Evolution of a Bariatric Patient

The Penn State Hershey Surgical Weight Loss Program has been operating for more than 15 years. Throughout this time, we have seen hundreds of patients become healthier versions of themselves. During the process, we not only see weight changes, but we often see changes in patients’ attitudes toward food, exercise, and themselves.

At the February 2009 support group meeting, we did an exercise to get a more in-depth look at these attitude changes from three perspectives. We had contributions from pre-op patients, from those who were about one year post-op, and from those who were more than two years post-op. Some of the responses from the more than 50 support group attendees are shown in the tables below. Even though some of them are contradictory, they are honest and from the heart.


Attitude Toward Food
Pre-op One Year Post-op More than Two Years Post-op
  • Comfort and security
  • My best friend
  • Social, fun, and enjoyment
  • Reward
  • Ate when stressed, happy, sad, bored
  • No life without food
  • Love/hate relationship
  • Food was guilt and shame
  • RESPECT food-afraid to get sick
  • Eat to live
  • Food is fuel not pleasure
  • Less is more!
  • The “fog” has lifted and there is more control over food
  • Still have to deal with cravings
  • Food overwhelms me
  • Still have to be careful
  • Old habits “knock on the door”- grazing, snacking
  • Still need to work at weight maintenance or weight loss
  • Try to cheat and push the envelope
  • Miss food
  • Still need support from others to stay on track
Food Habits
Pre-op One Year Post-op More than Two Years Post-op
  • Want lots of food-big portions
  • Obsessed with food-always looking for the next meal
  • Chaotic eating schedule
  • Skip meals or graze
  • A lot of nighttime eating
  • Eat out every meal
  • Eat quickly
  • Many yo-yo diets
  • Ate just to eat
  • Eat when hungry
  • Portions are controlled
  • Have to fill time with other things-not food
  • Eat “healthy” food
  • By the book-follow all of the dietitians’ recommendations
  • Eating is deliberate
  • Grocery shop and cook meals
  • Use a smaller plate
  • Eat slowly
  • Can eat sweets-and do eat them
  • Portions are controlled-the tool works
  • Feel hungry more quickly
  • Slacking with food choices
  • Know when I’m full
Attitude Toward Exercise
Pre-op One Year Post-op More than Two Years Post-op
  • From gung-ho to nothing
  • A chore
  • Don’t like to sweat
  • Don’t care
  • Too hard
  • I’m too big to exercise
  • I can do it
  • Appreciate being able to exercise
  • Enjoy it
  • It’s a pleasure
  • Still active
Exercise Habits
Pre-op One Year Post-op More than Two Years Post-op
  • Exercise is from the remote to the refrigerator
  • No habits, don’t do it
  • I need to get back to it
  • I have always exercised
  • It's a priority, vital
  • Consistent exerciser


  • On and off
  • Need to get back to it
Attitude Toward Yourself
Pre-op One Year Post-op More than Two Years Post-op
  • Tired of not being able to do things I want
  • Happy, confident
  • Ashamed of how I look
  • Have few friends
  • Scared of what people say about me
  • Wouldn’t change jobs
  • Hid from dating
  • Unhappy, but I didn’t think I was
  • I need to take care of myself
  • I’m always in the background
  • Hated myself
  • In pain
  • Destructive and felt guilty
  • I like myself and what I have become
  • Happy in my clothes, but not naked
  • More confident and sexy
  • Easier to buy clothes
  • No more plus sizes
  • Met new people and want to date
  • I still see the same person in the mirror
  • Can buy clothes at a regular store
  • Have more energy
  • Have more confidence
  • This is just me now