Weight loss surgery, also commonly referred to as bariatric surgery, is considered a safe and effective treatment option for persons who have struggled hard to lose weight and/or maintain it without medical assistance.
If you meet the following criteria, you may be eligible:
- You must be at least 18 years old.
- Have a BMI of 40 or higher, or
- Have a BMI of 35 or higher plus one or more obesity-related illnesses, such as diabetes or sleep apnea.
Advantages of Weight Loss Surgery
Although weight loss surgery is an efficient way to lose weight, it also has other advantages:
- Improving or treating several obesity-related diseases, such as type 2 diabetes, hypertension, sleep apnea, and joint discomfort
- Improving quality of life, including greater energy and mobility
- Improving your self-image, mood, and mental health
- Extending life expectancy by improving overall health
Obesity: An Overview
Obesity is progressive as well as a chronic disease that can damage a variety of body organs. It's like having an annoying small sister who begs you for food, so they don't go hungry, but then eat everything without gaining any weight - until one day your sister has grown into such a massive monster that she covers every piece of furniture! Obesity, like this whiny child, creeps up on us slowly, becoming more prominent with each passing year as its consequences spread throughout our lives.
Obesity develops when daily dietary adjustments are neglected, or physical activity is reduced to battle excessive caloric intake, resulting in poor health and disabilities (among others).
Obesity also causes or aggravates several other conditions, including but not limited to:
- High cholesterol
- Obstructive sleep apnea
- Degenerations of knees and hips
- Menstrual irregularities
- Gallbladder disease
Obese people have a medical risk of incapacity or death due to their condition. Adult-onset diabetes and high blood pressure are among the most serious side effects to be aware of (among others).
For some people, no amount of dieting, exercise, or lifestyle changes will make a substantial difference in their extreme obesity. Surgery is a solution. You've decided on weight loss surgery as an alternative for bettering your health and well-being. Take charge!
I. Different Types of Surgery
Roux-en-Y Gastric Bypass Surgery
Many people regard the Roux-en-Y Gastric Bypass to be the gold standard weight-loss procedure. Stapling is a treatment that involves creating a small (.5 to 1 ounce) stomach pouch equal to the size of an egg and gluing it together so that food does not mix with acid before entering your intestines as it does in most people's stomachs. The remaining stomach is not removed, but it is totally sealed off from the rest of the body to help digestion.
This newly formed pouch empties into the lower jejunum immediately, skipping the duodenum and calorie absorption. This is accomplished by separating the small intestine just beyond the duodenum and connecting it to the smaller new stomach pouch.
- Patients with diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea typically have their co-morbid illnesses completely resolve or improve.
- When compared to solely restrictive treatments, the average excess weight loss in the Roux-en-Y operation is often higher in compliant patients.
- It has both restraint and gastrointestinal properties.
- Weight loss of up to 75% of excess body weight can be achieved one year after surgery.
- Nutritional deficits provide a greater risk than limiting procedures.
- In menstrual women, vitamin B12 and iron deficiency can cause anemia.
- Dumping syndrome is a type of disorder in which stomach contents flow swiftly through the intestine. This can cause nausea, weakness, and excessive sweating, particularly after consuming sweets.
- Due to the stapling incision of the stomach, there is a risk of gastric leakage.
- Regain of weight
A sleeve gastrectomy is a conservative treatment that reduces the size of your stomach by removing two-thirds of it, limiting the amount of food you can eat.
A stapling instrument is used to construct a thin vertical stomach sleeve during this treatment. This sleeve is approximately the size of a banana and can store 3 to 5 ounces.
The stomach exit valve is still in place (Pylorus). This keeps the stomach emptying process going.
- The surgery shrinks the stomach and restricts the amount of food you can consume.
- There is less absorption and no GI tract rerouting.
- This supplement helps with high blood pressure and obstructive sleep apnea. It has also been demonstrated to help with hyperlipidemia and type 2 diabetes.
- The average excess weight decrease after a year is 59 percent.
- When compared to other surgical procedures, post-operative medication administration may be less of a concern.
- When compared to other surgical procedures, post-operative medication management may be less of an issue.
- Due to the stapled resection of the stomach, there is a risk of gastric leakage.
- Gaining weight.
- Reflux can be more common in persons who have had surgery.
Gastric banding is a type of weight-loss surgery in which a silicone band is placed around the top region of the stomach to reduce stomach size and food intake.
The band is wrapped around the top region of the stomach, and a tube is attached to it by the surgeon. The tube is inserted through a port in the abdomen's skin.
The degree of tightness around the stomach can be changed with a few adjustments. The band generates a small stomach pouch above it, separated from the remainder of the stomach by the band.
The amount of food taken by the stomach at any given time is reduced when the stomach pouch is smaller. As a result, after consuming a smaller amount of food, you will feel more satisfied. As a result, hunger is reduced, and overall food intake is also decreased.
This type of surgical operation has the advantage of allowing the body to digest food generally without intolerance.
