Lost to follow up happens, to be sure, but don’t we all wonder where they went? Why they are no longer coming to support groups and activities? And how you might recapture their attention and participation?
Since 2000, BSCI has specialized in providing bariatric professionals with research, insight and resources to really connect with their patients. Here are our top three tips to keep those veteran patients involved, engaged and inspiring others.
- Let them share & show off. For newbies, there is nothing like hearing from long-term, successful patients! And there is nothing that veteran patients love more than to have the opportunity to crow a bit, share their story, their before pants, and photos. At BSCI, we recommend that each support group meeting include a segment devoted just for that. Not simply, going around the room and having each share their name and how much weight they have lost, but a showcase time for a few patients. Assign your ‘feature patients’ in advance and encourage them to bring photos, clothes and family members to hear them tell their story. If you do multiple types of surgeries, perhaps select one patient for each. Provide them with some sort of certificate, pin or token for their accomplishment. Recognize and honor their accomplishments at 1 year, 2 years, 3 years and so forth. Keep them coming, by keeping them in the spotlight.
- Create Opportunities for them to serve. As you know, bariatric patients are so very grateful for their new lives, grateful to their surgeons for their skill and their bariatric team for their education and ongoing support. Many of your patients are likely seeking an opportunity to pay it forward, to give back. There are so many ways to use your patients in your program to the benefit of all. You may enjoy reading The Dangers & Benefits of Using Bariatric Patients in your Program. Give them an assignment, a job, a committee on which to serve.
- Enhance and Improve your post op educational content. I will always recall this statement made by a new patient, “I will keep attending support groups as long as I learn something new each time.” Years later, he was still coming! Quite a testament to the need for a variety of quality lessons, educational content and enticing topics that teach about the bariatric lifestyle, not just what to eat in the first few months following surgery. Once, again BSCI has come to the rescue with exceptional lesson plans, handouts and teaching aids. These research- based lessons are insightful and timely and appeal to veteran, struggling and new bariatric patients. Support Groups of Excellence Lesson Plans.
Thank you for caring about your bariatric patients. Not just the newbies, but your long-term veteran patients as well. I encourage you to try these tips and see if you can keep your patients participating in your program longer, and reduce the number of those labeled, ‘Lost to Follow-up.”
For lesson plans, effectively using volunteers in your program, agenda ideas and facilitation skills, consider our Support Group Leader Certification Course. we’d love to have you as one of our nearly 1,000 certified leaders and know you will learn and enjoy the content. 10 CEU’s
My awesome husband knows I love chocolate covered cherries. He buys them for me during the holidays and honestly, throughout the year, especially when they are going for $1.00 a box!
Last weekend, we did our grocery shopping and as expected, Roger put a box of those delectable delights in our cart. “They’re fruit, right?” he said with a grin. “Well, I suppose they are,” I replied.
Chocolate covered cherries are best when kept in the refrigerator. They are more chewy than gooey and take longer to eat that way. So, as we put away groceries, I put the box in the fridge, but this time, instead of putting them on a shelf, I put them in the fruit and vegetable drawer. Hmm, that was interesting. I could see them clearly through the crisper drawer, but I could also see the apples, pears, and oranges, which seemed to be glaring at me as well as if to say, we’re here too! Now, whenever I opened the door, my choices are pretty clear!
Often, I find myself looking for something sweet, and have learned over the last few years that sometimes, not always, but sometimes, fruit will hit the spot. So, I find myself thinking twice before I reach for a sweet snack. Every time I open the refrigerator door, I see so clearly that I do, indeed have a choice. It is my choice and mine alone. There is no one else here. Just me, the fruit and the candy. Much to my surprise, there have been a few times, that I preferred the apple, or the orange as my afternoon treat. Awesome! I am finally learning how much better I feel when I eat what my body needs.
The holiday season is filled with so very many choices. We can fill our days with shopping, gifts and parties. We can spend our time in service and the spirit of the season. We can go to church, or we can go see Santa. We can fill our bellies with candy or fruit.
