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Bariatric Surgery

Turn Knowledge into Knowledgeable Behavior

Most patients know the right things to do and not to do, but they have trouble putting their knowledge into practice.

Habits are just about the hardest thing to change, but the following can help you adopt healthier, non-food habits:


About Behavior Therapy:  Skill-power vs. Willpower

Behavior therapy for weight loss involves learning the skills needed to adopt new eating, activity, and thinking habits. It is partly based on the principles of classical conditioning, which would say that eating is prompted by antecedent events (cues) that become strongly linked and attached to food intake.

Eating cues can include, but are not limited to, situations (holiday gatherings, vacations, restaurants, socializing with colleagues after work), watching television, and emotions (stress, anger, frustration). The more often the cue and eating are paired together, the stronger the connection becomes between the two of them so that one actually triggers the other.

Your ultimate goal is to identify the cues that trigger inappropriate eating or activity for you and learn a new response to them.

Using Behavior Therapy for Weight Loss

Keeping the idea of classical conditioning in mind, behavior therapy for weight loss includes these steps:

  • Develop your problem-solving skills.
  • Set small, realistic goals.
  • Have a support system.
  • Maintain contact with your treatment program.

Problem Solving 101: Learn How to Change

Changing involves these steps:

Step #1: Define the problem. Identify the cues that trigger inappropriate eating or activity.

Step #2: Brainstorm for possible solutions to the problem:

  • Analyze your situation: what will help or hinder your efforts?
  • What specifically are you going to have to change, or what are the costs?
  • What will change for you, or what are the benefits of changing?
  • Think of strategies to help you overcome the problem and learn a new habit.

Step #3: Choose the solution(s) that best fits and implement them. This is your plan of correction when you begin to learn a new response to the cue.

Step #4: After working the plan, reassess the situation:

  • Have you been faithfully implementing the solutions?
  • Are the solutions working? Are you weakening the connection between the cue and the inappropriate eating or activity?
  • Do you need to consider another solution or approach?

Set Small, Realistic Goals

In order to set realistic goals, you must accept what weight loss can and cannot do for you. Weight loss absolutely improves your health, mobility and self-esteem. However, weight loss will not solve every problem you have ever faced in life. It does not guarantee you a better job with better pay. It does not guarantee that you will meet the love of your life, get married, have children and live happily ever after.

Focus on taking small, incremental steps to reach your goals. Your weight did not increase overnight and it will not be lost overnight, either. Likewise, you did not learn your eating habits overnight. It has taken your entire lifetime to acquire these habits; therefore you cannot fix them overnight.

Consider setting some non-weight goals, or health goals, in addition to your weight loss goals. Examples of non-weight goals include: lowering your blood pressure; being able to walk 30 minutes on a treadmill five days a week; and, for those with diabetes, keeping your Hemoglobin A1c levels below 7%.

Develop a Support System

It is helpful to have friends and family members who will support your weight loss efforts and can lift your spirits up when you become discouraged. Your support system needs to include more than just close friends and family members. It is very important to network with others who are considering gastric bypass surgery and those who have already gone through the process. This can best be done by attending support group meetings.

A large support group meeting is held monthly at West Penn Hospital where patients can learn more about the surgery from our surgeons, as well as learn from a variety of speakers including our psychologist, dietitian and plastic surgeons. The support group also provides a great opportunity to meet other patients.

Our psychologist also leads a small monthly support group specifically for patients who have already had bariatric surgery. Attending this meeting will help you to recognize the eating patterns you struggle with and recognize that you are not alone. You can also exchange information, strategies or helpful tips from others who share your experiences and challenges. Another idea is to find an "accountability partner": someone who will not let you slide, but who will ask you specifically about your weight, what you are doing well, and where there is room for improvement.

Stay in Touch!

Maintaining contact with your treatment program is also a good predictor of success. Our surgeons, physician assistants, dietitian and psychologist can serve as a resource of information for you and help to keep you on track.

Though the road to weight loss may seem overwhelming at first, remember to:

  • Take it one baby step at a time. Focus on one habit and work through the problem-solving steps to overcome the habit and learn a new habit.
  • Contact us with any questions or concerns you have.


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