8 Helpful Tips To Avoid Being a Non-Compliant Patient After WLS
May 28, 2019Patients particularly vulnerable to being non-compliant underestimate that no method of weight loss including bariatric surgery promises weight loss maintenance. Most importantly, patients may be unaware that there are many contributory factors that influence non-compliance.
Non-observance of unhealthy habits slowly creeping into daily routines such as continued grazed eating, eating beyond the feeling of fullness, decreased physical activity, unmanaged stressors with maladaptive coping mechanisms have a strong say in swaying compliance triggering weight regain. Mental health preparedness is important before and after having WLS.
Along with each pound gained feelings of frustration, failure, depression and shame sneak into patients psyche.
For many patients, these feelings contribute to cancellation of scheduled follow-up appointments with their surgeons, primary care physicians, dieticians and needed support groups.
This form of isolation suppresses compliance and circulates to non-compliance which impacts a patient’s ability to demonstrate their commitment to lifestyle changes.
Conversely, patients should not get discouraged as there are many options to remain compliant to maintain their weight loss.
TIP 1: Acknowledge That Obesity Is A Chronic Disease
Acceptance that obesity is a chronic disease is key to long term compliance.
Acknowledging obesity as a disease characterized by exacerbations and remissions, NOT, a moral issue removes associated feelings of blame and guilt. Variables beyond patients control such as genetic predisposition, hormones, environmental factors, emotional wellness, and sleep disorders contribute to obesity. Understanding this etiology will help remove the over-whelming “On Again/Off Again, Yo-Yo” dieting mentality.
Diets don’t work!
Sticking to personalized health care and food plan created by a team of multi-disciplinary professionals works. It will also remove the emphasis placed with the number on the scale as weight can fluctuate with water retention, or time of day, at any given moment.
Improved quality of life, practicing daily disciplines of life is the real barometers for success.
TIP 2: Don't Close The Door On The Past
Often patients become so excited about their success they develop amnesia about problems related to higher BMI’s before surgery. Patients must never forget why they elected to have weight loss surgery.
Examples:
- Shortness of breath upon exertion.
- Impaired mobility.
- Taking multiple medications for medical problems.
- Wearing a CPAP/BIPAP for sleep apnea.
- Hiding from mirrors or family pictures that have been taken.
- Difficulty Shopping for Clothes
- Avoidance of social events.
- Emotionally suffering from low self-esteem.
- Fearful of not fitting in chairs or being the largest person in a room.
Weight loss surgery is only a tool. The first year following surgery is considered “honeymoon phase” when the majority of weight loss occurs. Weight is a sign and symptom of obesity. Maintenance is the beginning of hard work to deal with this chronic disease.
Denial is the true culprit to compliance. Those who are likely to experience weight regain invariably deny they have a chronic condition and drift into old behaviors. Slow weight regain begins insidiously and appears seemingly innocent. Often starts with one non-mindful bite followed by thousands of non-mindful bites which lead to non-compliance and weight regain. Make sure to eat mindfully.
Therefore, honesty, introspection, diligence, are key ingredients for recovery. Maintenance is a result of living in the solution with strong commitments to lifestyle changes.
TIP 3: Plan To Succeed
Obesity is a disease. As with any other disease, one must perform ALL life’s daily activities realizing that LIVING with this disease is much better than DYING from this disease.
Health issues related to obesity such as cardiovascular disease, diabetes, sleep apnea, osteoarthritis, and impaired mobility promise to shorten one’s life span.
Patients must make it their top priority; go to any lengths to protect their recovery. Continued compliance and quality of life literally depend on it.
If you fail to plan you plan to fail. Examples: Prepare your food on Sunday for the work week. Don’t go to the market hungry. Prepare a list before going to market. Purchase foods only on the list.
To avoid temptation remove trigger foods from home environment. When dining at a restaurant ask the waitress to package half your meal before bringing to your table to avoid eating large portions.
Using mantras can mentally floss old thoughts and old behaviors with grazed eating, “No matter what I won’t engage in mindless eating, I won’t engage in mindless eating No matter what.”
TIP 4: Create A Bariatric Blanket
Nature detests a void. If food provided comfort during times of stress, then patients need to fill the void with new coping skills.
