Supporting a family member with sleeve gastrectomy

If a loved one is thinking of surgery, no doubt you have questions and maybe even reservations. I’ve tried here to summarise a few of the key issues that come up in the clinic when discussing the surgery journey with family members. Research shows us that the more support a sleeve gastrectomy patient has, the better they do in the long term. Support comes in many forms from your surgeon, dietitian and psychologist, to friends or forums with other sleevers and, of course, and probably most importantly, family. So here’s what you need to know about supporting a family member with sleeve gastrectomy.

The key concepts to supporting a loved one through their sleeve gastrectomy

1. Get involved

Join them at appointments, classes and support groups meetings. Read books and articles or even join forums together. This can take some pressure of them needing to remember every little piece of information and help you to gain a clearer picture of the process and life after surgery as well.

2. Be understanding

Remember, your loved one is going through a major life change and this can be stressful. Try to be there to talk about their concerns, their successes and their struggles without judging.

3. Help with changes

Your loved one will need to make changes to both what and how they eat. They will need to choose good quality food, eat smaller portions, eat slowly (taking 20-30 minutes for a meal) and not eat and drink at the same time. You can help by talking with them about these changes and trying to adopt some of these changes together. For example, eating more mindfully is something that we all should try to do, so this is a great exercise to explore together. Your dietitian and/or psychologist should be able to help you, but books such as ‘If not dieting then what?’ by Dr Rick Kausman and ‘Mindful Eating’ by Jan Chozen-Bayes are also fabulous resources.

4. Celebrate in new ways

Often celebrations involve food and alcohol (or revolve around them completely). To help your loved one through these times, try talking about other ways you might celebrate that doesn’t involve food, ask them about another gift and perhaps make a list of things you can now do together that you couldn’t do before that would be just as fun as a night out.

5. Be encouraging, rather than critical

Sometimes family members may begin to act like the “food police”, monitoring and criticising eating habits because they are trying to help. Instead, encourage the person rather than criticise and suggest other healthy activities (perhaps things you can do together) like trying a new healthy recipe or taking up a new hobby.  Try to also avoid making comments about their weight after surgery especially if they ask you not to. Putting focus on other NSVs (non scale victories) is a better way to congratualate them on their progress rather than the numbers on the scales. For example, how much faster they are walking to the shops or their new found confidence in public.

6. Look to the future together

Make plans and set goals that you can work on together. Great goals include travel, completing a fun run, gardening or house renovations. Focusing on the future will support the person with their weight-loss and help it to be a long-lasting success.

When making a decision about surgery…

Be sensitive and understand that this decision is not easy. The person you care about has thought about it carefully and not taken the decision lightly. Whilst a sleeve gastrectomy is elective surgery, it may be the only way to treat severe obesity and the other health problems that come with it and your loved one has more than likely tried everything else they can.

Listen to the reasons why they have made this decision so you can understand where they are coming from, sometimes it’s difficult to understand if you’ve not struggled with your weight, but I’m sure you’ve seen them struggle along the way. Ask the person what they know about the surgery. Look for more information together from all sources you can find and please attend their pre-op information sessions and appointments with the surgeon and dietitian so you can ask all the questions you have. The more informed everyone is about the process, the risks and life after the surgery, the better.

During the initial phases of surgery…

They will need your patience. During the Optifast phase they will be cranky (no carbs make anyone grumpy…) and you may well cop the brunt of it. Be patient. It will pass. After the surgery, they will go through pain initially and will need help . Immediately after the surgery, they will be sore, tired and probably wondering why they decided to go ahead. They won’t be able to lift anything heavy, so will probably not be able to do all the usual things you rely on them for. Give them a hand. It will pass, and they will be back to their usual selves and most likely able to do even more within a month or so. Initially after surgery what they can eat will change regularly too. They’ll go through phases – fluids, then puree, then soft food before they get back to eating more normally.

You won’t understand their eating habits. It’s pretty hard to comprehend that someone can be full after a cup of food, but this is what the surgery is designed to do! Often family members are really concerned about the amount of food their loved one is eating, but it’s okay. If they’re not hungry, don’t force them. But, if you are worried, just check with their dietitian.

You may react to their new eating habits in different ways: by eating their leftovers (often causing you to gain some weight), by not making any changes to your eating habits at all (which can make it harder for the person with the surgery to change their habits, reducing the success of the surgery), or by adopting the new eating and exercise patterns together. Often we all eat too fast and overeat, so adopting some of the same principles as a family can be of benefit to everyone.

Keep an eye out…

Making changes can be stressful and emotional for all involved. It can be very hard to make lifestyle changes and it will take time to adjustment (both for them and for you as the family). If the person used food to cope with stress, they may turn to other unhealthy ways of coping such as gambling, shopping, drinking or smoking. This is more likely to happen if the person did these things before surgery. If you notice any of these habits, your support is very important. Encourage them to see their psychologist and support them to find other ways to manage stress.

Remember to take care of yourself, too…

Taking care of yourself can help you to support your family member with sleeve gastrectomy. If you are struggling to cope with the changes at home or the stress becomes too much, please ask for help. You can talk to your doctor, a counsellor or psychologist or even join a support group in your area.

Remember the surgical team are here to help you, too. If you have questions, just ask!