The following answers the FAQs regarding what might happen after the surgery:

Do I need to take any medications after leaving the hospital?
What type of diet will I have after the operation?
Can I exercise after the operation?
How much weight will I lose?
Will I ‘overshoot’ and get too thin?





Do I need to take any medications after leaving the hospital?

If you had the gastric bypass operation, then you will have been started on some tablets whilst in hospital, which you will go home on and which you need to keep taking. These consist of vitamin, calcium and iron supplements, to guard against dietary deficiency and a tablet called ranitidine (trade name Zantac), which reduces the amount of stomach acid that you make. All of these tablets can be bought over the counter at the chemists, but the ranitidine is much cheaper by prescription.


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What type of diet will I have after the operation?

If you had the Lap Band procedure, then you will be allowed drinks on the same day of the operation, and may take liquid and soup the following day.

If you had the Gastric Bypass operation, then your new stomach will be X-rayed 1-2 days after the operation, and provided that there are no problems you will then be able to take oral fluids. Immediately after the operation there is some swelling around the new opening between the new small stomach and the intestine, and initially only finely minced or pureed food can leave the pouch. Also, there is always some swelling in the wall of the new stomach pouch, and for that reason the restriction for food is very strict at the beginning; just a few teaspoons of food will make you feel full. Gradually you will be allowed to increase what you eat and will be given thin soup at meal times. Your dietitian will arrange small portions of pureed meals for you. It is essential that only 1-2 teaspoons, in total, of pureed food is eaten at each meal. Too large a portion or food that is too thick may cause discomfort or even vomiting.

With time there is some ‘give’ and the stomach pouch allowing you to eat larger amounts of more solid food, but there will always be a restriction to what you can eat at a mealtime. With time you will get used to how much you can eat at one meal. You will find that hunger pains are a thing of the past and your appetite will be much reduced. You will still enjoy your food but adopting a sensible and healthy eating pattern now will ensure that you get the most from the surgery. Eating in restaurants can be difficult. Most patients find that choosing a starter and a dessert avoids leaving large amounts of food on the plate.

When you are discharged the pureed diet should be followed for a further 4-6 weeks. The exact length of time varies and some people feel comfortable to increase the range of foods earlier than others.

Right from the start it is important to get into good eating habits. From the day of the operation you have to try to clear your mind of what you were able to eat before – things are very different now. We see the post-operative period as a learning period, from a fresh starting point – almost like weaning an infant. It is very important to realize that the body will take time to adapt to the changes of the operation and it is wrong to rush ahead through the different stages, which are described later. It is much better to go slowly and you are much less likely to need to go back a step if you do this. Eating too much or the wrong type of food will cause bloating, discomfort and occasionally sickness, but this can be avoided by following the rules. There is a lot of trial and error and if a particular food does not agree with you, avoid it and try it again a couple of weeks later and it will probably be fine. Long term, food intolerances are very uncommon.

The following points should be kept in mind:

Have an adequate supply of nutrients including protein, fluid, vitamins and minerals.
a) Since you are unable to eat a large amount of food at one time, it is necessary to eat 4-6 meals a day to meet your nutritional needs.

b) Foods high in protein such as milk and meat are very important to aid the healing process after surgery and should be taken in the recommended amounts each day. If you find it difficult to eat pureed meat or fish have more of the protein as milk or dairy products.

c) It is essential to take your vitamin and mineral supplements each day. Take these with water as tea or coffee can reduce the absorption of essential nutrients.

All foods should be an applesauce consistency or pureed to this consistency.
Take fluids between meals only and sip these slowly. You won’t be able to drink a full mug in one go to start with, so have several small cups instead.
Try to drink a pint more fluid than you used to each day to make up for the water contained in food.
Fizzy drinks should be left to go flat before drinking.
Eat slowly and stop eating as soon as you feel full; that extra spoonful might be too much.
If you have problems with a particular food stop eating it for a few days and then try again. Many people find fish and eggs difficult to start with; so don’t worry if you cannot get on with these foods initially. You may find that your tastes change after the operation and you no longer enjoy food that you used to like. Experiment with other foods as you may now like them.
Pureed food can be very bland. After the first few weeks use herbs and spices to make it more interesting.
Do not eat sweets, chocolates or high fat snacks such as crisps as these may cause ‘dumping’ and/or diarrhoea, and will slow down the rate of weight loss.


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Can I exercise after the operation?

A month following your operation you should get into the habit of taking regular exercise such as swimming, brisk walking/jogging, or visiting a gymnasium; aim for at least 30 minutes a day, 3 times a week. It is safe to use toning tables after 6 weeks. You will notice that your ability to exercise improves very rapidly after the surgery. Apart from speeding up the weight loss by burning off more calories, exercise reduces blood pressure and blood cholesterol and improves muscle tone, which reduces the problems of sagging skin. Unfortunately, the operation does not cure the offensive and unkind attitude of some people towards those with a serious weight problem, but as patients get lighter they become less self conscious about their appearance and find swimming or jogging in the park more acceptable whereas before they might have been embarrassed and avoided it. Most people are able to return to work after 2-4 weeks. Driving should be avoided for two weeks after you get home.


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How much weight will I lose?

After the gastric bypass operation, weight loss is initially very swift – most patients will lose a stone a month. This will slow down with time as you approach your target weight. Weight loss after the gastric banding operation is slower, but can be increased by adjusting the band.

Patients are individual people and no two are the same. Of course different patients need to lose different amounts of weight and the dimensions of the bypass are adjusted to take this into account. As a rule of thumb however, most patients will lose about two thirds of their excess body weight in the first year, and about half of the patients will halve their weight after 12-18 months. After about 18 months the weight will probably have leveled off and most people are happy with their weight at this stage. It is possible to lose more weight by a combination of regular exercise and additional dieting usually by reducing high calorie snack foods or fluids rather than reducing the meal size. Unlike ordinary dieting, where weight is regained very rapidly when the diet stops, weight loss after the surgery is more permanent and once lost, weight tends to stay off.


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Will I ‘overshoot’ and get too thin?

This has not been a problem with any of our patients. The operation has been designed to reduce the calorie intake to a level that is adequate to nourish the patient at their correct body weight. The weight will fall until this point is reached, and will then stabilise.


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