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New Year’s resolution: Get healthy to improve surgical outcomes

Nina Singh-Radcliff, MD
Conditions
January 15, 2013
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Losing weight can decrease the incidence of several chronic and debilitating diseases, as well as their associated complications and risks during the surgical period. Additionally, it can facilitate recovery after surgery. Obesity increases the risk for:

  • Diabetes
  • Obstructive sleep apnea
  • Hypertension
  • Cardiovascular disease
  • Depression
  • Joint degeneration
  • Cancer

Additionally, obese patients may present special challenges for anesthesiologists:

  • Blood pressure monitoring (finding an appropriate fitting blood pressure cuff)
  • Locating veins to start IVs
  • Airway management including the placement of a breathing tube (intubation)
  • Medication dosing
  • Sensitivity to narcotics that can limit the efficacy of pain management
  • Surgical positioning
  • Increased risk of blood clots that can travel to the lungs
  • Increased overall mortality

After surgery, there are additional recovery benefits associated with weight loss. They include maintaining strength and energy, tolerating therapy and treatment side effects more efficiently, lowering the risks of infection, and healing and recovering faster.

Attempting to lose weight once you are scheduled for surgery is seldom an achievable goal. It’s often the story of “too little, too late.” With the arrival of 2013, comes the opportunity to make weight loss a New Year’s Resolution so that in the event you need surgery, you will be in your best possible shape. Even losing 10-15 pounds has been shown to:

  • Lower blood sugars in diabetics
  • Reduce blood pressure
  • Improve cholesterol levels
  • Lighten the stress on hips, knees, ankles and feet

Unfortunately, when it comes to losing weight, knowing is not half the battle. Additionally, statistics show greater than 80 percent of people who have lost weight regain all of it, or more, after two years. There are no magical diets, specific foods or short cuts. Successful long-term weight management generally requires attention to total energy intake, physical activity and behavioral modifications. Here are some suggestions on how to start losing weight so next year you can work on a NEW New Year’s Resolution:

Create attainable goals. Fad and overly restrictive diets may initially have dramatic results. Studies show dieters who follow these plans are more likely to regain the weight compared to more forgiving plans. Slow and steady weight loss is more likely to keep those pounds off. A goal of one to two pounds per week (four to 10 pounds per month) is considered reasonable and healthy. Consider making small changes in increments. Set goals for when to start, what calories you are saying adios to and how you will increase your exercise. 

Create a journal. Now that you have devised a plan, write it down! Keep a journal so as to log your goals and weight on a weekly basis. Additionally, keep a daily eating and exercise log to allow you to clearly see what you are consuming. Frequently, review your log to identify and correct problem areas.

One expert suggested to put on a bikini or swimsuit and take weekly photos: profile, frontal and rear shot. Include them into your journal. Because weighing scales may fluctuate depending on the time of day, last meal, fluid intake and bowel movements, pictures can help you chronicle your journey and gauge your progress. By keeping them in a diary, you can use them to assess and reassess your exercise and diet program.

Remove the temptations. Exorcise (not exercise) your kitchen and pantry from temptation. Remove snack foods such as cakes, cookies, chips, sugary colas and other empty calorie foods that can easily amount to several hundred calories if you succumb to temptation. Replace these items with healthy and nutrient dense foods such as:

  • Lean protein (deli meats, chicken breast, turkey breast, egg whites, fish)
  • Fresh fruits (apples, oranges, strawberries, grapes)
  • Raw vegetables (carrots, broccoli, mushrooms, squash, green beans)
  • Health snack foods (non-fat cottage cheese, sugar free jello, protein bar)
  • Bottled water

Keep a stash of these items at work so you can snack on them instead of the readily available donuts, bagels and pastries that have a moment on your lips but stay an eternity on your hips.

Assemble an entourage. Don’t keep your goal a secret. By sharing your goals with your friends and family, you may find support and may be more dedicated to reaching them. And maybe you’ll even find a weight-loss buddy among your peers. Having a partner is a great way to stay motivated and share ideas. For example, instead of sitting down on the couch after a meal, the two of you may be more likely to take a walk.

Positive reinforcement. Take time to celebrate your achievements. For every five pounds you lose, treat yourself to something special like a new hairstyle, piece of jewelry, electronic gadget or mini-vacation. In addition to enjoying the benefits of being healthy, creating a secondary reward system will give you something to look forward to and can be the icing on the cake, figuratively.

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Nina Singh-Radcliff is a member of the American Society of Anesthesiologists’ Committee on Communications. 

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