For me, I love it all! In our family we decorate, do parties and gifts, participate in service projects, visit Santa and go to church. We eat good proteins and vegetables and also enjoy a holiday treat or two.
I am grateful to have such plenty. I am grateful for this season and the many choices I have. I cherish my right to choose, own the consequences of my choices and allow others to do the same. May you find peace in your choices this holiday season and always.
Oh, and chocolate covered cherry anyone?
Enjoy this great article I wrote for Mountain Weekly in Jackson Hole, Wyoming.
Click here, like and share! https://mtnweekly.com/mountain-lifestyle/palisades-dam-lake-idaho/
Anxious to do everything right, and to finally find their answer to a lifetime of weight loss struggles, pre-op patients will do all that is asked of them. They attended required classes and support groups, complete psych evals & medical screenings, fill out all the forms, jump through all the hoops, and check off all the boxes. And off to surgery they go.
When post op questions come in like – “When can I have pasta? Or, “Is it ok if I have a diet coke?’ you wonder if they were listening at all!
As a 23-year WLS veteran myself, I remember intending to listen, trying to pay attention and take it all in, but with surgery eminent – my mind was overwhelmed with thoughts of will it hurt? will I survive the surgery? and can I really do this? So, I admit, like many of your patients I suspect, much of the information that I was taught before surgery, well, just didn’t stick.
Having worked with thousands of weight loss surgery patients for over 20 years we at BSCI have come to believe that while pre-op education is important, post op education is essential! Once the pre-op process, education and actual surgery is over, then important lifestyle learning can begin.
We have worked with hundreds of weight loss surgery programs and when we ask about their bariatric patient education programs, most refer to their websites and informational sessions. That is all well and good, but teaching about the different surgical procedure options, the first few months of dietary guidelines, availability of support groups and answers to insurance and financial questions, is not what we mean.
May I invite you to consider a new way of defining patient education. Or more specifically, post op education. Consider what you offer for your post-op patients in the way of long term, lifetime learning opportunities for post op patients. Opportunities beyond access to a dietician, exercise professional or mental health counselor.
Patients know how to lose weight but learning to maintain requires a completely different mindset. They have spent their lifetime following diets. Now they need to learn to think like a thin person, to learn more about the disease of obesity, their own metabolism and how to effectively use their surgical tool to manage their weight throughout the rest of their lives. Provide these resources for your patients after surgery and they will listen.
Consider these questions.
- Besides support groups, what post-op educational programs do you offer your patients?
- Does your bariatric team have the experience & resources necessary to educate and support your patients in long-term bariatric lifestyle learning?
- Are you taking advantage of the many telephonic and eLearning opportunities available for your patients and your staff?
- Do you offer an annual patient educational / celebration event?
We can help with all those things. Since 2000, BSCI has specialized in providing exceptional, long-term, resource-based education and support programs for weight loss surgery patients and the professionals who serve them. We are here to support you as you support your patients.
We can help you enhance your educational offering, expand your outreach and improve long-term outcomes for your patients.
Learn more about resources for patients
Learn more about resources for professionals
Click here to schedule a call with Colleen Cook to visit about your program needs and how we can help.
This is our third summer here in Star Valley, Wyoming and again, I am still on the hunt for wild huckleberries. They are an awesome little fruit, good for you, rare and hard to find. But now, finally, thanks to a friend, know what I am looking for and where to find them! Yahoo!
Last summer, we were excited to see all of the berries surrounding our home. Beautiful white flowers in the spring and loaded with berries in late summer. Someone told my husband that they were huckleberries! Knowing that they go for about $50 a Ziplock bag full, I was sure we would be rich! We had struck gold, right on our own land.
We invited some friends over to pick some. Sure enough my friend, her husband, another family, and lots of kids with buckets came over ready to pick. My friend promptly asked, “So, where are they?” “Everywhere!” I exclaimed. To my embarrassment and disappointment, she said, “Those are not huckleberries, they are service berries.” Not even close! Ugh!
