Measuring Your Success the Right Way After Bariatric Surgery

We discuss qualification for bariatric surgery in terms of excess weight based on the body mass index, or BMI. Then, virtually every conversation regarding the successful failure of surgery revolves around (or at least includes) weight loss. But is this the best way to measure your success after a procedure? Or are there other metrics you should consider when you decide to evaluate your progress?

We all know the answer to the first question, which is, of course, there’s plenty more than just weight loss that we need to consider when deciding if we’ve succeeded in our postop bariatric journey. The marketing around bariatric surgery may not always suggest it, but the primary goal is to improve the comorbidities (diseases related to, or worsened by obesity) associated with excess weight versus the weight loss itself. So, with that, let’s dive into what success looks like after bariatric surgery and when you should be satisfied.

Weight Loss

While we may say weight loss is not the primary measure of success after bariatric surgery, the simple fact is it’s the easiest way to measure your progress and, therefore, becomes an essential barometer for the other improvements you will see. Losing excess weight reduces the risk of comorbidities. We also measure the potential of each weight loss operation based on the average amount of excess body weight loss. This can range from 50 to 70% for a gastric sleeve or gastric bypass and up to 80% for a duodenal switch. Weight loss is excellent but ultimately a flawed measure of success. After all, several factors determine the appropriate weight for every patient. Gender, muscle mass, body frame, and more, including aesthetic considerations, all play a part. We also caution patients against focusing too much on a “goal weight number on the scale. If you don’t hit that goal or even if you go past it but are healthier than you were before the weight loss, you are achieving success. This is why, while it’s what we’ve got for now, the BMI is not the best measure of success.

Your Bloodwork

After surgery, you will periodically have a check-up and your blood drawn. This serves a couple of purposes: to ensure you do not experience any significant vitamin or mineral deficiencies and to help us understand more about your progress. If we see consistent reductions in cholesterol, blood pressure, blood sugar, and other markers, we know you’re going in the right direction, and it’s something you can use to motivate yourself further to reach your goals.

Waist Size

Recent studies have shown that a patient’s waist size better indicates cardiovascular risk than the BMI itself. This is because the white fat accumulating around the abdomen is mechanically and hormonally problematic. Male patients with a waist size greater than 40 inches and female patients with circumferences over 36 inches already have a significantly higher risk of cardiovascular disease. As your waist shrinks, so does your risk for future heart problems.

How You Feel

Not every measure of success is objective. One of the best subjective measures you can consider is how you feel having dropped the pounds and increased your activity levels. Almost every patient reports having more energy for themselves and their loved ones. Losing weight also reduces the strain on the heart, other organs, and your skeleton, making them work more efficiently and keeping you in better spirits. The good feelings from getting closer to your ideal weight are also socially productive. As our patients lose weight, they feel more inclined to socialize and catch up on many of the activities they were unable to perform in the past.

How You Look

It’s easy to say you shouldn’t be worried about how you look after bariatric surgery since there are so many other essential success metrics. However, we would be remiss if we did not discuss the benefits of liking what you see in the mirror. With that said, if you have lived much of your life with obesity, you may not notice that fantastic transformation right away. This is a phenomenon known as body dysmorphia and one many bariatric patients experience in the first few years after their surgery. Other patients may be critical of their new bodies because there’s invariably some excess skin after the weight loss. We suggest looking in the mirror and pointing out all the things you like about yourself. This may start as a short list, but it will grow with time. Eventually, you will see your bariatric procedure’s actual physical and emotional results.

Bonus: What You Can Do

For many patients, hitting rock bottom revolved around not being able to fit in an airline seat, not being able to tie their shoes, not being able to keep up with their children or grandchildren, or having to forgo enjoyable activities. As they start to lose weight, many of those activities become accessible again. Some patients see rapid progress in that direction. No matter how much weight you’ve lost or what your blood work looks like, being able to again perform activities you were able to before is a true success and should be enjoyed. 

The Bottom Line

It might sound cliché, but bariatric surgery is a marathon, not a sprint. You will see improvements across many parts of your life, but they often come slowly but surely. As such, having several success metrics will keep you motivated and focused. Here’s an example. As you push toward your goals, you may experience several plateaus in the first couple of years. If weight is your only metric, you may become discouraged when you hit this plateau. However, if you see that you are still dropping dress or pant sizes, you’re still progressing! Maybe you have more endurance, or your blood work is improving – you’re making progress. Of course, we always encourage you to ask us any questions about your progress and whether you believe you are going in the right direction. 

Please attend all your follow-up appointments, even if you think you have improved since the last one. There’s plenty for us to discuss and strategize to ensure you hit your targets.