Updated February 2021 | Written by the Public Education Committee | En español
Obesity is a disease that can be difficult to treat and is related to many other medical problems. Treatment for obesity goes beyond a quick diet or surgery. Patients should expect to have a new lifestyle that combines healthy eating, exercise, and regular visits to healthcare providers. This approach will offer the best chance for success to prevent weight regain and return of medical problems.
Diet
- Stay hydrated! Drink 64 ounces of fluid or more each day
- Be sure to take 60-100 grams of protein per day
- Immediately after surgery, patients start with a liquid diet and will advance eventually to solid foods
- Avoid foods with high amounts of sugar and starch
Immediately following surgery, patients will be on a special diet explained by their bariatric surgery team. Most patients will start out on a liquid diet for some weeks, then will slowly start to take soft foods, and then eventually solid foods. Soon after surgery, working to drink plenty of fluids is very important, but can be difficult. Patients will need to drink 64 ounces of fluids or more to avoid nausea, kidney problems, constipation, and fatigue.
In addition to staying hydrated, patients will need to focus on how much protein they take in. Most bariatric surgery programs will recommend 60 to 100 grams per day, depending on the patient. This will mean focusing on high protein foods and avoiding foods with high amounts of sugar and starch. Patients that don’t take in enough protein can experience weakness and muscle loss, and this can cause serious problems.
Vitamins and Minerals
- After weight loss surgery, patients will need to be on vitamin and mineral supplements for life
After any weight loss surgery, patients will need to take over the counter vitamins and minerals for life. Each bariatric surgery program will instruct patients on how much to take. These typically include: a multivitamin, Vitamin B12, Calcium, Vitamin D, and Iron. Some patients will need chewable vitamins, but some can take pills if tolerated. Patients who do not take vitamins every day for life can suffer sever and even life-threatening medical problems due to low vitamin and mineral levels.
Exercise
- Exercise is encouraged and can help maintain weight loss long-term
After weight loss surgery, patients often feel they have more energy and may want to exercise. Walking frequently, starting within just a few hours after surgery, can help patients recover faster. Each patient will be different and should check with their surgeon before they start intense exercise, but once this is started, it should be done with the goal on average to 30 minutes per day of moderate exercising. Exercise will also help keep the weight loss off when it becomes a habit.
Medications
- After weight loss surgery, many patients have their medications decreased or stopped by their doctor
- After surgery, some medications may be changed to liquid or chewable forms for a period of time
Many bariatric patients are already taking several medications for their medical problems. After surgery, patient will often be able to be taken off certain medications or their dosages will be decreased. These decisions will be made with the patient’s primary doctor and their surgeon. Some patients will need different forms of medications if they are taking extended-release drugs, and some will need adjustments in dosages very early after surgery. Changes such as liquid or chewable medications may be needed, and these should be done under the direction of a doctor or pharmacist. Many patients will be on some form of anti-acid medication for a period of time after surgery.
Smoking and Alcohol
- Most surgeons will require patients to quit smoking prior to weight loss surgery
- Alcohol use after weight loss surgery can cause serious problems
Patients who have chosen to undergo a major surgical procedure to make themselves healthier need to quit smoking for the rest of their life. However, quitting can be very difficult and primary doctors and surgeons can assist by giving tools to help patients stop smoking. Most bariatric surgery programs will require patients to stop all nicotine products before surgery. This is because tobacco use can cause multiple problems besides just lung cancer. Nicotine use worsens the body’s ability to heal from surgery, and puts patients at risk for heart attack, pneumonia and blood clots immediately after surgery.
Alcohol use after bariatric surgery can have serious consequences. Alcohol is absorbed more quickly into the blood stream after surgery, and bariatric surgery patients will have higher levels of alcohol in their system for a longer period of time after drinking compared to before surgery. These and other factors can lead to an increased risk of alcoholism in bariatric surgery patients.
Pregnancy
- Female patient should avoid pregnancy for 12 to 18 months after weight loss surgery
- Weight loss surgery often can help patients become pregnant
Female patient should have a birth control plan before surgery and avoid pregnancy for 12 to 18 months after surgery. In order to reach their lowest possible weight and ensure that they have adequate nutrition should they want to become pregnant. In addition, bariatric surgery patients who had problems getting pregnant before can find that they have a much easier time after surgery. This can happen even in women who weren’t having periods before surgery.
Struggles with Weight Loss and Long-Term Follow Up
- Obesity is a long-term disease and even after surgery, patients need regular follow-up
Early after surgery, patients will follow up every few months for the first year. They should have yearly visits with a bariatric specialist for life. These are important visits, since obesity is a chronic disease, and can continue or even return after surgery. Additional treatment- with weight loss medications, advice on lifestyle changes, and even more surgery can be part of long-term follow up.