We hope you’ve learned a lot from the last few videos we’ve shared…  

This one shares facts about Bariatric Surgery and need to know tidbits!

Exercise

When can I start exercising after surgery?

Right away! To start, you will take easy, short walks while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. If you lift weights or do sports, stay “low impact” for the first month.

Will I have to exercise after the procedure?

For many patients, exercise is important for stress control and appetite control, as well as burning off calories.

Lady running in a park

As we age, lack of activity can lead to being frail or fragile, which is quite dangerous to overall health. Healthy bones and avoiding muscle loss partly depend on doing weekly exercise.

Most patients also think of exercise as something that must be intense and painful (like “boot camp”). Regular, modest activity is far more useful in the long term. Even elite athletes can’t stay at a “peak” every week of the year. Instead, work with your surgeon’s program to find a variety of activities that can work for you. There is no “one-size-fits-all” plan. Expect to learn and change as you go!

Nutrition

Will I have to go on a diet before I have surgery?

Yes. Many insurance companies require patients to be on a weight loss program before qualifying for surgery.

Many bariatric surgeons put their patients on a special pre-operative diet, usually 2 or 3 weeks just before surgery. The reason for the pre-operative diet is to shrink the liver and reduce fat in the abdomen. This helps during the procedure and makes it safer.

Some insurance companies require a physician-monitored diet three to six months prior to surgery as part of their coverage requirement. These diets are very different from short-term diets and usually are more about food education and showing a willingness to complete appointments and to learn.

Silver Heart Bowl Filled of Red Pomegranate Seeds

Will I have to be on a diet after the surgery?

No. Most people think of a “diet” as a plan that leaves you hungry. That is not the way people feel after surgery.

Eventually, most patients get some form of appetite back 6-18 months after surgery. Your appetite is much weaker, and easier to satisfy than before.

This does not mean you can do whatever and whenever you want. Healthier food choices are important for the best results, but most patients still enjoy tasty food and even occasional “treats”.

Is weight loss surgery a ‘cop-out’? To lose weight, should people with obesity just go on a diet and exercise? top

Many people who suffer from obesity find it hard to lose weight and keep the weight off with diet and exercise alone. This is likely due to foods available and genes.

The National Institutes of Health (NIH) Expert Panel stated that, without surgery, long-term weight loss is nearly impossible for those affected by severe obesity. Studies show little long-term success with diet and exercise alone.(3) Weight loss surgeries are effective in maintaining long-term weight loss, in part, because these procedures change the body’s natural responses to dieting which make weight loss so difficult. When a person goes on a diet, their body produces more hormones that cause an increase in hunger and a decrease in calories burned.

This decrease in calories the body burns is more than explained by the decrease in body size. Therefore, there are significant differences between someone who has lost weight by diet and someone of the same size who has never lost weight. For example, the body of a person who reduces their weight from 200 to 170 pounds burns fewer calories than the body of someone weighing 170 pounds who has never been on a diet. This means that in order to maintain weight loss, the person who has been on a diet will have to eat fewer calories than someone who naturally weighs the same.

Weight loss procedures, unlike a diet, also cause biological changes that help reduce food intake. Energy (in the form of food) intake is decreased with surgery by restricting stomach size and limiting absorption. In addition, weight loss surgery changes the production of certain gut hormones (or signals) that communicate with the brain to reduce hunger, decrease appetite, and enhance the feeling of being full. In these ways, weight loss surgery, unlike dieting, produces long-term weight loss.

MORE: Protein Snack Ideas for Bariatric Patients

Pregnancy

When can I get pregnant after weight loss surgery?

Most groups advise waiting 12-18 months after surgery before getting pregnant.

Most women are much more fertile after surgery, even with moderate weight loss.

Birth control pills do NOT work as well in patients who are overweight. Birth control pills are not very reliable during the time your weight is changing. For this reason, having an IUD or using condoms and spermicide with ALL intercourse is needed. Menstrual periods can be very irregular, and you can get pregnant when you least expect it!

Will the baby be healthy?

Yes.

After surgery, there is much less risk of experiencing problems during pregnancy and during childbirth. There are also fewer miscarriages and stillbirths than in women with obesity who have not had surgery and weight loss.

Kids born after mom’s surgery are LESS at risk of being affected by obesity later, due to the activation of certain genes during fetal growth. There is also less risk of needing a C-section.

Lifestyle

How long after weight loss surgery will I have to be from work?

After surgery, most patients return to work in one or two weeks.

Will I lose my hair after surgery?

Some hair loss is common between 3 and 6 months following surgery but is almost always temporary.

The reasons for hair loss are not totally understood. Even if you take all recommended supplements and meet protein requirements, hair loss will be noticed until the follicles come back. Adequate intake of protein, vitamins, and minerals will help to ensure hair re-growth and avoid longer term thinning.

Will I need to have plastic surgery after weight loss?

