After Bariatric Surgery: The First 6 Weeks

After surgery for weight loss, your body needs time to adjust. Once you're ready, you'll be given programs to follow for your nutrition and physical activity. Follow these programs as directed. The success of the surgery depends on the choices you make. You'll need to make lifelong changes in your eating and exercise habits to maintain your weight loss. 

At home

At first, you may have stomach or bowel cramping, or upset stomach (nausea). Tell your healthcare provider if pain or nausea is severe or doesn’t improve with time. Take pain medicines as prescribed for 1 to 2 weeks. To ease back into your daily life, you may be given guidelines like those listed below:

• You may shower within 48 hours.

• You may return to driving once you no longer need pain medicines. This may be up to 3 weeks after surgery.

• You may resume sex in 3 weeks.

• You may return to work in 4 weeks, or as instructed, depending on the type of work you do.

• Don't lift anything over 10 pounds for 3 weeks.

• Ask about birth control. Certain bariatric procedures reduce the absorption of birth control pills (oral contraceptives). It's advised to delay pregnancy for 12 to 24 months after bariatric surgery. This gives the person the time to achieve weight loss and decrease the potential problems caused by post bariatric nutritional deficiencies.

Becoming more active

Activity helps you lose weight after surgery. Start easy, but try to be a little more active each day. You might try walking each day. This not only helps with weight loss, it can also help you recover faster. Other choices include chair aerobics or using a stationary bike. Each person's relationship with physical activity is different. Ask for help from your healthcare provider if you aren't certain what to do or which type of activity is best for you. The long-term goal, which may seem overwhelming at first, is to get to a point where you are doing an average of 30 minutes per day of moderate physical activity. With support and guidance, you can get there.

Working with your healthcare team

Your healthcare team members can help you adjust to changes after surgery. Here’s how:

• Your medical surgical team oversees follow-up care after surgery. Keep all your appointments, and ask any questions you have.

• Your dietitian sets up your new nutrition plan. They can help you plan meals you’ll enjoy. Talk with them if you're having trouble sticking to the required diet.

• Your psychiatrist or psychologist or other mental health provider can help you adjust to change. It may help to talk to someone about your body or other issues. Contact a bariatric surgery support group in your area, or join an online group, such as BariatricPal at www.bariatricpal.com . 

 When to call your healthcare provider

Call your healthcare provider if you have any of the following:

• Fever of 100.4°F (38°C) or higher, or as directed by your provider

• Chills

• A red, bleeding, or draining incision

• Nausea or vomiting that doesn't go away

• Increased pain at an incision

• Pain or swelling in your legs

• Trouble breathing or chest pain

• Symptoms your provider told you to report

• Feeling anxious or depressed

Eating during healing

After surgery, a special diet will help your stomach heal. At first, you'll just drink low-sugar liquids. You might have tea or broth, for instance. As you feel better, you’ll eat low-fat pureed or semisolid food, such as applesauce. When your system is ready, you’ll eat a range of foods in small amounts. Most bariatric surgery programs will recommend 60 to 100 grams of protein per day. To do this, you will need to choose high protein foods and stay away from sugar and starch. If you don’t take in enough protein, you can get weakness and muscle loss. This can cause serious problems. It's also important to stay hydrated. But follow your healthcare providers instructions for when to drink your fluid.

 Possible complications after surgery

Certain problems may happen after surgery, depending on the type of surgery you have. These problems can include:

• Malnutrition. Your body may not be able to absorb all the vitamins it needs. Symptoms include severe tiredness (fatigue), feeling cold, swollen ankles, or excessive hair loss. Take vitamin supplements as prescribed, for life, to help prevent this.

• Dehydration. A smaller stomach means liquids must be consumed in smaller amounts. Not getting enough liquids can lead to dehydration. Symptoms include feeling “dried out” or having dark and little urine. Drink small amounts of water and fluids during the day. Ask your healthcare team for guidelines on getting enough liquids.

• Dumping syndrome. This can happen after gastric bypass procedures. After eating high-sugar foods, you may have weakness, stomach cramps and pain, nausea, sweats, or, in some cases, fainting. Stay away from foods that cause any of these symptoms, such as soda or ice cream.

• Lactose intolerance. You may lose the ability to digest lactose. Lactose is a sugar found in dairy products. Symptoms include cramps, bloating, and diarrhea. Diarrhea may occur 60 to 90 minutes after a meal. Stay away from dairy foods, such as milk and cheese if this happens.

• Gastrointestinal issues. These can include nausea, vomiting, diarrhea, and abdominal pain. These symptoms may be short-term or persistent.

• Psychological issues. Bariatric surgery can lead to emotional and psychological changes, including depression, anxiety, and body image issues.

• Stomal stenosis. This is a narrowing of the connection between the stomach pouch and the small intestine. This can lead to vomiting and difficulty eating.