Bariatric surgery

Bariatric surgery (weight loss surgery) changes the natural digestion process in your body. This surgery is performed on your digestive system to reduce weight by decreasing the amount of food that is absorbed. There are different procedures and types for this surgery. Some of the most common ones include sleeve gastrectomy, roux-en-y gastric bypass (RYGB), adjustable gastric band (AGB), biliopancreatic diversion with duodenal switch (BPD/DS). The doctor will decide on the best and most effective procedure according to your specific conditions.

Medical conditions weight loss surgery is effective for

This type of operation is only recommended in certain cases. If someone has the conditions below, they may be qualified for bariatric surgery.

• People who are obese with a body mass index (BMI) of 40 kg/m²
• Individuals who have a BMI of 35-40 along with severe weight related health problems, such as:
  • diabetes type 2
  • sleep apnea
  • high blood pressure
  • heart disease
  • stroke

Remember that this surgery is not for everyone. Only people who have severe cases of obesity that cannot be improved by diet or exercise can have this operation.

The benefits of bariatric surgery

The most significant benefit of bariatric surgery is the fact that it reduces the odds of death due to the aforementioned health problems. Moreover, this also improves the health problems we mentioned earlier, these include diabetes, blood pressure, hypertension, and sleep apnea. 

How much weight can I lose through bariatric surgery?

• People who undergo gastric bypass surgery or gastric sleeve surgery, if they are committed, often lose 60%-70% of their excess weight after a year or two.
• If you had an adjustable gastric band (AGB) surgery, you are likely to lose about 50% of your excess weight. You may also continue to lose weight years following your surgery.
• Biliopancreatic diversion with duodenal switch (commonly referred to as duodenal switch) helps the patient lose approximately 30% of their excess weight in the first three months, and 70%-80 in a year.

While these numbers are the result of countless studies, you should also ask your doctor about how much you are expected to lose and in how long.

Post weight loss surgery symptoms and side effects

After you have your bariatric surgery, you would normally have some post-surgery symptoms. Here is a list of the symptoms you may experience:

• Fatigue and tiredness
• Mild swelling or bruising
• Anorexia (loss of appetite)
• Nausea, vomiting, and diarrhea (can worsen if you consume sweet meals or juice)
• Being unable to sleep
• Feeling light-headed
• Mild itching and sensations under the skin
• Gallstones that can also cause stomachache
• constipation
• Redness of the surgery scars (protect your scars from any damage and the sun)
• Emotional instability 

Of course, these symptoms do not appear too severely; however, symptoms can also indicate serious risks. These symptoms fortunately do not appear often, as only less than 5% of patients experience them. Inform your doctor in case you have the symptoms listed here:

• Severe swelling, bruises, pain or drainage from the operated spot can be signs of an infection
• Blood in stool
• Shortness of breath
• Blood clots
• A fever of 38 °C (100.5 °F) and above
• Chest pain
• Long-term nausea and vomiting (longer than 12 hours)
• Constant pain that does not go away even with medication  
• Cramps

Be sure to ask your doctor about the post-surgery instructions you need to follow or any other inquiry that you have about your condition. Although symptoms and even pain can be normal, you should definitely tell your doctor or nurse about anything that you are experiencing. Some problems can be easily solved with pain medication, while others may not be so easily dealt with.  

Bariatric surgery recovery process

The recovery process depends on the type of weight loss surgery you went through. If you underwent laparoscopic gastric bypass, you would experience a speedy recovery because the surgeon only makes small incisions in this scenario. That is to say, most patients spend two to 4 days in the hospital and can return to their daily routines after 4-5 weeks. If you had an “open surgery”, however, the recovery time will be longer since the doctor has to make larger cuts.

Furthermore, nurses and your surgeon will monitor you closely during your stay in the hospital. Your vital signs (pulse, blood pressure, heart rate, and tec.) will be kept under check. Doing light exercises and activities such as changing positions in bed, deep breathing, coughing, standing up, walking, and leg movement will enhance the recovery process by increasing blood circulation. This, in turn, decreases the chances of complications such as blood clots, providing you with a safer and faster recovery.

When you are ready to be discharged from the hospital and go home, you will be given instructions about what you should do during your recovery time. They will also give you details about the diet you need to follow. In addition, your home design should be suitable for someone who has just undergone surgery. Is everything easily accessible? Is the bathroom on the first floor? Do you need to make any decoration changes to make the place more convenient? We recommend that you describe your home to the doctor so that they can guide you about the changes you should make or tools you should buy to create an appropriate environment for yourself.      

