Making the commitment to have bariatric surgery is one of the biggest decisions you’ll make in your life — perhaps the biggest, as far as your health is concerned. While you may feel prepared for the surgery and recovery itself, there are some common weight loss struggles you may not be aware of.

Below are 10 of the most common — yet rarely discussed — struggles bariatric patients face after surgery and some tips and tricks to help you overcome each one.

Mental and emotional struggles

Weight loss surgery doesn’t always improve body image. It can take time, and in some cases even counseling, for bariatric patients to adjust to the new image they see in the mirror. Some patients may also experience mood swings after weight loss surgery, or experience “food grief” as they learn to develop a new relationship with food. These and other mental and emotional challenges are common among bariatric patients, and many patients find encouragement from joining a weight loss support group or seeking the help of a licensed counselor.

Weight loss plateaus

Every bariatric patient will experience a weight loss plateau at some point. This can be particularly discouraging after experiencing rapid or steady weight loss for some time. Most patients find that by increasing their protein intake, drinking more water and changing up their exercise routine, the weight begins to come off again after a few weeks of little or no weight loss. Do not give up if you hit a plateau. Instead, seek encouragement and advice from your weight loss doctor.

New way of grocery shopping

It can take some time to adjust to grocery shopping after weight loss surgery. Do not be deceived by foods labeled as “healthy.” Instead, learn to read the nutrition labels on everything. Watch out for added sugar and high amounts of calories, fat and carbohydrates. As a general rule of thumb, stick to fresh produce and lean meats as much as possible and avoid processed foods and most anything found on the inside aisles of a grocery store.

Difficulty eating out

The reality is that most restaurants don’t serve meals created for people who have had weight loss surgery. The bariatric patient must adhere to a strict diet with small portion sizes. Eating at most restaurants can be a challenge and many patients find it easier to cook meals at home rather than going out to eat. But that’s not to say it can’t be done and that bariatric patients are no longer to able to enjoy eating out in a social setting. The key is to plan ahead, order smaller portions (such as a kid’s meal) and know your limits.

Excess skin

When excess weight comes off slowly, as with diet and exercise, the skin that has been stretched with weight gain is often unable to adapt and shrink as needed. Bariatric surgery often results in such rapid weight loss that the skin loses some of its elasticity, and many patients are left with loose, sagging skin. The good news is that there are cosmetic procedures that can remove the excess skin once weight loss has normalized. Talk to your weight loss doctor about options to remove any unwanted skin after weight loss surgery.

Relationship changes and challenges

Dramatic weight loss that often accompanies weight loss surgery isn’t just an adjustment for the patient. Spouses and significant others can react in many different ways to the “new” you. Some may find it difficult to be supportive of the new healthy lifestyle required after weight loss surgery. If you are facing relationship challenges after weight loss surgery, consider inviting your significant other to join you at your weight loss support group.

Adopting a healthier lifestyle

Weight loss surgery isn’t a magic fix for obesity. It is a tool that can help patients lose excess weight and improve their overall health, but it goes hand in hand with lifestyle changes, such as eating a healthier diet and exercising regularly. Adjusting to this new lifestyle takes time. Many patients find encouragement from others on the same journey through weight loss support groups.

Discouragement when weight loss slows down

Immediately following a bariatric procedure, most patients experience a period of rapid weight loss. It is easy for patients to become complacent during this post-op time when weight comes off easily. Discouragement or disappointment when this period of rapid weight loss ends is among the most common weight loss struggles bariatric patients face.

Lack of support from family and friends

Not everyone understands the decision to undergo a weight loss procedure, and many patients find that family members or friends may not be supportive of their decision. Having a strong support network around you after surgery is essential to your success, which is why many weight loss surgeons offer their patients access to online and in-person weight loss support groups.

Addictive behaviors

Some studies have found that bariatric patients may be more prone to developing addictive behaviors, such as excessive alcohol use, after surgery. This is because many weight loss surgery patients have a history of using food as a coping mechanism to deal with stress and emotions. Bariatric surgery restricts stomach capacity so patients can no longer overeat (without repercussions), so some patients may turn to other coping mechanisms such as drug or alcohol use.

If you are experiencing any of these weight loss struggles, we hope it encourages you to know that you are not alone. Contact your First Baptist Medical Center weight loss doctor today if you find yourself facing an unexpected challenge after weight loss surgery. We offer support groups, fitness inspiration and nutritional guidance to help you along the way.