Jefferson Health

Recovery After Bariatric Surgery

During your first week home, you are encouraged to walk around your house (or outside) often. You will be on a liquid diet as prescribed by the postoperative diet plan. Bottom line: You need to sip fluids all day. While activity is encouraged, you shouldn't be doing any strenuous activity or lifting anything more than about 20 pounds.

Follow-Up Visits

You will be seen in our office in one to two weeks, one month, three months, six months and one year following your surgery. During these visits, we will monitor your recovery and provide additional nutritional counseling. We will also perform routine blood work and any other testing you may need.

When to Call the Office

When you leave the Hospital, we will give you discharge instructions explaining your early postoperative recovery. As a general rule, in the first month following surgery, you should call the office immediately (day or night) for any of the following reasons:

  • Nausea and vomiting
  • Fever greater than 101º Fahrenheit
  • Increased pain
  • Inability to drink
  • Light-headedness
  • Generally not feeling as well as you did earlier in your recovery
  • Any questions or concerns

Changes to Day-to-Day Life

Weight loss surgery represents a major life change and can introduce many issues to your day-to-day life. Our team can talk with you at greater length about what to expect after surgery, but the following provides a high-level overview of impact on:

Diet

Regardless of which procedure you choose, weight loss surgery will help control hunger and make you feel satiated with a much smaller amount of food. The goal is to eat three small (4-ounce or half-cup) meals each day. These meals will be largely protein based with some fruits and vegetables; overall, they should be pretty ordinary foods. Very tough or chewy foods, such as meats and bread, will often give people difficulties. Foods that contain a lot of sugar or carbohydrates should be avoided after gastric bypass surgery, as it may cause dumping syndrome. Occasionally, some people will develop dislikes or problems to very specific foods; these vary from patient to patient.

Supplements

You will need to take a multivitamin and calcium supplement daily. During the rapid weight loss phase, you will also drink protein shakes, which many patients substitute for one of their three daily meals. Although the procedures performed at Jefferson have only a modest effect on absorption of nutrients, your blood work will be checked frequently to identify any additional supplements that may be needed. On average, patients need to take one to two supplements daily in addition to the multivitamin and calcium.

Exercise

The goal of weight loss surgery is to help patients live a healthier, more active life. After recovery from surgery, you should have no physical limitations as a result of the procedure. On the contrary, regular exercise is strongly encouraged because it will improve your weight loss outcome. Most patients lose the physical limitations placed upon them by their weight and are able to do activities and exercise they were not able to do before surgery.

Bowel Habits

This is a very common question and concern for people contemplating weight loss surgery. Just as people have a wide variety of bowel habits before surgery, there are a wide variety of bowel habits afterward, too. Some patients experience constipation, usually from not taking in enough fluids. Others experience loose bowels or gas, which can also be related to diet. However, research regarding the degree of bowel habit changes has shown that these changes do not take away from the positive overall weight loss experience following surgery. In other words, most patients are happy to deal with these changes in exchange for the weight loss!

Nausea and Vomiting

In general, patients who have gastric bypass or gastric sleeve surgeries should not have nausea or vomiting if they are following the prescribed diet plan. Nausea and/or vomiting are most commonly caused by patients eating too fast, too much or too often. Poor food choices can also lead to nausea or vomiting. If this is not the case, then nausea and/or vomiting can be an indication of a problem that needs to be brought to our attention. Occasionally, the opening created by the surgery becomes too small and needs to be dilated with a minor procedure for gastric bypass patients.

Dumping Syndrome

Following gastric bypass surgery, eating foods which have a lot of sugar or carbohydrates should be avoided as it may cause dumping syndrome. This is caused by these foods entering the intestine at a point where they would normally (before surgery) have been broken down already higher in the intestine (which is now bypassed). The body misinterprets how much sugars have been eaten and reacts by sending fluids into the intestine and producing extensive amounts of insulin in the blood. This can cause abdominal cramping or bloating, pain, lightheadedness, clammy skin, generalized weakness, a severe drop in blood sugar and even loss of consciousness. This usually occurs minutes to a few hours after eating.

Alcohol and Tobacco

While we prefer that these be avoided after weight loss surgery, the reality is that they are not. Tobacco use can contribute to the development of an ulcer after weight loss surgery, which is why we strongly recommend avoiding it. The empty calories in alcohol will reduce your total weight loss, which is why we strongly recommend avoiding it. What's more, alcohol's effects can also be dramatically increased after weight loss surgery, with much smaller quantities causing profound intoxication. Extreme caution must be used with the consumption of alcohol after weight loss surgery. In general you should completely avoid all alcoholic beverages for at least a year following surgery.

Hair Loss

Some hair loss can occur during rapid weight loss. This may be due to a mild nutritional deficiency, hormonal changes with weight loss or a combination of the two. We will usually prescribe additional nutrition supplements if hair loss is experienced. The good news is that when the weight loss slows down, the hair loss reverses in almost everyone.

Loose Skin

After massive weight loss, your skin will be looser than it was prior to the weight loss. Your skin's natural ability to snap back to the shape of your underlying body tissue will determine how loose your skin ends up being. Everyone is different. Sometimes, this loose skin can result in rashes or infections. Other times, people just think the skin is too loose.

About a quarter of patients are content with how their skin looks; a quarter think their skin is loose but do not want surgery to remove it; about half of patients express that they think their skin is loose enough to consider removal. Most people do not get secondary surgery because of economic barriers, but about 10 % of all patients have surgery to remove the extra skin. The medical reason to remove the extra skin is the presence of rashes or infections. However, you should know that many insurers consider this to be cosmetic surgery and will not cover it.