The Long Process

People who contemplate bariatric surgery have experienced a life defined by their weight. They’ve fought it by trying all kinds of diets, exercise, supplements, maybe even prescription drugs. It is emotionally exhausting and it is not unusual to feel defeated and hopeless from the years of failure. Then, to make life even more unbearable health problems start piling up. Surgery is the last option, but the obstacle course laid out prior to receiving approval from all of the medical providers and the insurance company is a daunting and expensive one.

For a presurgical bariatric patient the day we receive the phone call that we are approved there is a feeling of relief, accomplishment, excitement and hope. It almost doesn’t seem real at that point. Then, for most of us, it gets complicated. It is no longer about the quest for obtaining approval. Reality sinks in and attention shifts to that one day and the life changes afterward.

It Suddenly Gets Real

After the celebration wears off, the commitment and the dangers take center stage in our minds. A mix of anxiety about potential complications, sticking to the plan and the thought of not being able to eat favorite foods starts to seep in. The what-ifs and emotional preparation is tough. Presurgical liquid diets can add even more stress. The experience can add to the anxiety and fear or cause doubts that we are ready for such a big change.

Major complications from bariatric surgery are rare. The majority of bariatric surgeries go smoothly, without serious complications, but once the quest for approval is over there is time to rethink, doubt and worry about that potential.

Processing, Waiting, and Coping

After approval it can be a few weeks to a few months before the day of surgery. Most people have to follow a presurgical diet. Some surgeons require a certain amount of weight loss before surgery. Presurgical diets can be grueling. For some patients, weeks of a liquid diet are required. That brings its own emotional difficulties.

Our brains start fearing that we will never be able to eat our favorite foods. The cravings can become unbearable and many people slip and have what is referred to as Food Funerals. For some people who give in to those fears it can mean a delayed surgery and more time spent in that limbo.

Weight loss surgery is serious, and complications though rare, are a real possibility. In the days leading up to surgery all of those potential risks seem to be more real. But there is help in coping. Support groups can help. Talking to people who have been through the same experience can allay fears. Surgeons’ offices are accustomed to receiving calls with questions and fears about surgery. Truthful answers from the surgeon’s office can help.

Everyone has fears and anxiety prior to surgery. With serious doubts, it’s a good idea to call a therapist to discuss them. The psychiatrist or therapist who did the psychological evaluation is a good person to contact. They are professionals who have expertise in dealing with bariatric surgery and all of the emotional implications. People scheduled for surgery have contemplated weight loss surgery often for years. They have spent the time, money and emotional effort to meet all of the requirements for surgery. For them, the answer was clear a long time ago:  the surgical risks and change in lifestyle is worth it.

Embrace It

It may feel like forever, but it isn’t. Marking the days to surgery may be difficult, but it does end and the results are worth the struggle. The weeks before surgery are preparation time. It’s helpful to read about the post op diet stages, ask questions and attend workshops or groups arranged by the surgeon’s office. Sampling protein shakes and finding the right supplements are best done in advance of surgery. This is the time to rid the house of foods that aren’t on the plan. Understanding and sticking to the plan is essential to success. It’s also a lifelong learning process — best to start early.

My advice to people in this limbo: follow the rules (at least keep learning and trying), ask questions and enjoy the the tool which will help you to change your life.