Paying attention. Learning to choose wisely. Planning. Coping with stress. Not eating when sad or mad or lonely. Exercising. Picking yourself up after slipping. Sticking with it. It sounds like a plan for weight loss, right? It’s also how to avoid gaining weight, and a good map for self-care overall. It is, finally, the path to long-term success after weight loss surgery, too.

Weight loss surgery, as Dr Oz’ book You, On a Diet says, is not “the easy way out”. Nor does it mean “you never have to worry about dieting again”. Losing weight (and not gaining it, for that matter), requires just about everyone in today’s world to pay attention to what and how they’re eating. If you have weight to lose, it’s going to take a lot of attention, and the often uncomfortable work of making lasting habit change. That’s really the only way.

That said, the effort it takes to reach and maintain a healthy weight rewards you. Better health, more energy, a longer life: these are among the rewards. And for some—especially those facing the most difficulty–bariatric surgery offers a viable way to lose weight. The surgical change prevents overeating for a time. However, people can and do eventually regain (at least some) lost weight unless new habits are firmly rooted. The best way to think of surgery, then, is as a tool to help weight off relatively quickly, while you learn and practice and reinforce the habits that will keep it off for good.

 These habits resemble those we all should adopt. With surgery, though, some take on much greater importance. For the post-surgical body must live on a small number of calories. Yet it still needs key nutrients and muscular strength. And given the body’s easy tendency to gain weight (pretty much a given here), overeating and stomach-stretching must be avoided. I outline here the habits most likely to ensure long-term success after surgery. And by success I mean weight loss. But I also mean little or no regain, and a feeling of better health and well-being. Those who achieve this kind of success are most likely to:

1. follow nutritionist’s recommendations for pre-and post-surgery quite closely. When they don’t, they figure out what went wrong, pick themselves up and start again. “Progress not perfection”, in other words.
2. learn to think and plan ahead. This means bringing the right foods, in the right amounts, with them at times. It means keeping the right foods at home, too.
3. develop alternate means of coping with stress and feelings. Emotional overeating can undo a person’s best efforts lose. It’s crucial to seek a therapist’s help if emotional eating persists.
4. get help for binge eating. Reducing, if not completely eliminating, this behavior goes far in avoiding post-surgical problems.
5. think about, and anticipate, what this change will really mean for the rest of one’s life. There may be no way to fully do this ahead of time, but thinking and talking about it helps prepare the mind. Most practices require some pre-surgical contact with a psychologist. This clinician, or one’s own therapist, can help here.
6. exercise—in some form, even when physical limitations (such as arthritic knees) exist.
7. make sure they have supportive people in their lives. This might mean avoiding or not telling people who would be very unsupportive. It might mean going regularly to a support group (usually offered by the surgical practices). It might mean teaming with a friend or two who’s also post-surgery. It certainly means enlisting the understanding of one’s spouse or significant other, for practical purposes (like cooking and shopping) and emotional support.
8. seek help if they’re struggling. With the altered stomach as a weight loss “tool”, it can be easy to get back on track with a little support. Those who recontact their nutritionist or therapist early on, before a problem drags on, fare best.

(Part 3 of this article will address resources, and life after surgery.)