Some patients may choose to have plastic surgery, but this depends on many factors.

Do most people who have weight loss surgery regain their weight?

No. A small number of patients can regain their weight but the vast majority lose significant weight and keep this weight off.

More than 95% of patients will successfully lose half of their extra body weight or more after surgery for weight loss. (1) Roux en Y gastric bypass patients, for example, on average lose approximately 70% of their extra body weight initially, and 2 years or more after surgery will regain approximately 5% of their extra body weight. (2) Compared to these results, patients who attempt weight loss without surgery, on average, are able to lose little weight and may gain weight in the long term. (3)

Vitamins & Medications

Can I go off some of my medications after weight loss surgery?

Many patients are able to stop using some medications.

Will I have to take vitamins after surgery?

You will need to take a multivitamin for life.

You may need higher doses of certain vitamins or minerals, especially Iron, Calcium, and Vitamin D. You will also need to have at least yearly lab checks. Insurance almost never pays for vitamin and mineral supplements but usually does pay for labs. You can pay for supplements out of a Flex medical account.

Do weight loss surgery patients have serious health problems caused by a vitamin deficiency?

As long as patients take their appropriate vitamins, it is rare to have health problems from vitamin deficiency.

Weight loss surgery can lead to reduced amounts of vitamins and minerals because people eat less and may absorb less in the intestines. Weight loss surgeries have different effects on vitamins and minerals based on how much change in absorption they cause. Deficiencies in vitamins, minerals, and protein can negatively affect health causing:

  • Fatigue (feeling tired)
  • Anemia (low levels of red blood cells that carry oxygen through your body)
  • Bone and muscle loss
  • Impaired night vision
  • Low immunity (your body’s ability to stay healthy)
  • Loss of nerve function (can affect your senses such as touch, taste, and smell)
  • Mental function deficits (changes how clearly you think)

Fortunately, nutrient deficiencies following surgery can be easily avoided with a good diet and the use of supplements including vitamins, minerals, and sometimes protein supplements. Before and after surgery, patients are advised of the appropriate diet and vitamin supplement needed. Most weight loss surgery programs also require patients to have their vitamins and minerals checked on a regular basis after surgery.

Nutrient deficiencies and any associated health problems are preventable with monitoring and patients following diet and supplement (vitamin and mineral) recommendations. Health problems due to deficiencies usually occur in patients who do not regularly follow up to monitor healthy vitamin and mineral levels. Be sure you stay in touch with your weight loss surgery team for the best results.

Mental Health

Is obesity caused by food addiction, similar to alcoholism or drug dependency?

“Food addiction” as a cause of obesity is extremely rare.

Does weight loss surgery increase the risk of alcohol abuse?

There is a small group of patients after weight loss surgery who have a problem with alcohol abuse. Most of those people, but not all, already had experiences with alcohol abuse before surgery.

Does weight loss surgery increase the risk of suicide?

After surgery, most patients have improved mental health but there may be a small increase in the risk of suicide. This is why patients are required to have a mental health screening before surgery.

People affected by severe obesity who are seeking weight loss surgery are more likely to suffer from depression or anxiety and to have lower self-esteem and overall quality of life than someone who is of normal weight. Weight loss surgery results in significant improvement in mental health for the majority of patients.

However, studies have found a small but significant increase in suicide following weight loss surgery. (7, 8) In some cases, these may have been patients with undiagnosed mental disorders, and in others, patients may have experienced major life stressors that can increase the risk for suicide, but in rare cases, the suicides are unexplained. For this reason, comprehensive bariatric programs require psychological evaluations prior to weight loss surgery. Many programs have therapists available for patient counseling after surgery. In addition, if a patient sees a psychologist or psychiatrist before surgery, they should continue seeing them after surgery.

Risks

Is the chance of dying from weight loss surgery more than the chance of dying from obesity?

No. Weight loss surgery is very safe and decreases the chance of dying from obesity. In fact, weight loss surgery is safer than removing the gallbladder or having a knee replacement.

A recent study of 209,116 patients found the risk of death from weight loss surgery was 0.16% or approximately 1 in 600. (4) This rate is considerably less than most other surgeries, including gallbladder and hip replacement surgery. Large studies find that the risk of death from any cause is considerably less for patients after weight loss surgery than for those who have severe obesity and have never had the surgery. Patients who have weight loss surgery have a reduction in their risk of death by 40%. Death related to diabetes is reduced by more than 90% and from heart disease by more than 50% for patients after weight loss surgery. (3) The benefits of weight loss surgery far outweigh the risks. As with any serious surgical operation, the decision to have weight loss surgery should be discussed with your surgeon, family members, and loved ones.

Choosing A Doctor

It’s important to choose a doctor and facility that’s knowledgeable, experienced and trusted in performing these procedures effectively.  The pre and post-surgery care are just as important as the surgery and Dr. Joseph and his staff are trained, experienced, and ready to help you discover the quality of life you desire!   

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