Life After Surgery
Surgery is not a quick fix, nor is it the easy way out as some may say. This endeavor on which you are about to embark requires dietary, lifestyle and psychological changes that are not always easy. This surgery is intended to be a tool to help you in the quest for a healthier life. If you commit to using this tool correctly it will make it physically easier to make the required adjustments in your eating and lifestyle habits. Another vital tool for you after surgery is our dedicated and accessible interdisciplinary team of professionals who will be there to support your efforts. We will be there with you every step of the way!
Diet After Bariatric Surgery
The changes made during surgery will require permanent changes in your eating habits that must be followed for successful weight loss in your new life after bariatric surgery. Post surgery dietary guidelines will vary based on they type of surgery you have. You will have to attend an intensive nutrition class before surgery where you will receive a manual that spells out your post surgery diet along with everything else that is important to your success. It is very important that you follow the dietary guidelines if you want to be successful. The following are some of the generally accepted dietary guidelines for a healthy diet after bariatric surgery:
- When you start eating solid food, it is important to chew your food thoroughly and eat very slowly. It is important to wait two to three minutes after swallowing before putting the next bite of food in your mouth.
- Don’t drink fluids while eating. They will make you feel full before you have eaten enough food. Fluids consumed with meals can cause vomiting and dumping syndrome, and can lead to feeling hungry sooner after a meal.
- Don’t eat desserts and other items with sugar if they have more than 3 to 5 grams per serving size.
- Don’t drink your calories!! Avoid carbonated drinks, high-calorie nutritional supplements, milk shakes, foods high in fat, and foods that have no nutritional value.
- Avoid alcohol.
- Limit snacking between meals. Eating after bariatric surgery will be much different than before!
Going Back to Work After Bariatric Surgery
The timeframe for returning to work varies based on the individual, what surgery you have and what line of work you are in. Some patients who have desk jobs have retuned after only 5 days while others have needed 3-4 weeks to feel adequately ready. Those who have jobs that require lots of activity may want to take at a little more time off to recover. The amount of time you will need is something that can be discussed with your practitioner as it is case by case.
Birth Control and Pregnancy
Under appropriate circumstances, pregnancy can be safe after weight management procedures (WMP). However, due to the severe risk of birth defects and associated medical problems, including, but not limited to, neural tube defects, malnutrition, low birth weight, prolonged neonatal ICU stay, and even autism, it is absolutely imperative that you avoid pregnancy for the first 18 months (1.5 years) after bariatric surgery. Additionally, we absolutely mandate that you not get pregnant during periods of acute weight loss.
In other words, do not get pregnant until your weight has been stable for at least a full year! This is for the safety and health of you and your baby
If you do become pregnant, it is important that labs are monitored regularly to ensure that vitamin or mineral deficiencies do not occur. A prenatal vitamin along with 1500 mg of calcium citrate needs to be taken daily to prevent neurological or skeletal defects to the fetus. Make sure that your surgeon or practitioner is aware of your pregnancy so that he/she can make the appropriate referrals.
Both men and women who were infertile prior to bariatric surgery may regain their fertility. Therefore, if you are not planning a pregnancy, you need to consider taking proper precautions. The absorption of oral birth control pills can be affected by the malabsorptive portion of the bypass surgery (not the lap band or sleeve). It is recommended that women talk to their OB/GYN about changing to a patch, shot, vaginal ring or IUD for birth control or even consider using 2 methods of birth control for the first 18 months after surgery.
Long-Term Follow-Up After Bariatric Surgery
After surgery it is vital to your success to follow up with our office. Those that follow up regularly tend to do the best with their weight loss outcomes.
This is not a quick fix and our office is there to guide you on your journey. After surgery you are at risk for things such as nutritional deficiencies and some weight regain. Following up with our office and getting your required labs and check ups will prevent these from happening. Plus we love to see your success and take part in your transformation!
