4 Times Patients Didn't Adhere to Their WLS Guidelines

Article By: Rachel Ignomirello, MS, RDN, CSOWM, LDN

Rachel Ignomirello is a Bariatric Dietitian and Board-Certified Specialist in Obesity and Weight Management.

Today’s blog really captures this quote from Otto von Bismarck: “Only a fool learns from his own mistakes. The wise man learns from the mistakes of others.” These words ring especially true when patients navigate the challenging and transformative journey of bariatric surgery. That’s why it's important to hear real-world stories that underscore the importance of following guidelines and heeding the advice of professionals during the postoperative phase. As we delve into these cautionary tales, I hope you'll gain valuable insights and avoid these pitfalls, making your own journey smoother and more successful. Their stories are both enlightening and cautionary, showing us that every decision we make post-surgery can have a profound impact on our outcomes.

**To respect privacy and confidentiality, names and identifying details have been altered in the following stories.

1) Story #1 - The thirsty travails of Tom. Meet Tom, an avid adventure enthusiast with a passion for hiking. Before undergoing his bariatric surgery, he received thorough education about taking small sips and making hydration a priority, especially during fluid loss due to illness or sweating. He thought that maintaining adequate fluid intake post-surgery would be effortless. However, he underestimated the critical importance of staying well-hydrated and consistently pushed his limits. Despite numerous warnings about his low fluid intake, he frequently experienced dehydration. He felt depleted and had to stop hiking.

Tom's struggle with dehydration led him to the hospital multiple times for intravenous (IV) fluids and treatment for kidney stones. Tom's journey serves as a powerful reminder that hydration isn't only vital during workouts... It's an essential daily necessity, particularly after undergoing bariatric surgery. Always remember to sip, sip, sip!

2) Story #2 - Dana's diet dilemma. Dana, a food lover at heart, struggled to adhere to her recommended post-op diet. She attended all our program classes, nutrition appointments, and provider consultations before and after surgery. At a time when she was only supposed to be eating soft foods like egg and yogurt, she reintroduced challenging items like red meat, bread, pizza, and sweets. She allowed temptation to win, indulging in foods she knew she shouldn't.

The consequences? Constant discomfort, zero weight loss, and even emergency room visits due to severe vomiting and dehydration. She jeopardized her recovery and safety all because she couldn’t follow her diet prescription. She stopped following up at the office, which only makes me more concerned for her success and safety. Dana's story teaches us that following the prescribed diet is not about restriction but about setting yourself up for success on the road to recovery.

3) Story #3 - Navigating parenthood, Nikki’s story. Nikki and her partner were filled with joy at the prospect of starting a family. However, their journey to conceive was marked by years of struggle. Nikki's doctor identified her weight as a factor affecting her hormones and fertility. Understanding the importance of addressing this, she made the wise decision to undergo bariatric surgery. During her preoperative education, she learned about the significance of waiting 12-18 months before attempting pregnancy, along with various contraceptive options.

Despite the guidance, impatience got the best of them around the time of her surgery. Just two months postoperative, Nikki contacted our office with the surprising news of an accidental pregnancy. She hadn't yet fully healed from her bariatric surgery, and now she had to navigate pregnancy. The challenges included struggling to stop weight loss and facing the complexities of a high-risk pregnancy. These complications not only affected her health but also posed risks to her unborn baby. Nikki's story serves as a poignant reminder that patience is indeed a virtue, especially when it pertains to the crucial journey of bringing a new life into the world.

4) Story #4 - The supplement saga of Sarah. Sarah received thorough education about the significance of bariatric vitamins before her surgery. In one of my classes, she learned about how smaller portions and altered absorption post-surgery can lead to deficiencies. After her surgery, she faced challenges in tolerating bariatric vitamin capsules. Instead of reaching out to her bariatric team for guidance, she turned to the internet and came across an ad promoting bariatric vitamin patches. Unbeknownst to her, these patches lacked the essential nutrients her body needed for recovery and weren't supported by scientific research.

Later that same year, Sarah was admitted to the hospital with severe Wernicke encephalopathy, a serious neurological disorder affecting mental state, vision, and muscle function. Subsequent lab tests revealed a severe B-vitamin deficiency. This revelation shocked her, as she believed she was taking the right approach by using vitamin patches. Sarah's story underscores the vital lesson of choosing the correct supplements and consulting a bariatric dietitian to ensure the appropriate supplementation post-surgery.

PS - Taking your daily bariatric vitamins after surgery should be easy. BariMelts bariatric vitamins dissolve smoothly in your mouth and meet ASMBS Guidelines. We even offer the BariMelts WLS Essential Starter Pack with the 3 key vitamins you need after surgery!

These real-life tales serve as a beacon of caution for us all. The bariatric journey is a significant chapter in your life, and learning from the experiences of others is an essential part of making your journey a successful one. Stay informed, adhere to guidelines, be patient with your progress, and choose wisely. Your future self will thank you for it!

BariMelts provides general recommendations, not to be construed as medical advice. Please consult your doctor.