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Recovering from Weight Loss Surgery?

Recovery takes effort. The diet is strict. Your body is trying to heal. Your weight is beginning to adjust. The recovery stage of the process becomes easier once you start to see positive changes. The timing varies by patient. Some patients begin to lose pounds within days of their surgery. For others, a couple of months go by before they see noticeable weight loss. With courage and a circle of support, you will make it through recovery and start to do things like never before.

For a personal perspective on recovery, click here.

  1. What do I need to do to be successful after surgery?
  2. Why is it so important to drink so much water?
  3. What is dumping syndrome?
  4. What if I'm not hungry after bariatric surgery?
  5. Is there any difficulty in taking medications?
  6. How long will I be off solid foods after bariatric surgery?
  7. What are the best choices of protein?
  8. How can I be sure I am eating enough protein?
  9. Will I be able to eat "spicy" foods or seasoned foods?
  10. Will I get a list of suggested eating patterns & food after surgery?
  11. Why is exercise so important?
  12. How much exercise is needed after bariatric surgery?
  13. Is there a difference in the outcome of bariatric surgery between men and women?
  14. Do I meet with a nutritionist after surgery?
  15. What is the follow-up schedule?
  16. How can I find a support group?
  17. How to eat post-surgery?
  18. How long should patients stick to a liquid diet?
  19. What foods should be avoided?
  20. What type of exercise is recommended?
  21. What happens after weight loss surgery?

What do I need to do to be successful after surgery?

Although the steps for recovery are different for everyone, here are some common examples:

  • Immediately after bariatric surgery, your doctor will review the dietary instructions received in preoperative education.
  • Many bariatric surgeons begin patients with liquid diets, and after a period of time, move them on to semisolid foods. Later, when the surgeon deems it appropriate, patients can begin eating solid foods.
  • Easing slowly into a solid-food diet is necessary and important to allow time for proper healing of your new stomach pouch. It also allows time to learn the new way of eating and get used to new feelings of fullness. This prevents vomiting and helps you avoid stretching your pouch.

Bariatric patients may hear the following, but again, following your doctor's specific orders is always best:

  • When the patient is able to eat solid food, he or she should eat two to three meals per day.
  • Recommended sources of protein are lean meats (chicken, turkey, and fish), lean ground beef, and other low-fat sources such as eggs, egg whites, low-fat cheese, low-fat cottage cheese, and fat-free, low-sugar yogurts.
  • To help avoid dumping syndrome, you may want to cook foods without using fat and season food to taste. It's a good idea to avoid sauces, gravies, butter, margarine, mayonnaise, and foods high in fat and/or sugar. Read labels and avoid sugars, sugar alcohols, and saturated fats greater than three to five grams per 1/4 to 1/2 cup serving.
  • Eating between meals is often not suggested. Drinking flavored beverages, even diet soda, between meals is not suggested. Use only calorie-free, carbonation-free drinks.
  • Staying hydrated with plenty of water is generally recommended. Avoid caffeine until 64 ounces of water can be consumed in a day.
  • Patients are generally told to exercise aerobically every day for at least 20 minutes (walking, bike riding, stair climbing, etc.). Weight/resistance exercise can be added three to four days per week, as instructed by your doctor.

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Why is it so important to drink so much water?

When you are losing weight, there are many waste products to eliminate, mostly in the urine. Some of these substances tend to form crystals, which can cause kidney stones. A high water intake protects you and helps your body rid itself of waste efficiently, promoting better weight loss. Water also fills your stomach and helps create a feeling of fullness. If you feel a desire to eat between meals, it may be because you did not drink enough water in the hour before.

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What is dumping syndrome?

Eating simple sugars (such as sugar, honey, and corn syrup), high-fat foods, or other small-particle foods can cause dumping syndrome in those patients who have had gastric bypass surgery. This occurs when these products, which have a small particle size, are “dumped” from the stomach into the intestine at a rapid rate. Water then is pulled into the intestine from the bloodstream to dilute the sugar load. This flush of water causes symptoms that can include diarrhea, rapid heart rate, hot flashes or sweating and clammy skin, dizziness, or the feeling of needing to lie down. Some individuals experience some or all of these symptoms after eating more than 3 to 5 grams of sugar, alcohol sugar, or greasy foods, while others can handle greater amounts.

  • Though the symptoms are unpleasant, dumping syndrome is a helpful condition. Some patients will avoid sugar because of the very unpleasant symptoms it can cause. Dumping syndrome generally occurs 10 to 30 minutes after eating and the symptoms can last for 30 minutes to two hours.
  • The best treatment is prevention by avoiding foods that cause dumping syndrome. If you have dumping syndrome, lie down for a short while to lessen the symptoms. Dumping syndrome is a positive side effect of the surgery; it helps you learn to eat healthy!

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What if I'm not hungry after bariatric surgery?

It's normal not to have an appetite for the first four to six months after bariatric surgery. Continue to drink liquids, and contact your bariatric surgeon or primary care physician if you are having trouble eating two to three meals a day.

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Is there any difficulty in taking medications?

Most pills or capsules are small enough to pass through the new stomach pouch. At first, your doctor may suggest that medications be taken in crushed or liquid form. As a general rule, ask your surgeon before taking whole pills/capsules if they are bigger than a small peanut. Some liquid medications (sorbitol, maltitol, xylitol) may cause dumping syndrome because of their excessive alcohol sugar content.

