Post-Surgery, Relationships, Uncategorized

How To Support Someone Having Bariatric Surgery

How can I support them in their decision?
Be sensitive and understand that this decision is not easy. The person you care about has thought about it carefully. This surgery is a choice. However, it may be the only way to treat severe obesity and the other health problems that come with it.
Ask the person what they know about the surgery. The more information everyone has, the better. Then look for more information together.
Listen to the reasons why they have made this decision. It helps to keep an open mind and support them through this process.

If you are not sure how to support them, ask what would be most helpful to them. They may need emotional support, practical support, or your company in trying out new activities.

How can bariatric surgery affect the one I care about?
After the surgery, people may feel many positive effects. Besides health benefits, they may have more energy and be able to move around more easily. Their mood and self-confidence may also improve. People often say they enjoy a more active life after surgery.

Making changes can be stressful and emotional. It can be very hard to stick to lifestyle changes, such as diet and exercise. If the person used food to cope with stress or strong feelings, they may turn to other unhealthy ways of coping after surgery.
This can include:
problem gambling
problem shopping
drinking or using drugs
smoking

This is more likely to happen if the person did these things before surgery.
Your support is very important. You can help them find healthier ways to manage stress or their strong feelings.

How can bariatric surgery affect me?
The surgery can also affect the family and friends of the person having bariatric surgery. After surgery, the person you care about will change their eating habits. They will:
eat less
eat more slowly
eat more regularly
avoid certain types of food

You may react in different ways. Here are some things that may happen:
You offer to eat the “left over” portion, causing you to gain weight.
You choose not to make any changes in the way you eat. This can make it harder for the person you care about to stick to their new eating habits. They may regain some or even all of the weight they lost after the surgery.
You adopt the new eating habits together. Making changes with the person can help the whole family. It can have benefits that lead to a better quality of life for all.
Having a family member who has had bariatric surgery can be hard for you too. It can mean making changes to your lifestyle as well. You may find this stressful especially if you do not feel ready to make the same changes as the person having surgery and do not wish to give up familiar and comfortable habits. It’s important to be open and honest with the person having surgery so that you can work through any changes in your relationship.

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Remember to take care of yourself. This can help you to support the person who had the surgery. Ask for help if you have problems coping with these changes or the stress becomes too much. You can:
talk to your doctor
seek counselling services
join a support group in your area

How can I help?
There are many things that you can do to support the person through this process. Here are some examples:

Get involved
Join them at appointments, classes, support groups and follow up meetings. Gather information together. You may want to read the same books or join internet forums together. This can help the person think through some of their questions or concerns. It can also help take some of the pressure off, and make it easier to remember more information. Please check any information you get from the internet with your health care team.
Give emotional support
Remember, the person you care about is going through a major life change. This change can be stressful. Be there to talk and listen to their struggles without judging.

Help with diet and changes to eating habits
Making changes to eating habits includes both what they eat, and how they eat. You can help by talking with them about these changes.
They will need to:
eat a healthy and balanced diet
eat on a schedule
avoid drinking 30 minutes before and after, as well as during mealtimes
eat smaller portions
take longer as they will need to chew more frequently

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Celebrate in different ways

In many cultures, people celebrate and come together with food. Cooking, eating and talking about food may be an important part of your relationship. To help the person you care about, try these things:

talk about other ways to show you care that do not center around food
ask them how they would like to celebrate differently
make a list of other activities you can enjoy together

Be helpful, not critical

Sometimes family members may begin to act like the “food police”. They monitor and criticize eating habits because they want to help. Try to avoid this. Encourage the person and suggest other healthy activities. Some examples are trying out a new recipe or starting a new hobby. Also, it can be helpful to do them together if you feel comfortable.

Be careful what you say after surgery

Avoid making comments about weight after surgery. The person who has had bariatric surgery may not feel comfortable with these comments. Be sensitive about how you congratulate what they have done.
Do it in a way that does not put the focus on the numbers.
It may be hard for the person to see how much weight they have lost, especially right after surgery. It is important to listen to the person during this time and talk about what they have managed to do.

Look forward together
Make plans and set goals that you can work on together. This will support the person with their weight-loss and help it to be a lasting success.
Some examples are:
traveling
running for charity
gardening
starting projects to improve your home

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Going out to eat
Check restaurant menus ahead of time to decide if it is a good place for the person to dine at.
Remember, the person can be more sensitive to smell after surgery.
Plan to have lots of time to enjoy the food. Eating after surgery will take longer than usual.
Try ordering a meal and an appetizer to share, instead of 2 meals.
Patients should not drink alcohol for at least 6 to 12 months after surgery. If you want to have a drink, ask them how they would feel about it.
Ask the server to pack leftover food.
The person may not want to be in a place where others are eating. If it is a group event, maybe you can join the group after the meal is over.

Other questions you may have

Is it rude to eat in front of them?
Every person has their own feelings about this. Some may be grieving over the loss of some types of food after surgery. They may not want to see others eat in front of them. Others may not mind. Understand that they are trying to have a new relationship with food. If you are not sure, ask them in a sensitive way.

Can I offer them an alcoholic drink?
Usually doctors tell their patients not to drink alcohol at least 6 to 12 months after surgery. Even after this time, it is important to limit alcohol. Some patients may feel the effects of alcohol more strongly after surgery. Also, alcoholic drinks have empty calories. Keep these things in mind. Before you offer, ask them how they feel about having an alcoholic drink.

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How soon can they start to exercise?
The advice for most patients is to avoid hard physical activities for at least 4 weeks after surgery. The answer may be different for each person. Ask a member of the health care team at the follow up appointment after surgery.

What can I do if they are starting to return to their old problem habits?

It is important to understand these things:
Surgery is only a tool to help them kick-start healthy eating habits and an active lifestyle.
The person may return to their old habits. This can happen as their body starts to adjust after surgery and they can eat more.
These habits or lifestyles do not just go away. It takes a lot of effort to change them over time.
The person may have a hard time getting used to these changes.

Talk to the person about your concerns. Do this in a sensitive way, without judging or criticizing. Encourage them to go to their follow-up appointments at the Bariatric Surgery Program. You can also talk about your concerns with the health care team. They are your partners in supporting your loved one.

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About Janet Klein

Janet Klein, MS, RDN, CDN, CDE. is Orange Regional's Bariatric Surgery Program Director. She received her Bachelor of Science Degree in Dietetics from the State University College at Oneonta and her Master of Science in Education from Queen’s College University. She is a Certified Diabetes Educator, a Registered Certified Dietitian-Nutritionist, American Heart Association Certified Cardiovascular Counselor and a member of the Integrated Health group of the American Society for Metabolic and Bariatric Surgery (ASMBS). She brings more than 35 years of clinical, educational and leadership experience to Orange Regional, where she spearheaded the Bariatric Surgery program in 2008, received Accreditation for the program through the American Society for Metabolic and Bariatric Surgery (ASMBS) in 2011, re-accredited the program through the American College of Surgeons (ACS) Bariatric Surgery Quality Improvement Program (MBSAQIP) in 2014, and continues to lead the program with passion 10 years later. Janet can be reached at 845-333-2123 or jklein@ghvhs.org.

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