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Life after weight-loss surgery

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You may have just started to think about weight-loss surgery. You may have already made the decision to have surgery. These surgeries can help you lose weight and improve or eliminate many health problems, improve your quality of life, and allow you to live longer.

Yet, it is important to understand that there will be many other changes in your life, including the way you eat, what you eat, when you eat, how you feel about yourself, and much more.

Weight-loss surgery is not the "easy way out." You will still need to do the hard work of dieting and exercising.

Weight-loss surgery can help train you to eat less, but surgery is only a "tool." You still have to make the right food choices.

What does rapid weight-loss feel like?

As you lose weight quickly over the first 3 to 6 months, you may:

  • Have body aches
  • Feel tired
  • Feel cold
  • Have dry skin
  • Have hair loss or hair thinning
  • Have mood changes

The good news is that these problems should go away as your body gets used to your weight loss and your weight becomes stable. It is important that you eat enough protein and take vitamins.

Some may notice themselves becoming sad after having weight-loss surgery. The reality of life after surgery may not exactly match your hopes or expectations. You may be surprised that certain habits, feelings, attitudes, or worries may still be present. Examples include:

  • You thought you would no longer miss food after surgery, and the urge to eat high calorie foods would be gone.
  • You expected friends and family would treat you differently after you lost weight.
  • You hoped the sad or nervous feelings you had would go away after surgery and weight loss.
  • You miss certain social rituals such as sharing food with friends or family, eating certain foods, or eating out with friends.

For others, complications or a slow recovery from surgery or all the follow-up visits may conflict with the hope that everything was going to be better and easier afterward.

How will eating and drinking be different?

After gastric bypass or gastric banding the opening for your new stomach pouch will be very small. Food that is not chewed well can block this opening and may cause you to vomit or have pain under your breastbone.

After sleeve gastrectomy your entire stomach will be smaller and food that is not chewed well can get caught in the sleeve.

You will remain on liquid or puréed food for 2 or 3 weeks after surgery. You will slowly add soft foods and then regular food to your diet. In most cases, you will be eating regular foods by 6 weeks.

At first, you will feel full very quickly, sometimes after just a few bites of solid food. The reason is that your new stomach pouch will hold only a tablespoonful (.5 ounce) of food soon after surgery. Even when your pouch is larger, it will not hold more than about 1 cup (150 mL) of chewed food. (A normal stomach can hold up to 4 cups or 600 mL of chewed food.)

Once you are eating solid food, each bite must be chewed very slowly and completely -- up to 20 or 30 times. Food must be smooth or puréed before swallowing.

  • Each meal should take at least 20 to 30 minutes.
  • You will need to eat up to 6 small meals throughout the day instead of 3 big meals.
  • You will need to avoid snacking between meals, unless the dietitian recommends specific snacks.
  • Some foods may cause some pain or discomfort when you eat them if they are not chewed very well. These include pasta, rice, bread, raw vegetables, meats, and any dry, sticky, or stringy foods.

You will need to drink up to 8 glasses of water or other no-calorie liquids every day.

  • But you will need to avoid drinking anything for 30 minutes before or after you eat food, and when you are eating. Having liquid in your pouch or sleeve will wash food out of your stomach and make you hungrier.
  • Like with food, when drinking you will need to take small sips and not gulp. Some doctors recommend you not use a straw, as it may bring air into your stomach.

Will you still need to worry about calories?

After surgery, your doctor, nurse, or dietitian will teach you about foods you can eat and foods to avoid. It is very important to follow your diet. Eating mostly protein, fruits, vegetables, and whole grains will still be the best way to lose weight and then keep it off.

You will still need to stop eating when you are satisfied. Eating until you are full all the time can stretch out your pouch or sleeve and result in gaining weight back.

You will still need to avoid foods that are high in calories. Your doctor or nutritionist will likely tell you:

  • NOT to eat foods that contain a lot of sugar or other carbohydrates and fat.
  • NOT to drink fluids that have a lot of calories and to avoid drinks that have sugar, fructose, or corn syrup in them.
  • Fruit drinks taste good but have lots of calories.
  • NOT to drink carbonated drinks (drinks with bubbles).
  • NOT to drink alcohol. It contains a lot of calories, but it does not provide nutrition. Avoid it if you can.

Staying healthy

It is important to get all of the nutrition you need without eating too many calories. Because of this quick weight loss, you will need to be careful that you get all of the nutrition and vitamins you need as you recover.

If you have one of the stapled weight loss operations, you will need to take extra vitamins and minerals for the rest of your life.

You will need regular checkups with your doctor to follow your weight loss and make sure you're eating well.

Changes in your body

After losing so much weight, a number of changes in your body shape and contour will likely be present. These changes may include excess or saggy skin and loss of muscle mass. In general, the more weight that you lose, the more excess or saggy skin that you may have. Excess or saggy skin tends to show most around the belly, thighs, buttocks, and upper arms. It may also show in your chest, neck, face and other areas as well. Some people can be helped by seeing a plastic surgeon after their weight loss has stabilized - usually about a year after surgery.

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Review Date: 1/30/2018

Reviewed By: John E. Meilahn, MD, Bariatric Surgery, Chestnut Hill Surgical Associates, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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