Knowing What to Expect and Access to Success

The information provided herein is to give you a general idea of what you may encounter, experience or need to address after you have had bariatric surgery. This information is not meant as an absolute nor is it an indication that you will experience any of the information outlined below. Any questions, concerns or issues are to be addressed directly with our office and this informtion does not replace a consult or medical review by our surgeons.

Information below was compiled from WedMd and the Consumer Guide to Bariatric Surgery websites. To read more please visit their respective website.

webmd after surgeywls-logo1Obesity affects more than 60 million Americans. Obese people often suffer serious health problems and have higher rates of heart attacks, strokes, diabetes, and cancer. For severely obese people who can’t lose weight any other way, weight loss surgery can quite literally be lifesaving.

But weight loss surgery is no quick fix. To be successful, surgery must be followed by lifelong changes in eating and behavior. And weight loss surgery, like any major surgery, carries risk. Studies also suggest people undergoing surgery for weight loss live longer than people of similar weight who don’t have surgery, and 95% of people report an improved quality of life.

Potential Problems After Weight Loss Surgery

Most people experience no serious problems after weight loss surgery though 10% do have minor complications. Less than 5% experience serious (potentially life-threatening) complications. These % are substantially less when performed by a Center of Excellence designated bariatric surgical practice.

  • Wound infections can happen up to three weeks after surgery. Symptoms include redness and warmth, pain, or thick drainage (pus) from the surgical wound. Wound infections require antibiotics and sometimes further surgery
  • Constipation is common after weight loss surgery. Liquid cathartics like mineral oil can help. Avoid granular fiber (Metamucil or psyllium), which can cause obstructions.
  • Bleeding in stool, or black stools, can be serious. Let your doctor know about this immediately, or go to an emergency room.
  • Blood clots to the lungs, called pulmonary emboli, occur less than 1% of the time. They are the most common cause of death after weight loss surgery. Blood clots can usually be prevented with blood thinning medicines and frequent activity.
  • Leaks in the new connections made by the weight loss surgery are rare, but serious. They usually occur within five days of the surgery. Abdominal pain and feeling ill are common symptoms — these should prompt a call to your doctor.
  • Gallstones commonly occur with rapid weight loss. Up to 50% of people will develop gallstones after gastric bypass surgery and these are usually harmless. However, gallstones can cause nausea, vomiting, and abdominal pain, requiring surgery. About 15% to 25% people require gallbladder removal after gastric bypass surgery.
  • Dumping syndrome occurs after eating high-sugar meals after weight loss surgery. Sodas or fruit juices are common culprits. The sugary food rushes through the stomach and can cause nausea, vomiting, and weakness.
  • Excess skin may need to be removed after rapid weight loss. This requires additional surgery.

Nutrition After Weight Loss Surgery

Weight loss surgery causes significant changes in how the body absorbs food. It becomes harder to absorb certain nutrients, including:

  • Iron
  • Vitamin B12
  • Folate
  • Calcium
  • Vitamin D

Up to half of patients undergoing “roux-en-Y” gastric bypass surgery experience some vitamin deficiency. Anemia (a low blood count) is also common. Most of these vitamin deficiencies can be reduced or prevented. Taking a “one-a-day” multivitamin may not be enough, though. Your physician can check the levels of nutrients in your blood. Many people will require supplements of specific nutrients, like iron or vitamin B12.

Lifestyle Changes After Weight Loss Surgery

Weight loss surgery can produce dramatic results. But the gains from losing weight are not automatic. The process requires permanent lifestyle changes to be successful.

  • Eating small frequent meals. The small stomach created by weight loss surgery can only hold so much. Eating large meals can cause problems. Many people with obesity are “binge eaters.” Adapting to eating smaller meals can be a challenge.
  • Committing to nutrition. Serious malnutrition occurs easily in weight loss surgery patients. Avoiding it means taking a new approach to diet and nutrition. A dietitian can help create a plan.
  • Exercise . People who exercise after weight loss surgery are less likely to regain weight. Exercise can often be easier after substantial weight loss. Many severely obese people are not used to exercising regularly.

Many weight loss surgery centers offer behavioral counseling programs. These can help people make a true lifestyle change through fitness before and after weight loss surgery.

Coping With Emotional Changes After Bariatric Surgery

Some people who opt for gastric bypass surgery, gastric sleeve surgery, adjustable gastric banding or other types of bariatric surgery may be under the impression that it will cure their obesity forever, improve their relationships and solve all of their problems. Bariatric surgery is not a magic bullet or a panacea for what is wrong with your life, it is just a tool to help jumpstart your weight loss journey.