We enjoyed the night with them and the next day I picked buckets of service berries. It turns out this berry is well-known and used for many things. In some areas they are called Saskatoons. Service berries are not very juicy or tasty, but our grandkids and I made muffins and they loved them on their ice cream. (I learned that if you add enough sugar you can make anything into syrup).
This year our bushes are loaded once again with service berries, and I’ll use them, but I want huckleberries! My husband, Roger, kindly asked, “What is the big deal about huckleberries? Can’t you just plant some, or buy them frozen?” So, I started thinking. Yes, I suppose I could, but I was pretty stuck on finding wild ones in the woods. And I finally did!
I know now that the huckleberry bush is low to the ground and the berries are almost impossible to see from a standing position. (Even when you are only 5’2). While some berries are easy to pick because they grow in clusters, huckleberries grow one by one on single branches underneath the leaves.
I went out again today and all the while I was picking, I kept asking myself why this was so important to me. Why was I set on finding wild huckleberries? Then this insightful quote from Thomas Paine came to mind:
“That which we obtain too easily, we esteem too lightly. It is dearness only
which gives everything its value.”
And isn’t that true of so many things? We take for granted things that come easily – and relish, prize, and value those things that take a bit of effort. Or in this case, a lot of effort!
Last week, I took 3 of our grandkids to hunt for huckleberries and 2 of them gave up almost immediately. But, my little 4-year old granddaughter, Hadley, stuck with it and hit the jackpot. She was proud, and I was prouder. She and I took our little bucket of berries home and made syrup for our pancakes the next morning. Just the two of us. “To the victor goes the spoils.”
That was the headline of BSCI’s first brochure, way back in the late 1990’s. You see, as a weight loss surgery patient from 1995, I quickly recognized, that while the surgical care, multi-disciplinary clinical team and support groups were important, there was something more that was needed.
Like most of you, I suspect, I knew how to lose weight. I had spent my life researching diets, preparing for diets, on diets, screwing up diets. I could and did lose hundreds of pounds over and over again. When I went in for my surgical consultation, I recall saying to the doctor, with tears in my eyes, “please help me fix this!” I knew that a surgical intervention was needed, I knew that I would lose weight and fast! But, I also knew that I was responsible for changing my life and implementing habits that would ensure that I was able to maintain.
The first year was unbelievable! I started at 250 pounds and in exactly one year, I had lost exactly half my body weight. At my one-year check up, I was 125 pounds! Wahoo! I was bullet proof and so excited about my new healthy self.
But, once I reached my goal, my focus and my needs changed. I no longer needed classes, consultations about surgery options, possible complications, pre and post op diets, insurance and costs, and what would happen in the hospital. I no longer need support groups where the discussion focused mostly on the newbies.
I knew that there was so much more that I needed to learn about myself, my metabolism, my food addictions. I had to find out what successful long-term WLS patients knew and do what they did. I needed to learn how to think and behave like a thin person. I needed to learn and embrace a bariatric lifestyle.
Yes, weight loss surgery was an essential intervention for me. But it was just the beginning of my commitment to learn and succeed. It was just the beginning of the work and the ups and the downs of learning to use my “tool” to manage my weight. Surgery was good for a start.
Now for the rest of the story. As they say, find a need and fill it. For over 23 years, I and our BSCI Dream Team have created much needed educational and support programs to help patients learn how to live a successful bariatric lifestyle. We have helped tens of thousands of weight loss surgery patients all over the world to embrace a lifetime of learning to manage and maintain their weight.
Wherever you are on your weight loss journey, my advice to you is simple. Be a lifetime learner. Commit the time, resources and focus necessary to learn about yourself, and what it will take for you to manage and maintain your goals. Learn and then learn some more. And as you might expect, here are some resources to get you started!
