Life after weight-loss surgery

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 care 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 - 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 are eating enough protein and taking vitamins.

Some may notice themselves becoming sad after having weight-loss surgery. The reality of life after surgery may not exactly match the hopes or expectations present beforehand. 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?

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. Most of the time, 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 of food soon after surgery. Even when your pouch is larger, it will not hold more than about 1 cup of chewed food. (A normal stomach can hold up to 4 cups 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.

  • 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.
  • Each meal will take at least 30 minutes.
  • You will need to eat 6 small meals throughout the day instead of 3 big meals.
  • You will need to avoid snacking between meals.
  • 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 liquids that do not have calories every day.

  • But you will need to avoid drinking anything for 60 minutes before or after you eat food, or when you are eating. Having liquid in your pouch will wash food out of your pouch and make you hungrier.
  • Like with food, you will need to take small sips and not gulp. Do NOT use a straw, since it brings air in 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 full. Eating more after you are full will stretch out your pouch and reduce the amount of weight you lose.

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 fats, sugar, or carbohydrates
  • NOT to drink fluids that have a lot of calories and to avoid drinks that have sugar, fructose, or corn syrup in them
  • 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 gastric bypass surgery, 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 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.

Update Date: 7/1/2011

Updated by: Alex Nagle, MD, Director of Bariatric Surgery, Northwestern Memorial Hospital, Assistant Professor of Surgery, Division of Gastrointestinal & Oncologic Surgery, Northwestern University Feinberg School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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