After Weight Loss Surgery

  • What can I expect after weight loss surgery?
    • After gastric bypass, most patients can expect to lose 60 percent to 70 percent of their excess weight within the first year. Sixty percent to 70 percent of patients can expect to maintain their weight loss long term.
    • After the gastric sleeve, approximately two-thirds of patients can expect to lose 30 percent to 50 percent of their excess weight within the first year.
    • After gastric banding, approximately two-thirds of patients can expect to lose 50 percent to 60 percent of their excess weight in the first two years.

    Most obese people have medium-to-large body frames (bone and muscle). Reaching a so-called "ideal" body weight is unrealistic, and may even be dangerous. Fortunately, most people look and feel terrific at a 60 percent loss of excess weight. More importantly, they are much healthier.

    Most patients experience significant improvement or completely resolved obesity-related medical conditions, such as high blood pressure, diabetes and sleep apnea. All of these factors help to increase self-esteem and improve quality of life.

    Remember, though, that obesity is a complex problem, one that is not cured solely by an operation. Keeping the weight off requires ongoing dietary, exercise and behavioral changes, as well as long-term participation in the program.

  • Recommended diet and exercise after weight loss surgery include:
    • Making the main source of nutrition protein-containing foods, fruits, and vegetables.
    • Eating and drinking very slowly (small bites and sips).
    • Separating liquids from meals (do not drink for at least 30 to 45 minutes after each meal).
    • Drinking at least 64 ounces of water every day
    • In addition to the water, sugar-free, caffeine-free, non-carbonated beverages may be used.
    • Avoiding concentrated sweets and high fat foods.
    • Taking daily supplements of multivitamins, calcium citrate, vitamin B12, protein and iron (generally for menstruating women ).
    • Slowly increasing physical activity, beginning with walking immediately following surgery.
    • Maintaining regular follow-up with your surgeon and dietitian.
    • Attending support group meetings.
  • Eat frequent smaller meals instead of fewer larger meals

    Diet changes after weight loss surgery can be a challenge, but it cannot be overemphasized that, in order to avoid stretching the pouch, it is better to consume frequent small meals (4-5 times per day) than to consume fewer large meals. If patients consume more food than their pouches were meant to hold, the pouch could stretch, which will result in weight gain.

    In gastric bypass patients, the staple line can pop open under pressure from excess food with serious or even deadly consequences.

    Healthy snacks, such as cheese sticks, carrots or celery can be consumed between meals when hungry. Patients can maintain their small pouch size indefinitely by consuming frequent smaller meals.

  • Achieving Weight Loss Goals

    Here are some suggestions to help patients who have undergone weight loss surgery maximize chances for long-term success:

    Be prepared to make major, permanent changes in dietary, behavioral and social habits.

    For example, if cravings for carbohydrate-rich foods (such as bread, rice, and pasta) or sweets (such as candy and ice cream) caused you to consume large amounts of these items, make a decision to get rid of these types of food from your home.

    Family must be supportive of your decision.

    It is often difficult or impossible to "prove" your will power to overcome the temptation of eating unhealthy foods when these are within your reach. If depression played a factor in eating large amounts of food, seek professional help to change that behavior. Anything less than total commitment leads to a high likelihood of failure.

    Demonstrate a strong motivation or commitment to modify eating habits and lifestyle.

    Even after successful surgery and significant weight loss, some patients ultimately regain some, most or all of the lost weight. A medical evaluation usually reveals pouch enlargement from overeating and/or unwise dietary choices. For these reasons, patients will usually not be considered for surgery if they do not demonstrate a strong motivation or commitment to modify their eating habits and lifestyle.

  • Diet Changes After Weight Loss Surgery

    Physicians recommend well before weight loss surgery that patients change their diet to include only the following four food groups:

    • Protein-rich foods, such as meat, fish, cheese, or soy-based products like tofu
    • Vegetables
    • Fruits
    • Small amounts of high-fiber starches, such as whole wheat wraps or bread

    If food does not fit into the four categories, avoid it. For example, muffins, bagels, French fries, donuts, candy, rice, pasta, or potatoes do not qualify as part of the four food groups above.  Also, beverages can't contain sugars or calories. Fruit juice consumption is not recommended.

    "Dieting" usually means a temporary change in what someone eats. Patients must make a permanent change in how and what they eat. 

    Weight loss surgery is meant to help limit food intake by reducing feelings of hunger. Patients must be responsible after the surgery to consume fewer calories than they burn to lose weight. Dietary restrictions after surgery often will appear to be more rigorous than any other dietary program tried in the past.