LEARN the what successful patients know: The Success Habits of Weight Loss Surgery Patients
LEARN how to personalize your own maintenance plan: 5 Day Bariatric R.E.S.E.T.
LEARN how to get back on track and manage set-backs; Back On Track Program
LEARN how to lead, inspire and support others. Support Group Leader Certification
All my best to you for a lifetime of good health and happiness,
Colleen M. Cook, President, Speaker, Author
Through the years, I have been a strong advocate for involving patients in bariatric aftercare programs. Most agree that successful patients bring more patients, but there is also an important role they can play in both support groups and aftercare educational programs. Successful patients bring personal experience, knowledge and lifestyle habits, that when given the opportunity to share, enrich and enhance a programs ability to really connect. In our survey of over 1,000 bariatric patients, we learned that over 64% prefer that a post op bariatric patient lead support groups!
This is an important message to hear and respond to. Involving a well-trained professional team of RD’s, RN’s, exercise and mental health professionals is essential, but what I believe what we are hearing is a desire for fewer lectures and more real-world discussion about and from bariatric patients.
Unfortunately, there are a few concerns and challenges that a bariatric program may face when having non-healthcare professionals teach lessons, lead support groups and run programs. I believe the concern is two-fold. 1. Losing control over the group and 2. Liability issues. Let me share an experience that addresses both.
Years ago, a large bariatric program in Ohio recognized that their patients had been starting support groups in the outlying areas. Lots of them. At first, it felt like losing control, but they smartly decided to embrace the leaders, support their efforts, and provide some structure. They invited as many support group leaders as they could find, into their hospital. The provided a light lunch, networked with them and learned about their groups. They had them sign support group leader agreements which covered a variety of liability and confidentiality concerns. I was brought in to provide training for their bariatric patient support leaders, help establish topic schedules, and implement good communication between the patient support leaders and the hospital.
They continued their hospital-based group, but also provided new patients with a list of smaller, local groups they could attend online in their own area. Now they had a network of support groups, all teaching the same monthly lesson plan, encouraging prospective patients to choose their awesome hospital and welcoming new patients into the fold. The results were exceptional!
In addition to having bariatric patients lead support groups, consider what a great help they can be in planning holiday parties, family summer socials, and patient educational events. There are many patients who have skills and experience as educators, speakers and organizers. And you will not find a more willing group of people willing to give back by paying it forward. Lighten your load, expand your outreach and engage your patients.
To learn more consider our Bariatric eLearning module: Energizing Your Support Group with Patient Volunteers
I want it to be spring! I really do, but I don’t feel like I am quite ready. Roger and I spent all winter working inside our warm and cozy log home. We have been able to finish up many of our projects and we are so pleased with our work. But as for me? Well, I am a mess! With so much to do it has been so easy to put myself last – bottom of the list – not a priority. I think I am committed to my own self care, and know how important it is to stay accountable, keep myself on track with my portions, eating, drinking, vitamins, exercise, (see Success Habits of Weight Loss Surgery Patients). I wrote the book, after all. Knowing what I should do is easy. But doing it, under any and all circumstances is another thing entirely.
After 22 years of living a bariatric lifestyle, I know that staying on track requires constant diligence and focus. I also know it can be exhausting. As I think about my ‘winter’ I have learned something about my habits and which of them go out the window first. Here is my list. The first to go is exercise. No surprise there. If I am not going to my gym, I stop weighing. DANGEROUS! Next, I move into a “keep the good foods that I love while I add in a little treat here and there.” phase. I am still conscious at that point, but then, what seems like all of a sudden, I mindlessly slip into eating nothing but junk! My portions get out of control, and I let my self run out of vitamins, go too long in between haircuts. Ahhhh.
Ok, I am done whining. But here is the cool thing, I know where I am! And I know exactly what I need to do. With spring (and several speaking engagements) around the corner, I am ready for my Bariatric R.E.S.E.T! How about you? Here are the steps I take.
