Post Surgery Nutrition and Weight Management
The changes made to your gastrointestinal tract will require permanent changes in your eating habits that must be followed for successful weight loss. Post-surgery dietary guidelines may vary and will be determined by your bariatric surgeon. You may hear about post-surgery guidelines different from the ones you receive. It is important to remember that these guidelines will be different depending on the surgeon and type of procedure. What is most important is that you follow the guidelines given to you by your surgeon. The following are some of the generally accepted dietary guidelines:
- When you start eating solid food, it is important to chew your food thoroughly and eat very slowly. Wait two to three minutes after swallowing before putting the next bite of food in your mouth. You will not be able to digest steaks or other chunks of meat if they are not ground or chewed thoroughly
- Don't drink fluids while eating. They will make you feel full before you have eaten enough food. Fluids consumed with meals can cause vomiting and dumping syndrome, and can lead to feeling hungry sooner after a meal
- Don't eat desserts and other items with sugar if they have more than 3 to 5 grams per serving size
- Avoid carbonated drinks, high-calorie nutritional supplements, milk shakes, foods high in fat, and foods that have no nutritional value
- Avoid alcohol
- Limit snacking between meals
Weight Management After Surgery
Bariatric (weight loss) surgery is meant to help you keep off excess body weight for life. Maintaining weight loss means a dedication to a new lifestyle—finding new ways to deal with food, get exercise and even relate to other people.
Following surgery, your body will give you signals to stop eating before you take in extra calories that would cause your excess body weight to return. It's what you do with these signals that counts. When you take on new habits and truly stick to them, you can achieve lasting weight loss without dangerous weight loss/weight gain cycles. At least two-thirds of patients who have gastric bypass surgery are able to keep off at least 50 percent of their excess weight for 10 years or longer.
Your surgeon, nutritionist and psychologist will each be involved in providing you with ongoing support following your procedure. The Rochester General Bariatric Center also offers free support groups where you can share your experiences, insights and concerns with other patients as you lose fat, gain muscle and begin to adopt your new lifestyle to keep the weight off for good.
Frequently Asked Questions on Diet, Nutrition and Weight Management
How much food will I be able to eat following surgery? How often will I be able to eat?
Most patients are instructed to eat 1/4 cup, or 2 ounces, of food. As time goes on, you can eat more (as instructed by your medical team). Most people can eat approximately 1 cup of food after a year or more following surgery.
What could happen if I don't follow one or more of the dietary guidelines?
The guidelines are designed to improve the chance of long-term success in weight loss. If you don't follow the guidelines, you may not lose or maintain the loss of the estimated 70 to 90 percent of excess body weight. You may also experience complications such as vomiting, diarrhea or malnutrition after surgery.
How soon will I be able to walk?
Soon after surgery, doctors will require you to get up and move around. Patients are asked to walk or stand at the bedside the night of surgery and take several walks the next day and soon after. Upon leaving the hospital, you may be able to care for all your personal needs, but you will need help with shopping and lifting, and with transportation.
How soon can I drive?
You should not drive until you have stopped taking medications (associated with surgery) and can move quickly and alertly, which usually happens one to two weeks after surgery.
When can I go back to my normal activity level?
Your ability to resume presurgery levels of activity depends on your physical condition, the nature of the activity and the type of bariatric surgery you had. Many patients return to normal levels of activity within six weeks of surgery.
Should I use birth control?
It is strongly advised that women of childbearing age use the most effective forms of birth control during the first 16 to 24 months after bariatric surgery.
Is there a difference in the outcome of bariatric surgery between men and women?
Both men and women generally respond well to this surgery. In general, men lose weight slightly faster than women do.
Why is exercise so important?
When you have bariatric (weight loss) surgery, you lose weight as the amount of food energy (calories) you can eat becomes much less than your body needs. Your body has to make up the difference by burning unused fat or muscle tissue. Your body will tend to burn any unused muscle before it begins to burn the fat it has saved up. Without daily exercise, your body will burn unused muscle, and you will lose muscle mass and strength. Daily aerobic exercise for 20 minutes will tell your body to use your muscles and force it to burn the fat.
How much exercise is needed after bariatric (weight loss) surgery?
Exercise is an important part of success following your bariatric surgery. Exercise will actually begin the afternoon of your surgery. You must be out of bed and walking, and the goal is to walk farther every day after that, including the first few weeks at home. You may be encouraged to begin exercising about two weeks after surgery. The type of exercise depends on your overall condition and will only be limited by your discomfort. 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 move on to more demanding activity when they are able.
Why is it important to drink so much water?
When you are losing weight, there are many waste products to eliminate, mostly in the urine. Some of these substances tend to form crystals, which can cause kidney stones. A high water intake protects you and helps your body efficiently rid itself of waste, promoting better weight loss. Water also fills your stomach and helps create a feeling of fullness. If you feel a desire to eat between meals, it may be because you did not drink enough water in the hour before.
What is dumping syndrome?
Eating simple sugars (such as sugar, honey and corn syrup), high-fat foods or other small-particle foods can cause dumping syndrome in patients who have had gastric bypass surgery. This occurs when these products, which have a small particle size, are "dumped" from the stomach into the intestine at a rapid rate. Water then is pulled into the intestine from the bloodstream to dilute the sugar load. This flush of water causes symptoms that can include:
- Rapid heart rate
- Hot flashes
- Clammy skin
Some individuals experience some or all of these symptoms after eating more than 3 to 5 grams of sugar, alcohol sugar or greasy foods, while others can handle greater amounts.
Though the symptoms are unpleasant, dumping syndrome can be a helpful condition. Some patients will avoid sugar because of the very unpleasant symptoms it can cause. Dumping syndrome generally occurs 10 to 30 minutes after eating, and the symptoms can last for 30 minutes to two hours.
The best treatment is prevention by avoiding foods that cause dumping syndrome. If you have dumping syndrome, lie down for a short while to lessen the symptoms. Dumping syndrome is a positive side effect of the surgery; it helps you learn to eat healthy!