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While weight loss surgery (WLS) is considered the most successful treatment for morbid obesity, it is just the first step toward a fresh start. Weight regain is a common phenomenon, as is illness when weight loss surgery patients do not follow recommended guidelines. 
Breaking old patterns, establishing an effective post-WLS lifestyle, and addressing the emotional issues that often complicate obesity takes more than commitment; it takes support, information, and resources.  

The National Association for Weight Loss Surgery (NAWLS) helps WLS patients shape new lives. We teach people what they need to know and help them makes the changes they need to make to achieve long-term WLS success -- physically, mentally, and spiritually.

 In a November 2005 poll conducted by NAWLS, the following were identified as the top 10 mistakes WLS patients make:
1^st Mistake:  Not Taking Vitamins, Supplements, or Minerals   

Every WLS patient has specific nutritional needs depending on the type of surgery you have had. Not only is it a good idea to ask your surgeon for guidelines, but also consult with an experienced WLS nutritionist. Understand there is not a standard practice that all surgeons and nutritionists follow in guiding WLS patients. So, it is important to do your own research, get your lab tests done regularly, and learn how to read the results.   

Some conditions and symptoms that can occur when you are deficient in vitamins, supplements, or minerals include:  

Osteoporosis; pernicious anemia; muscle spasms; high blood pressure; burning tongue; fatigue; loss of appetite; weakness; constipation and diarrhea; numbness and tingling in the hands and feet; being tired, lethargic, or dizzy; forgetfulness, and lowered immune functioning.  

Keep in mind, too, that some conditions caused by not taking your vitamins, supplements, or minerals are irreversible.  

2^nd Mistake:  Assuming You Have Been Cured of Your Obesity   

A "pink cloud" or honeymoon experience is common following WLS. When you are feeling better than you have in years, and the weight is coming off easily, it's hard to imagine you will ever struggle again. But unfortunately, it is very common for WLS patients to not lose to their goal weight or to regain some of their weight back.   

A small weight regain may be normal, but huge gains usually can be avoided with support, education, effort, and careful attention to living a healthy WLS lifestyle. For most WLSers, if you don't change what you've always done, you're going to keep getting what you've always gotten -- even after weight loss surgery.  

3^rd Mistake:  Drinking with Meals   

Yes, it's hard for some people to avoid drinking with meals, but the tool of not drinking with meals is a critical key to long-term success. If you drink while you eat, your food washes out of your stomach much more quickly, you can eat more, you get hungry sooner, and you are at more risk for snacking. Being too hungry is much more likely to lead to poor food choices and/or overeating.  

4^th Mistake:  Not Eating Right  

Of course everyone should eat right, but in this society eating right is a challenge. You have to make it as easy on yourself as possible. Eat all your meals--don't skip. Don't keep unhealthy food in sight where it will call to you all the time. Try to feed yourself at regular intervals so that you aren't as tempted to make a poor choice.   

And consider having a couple of absolutes: for example, avoid fried foods completely, avoid sugary foods, always use low-fat options, or only eat in a restaurant once a week. Choose your "absolutes" based on your trigger foods and your self knowledge about what foods and/or situations are problematic for you.  

5^th Mistake:  Not Drinking Enough Water   

Most WLS patients are at risk for dehydration. Drinking a minimum of 64 oz. of water per day will help you avoid this risk. Adequate water intake will also help you flush out your system as you lose weight and avoid kidney stones. Drinking enough water helps with your weight loss, too.  

6^th Mistake:  Grazing  

Many people who have had WLS regret that they ever started grazing, which is nibbling small amounts here and there over the course of the day. It's one thing to eat the three to five small meals you and your doctor agree you need. It's something else altogether when you start to graze, eating any number of unplanned snacks. Grazing can easily make your weight creep up. Eating enough at meal time, and eating planned snacks when necessary, will help you resist grazing.   

Make a plan for what you will do when you crave food, but are not truly hungry. For example, take up a hobby to keep your hands busy or call on someone in your support group for encouragement.  

7^th Mistake:  Not Exercising Regularly   

Exercise is one of the best weapons a WLS patient has to fight weight regain. Not only does exercise boost your spirits, it is a great way to keep your metabolism running strong. When you exercise, you build muscle. The more muscle you have, the more calories your body will burn, even at rest!   

8^th Mistake:  Eating the Wrong Carbs (or Eating Too Much)  

Let's face it, refined carbohydrates are addictive. If you eat refined carbohydrates they will make you crave more refined carbohydrates. There are plenty of complex carbohydrates to choose from, which have beneficial vitamins. For example, if you can handle pastas, try whole grain Kamut pasta--in moderation, of course. (Kamut pasta doesn't have the flavor some people find unpleasant in the whole wheat pastas.) Try using your complex carbohydrates as "condiments," rather than as the center point of your meal. Try sprinkling a tablespoon of brown rice on your stir-fried meat and veggies.   

9^th Mistake:  Going Back to Drinking Soda   

Drinking soda is controversial in WLS circles. Some people claim soda stretches your stomach or pouch. What we know it does is keep you from getting the hydration your body requires after WLS--because when you're drinking soda, you're not drinking water! In addition, diet soda has been connected to weight gain in the general population. The best thing you can do is find other, healthier drinks to fall in love with. They are out there.  

10^th Mistake:  Drinking Alcohol   

If you drank alcohol before surgery, you are likely to want to resume drinking alcohol following surgery. Most surgeons recommend waiting one year after surgery. And it is in your best interest to understand the consequences of drinking alcohol before you do it.  

Alcohol is connected with weight regain, because alcohol has 7 calories per gram, while protein and vegetables have 4 calories per gram. Also, some people develop an addiction to alcohol after WLS, so be very cautious. Depending on your type of WLS, you may get drunker, quicker after surgery, which can cause health problems and put you in dangerous situations.   

If you think you have a drinking problem, get help right away. Putting off stopping drinking doesn't make it any easier, and could make you a lot sicker.