- Own it! (That means weigh-in)
- Decarb my house
- Buy a new water bottle
- Schedule in exercise
- Order vitamins
- Buy good food favs
And I say, “Spring? Bring it on!”
As my husband lay in a hospital bed, recovering from a total hip replacement, I searched diligently for a way to show my love and support. Then, I found the perfect answer, “licorice and Oreo cookies!”
After 50 years in the workforce, my mother is retiring. Though she is not happy about it, I want to find a way to celebrate her many years of hard work. Oh, I know! I will bake her a pie. A cherry pie! That is her favorite.
Hard to believe, but our oldest son, Craig is turning 27. He is a wonderful young man with a great wife and an adorable son, Skyler. That surely is cause for a special family dinner. Prime rib, all the trimmings and of course, I will bake a cake.
I suspect that many of you are just like me. Even after 19 years as a weight loss surgery patient, when I feel the need to show my love, support or appreciation for someone I use food. It seems we all do. And that, I am afraid, has been the case since the beginning of time- you know, killing the fatted calf and all that. We love, we celebrate and we motivate with food.
I have been wondering if it would be a futile endeavor, or would it actually be possible to change this behavior? Now, I know that I cannot be responsible for everyone else, but I can be responsible for the choices I make. One day, one event and one holiday at a time.
So, now that the good candy from the gingerbread house is about gone… along comes another sweet holiday, Valentines Day. You know, expensive dinners, heart-shaped cookies, cakes, and candy.
In years past, Valentines Day has been the perfect excuse to bake giant heart-shaped sugar cookies with white icing and red sprinkles. But, this year I am going to do things differently. I know, it will be tough, now that Reese’s Peanut Butter Cups come in a heart shape, but I am committed to showing my love for my family and friends without using food! I have decided to spend my cookie baking time, writing heartfelt letters and notes of appreciation to those I love. My hope is that my words will fill their hearts, and that they will feel loved and appreciated, warmed and emotionally fed, and that they will not miss the cookies.
Won’t you join me this Valentines Day, by doing what you can to fill someone’s heart – rather than their stomachs? I love you – here’s a note!
It is exciting to see support group participants reach out to one another, cultivate new relationships, and truly connect with others in their group. Surely, there are many great benefits from attending – new friends, new fans, new supporters.
However, if you are paying attention, you may find that smaller cliques are starting to form. Cliques might include those who have had a similar procedure, or surgery at the same time. All well and good as long as new group members don’t feel excluded, left out and like they don’t belong. Here are a few tips to help you ‘manage’ your support group as you do your best to ensure that everyone feels apart, wanted and needed.
- Notice newcomers who may be alone. As a busy group leader, you may not have time to notice yourself, but what if you assigned a few of your veteran patients to serve as sort of a welcoming committee? Patients who have been around awhile, who may be losing interest in support group. Give them an opportunity to give back.
- Be deliberate about segmenting your large group. You may find that what they are seeking is more intimate conversation. Many feel more comfortable sharing and asking questions in smaller groups. If your group is large, consider having them meet all together for the first half- then let them know that they will have the opportunity to join smaller discussion groups for the last half. Organize them by topic interest, stage of weight loss, month of surgery, type of procedure, or any number of ways.
- Know your support group members. This takes not only focus, but skill. It’s hard sometimes to remember names let alone a patient’s likes and dislikes. But imagine how united your group would feel if you gave them opportunities to share with one another more than just their weight, their non-scale victories and their questions. Learning to live a bariatric lifestyle is about more than just food. Give them a chance to connect on another level. Feature more lifestyle lesson discussions like relationship changes, fitting in, exchanging habits, paying it forward. Help them be people, not just patients.
- Play fun, interactive getting to know you games. Having a fun, participatory activity during support group, will help all members stay involved and engaged. By organizing teams you will give them the opportunity to mix and mingle with other group members they may not otherwise know.
- And, yep, as you may know we have lesson plans, games and activities ready to go. Check them out: (Digital Support Group Lesson Plans).