  • Preparing yourself for some of the psychological hurdles that may arise as you begin to adjust to your new body and your new life may help you cope with some of the physical and mental ups and downs that will occur along the way.
  • Here are some helpful tips from our advisor Jacqueline Stark Odom, PhD the director of psychology at the Beaumont Weight Control Center of Beaumont Hospital in Royal Oak, Michigan.

Get to Know Yourself After Surgery

It is common for overweight people to disconnect from their bodies. Some avoid looking at their bodies and many withdraw from life. Once thinner, some people still view themselves as obese. Adjusting to your new body size can be difficult, especially if you have spent years thinking of yourself as a fat person. Give yourself time. In a sense, it is like getting to know anew body.

  • Exercising more may help you develop a healthier body image. Support groups may also help as you struggle to accept the new, thinner and healthier you.

Set Realistic Expectations

Losing weight will improve your overall quality of life, but it will not dramatically improve your marriage/relationships. If your marriage was rocky before your surgery, most likely it will still be rocky after your bariatric surgery. That said, it may improve your sex life, which can help revive or add some spice back into stale relationships.

Keep Your Weight Loss in Perspective

Initially, you may feel like you are ‘wasting’ away.  This can be unsettling. You may begin to worry that the weight loss will never stop and you will be at risk for serious physical complications as a result.

  • After years of fighting the battle of the bulge unsuccessfully, this dramatic weight loss may also be quite energizing and empowering. It is often called the honeymoon phase. You may feel that the battle has been won forever. This can set you up for depression down the road if you do regain weight. What further complicates this is that those who experience weight regain after bariatric surgery often feel shame and humiliation, preventing them from seeking professional help for their depression.
  • Keep your weight loss in perspective, stay committed to the dietary and lifestyle changes needed to maintain your weight loss, and if you hit a roadblock or plateau, talk to your bariatric surgeon.

Avoid Addiction Swapping

You may feel a sense of loss after bariatric surgery. Food was a very important and central part of your life. You likely spent hours planning, acquiring and thinking about food. This food obsession consumed your life. You may have used food to comfort yourself, to provide an activity, as a reward or to relieve stress after an exhausting day.

  • Food may have also been an integral part of your social life. How can you attend a party or go out to lunch with colleagues now that you can’t eat the way you used to?
  • Bariatric-surgery regret may also occur. You may feel sorry for yourself that you can no longer eat or enjoy your favorite foods, leading to questions of whether having the surgery was the right decision.
  • Alcohol use, drug use and even gambling are other issues that may come up after bariatric surgery. The concept of addiction swapping occurs when alcohol or drug use takes the place of food. Being forewarned is being forearmed. If you notice addiction swapping occurring, seek help.

You must also find new ways to enjoy yourself in social situations. Consider taking a power walk with a colleague at lunch instead of hitting an all-you-can-eat buffet. For other tips on how to socialize without sacrificing your waistline, check out our article on avoiding holiday weight gain here.

Keep Your True Friends Close

Make new friends, but keep the old? Not so fast. You may need to evaluate some of your relationships after bariatric surgery. Some of your old friends may not provide the kind of support and encouragement that you need. The still-overweight binge buddies may try to sabotage your success by making negative comments or encouraging unhealthy eating. Establishing a healthy support system is crucial to long-term success after bariatric surgery.

Watch Out for Disordered Eating

If you have had a weight problem for most of your life, you may find the notion of developing an eating disorder laughable, but you are at risk. People who have bariatric surgery sometimes develop the type of disordered eating that can turn into an eating disorder such as bulimia or anorexia.

  • A common post-surgical effect is vomiting caused by eating the wrong food too quickly and not chewing thoroughly. This may become problematic if you begin to habitually rely on vomiting to get rid of certain foods and prevent weight gain.

Chewing and spitting out food is another unhealthy habit that may develop. Unable to fully indulge their old eating habits, some people may want to at least taste the food that once provided so much pleasure. Such behaviors may seem harmless, but can develop into serious eating disorders that may rob you of your quality of life just as your obesity did. If you are showing signs of an eating disorder, discuss it with your doctor. Help is available.

Consider Post-Bariatric Body Contouring Surgery

Most often there is an increase in self-esteem after bariatric surgery, but massive weight loss can result in a stretching or loosening of skin, mostly around the abdominal area. Many people don’t like the way their body looks. Post-bariatric body contouring surgeries can help improve overall appearance and self-esteem.

Reclaim Your Health, Your Body… Renew Your Life