became more and more regular.
As the weight was coming back on I knew I needed to do more. After four years my weight had increased by about 8-10 kg but I was maintaining. Then a couple of years later I started to see my weight climb again and by this time I was not using any of my tools except for regular visits to Cathy. But I realised no one else can do this for you, you have to commit to eat healthy, be healthy. Be an adult!
You may experiment with new approaches, and they are great when they work. But there are times when you fall off the wagon and need to re-focus. For me, I just need to go back to basics and re-focus on using ALL of the tools I have for success. My tools are my regular visits with Cathy (about every 6 weeks or so), my gym membership, weekly personal training, monitoring eating using Easy Diet Diary, and listening to Connie Stapleton’s podcast. Her words “You’ve gotta do, the gotta do’ems” stick in my head.
The podcast episodes that resonated the most for me are:
Episode 5 – about the need to focus on healthy actions not the fear of regain.
Episode 19 – about when the lights go down.
Episode 24 – learning to develop habits…
I’ve learnt more about habits by reading “Atomic habits by James Clear” that
It was a year or two after my sleeve that I was pushing things a bit too much. I think it’s human nature to see how far you can push our boundaries but there is always a consequence. I learnt how to “cheat ” I realised I could eat anything in small amounts, and more often. So yes the weight did start to creep back up. It was when in consultation with my surgeon we decided the SADI was my best option but I had to start seeing a dietitian again. A couple of my friends knew my story and recommended Cathy. They said she was amazing. So I started seeing her and I finally had someone to ” work with me” who explained things in a manner to which I could understand. Cathy taught me and encouraged me and was on my side. Working with me, it was a new life a new way and I finally felt supported.
So a couple years after my sleeve I made the decision to have my second surgery. It was the BEST DECISION I MADE…. I definitely didn’t think it at the time…but once again I listened to the professionals and I taught myself how to deal with it….. I am now 4 years post SADI (July 2023) and I am WOW ….. FEELING AMAZING PHYSICALLY 🙂
Not giving up
It was in my 7th year that the light bulb moment hit. I started to learn again. I was able to pinpoint my what real problems, not what I assumed they were. I didn’t consider myself to be an emotional eater until one day after a stressful situation at work. I walked into the office of a colleague, debriefed, then headed straight to the fridge on my way back to my office. That’s when I realised I am in fact, a stress eater. Cathy had told me about Connie Stapleton “BariAftercare The Podcast” and after listening to that I had more insight about my relationship with food.
I experimented again, using trial and error to discover what really will worked for me. I developed a sense of self trust and self-care that was previously non-existent. One thing I have learned, an invaluable lesson actually, is that when you stop focussing on the fear of re-gain, and start focussing on eating healthy, the results will come. As a result of that, I am experiencing weight loss again and to date have lost 5 kg in the last 3 months.
It wasn’t until I started this journey that I had any idea of my inner health. Over the last 4 years with the guidance of Cathy I have learnt so much about my body and looking after myself. I had never been a tablet taking person. I would rather have a glass of water and some fresh air to get rid of a headache. I would have been lucky to use a packet of Panadol in a whole year. But when I agreed to have my second surgery (the SADI) it was made very, very clear that I was making a life time commitment to checking on my vitamin levels and taking supplements on a regular/daily basis. So I have committed to this for life. I see Cathy on a regular basis and have twice yearly bloods taken and follow up with her to ensure all my nutrient levels were correct.
Then I learnt something new again recently. I was innocently having an Arbonne fizz stick or a Berocca just to feel a bit more energy and little did I know it pushed my vitamin b6 to dangerously high levels. So now I make sure I take vitamin supplements DAILY as directed under the guidance of Cathy. At anytime I have had concerns she has always been willing to advise and assist. If I had not done what I was advised to do I dread to think of the consequences.
I am always astounded when people say yeah I had weight loss surgery but I don’t take any supplements. I don’t see a dietician. It doesn’t make sense to me not to give yourself the best opportunity to thrive.
A new you
I’m so very very happy with where I am at in my life, and I feel good within myself. I’ve gained a greater peace of mind by having the support that I know works for me. When I had my surgery I had no one close to me who had travelled this journey. My support were the professionals I had chosen. You 100% need to speak with professionals and be guided by them as they have your best interest at heart.
We make these changes with our body to give ourselves the best opportunity to thrive in life. How can you not follow through with this commitment. I am forever grateful for finding Cathy and being guided by her many years of experience.
Now I know you have to constantly keep yourself in check. See your doctor, see your dietitian, SEE your psychologist, keep taking those supplements, keep having those blood tests. Learn what you need to do to live that happy, healthy life you at one stage only ever dreamed of. It is truly worth it.