Diet after bariatric surgery

Diet is one of the most important things to be aware of after your surgery. Your doctor will most likely provide you with some tips about what you should eat and how much. It is worth noting that since your stomach has now become smaller and can only contain one-fourth of what a normal stomach contains, you cannot eat large meals. In case you are a binge eater, try to change that habit; otherwise, you may harm yourself. This means that you now have to eat smaller chunks of food but more frequently. Moreover, try to eat as healthily as possible to help your body receive all the required nutrients.

Taking multivitamin and mineral supplements should also be part of your dietary plan since the surgery makes it more difficult for the body to assimilate nutrients such as iron, calcium, vitamin D, and vitamin B12. 

Within the first few days, your doctor is most likely to recommend a liquid diet (soup and such foods). Then, you can gradually move on to softer foods (soft baked potatoes, for example). Finally, six weeks after your surgery, you can start eating normal food again, provided that they are healthy.

When you do start your normal diet, make sure to chew meticulously to the point where the food becomes like a soft pulp. By doing this, you are making sure the food easily enters the stomach without being blocked and causing you to vomit.

Eating habits that must be avoided

• Drink slowly and do not gulp.
• Do not drink during meals, as it washes the food out of your stomach, causing you to feel hungrier. 
• Avoid snacking between meals.
• Instead of having 3 large meals per day, divide them into 6 smaller parts.
• Do not eat fast, but slowly and carefully.
• Do not forget to stay hydrated. Drink water, not soda. You should drink 7-8 glasses of water (2 liters) every day.

Exercise after weight loss surgery

Exercise is an integral part of the weight loss process. Weight loss surgery alone cannot guarantee that you are going to stay in shape, which is why you should come up with a regular exercise plan. You can also ask a personal trainer to give you a daily schedule. Consequently, exercising helps you burn calories, increase your metabolic rate, and keep your blood sugar in check.

Initially, you should only aim for light exercises, such as walking. Avoid sitting or standing for too long as they may cause the formation of blood clots in your legs. Instead of using the elevator, try the stairs if you can. Do not put too much pressure on yourself, but also try to be as active as you can.

After at least 6 weeks, when you have fully recovered, you should start more challenging activities, like swimming, cycling, jogging, light-weight lifting and etc. Getting a gym membership is also a good idea. Try all kinds of exercises and sports in order to find your favorite. This will make it easier for you to stick to something and continue doing it as a regular activity.

Try to add more strenuous activities to your program or simply do more of your current exercises after a while. It is important to add up to the challenges as your body gets used to them. This assures a steady improvement of your physical health. For example, start with short walks, then add to the distance, and consequently start jogging that distance. After you feel more confident and prepared, you can start other exercises.

FAQ

• Can I get pregnant after weight loss surgery?
  • Yes, you can. In fact, you are more fertile after your surgery. However, We DO NOT recommend getting pregnant soon after your surgery since it can cause complications before, during, and even after the childbirth process. Most surgeons believe it is safe to get pregnant 12-18 months past your operation. Birth control pills are not as effective when you are going through weight change. Therefore, use other means such as condoms and IUD to prevent pregnancy.
• Will the baby be healthy?
  • Yes. In fact, the child will be healthier after the mother’s weight loss. The chances of the child’s developing obesity later on in life will be much slimmer. Similarly, the childbirth process will be safer, decreasing the odds of stillbirths, miscarriages and the need for a C-section.
• Can I get back to work after my bariatric surgery?
  • Not immediately. You can get back to work 1-2 weeks after your surgery. Of course this also depends on the type of surgery you had. This is where your surgeon can help you out with the information relevant to your particular case.
• Is it true that weight surgery results in hair loss?
  • Temporarily, yes. This happens between 3-6 months following your operation. Although the cause of this phenomenon is unknown yet, consumption of protein, minerals, and vitamins will help the hair to regrow.
• Is it safe to drink alcohol after bariatric surgery?
  • It is safe to avoid alcoholic beverages in the six months following your bariatric surgery. When your surgeon permits you to drink alcohol, it is safer to drink low-calorie or zero-calorie alcohols. Furthermore, high-sugar beverages are not recommended because they may interfere with the metabolism and lead to complications.
• Is it ok to smoke after my weight loss surgery?
  • Smoking right after the surgery can lead to severe health problems. It can inhibit and slow the healing process by causing potential lung problems, infections, and messing up with the blood supply that is transferred to the healing tissues. Please, wait at least 3 months before you go back to smoking
• What is the best age for bariatric surgery? Am I in the qualified range?
  • There is no specific answer to this question as every case varies. Ordinarily, this surgery is safer and more beneficial in relatively younger ages than in older people. Of course, the youngest age to be qualified for this surgery is 18, but this may not be the best age as the individual may not be able to comprehend the outcomes of this surgery. Having said that, the patient has to be mentally and physically mature to have this surgery.