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Life After Weight Loss Surgery

It is very important that you adhere to recommended dietary guidelines. The modifications that have been made to your gastrointestinal tract will require permanent changes in your eating habits that must be adhered to for a successful and healthy weight loss. The following are some general dietary weight loss surgery guidelines.

The basic rules are simple and easy to follow:

Immediately after surgery, your surgeon and bariatric team will provide you with special dietary guidelines. You will need to follow these guidelines closely. Many surgeons begin patients with liquid diets, moving to semi-solid foods and later, sometimes weeks or months later, solid foods in small amounts can be tolerated without risk to the surgical procedure performed. Allowing time for proper healing of your new stomach pouch is necessary and important.
When able to eat solids, eat 2-3 meals per day, no more. Protein in the form of lean meats (chicken, turkey, beef, fish) and other lean, low-fat sources should be eaten first. Filling your new stomach up with solid protein helps you have no room for carbs which is the primary method that weight loss surgery works. These proteins should comprise most of the volume of the meal eaten. Foods should be cooked without fat and seasoned to taste. Avoid sauces, gravies, butter, margarine, mayonnaise and junk foods. Avoid foods that are cooked too dry.
Never eat between meals. Do not drink carbonated or sugary beverages, even diet soda, between meals to prevent prematurely stretching your new stomach.
Drink 2-3 quarts or more of water each day. Water must be consumed slowly, 1-2 mouthfuls at a time, due to the restrictive effect of all the operations. Ideally, 64 ounces of liquids of some type should be consumed daily. If your urine is dark, you are not drinking enough liquids.
Exercise aerobically every day for at least 20 minutes (one-mile brisk walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be added 3-4 days per week, as instructed by your medical team which may include the surgeon, registered dietician, and/or bariatric medical specialist.

Please note that the dietary guidelines may be different but pretty similar for each weight loss procedure that is preformed. For more information please contact our dieticians for more specific dietary guidelines who you can meet in person at our Free Information Seminars and regular visits before and after surgery.

Going Back to Work

Many patients return to full before surgery levels of activity within 4-6 weeks after their procedure. Most patients who had a minimally invasive laparoscopic procedure may be able to return to work and normal activity within 2 weeks. Dr. Feng will discuss your options and when your can return to work.

Follow-up testing after Surgery

Life After Weight Loss Surgery There are still long-term effects on nutrition. This is due to the fact that the overall amount of food eaten each day is so small, you may not be able to get all your essential nutrients, including vitamins and minerals from food alone. The gastric bypass even causes malabsorption of certain nutrients. Over time you will need periodic checks for anemia, electrolytes, kidney, liver and thyroid function, cholesterol panel and bone density. Of course, vitamin, mineral and micronutrient levels are checked also, such as vitamin B-1 (thiamine), B-6, B-12, D-25OH, serum folate, and iron levels. Follow-up tests will be conducted every 6-12 months after surgery or as needed, and need to be checked lifelong on an annual basis. As a patient of Dr. Feng, you can enroll in the PAMF EPIC electronic health record system which will automatically and conveniently remind you about which tests to get checked anually long term so you primary care doctor can even order the proper tests. Remember, with the stomach reduced to smaller than the size of a golf ball with or without malabsorption, depending on the type of procedure, deficiencies can occur. Commitment to annual follow-up with Dr. Feng with this testing is required and critical to lifelong healthy living after weight loss surgery.

Exercise after weight loss surgery

When you have a weight loss surgery procedure, you lose weight because the amount of food energy (calories) you are able to eat is much less than your body needs to operate. It has to make up the difference by burning reserves or unused tissues. Your body will tend to burn any unused muscle before it begins to burn the fat it has saved up. If you do not exercise daily, your body will consume your unused muscle, and you will lose muscle mass and strength. Daily aerobic exercise for 20 minutes will communicate to your body that you want to use your muscles and force it to burn the fat instead.

Amount of exercise after weight loss surgery?

Many patients are hesitant about exercising after surgery, but exercise is an essential component of success after surgery. Exercise actually begins on the afternoon of surgery - the patient must be out of bed and walking. The goal is to walk further on the next day, and progressively further every day after that, including the first few weeks at home. Patients are often released from medical restrictions and encouraged to begin exercising about two weeks after surgery, limited only by the level of wound discomfort and mainly focusing on aerobic exercise. The type of exercise is dictated by the patient's overall condition. After 4 weeks, the patient can start the recommended weight and resistance training.

Some patients who have severe knee problems can't walk well, but may be able to swim or bicycle. Many patients begin with low stress forms of exercise and are encouraged to progress to more vigorous activity when they are able.

Can weight loss surgery help other physical conditions?

According to current research, weight loss surgery can improve or resolve associated health conditions.

Condition	Percentage found in preoperative individuals	Percentage cured 2 years after surgery
Diabetes or insulin resistance	34%	85%
High blood pressure	26%	66%
High triglycerides	40%	85%
Sleep apnea	22% in males, 1% in females	40%

Support Groups

There are many weight loss program support groups provided to patients with excellent opportunity to discuss their personal and professional issues. Weight loss surgery will not resolve immediate existing emotional issues or heal the years of damage that obesity might have inflicted on your well being.

Dr. Feng has resources to assist you with short term and long term questions and needs. Dr. Feng has ongoing post-surgical support groups to produce the greatest level of success for our patients. Our behaviorist and psychologist can provide additional psychological support on an individual basis as needed.

The Importance of Support from Friends and Family

The changes in your diet and lifestyle after surgery will last a lifetime. And you'll have a greater chance of long-term success if you surround yourself with people who understand and support your goals.

Things you can do

Help your friends and family members understand why you've chosen a surgical solution. Many people are under the impression that weight loss surgery is an experimental treatment rather than one with more than 50 years of history. Direct them to this web site or others in our Additional Resources section. It's important that they understand that morbid obesity is a disease and that diets don't and didn't work for you.
People who are morbidly obese often report that their spouses, or others close to them, seem to discourage weight loss. These people see your weight as part of your identity. Understand that this is a fear of change. Discuss your reasons for having surgery. They need to know that your health is at stake and you will be counting on them to help you during and after surgery.
Attend support groups in your area or visit them online. Your surgeon's office and team will help you here. Surround yourself with people who share your situation. Ask questions and receive answers in a supportive environment. Form a network to share recipes and exercise tips. It's important for you to know that you are not alone. There are knowledgeable, friendly people available to support and help you.