- Obese people may be able to lose weight for the long term
- Recovery is pretty quick
- Decreased risk of wound infections and hernias following surgery
- Decreased risk of diabetes, high blood pressure, urine leakage, and other obesity-related diseases
- No loss of nutrient absorption
- In many cases, post-surgery enhanced quality of life
- Allergic reactions, breathing difficulties, blood clots in the legs that might spread to the lungs (pulmonary embolism), blood loss, infection, and heart attack or stroke during or after surgery are all possible side effects of anesthesia.
- When compared to other forms of surgery, weight loss may be slower.
- The band may slip, have mechanical issues, or dissolve into the stomach, necessitating removal.
- The port may shift, requiring extra surgery. It is estimated that 15 to 60% of people will require further surgery.
Overeating might cause vomiting or esophageal dilatation; thus, the individual should carefully follow the dietary requirements.
Gastric banding poses the same dangers as other types of weight loss surgery
- Stomach, intestines, or other abdominal organ injuries during surgery
- Stomach ulcers, heartburn, and inflammation of the stomach lining (gastritis)
- Wound infection
- Gastrointestinal scarring that might cause bowel block
- Poor nutrition due to limited/reduced food intake
II. Surgery Preparation - Pre-Operative Nutrition
Start making little adjustments each time you meet with members of the team as a pre-surgery candidate. You would be overwhelmed if you waited until after surgery.
Stop Smoking Right Now: Smoking cessation is needed in all patients.
- Obesity is more harmful to your long-term health than smoking.
- Lung function is hampered, and the risk of pneumonia is increased.
- Anesthetic problems are more likely to occur.
- Blood clotting in the lungs and legs is more likely to occur.
- Reduces skin circulation and hinders healing.
- Increases the risk of ulcers by stimulating stomach acid production.
It's critical to lose weight before surgery.
Your nutritionist will assist you in making the necessary modifications to reduce weight.
This reduces the danger of surgery and creates healthy eating habits. Aim for a weight loss of 10 to 20 pounds.
Coffee, both regular and decaf, can aggravate your stomach pouch or sleeve. Caffeine being a diuretic, can cause dehydration. For the first two months after surgery, we recommend avoiding coffee and caffeine totally
Remove carbonated and sugar-sweetened beverages from your diet
Carbonation can make you feel uneasy. Sweetened beverages are high in empty calories and might lead to bloating.
Drink at least 64 ounces of water every day.
Choose beverages that are caffeine-free and have fewer than ten calories per 8-ounce serving.
Don't consume alcoholic beverages.
You should set a target for 30 minutes of exercise every day. Find a hobby that you enjoy. If you're new to exercising, you might want to start lightly and work your way up to your desired outcome. More advice and suggestions can be found in the "Exercise" section.
Remove all foods and beverages from your kitchen that you should avoid.
When you don't have access to certain things, it's much easier to make healthy dietary choices. If your family objects, explain why it is a good idea for all of you to begin eating a healthy diet.
Start taking a complete multivitamin once a day and a calcium supplement with vitamin D (500 mg) once a day in advance of surgery.
Practice Meal Rules
Every day, eat three meals and a planned snack.
- Never miss a meal. Snacking or eating more significant portions at the next meal often more than makes up for it.
- You should never skip meals after surgery because you won't compensate for the nutrients you missed.
Protein must be included in every meal and snack.
Meat, chicken, fish, eggs, low-fat milk, low-fat cheese, Greek yogurt, cottage cheese, almonds, legumes, and soy products are all excellent protein sources. Protein helps you maintain muscle mass while also allowing you to reduce fat.
At each meal, include a fruit or vegetable.
Use a tiny plate (8" or smaller in diameter) or bowl to reduce portion sizes.
Take dime-sized bits and chew everything until it resembles applesauce.
Slowly eat. Try making your meals last at least 30 minutes. Putting your utensils down between bites may be beneficial.
Stop eating as soon as you reach a comfortable level of fullness. You don't have to eat everything on your plate! Keep in mind that food is a source of energy.
Drink your beverages slowly. There will be no gulping. Drink a cup of water, one teaspoon at a time, to get used to it. Using a travel coffee mug to drink from may assist you in slowing down.
Drinking while taking meals is not a good idea. Stop drinking 30 minutes before you eat, and don't drink again for 45 minutes. Drinking while eating solid food may cause you to overfill your pouch, wash the food out of the pouch too quickly (causing dumping syndrome and/or increased hunger), or limit the amount of protein you can consume.
Size of Plate & Portion
The graphic below depicts a smaller plate and the sort and amount of food that should be served on it.
These should account for half of your dish and include non-starchy vegetables (examples: broccoli, green beans, sliced cucumbers, cauliflower, summer squash, carrots, spinach, sliced tomatoes, kale.)
With little additional fat, steam, broil, or roast veggies.
Avoid typical salad dressings if you're eating a salad because they're always heavy in calories or fat. Choose a mild or fat-free dressing instead. Also, stay away from high-calorie toppings like croutons and a lot of cheese.
Corn, peas, potatoes, winter squash are examples of starchy vegetables that should be limited to 12 cups and used to replace the starch half of your plate.