In one way or another, we all must hold ourselves accountable. To be successful and stay successful, you must set up a system of accountability. Schedule regular appointments with your surgeon, practitioner, dietitian, and social worker. Attend support groups. Weigh yourself regularly. Keep food and exercise logs. Our staff is always available to help you with these activities.
Since morbid obesity is a lifelong condition, you will need continued support from your bariatric team and other weight loss surgery patients. The weight loss surgery itself will not immediately resolve existing emotional issues or heal the years of damage that morbid obesity might have inflicted on emotional well-being. Support groups will be held once a month, in person and on-line if you live far away. These meetings are a way for you to share your successes and struggles with others. You can also receive good advice from other patients. You must be careful with information on the internet, misinformed people may lead you in the wrong direction. For the best advice, please contact the staff at Bariatric & Aesthetic Surgery Associates.
Common problems after surgery
Nausea and Vomiting
Eating too fast or not chewing well, eating the wrong foods (foods high in fat or sugar content or too dry), and/or eating too much or drinking liquids with meals can cause nausea and vomiting. If you vomit, take time to think about what may have caused it. If nausea or vomiting occur after you eat a new food, wait several days before trying that food again. If you’re uncertain, call your surgeon’s office.
Insufficient Weight Loss
In most cases, this is related to dietary indiscretion (eating too much, grazing,and/or eating the wrong foods), inactivity or slipping back into old habits. The majority of the people who gain weight back after surgery have failed to follow up, get lap band adjustments, or make changes in their lifestyles. It cannot be emphasized enough, the surgeries are a tool- if you don’t follow the rule of the tool you cannot expect to have success.
Weight loss surgery patients must take vitamin supplements for life. Serious problems can occur if you do not take your vitamins and minerals every day. Consequences of vitamin deficiency vary. For example:
- Calcium deficiency may lead to weakened and broken bones.
- Iron deficiency may lead to dizziness, chronic fatigue, and low blood count.
- Vitamin B12 deficiency may lead to tingling of hands and feet, nerve damage, and fatigue.
- Vitamin B1 (Thiamin) deficiency may lead to mental confusion, muscle weakness, and numbness in your toes and fingertips.
- Vitamin and mineral levels in your blood must be monitored at least yearly. If necessary, your vitamin/mineral supplement doses may be adjusted by your surgeon or dietitian. This is why it’s important for you to continue your follow-up with your surgeon.
Drink lots of water (at minimum eight cups or 64 ounces of fluid per day). If you are not drinking enough water you may struggle with constipation. If you are taking fibers, be sure to drink even more than the required amount of water.
If you do not exercise you will not lose as much weight as you desire and you may struggle with weight gain in the future. Without exercise you will lose fat and muscle as you are losing weight. The only way to tell your body to take the fat and leave the muscle is with exercise.
Temporary hair loss
Temporary hair loss can occur from rapid weight loss, but may also be caused by inadequate protein in the diet. This situation is usually temporary.
Gas problems are also common after weight loss surgery. If you have gas pains at home, try simethicone drops, Bean-O, Phazyme, or Gas-X. If the problems continue, call your surgeon’s office.
If you have diarrhea, limit greasy foods, milk, and milk products. If you had a bypass you may be having dumping syndrome from high sugar foods. Avoid very hot or very cold foods or drinks. Pay attention to the new kinds of food or drink you are taking. Make sure you drink an adequate amount of fluid. If the diarrhea does not resolve, call your surgeon’s office.
Generally observed only in gastric bypass patients (not in LAP-BAND® patients), this happens when food is taken together with liquids or when high sugar foods are eaten. Eating refined sugars and dense fats, which are “dumped” into the small intestine too quickly, usually causes it. Symptoms include abdominal fullness, nausea, lightheadedness and crampy abdominal pain followed by diarrhea. Usually the dumping syndrome can be controlled by diet and behavioral modification.
Dehydration can occur when you do not drink enough fluids. Make sure you drink at least eight cups (64oz) of fluid each day, but not at meal times. Sipping fluid throughout the day will help you meet the fluid requirement.