Life after weight-loss surgery
You may have just started to think about weight-loss surgery. Or you may have already made the decision to have surgery. Weight-loss surgery can help you:
- Lose weight
- Improve or eliminate many health problems
- Improve your quality of life
- Live longer
It is important to understand that there will be many other changes in your life. These include 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 eating healthy foods, controlling portion sizes, and exercising.
As you lose weight quickly over the first 3 to 6 months, you may feel tired or cold at times. You may also have:
- Body aches
- Dry skin
- Hair loss or hair thinning
- Mood changes
These problems should go away as your body gets used to the weight loss and your weight becomes stable. It is important that you follow your doctor's recommendations for eating enough protein and taking vitamins.
You may become sad after having weight-loss surgery. The reality of life after surgery may not exactly match your hopes or expectations before surgery. You may be surprised that certain habits, feelings, attitudes, or worries may still be present, such as:
- 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.
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?
At first, you will feel full very quickly, often after just a few bites of solid food. The reason is that your new stomach pouch or gastric sleeve will hold only a small amount of food soon after surgery. Even when your pouch or sleeve is larger, it may not hold more than about 1 cup (240 milliliters) of chewed food. A normal stomach can hold up to 4 cups (1 liter) 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 a smooth or puréed texture 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 well. These include pasta, rice, bread, raw vegetables, or 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.
- Avoid drinking anything while you are eating, and for 60 minutes before or after you eat. 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 straws because they bring air into your stomach.
Will You Still Need to Think About Calories?
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.
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 keep it off.
You will still need to stop eating when you are satisfied. Eating until you feel full all the time may 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 dietitian will likely tell you:
- DO NOT eat foods that contain a lot of fats, sugar, or carbohydrates.
- DO NOT drink fluids that have a lot of calories or that contain sugar, fructose, or corn syrup.
- DO NOT drink carbonated drinks (drinks with bubbles).
- DO NOT drink alcohol. It contains a lot of calories, and does not provide nutrition.
It is important to get all of the nutrition you need without eating too many calories. Because of the quick weight loss, you will need to be careful that you get all of the nutrition and vitamins you need as you recover.
You will need regular checkups with your doctor to follow your weight loss and make sure you are eating well.
Changes in Your Body
After losing so much weight, you can expect changes in your body shape and contour. These changes may include excess or saggy skin and loss of muscle mass. The more weight you lose, the more excess or saggy skin you will 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. Talk with your doctor about options for reducing the excess skin.
American Society for Metabolic and Bariatric Surgery website. Life after bariatric surgery. asmbs.org/patients/life-after-bariatric-surgery. Accessed April 22, 2019.
Mechanick JI, Youdim A, Jones DB, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21 Suppl 1:S1-S27. PMID: 23529939 www.ncbi.nlm.nih.gov/pubmed/23529939.
Richards WO. Morbid obesity. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 47.
Review Date: 3/22/2019
Reviewed By: Ann Rogers, MD, Associate Professor of Surgery; Director, Penn State Surgical Weight Loss Program, Penn State Milton S. Hershey Medical Center, Hershey, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.