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How long will I be off solid foods after bariatric surgery?

Most bariatric surgeons recommend a period of four weeks or more without solid foods after bariatric surgery. A liquid diet, followed by semisolid foods, may be recommended for a period of time until necessary healing has occurred. Your surgeon will provide you with specific dietary guidelines.

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What are the best choices of protein?

Best choices include eggs, low-fat cheese, low-fat cottage cheese, tofu, fish, other seafood, chicken (dark meat), turkey (dark meat), lean ground beef, canned low-fat meats (tuna or canned white chicken), and thinly sliced deli meats.

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How can I be sure I am eating enough protein?

Most experts suggest 30 to 65 grams of protein a day. Check with your surgeon to find the right amount for your type of surgery. Too much protein is not beneficial, as it is used as a calorie source instead of protein for the body. Not having enough protein will result in fatigue. Without protein supplements, the average protein intake is 20 to 30 grams a day from regular food alone. Some programs recommend protein supplements, while other programs do not.

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Will I be able to eat "spicy" foods or seasoned foods?

Most patients are able to enjoy spicy foods after the first six months following surgery.

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Will I get a list of suggested eating patterns & foods after surgery?

Surgeons provide patients with materials that clearly will describe a suggested diet and dietary expectations. After surgery, health and weight loss depend on following these guidelines. You must do your part by limiting high-calorie foods, avoiding sugar, snacks, and fats, and strictly following the diet set by your surgeon.

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Why is exercise so important?

When you have bariatric surgery , you lose weight as the amount of food energy (calories) you can eat becomes much less than your body needs. Your body has to make up the difference by burning unused fat or muscle tissue. Your body will tend to burn any unused muscle before it begins to burn the fat it has saved up. Without daily exercise, your body will burn unused muscle, and you will lose muscle mass and strength. Daily aerobic exercise for 20 minutes will tell your body to use your muscles and force it to burn the fat.

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How much exercise is needed after bariatric surgery?

Exercise is an important part of success after surgery. Exercise actually begins on the afternoon of bariatric surgery––the patient must be out of bed and walking. The goal is to walk further every day after that, including the first few weeks at home. You may be encouraged to begin exercising, limited only by discomfort, about two weeks after surgery. The type of exercise depends on your overall condition. Some patients who have severe knee problems can't walk well, but may be able to swim or bicycle. Many patients begin with low-stress forms of exercise and move on to more demanding activity when they are able.

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Is there a difference in the outcome of bariatric surgery between men and women?

Both men and women generally respond well to this surgery. In general, men lose weight slightly faster than women do.

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Do I meet with a nutritionist after surgery?

Personal nutrition counseling after surgery is available as needed or as required by your physician.

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What is the follow-up schedule?

Although weight loss operations such as the sleeve gastrectomy do not alter your ability to absorb vitamins and nutrients, you will need to supplement with vitamins early on as you get used to your new diet. We will follow your weight loss progress as well as monitor your vitamin and nutritional levels closely.

To ensure success, we recommend that you see us every three months for the first year and twice a year after that.

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How can I find a support group?

Support groups give patients an excellent chance to talk about personal and professional issues. Most patients learn, for example, that bariatric surgery will not fix existing emotional issues right away or heal the years of damage that morbid obesity might have caused to their emotional well-being. We have support groups in place to assist you with short-term and long-term questions and needs. Ongoing support after surgery helps to achieve the greatest level of success for our patients.

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How to eat post-surgery?

All patients are different, but most should start with liquid-only diets. This ensures that the patient’s new stomach is able to heal properly while also allowing the patient to get used to a new kind of quicker sensation of being full. This also limits the potential for adverse reactions like vomiting or stretching the new stomach pouch.

After subsequent determinations by a doctor, the patient can slowly move from a liquid-only diet to semisolid foods, and eventually to solid foods. At this point, the patient should stick to a diet of three meals a day and a single, healthy snack between each meal per day.

Patients should also stay vigilant regarding hydration, drinking plenty of water.

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How long should patients stick to a liquid diet?

Because the patient’s stomach needs to heal, the general consensus is that a patient should wait about four weeks before consuming solid food after a procedure. This can also help a patient get used to their altered stomach without risking adverse effects.

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What foods should be avoided?

Foods with saturated fats between 12 and 20 grams per serving are not recommended. Sugars, including those from alcohol, should also be avoided. Additionally, gravy, butter or margarine, mayonnaise, and other ingredients that are high in fat and sugar should not be consumed or used to cook with—these high-fat or high-sugar items can lead to dumping syndrome.

Flavored and/or carbonated beverages are also to be avoided, particularly in between meals. Diet versions should also be off limits. Caffeine consumption should be limited until after the patient is able to consume 64 ounces of liquid in the course of a day.

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What type of exercise is recommended?

Aerobic exercise lasting at least 20 minutes is recommended every day. This can include anything from walking to stair climbing. Resistance or weight training is also acceptable for up to four days per week.

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What happens after weight loss surgery?

Though bariatric surgery does not radically alter the body’s ability to absorb nutrition from consumed food, supplements are usually necessary while patients adjust to a new lifestyle after a surgery. Doctors should monitor patient progress to ensure there are no complications and that proper nutrition is being maintained. For the first year, we recommend that patients visit for follow-ups once every three months for the first year, then once every six months thereafter.

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