Aftercare in Bariatric Surgery: Your Patients Need You Now More Than Ever!

It’s no secret that weight loss surgery is only an early step in the process of getting healthy for bariatric patients. You yourself have probably explained that very thing thousands of times to your patients and potential patients. If patients are to get healthy, you tell them, weight loss surgery will be only the starting point of their new lifestyle. Success depends on the months and years ahead.

Plenty of research backs up the role of aftercare in weight loss surgery success. Nutritional deficiencies are rampant without counseling, but can be prevented or treated before they are serious with proper monitoring. Failure to lose weight and weight regain are ever present worries, and these outcomes are linked to poor attendance at aftercare appointments.

Replacement addictions and mental disorders are common, and patients need psychological help and support to prevent and work through these issues.

So why does all this matter? As an experienced surgeon or other bariatric professional, you already know and preach the importance of long-term commitment after weight loss surgery. But are you being a good example to your patients?

Take a hard look at your practice. Are your actions consistent with the message you are trying to give your patients? Do you give them the support they need to build a healthy environment after weight loss surgery? Or do you think of surgery as the end of your major responsibilities as their bariatric surgeon?

Your bariatric center can do some basic things to help your patients thrive after surgery. First, put them first. You may not even realize it, but you may be putting them second once they’re out of surgery. Do you find yourself too busy to return calls to your old patients while you’re able to quickly get back to potential patients? If you give patients the message that they’re not important to you anymore, they’ll start to feel the same way about themselves – and treat themselves like second priorities. Give them the respect and attention they deserve and that you gave them when they first came to you inquiring about surgery, and you’ll get your reward in the form of good results, patient referrals, and glowing reviews.

These are some other basic steps you can take to put your post-surgery patients first.

  • If you don’t already have one, set up a multidisciplinary team to take care of patients for the first several months or year after surgery.
  • Set regular appointments with yourself and other members of the multidisciplinary team. Some research (for example, Seager et al., 2012) suggests that shared medical appointments are effective and patients are satisfied with them. And, of course, they save your practice money.
  • Run support groups, since regular attendance at support group meetings can be an indisputable predictor of bariatric surgery patient success. If your practice is small, pool resources with other bariatric centers to form support groups.
  • Form relationships with patients’ general practitioners and other main doctors, such as endocrinologists for diabetes patients. A quick phone call can keep them in the loop so they can better support your patient, and knowing that all of their doctors are up-to-date on post-surgery goals and instructions can help your patient stay accountable.

Post-surgery care goes beyond the clinic, but surgeons and IH professionals can be supportive of outside resources, too. Talk frequently about outside support, such as from friends and family, when you see patients, and suggest ways for them to get help from friends and family. Encourage members to join online support networks so they don’t worry that asking online weight loss surgery friends for advice is “going behind your back.”

The potential for success after weight loss surgery needs to come from within the patient, but surgeons and IH professionals have the ability to develop this potential. Go beyond excellent surgery prep and a complications-free surgery, and think about what you can do to make your bariatric patients successful for years to come.

  • Alex Brecher writes about basic postoperative bariatric care, which was in articles since 1980 but must not be forgotten. Follow-up appointments are mandatory for optimal patient care, surveillance and nutrition, and also for the surgeon’s education and documentation of the operation’s durability. One thing pointed out by Robert Rutledge in the Obesity Surgery journal in the early 2000s was the use of email (which can be simpler for the surgeon than phone calls), for urgent communication or to move up an appointment.

    • Alex Brecher

      Dr. Deitel,

      Thank you for your reply! You are right – it is always good to remember the importance of “going back to the basics.” Dr. Rutledge’s recognition that something as simple as surgeon availability and accommodation of patients’ scheduling needs can have an effect on patient success is a clear example of going back to the basics.

      In a more recent article (Obesity Review, 2011), Dr. Rutledge and colleagues again found that simple behaviors can affect patient success in regards to weight management. This time, the focus was on time-limited obese patients. Without much additional effort, and without taking much patient time, doctors can promote healthy behaviors such as getting enough sleep and television viewing and expect patients to better manage their weights. All it takes is physician awareness and a commitment to including these aspects of a patient’s life in the care plan.

      Bariatric surgery or not, doctors can help patients by thinking of them as people – not just as a body on an operating table or as an 11:00-11:30 a.m. appointment.

  • Sean Gomez Abril

    I absolutely agree with this part of our treatment. Obese patients treatment is not only the surgery but the pre and postoperative management. After surgery, the patient has to be followed to assure they learn their new habits with healthy behaviours. I agree with the multidiscliplinar management. And I hve found very useful the use of media as mail or whatssap to communicate with my patients!

  • I completely agree with this article. The surgery is actually the easiest part of this process. Our practice sees our patients monthly for the first year after bariatric surgery. It gives them someone to be accountable to and also helps our patients to realize that we are here to help them with this life changing process. We tell our patients that bariatric surgery should be used as a tool. We can provide the tool, but we also have to make ourselves available to our patients consistently to help them learn to make lifestyle changes to their diet. Lifelong lifestyle behavior modifications is a must with bariatric surgery.

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