Falling off the Face of Follow-Up

Teri Kai Holtzclaw, Ph.D

I climbed my first mountain when I was thirteen years old.  I remember how heavy my body felt as I hiked up the trail along side my fellow campers.  Granted, we were camping in the North Georgia Montains but it mght as well have been the tallest peak  in the Alps!  I don't recall how many times I had to stop and catch my breath and I vaguely remember fighting back the tears when I thought I couldn't make it.  Once we reached the top I realized that the expectiaion was to repel down  --

Leaning over the edge, looking down, I knew that falling off the face of this mountain was not what I wanted to happen anytime soon.  In fact, even the idea of willfully repelling downward seemed insane to me.

Decades later, I am reminded of the challenges faced in my childhood.  Facing long term postoperative weight management and maintenance is similar to climbing that Georgia Mountain.  Granted, the decision to have the surgery itself was momentous enough, but it wasn't the peak of my weigh loss success--the surgery was merely one step amongst many.  Effective follow up postoperatively is the key to reaching the top of the mountain.

How many of us take time out in our postoperative hike to stop and catch our breath?  When was the last time you reread your patient manual or had your blood work done?  Are you aware of what and why you eat?  Are your portion sizes getting out of control?  What does your exercise regimen look like?  Do you know the latest research regarding Bariatric vitamins and how to best supplement you diet in order to maintain this good health that you put your life on the line to obtain?  Perhaps you are one of the hundreds of postop's who is struggling to hold back the tears and the weight from flooding back on. Perhaps you started out on the uphill path and became discouraged by your own lack of motivation.  Perhaps you are the patient who didn't tell anyone you had weight loss surgery and therefore you may feel you have no one to turn to as the weight begins to creep back on.  Are you one of the ones trailing behind the super patient? Who is the super patient you ask? The super patient is the one patient in your support group who makes obtaining and maintaining look like a cake walk.  He or she is eating everything and not gaining a pound.  It's so unfair.

Are you one of the ones falling off the face of followup?  Many of us are falling off the face of follow up because we have lost our way and lost sight of the path toward success.  We can't see where we are going because we are too busy looking to see where everyone else is heading without us.  We are our own greatest stumbling blocks.  So what can we do you ask? How do we clear the way and resume our hike up the mountain?

First, we must place the focus back on our own journey and stop comparing our path to someone else's.  Get off the super patient's trail and begin mapping your own trail.  Marking your own trail gives you greater confidence, self-esteem and teaches you to be your own guide.  Next, you need to go back to the beginning and retrace your steps.  Make an appointment to have your blood work done.  Get back on a regular exercise regimen.  Keep a food diary for one week and pay attention to your portion sizes.  Take time to evaluate when you eat, why you eat and what you eat.  Inventory what is in your refrigerator, freezer and pantry - Don't forget that drawer beside your bed where many of you keep your emergency snack stash.  How is your stress level? Are you balancing out your personal and professional interests or is one getting more of your attention then another?  Attend support group.  Increase your physical activities and decrease your sedentary lifestyle.  Subscribe to publications that keep you aware of the latest breakthroughs and research surrounding obesity surgery and weight management.

Following through with followup is essential to your long-term weight management and weight maintenance program.  Don't allow complacency to settle into your new body.  Remain vigilant.  And know that managing your weight loss is a life long journey up the tallest mountain you have ever seen.  See you at the top!

Dr. Holtzclaw is the Psychological Services and Behavior Management Specialist at U.S. Bariatric in Ft. Lauderdale, FL.