Life After Weight-loss Surgery

You will be seen frequently in our clinic by the surgery team

• Gastric bypass patients are scheduled to visit 2-3 weeks after operation, and then at 3 months, 6 months, 1 year, and annually thereafter. Patients continue to receive guidance about diet and exercise, and have nutritional follow up with laboratory tests.
• Gastric band patients are seen 2 weeks after surgery and every 4 weeks thereafter until the band is properly adjusted (usually a period of 3-9 months), and then every 3-6 months until weight and health issues stabilize. Patients receive continuing guidance regarding diet and exercise, and have careful medical and nutritional follow up.

Support groups

Support groups are open to individuals at any step in the process. For those who have undergone gastric bypass or banding; attendance is strongly encouraged. We cover a variety of topics, from nutrition and cooking to exercise and plastic surgery, with frequent guests from these disciplines.

• Meetings are held each month in the evening at a convenient location, call for times and locations, as they may change.

Nutritional

While there are a number of similarities with regard to nutrition after gastric banding and gastric bypass, there are important differences.

What both groups of patients have in common:

• Each must learn the importance of eating nutritious foods including properly prepared lean meats, fruits and vegetables.
• Foods may be eaten fresh in the case of fruits and vegetables, but all foods should be prepared with as little added sugar, fat and salt as possible, and should not be fried.
• Both groups should avoid bagged, boxed, packaged and processed foods such as chips, cookies, and most pre-prepared meals.
• Patients should avoid all empty calories, including liquids and the majority of soft foods with calories (with exceptions for supplements and low fat/no sugar added dairy products).
• Liquids may have to be consumed primarily between meals (this is a must for band patients).
• Portion sizes will be much smaller than before surgery, and food will have to be cut up into small pieces and chewed well.
• Some foods may be difficult to tolerate including whole meats such as steak, sticky foods such as rice, and most kinds of bread.

Gastric bypass patients:

• may find lean meats are particularly difficult to swallow, so protein supplements are recommended, especially during the first several months after surgery.
• often experience “dumping syndrome” after eating sweets, which includes abdominal symptoms and shakiness, so foods and drinks high in sugar, including non-diet sodas or juices, should be avoided.
• do not absorb all of the calories, vitamins and minerals they eat, so a daily multivitamin, calcium and vitamin D are a must, with some patients requiring iron supplements as well; regular laboratory tests ensure proper nutrition.

Adjustable gastric band patients:

• find the feeling of fullness after eating is important in helping control appetite and food cravings, decreasing portion sizes, and limiting overall food intake.
• know soft foods and liquids do not cause fullness, and wash solid food past the band, so they need to be avoided 30 minutes before and 1 hour after meals.
• learn that solid foods that empty slowly from the pouch above the band provide the most benefit.

Physical activity

Physical activity is extremely important for a good result in terms of weight loss, and for improving overall health after any bariatric procedure.

• We agree with the new Federal Guidelines regarding physical activity
• The resumption of physical activity will depend on how you are recovering. In general, band patients may begin exercising within a few days, and bypass patients within a few weeks, after operation.
• Patients should develop habits of regular exercise:
  • aerobic activity: at least 30 minutes, 5 times per week
  • resistance training (pushups, bands, weights): at least two times per week to improve weight loss and minimize muscle and bone loss

Counseling

• Patients receive continuing guidance regarding diet and exercise, along with careful medical follow up. Specialists such as nutritionists are available as needed.

Benefits of Weight Loss Surgery	Candidates for Weight Loss Surgery	Procedures Offered at UNC	Taking The First Steps	What To Expect	Seminars & Support Groups