What Is Happening to Your Body?
August 28, 2013A Turning Point: What Is Happening to Your Body One-Year Post Surgery?
We now know that gastric bypass surgery triggers certain physiological mechanisms in the body that promote weight loss–primarily in the first year. It is not just restricted food intake that helps shed pounds but this physiological response to the surgery as well. One of the most notable responses is a loss in appetite and an increase in satiety.
What happens is the production of ghrelin, the "hunger" hormone, decreases post surgery. This hormone signals hunger and prompts you to eat more, which in turn increases the desire for high-calorie foods over low-calorie foods. We’ve also learned that the production of the intestinal bacteria in people who have lost weight after surgery, resembles what is found in people who are not obese.
While many metabolic abnormalities associated with weight gain are reversed with bariatric surgery, the jury is still out on how long these metabolic changes remain and for how long–specifically how the body’s genes handle fat and sugar.
Regardless of the perks of bariatric surgery that first year, patients should not let their guard down or slip into unhealthy habits. Approximately a year out, patients begin to get their appetite back as ghrelin production begins to increase. They are also able to eat more because the size of their stomach has stretched a bit.
Studies have shown that the body is prone to re-gain weight once it has already been significantly heavy. Like water, it’s as if the body will always take the path of least resistance rather than break a new trail, establishing a new way to be.
Maintaining good dietary and exercise habits should begin from the get-go; do not wait until this year-long “honeymoon” period ends. Eating fast carbohydrates (i.e., crackers, cookies, chips, fries, soda) may not have influenced your weight as much within that first year, but as the above physiological changes flatten out, this kind of eating will undermine your goal to lose weight significantly.
Beware of the following red flags:
- Eating or drinking due to stress or to find comfort.
- Craving addictive foods. Know what foods are designed to be addictive–usually processed food high in sugar, fat and salt. There is a reason why you can’t just eat one.
- Erosion of good habits–stick to your exercise goals. Have someone hold you accountable.
- Easy access to junk food–keep healthy options in your kitchen, at work, and in the car. Carry protein drinks with you.
- “I deserve this.” “I’m cured.” “I don’t have time.” “Just this once.” Gag that rationalizing rebel rouser. Put on your mental-boxing gloves and give this type of rational a hard right.
I suspect in the next ten years, research will reveal remarkable insight into the changes short and long-term associated with bariatric surgery. While research casts a wide net in helping us understand the “whys” and “why nots,” it is just as important to consider each patient individually–what is known as “precision medicine” these days, particularly in regard to individual genetics. Taking time to listen and focus on what is happening with a patient may also reveal answers and solutions specific to that patient, regardless of the “majority” of patients. Being proactive, open and forthcoming with your doctor will help move our knowledge forward in understanding the impact of bariatric surgery on your body and others.
Milton Owens, MD, FACS, FASMBS serves as the director and as a surgeon with the Coastal Center for Obesity. Read his full bio here.
* Dr. Owens and a special guest will be hosting a breakout session at the OH National Conference in October!