Stress is a precursor to weight regain. Often people quickly turn to their favorite pacifier “comfort eating” when faced with unanticipated stress. Big business recognizes this all too well-feeding folks' emotions by bombarding messages on television, billboards, and magazines. These advertisements promise heavenly bliss with married messages of “taste and comfort all in the same bite.”
Practice New Coping Skills with a Bariatric Blanket. Consistent use of new coping skills is three-fold.
- Fills the void of previous reactions to stress.
- Helps change publicized perceptions
- Pointedly break the cycle of weight loss and weight regain.
Wrapping oneself in a bariatric blanket is uplifting. Blankets can be real or imaginary. It is woven with new threads to create a comfy place when the going gets tuff.
Fill one side of the blanket with “Now I Can’s.” Pleasures following weight loss surgery, such as
- NOW I CAN WALK
- NOW I CAN DANCE
- NOW I CAN PLAY GOLF
- NOW I CAN SWIM
- NOW I CAN TIE MY SHOES
- NOW I CAN SHOP FOR CLOTHES
- NOW I CAN PLAY WITH MY CHILDREN/GRANDCHILDREN
The flip side of Bariatric Blanket focuses “Courage to Change.” This side reminds patients who braved bariatric surgery they can boldly confront any life stressors. Include colorful coping skills such as:
- Tea Time for Tuff Times
- Meditation Works for Me
- Walking Clears My Mind
- Breathing Techniques Soften My Anxiety
- Following My Food Plan Eliminates Stress Eating
- Watching Funny Movies Relaxes Me
- Attending Support Groups Makes Me Feel Connected
- One Day at a Time makes it Easier to be Compliant
- Calling Likeminded Bari-Buddies Builds Comradery
- Crochet and Knitting Keeps My Hands Busy Watching TV
A smaller literal version can even be created to carry in a purse or pocket.
TIP 5: Schedule and Keep Follow-Up Visits
Keeping scheduled appointments at the bariatric center is critical. Follow-up appointments with your surgeon, registered dietician, and mental health counselor are essential to assess for vitamin deficiencies, wellness and continued long-term success.
Most patients take their automobiles for regular oil changes and tire rotations knowing these are essential to preserving a car’s proficiently to keep it running.
The same watchfulness needs to apply for patients to keep bodies proficient ardently.
Our bodies are the best vehicles for transportation we will ever possess. Fueling them with high test foods, keeping regular check-ups with trained medical professionals are quintessential for self-preservation.
TIP 6: Establish A Support System
It is difficult traveling the road less traveled by oneself.
There are many options ready to lend a hand for life long compliance:
- Life-Coaches
- Mental Health Professionals
- Support Groups
- Bari-Buddies
- Like Minded Positive Friends
- Bariatric Registered Dieticians, Psychologists, Surgeons
- Primary Care Physicians.
- Exercise Physiologists or Trainers
Important to note: It is best to remove oneself from negativity and nay-sayers, as this can be toxic for one’s emotional wellness.
TIP 7: Don’t Compare Yourself To Others
A healthy body image is imperative to one’s mental wellness. Comparing bodies to movie stars, models, athletes, even friends bestows feelings of inadequacy and failure.
It is especially important to feel comfortable in one’s own skin by choosing a realistic goal weight. Having the body that is “Just Right For You” is the objective.
Unrealistic expectations are the leading cause of disappointment and despair. Non-judgmental attitudes shrink these sorts of negative feelings.
Seek the advice of a specialized mental health counselor trained to help with body image issues.
A consult with a plastic surgeon is informative for the removal of excess skin. Sometimes insurance companies reimburse for these procedures.
TIP 8: Step It Up
Have Fun! Keep Active. Grow into physical fitness with daily exercise. Devote 30 minutes each day to exercise. If this is initially difficult, try ten minutes at a time, three times a day. Build your exercise routine to include resistance and aerobic activities.
Find activities that can be enjoyed with others such a water aerobics, basketball, tennis, hiking, walking. This will double your fun!
 | ABOUT THE AUTHOR Linda Trainor, RN, BSN has spent the past 14 years working as the Nurse Coordinator for the Bariatric Surgical Program at Beth Israel Deaconess Medical Center (BIDMC) in Boston. She has earned dual certifications as a Bariatric Nurse and Metabolic Surgical Case Reviewer. Linda is also a Published children’s author, Bradley the Dog Who Couldn’t Stop Eating and Editor-in-Chief of BIDMC’s Weight-Loss & Wellness E Newsletter. |
