Lifetime Follow-up Care After Bariatric Surgery

Bariatric Surgery is one of the most effective tools against the chronic disease of obesity. However, it requires a lifelong commitment to making significant lifestyle changes. One of the most important changes is a commitment to consistent follow-up check-ups with your bariatric specialist. Along with regular annual checkups with your primary care physician.

Compliance with follow-up appointments with a bariatric specialist is crucial to successful permanent weight loss. During the first two years after surgery, while they are experiencing rapid weight loss, most patients keep their scheduled follow-up appointments. These initial post-surgery checkups are key to identifying and treating any post-operative complications, as well as closely monitoring obesity-related diseases like Type II diabetes, high blood pressure, and high cholesterol. The rapid weight loss experienced after bariatric surgery can have dramatic effects on co-morbidities like diabetes mellitus requiring frequent changes or even discontinuation of medications used to treat them.  Also, your bariatric team will verify you are staying hydrated, consuming sufficient protein and have not developed any vitamin deficiencies since your surgery.

However, once patients are three or more years out from surgery compliance with the annual bariatric follow-up appointments decreases significantly for several reasons.

First, patients who have accomplished their weight loss goals no longer think they need additional specialized follow-up care, which is not true.  The changes made to the body during bariatric procedures either restrict the amount of food a patient can take in or cause malabsorption of key nutrients. As a result, bariatric patients can develop life-threatening vitamin or mineral deficiencies several years after surgery.

Weight gain is another common reason for patients not keeping their annual bariatric surgery follow up appointments.  Patients who have experienced weight gain have expressed embarrassment over the reversal or feel the appointment is a waste of time since they have regained weight. At Bagshahi Bariatric and General Surgery, we are committed to helping our patients succeed, and we understand that setbacks may occur due to changes in exercise or the return of pre-surgery eating habits. Studies have also shown that keeping follow up appointments can help prevent or reverse post-operative weight gain several years out from surgery. During your annual bariatric follow-up exam, your bariatric team will help identify eating behaviors and lifestyle changes that may contribute to weight gain and provide guidance on what adjustments need to be made to lose any regain.

However, weight gain can also be a sign of a medical issue.  Yearly check-ups with your bariatric provider are the best way to catch any developing medical issue or nutritional deficiency related to your surgery. These specialized checkups require more detailed test and checks than those typically run during a standard annual checkup with your primary care physician.

These include:

• A Bariatric blood panel to check additional vitamin and mineral levels to ensure no vitamin deficiencies have developed due to the restrictive or malabsorption facets of your bariatric surgery.
• A bone density scan to ensure sufficient calcium intake.
• Check for weight gain which may indicate complications of surgery, changes in diet, exercise or mental wellness. Quick identification and treatment or behavior modification can prevent further weight gain.
• Status of any obesity-related diseases ensuring they are still in remission or further modifications in medication or treatment are not necessary.

Unfortunately, some patients are unable to keep follow-up appointments with their surgeons for reasons beyond their control. They may have moved to a new city. Their surgeon has retired, or a change in insurance plans may no longer cover their original surgeon.  Bagshahi Bariatric and General Surgery is one of the few bariatric surgery clinics in the Dallas Fort Worth area that will provide follow up care for bariatric patients whose procedures were done by other surgeons.

In summary, patients wanting to experience the best possible results from bariatric surgery should keep all their recommended follow up appointments. However, lapsed patients can easily reestablish care with a bariatric specialist to prevent or treat any nutritional deficiencies or health issues that may have developed since their last appointment.