Vegetables with a buttery, creamy, or cheesy sauce should be avoided.
Twelve cup servings of rice, pasta, winter squash, sweet potatoes, white potatoes, maize, peas, or one slice of bread are included. Whole grains are always a superior choice, such as brown rice, whole wheat bread, or whole wheat pasta. Low-calorie breads should be chosen. Bagel Thins, Arnold's® Sandwich Thins, Joseph's® wraps, Pepperidge Farm® Deli Flats, and Light Wheat Bread are all excellent options.
3 to 4 ounces of grilled, baked, or broiled meat, poultry, fish, two eggs, or one cup of legumes should make up a quarter of your plate (beans). It's preferable if you eat your protein unprocessed. Sauces that are creamy, cheesy, or buttery should be avoided. Breaded foods like fried chicken, chicken nuggets, and fish sticks should be avoided.
Your daily protein goal (both before and after surgery) should be 60 to 80 grams. This is easily accomplished by eating eight to ten portions of the items listed above each day (two to three servings per meal). You lose lean muscle mass if you don't eat enough protein, slowing your metabolism and making weight loss more difficult. Proteinex can be taken or added to foods to increase their protein level.
Protein bars should be avoided because some include sugar.
Take The Big Five, for example.
These are difficult to modify behaviors that may take longer to complete.
- Stop smoking and eat three meals a day, for example. (After surgery, you cannot miss meals.)
- Caffeine should be avoided. (This is especially true if you eat more than one or two every day.) You should be entirely caffeine-free by the time you join workshops.
- Stop consuming soda and begin your walking program. We want you to be able to walk for 30 minutes every day. Start cautiously (10 minutes) and gradually increase if necessary.
What can your supporters do to assist you?
It is critical to be surrounded by individuals who are supportive and helpful when you ask for aid. They could help you in a variety of ways, including:
- Taking a stroll with you (or watching the children so you can go by yourself).
- Eliminating foods that cause you to lose attention by acting as triggers.
- Staying at the table until the meal is finished (it will be slow for you).
- Keep in mind the importance of continuing to take vitamins following surgery. It is not a choice.
Social Life After Surgery
Food is likely to be present at many of your social gatherings. There's no reason to give it up. It's not about the food at social gatherings; it's about having fun with your friends and family. However, ensuring that you have food to eat may necessitate some planning on your part. You may have to bring it with you first.
This is a precious life skill. How can you deal with stress without turning to comfort food? The disturbance created by stressful or emotionally challenging circumstances triggers weight regains in those who have had weight loss surgery.
III. Diet After Surgery
This is a precious life skill. How can you deal with stress without turning to comfort food? The disturbance created by stressful or emotionally challenging circumstances triggers weight regains in those who have had weight loss surgery.
After surgery, the majority of patients stay in the hospital for two days. You will not be able to eat or drink anything on the day of operation. The stages of the diet start the day following surgery.
After surgery, take a few sips of water in the morning.
For the first two hours, sip one ounce every 15 minutes, then gradually increase the amount. You should have consumed 32 ounces of fluid by the end of the day.
Liquids that are sugar-free and transparent (see-through). It begins the day following surgery at lunchtime. Broth, decaf tea, Crystal Light® diet gelatin, artificially sweetened fruit drinks are just a few examples.
Low-sugar, low-fat proteinex, and smooth drinks begin the day after surgery at supper and last for two weeks.
This stage begins the day after surgery at supper and lasts for two weeks following discharge. Be mindful that at this point in the diet, there isn't much diversity. Regardless, make sure you stay on this stage for the entire two weeks. Too soon after starting solid foods, you may experience pain or need to return to the hospital. At this point, all foods must be liquid and smooth. To let your new stomach heal, avoid chunks or pieces of food.
It's crucial to meet your 64-ounce daily fluid goal. In addition to water, proteinex, smoothies, milk, sugar-free popsicles, and other beverages provide hydration.
Attempt to meet your daily protein goal of 60 to 80 grams, but don't worry if you don't meet it. When you reach Stage 4, you'll be able to choose from a far wider variety of protein sources.
You can eat whatever you like at this stage.
Proteinex 30oz and Proteinex 2Go should be on your essential shopping list.
Smooth Greek yogurt, plain or low-sugar.
Dannon® Light & Fit Greek flavors include toasted coconut and vanilla, raspberry chocolate, banana cream, and strawberry cheesecake; Yoplait® 100 calorie Greek vanilla or lime flavor; Chobani® vanilla; Yoplait® Greek whips; and Oikos® Triple Zero.
Smooth normal yogurt, plain or low-sugar
- Dannon® Light & Fit Lemon flavor, for example.
- Milk that is either nonfat or 1% fat
- Fairlife® fat-free milk
- Lactaid® low-fat milk or plain soy milk
- powdered nonfat dried milk
- Carnation® Breakfast Essentials with No Sugar Added
- Popsicles with no added sugar
- Jello® with no added sugar
- Smooth soups with low sodium (strain if necessary) o Low-sodium broth, bouillon, or consommé (examples: tomato, creamy pea soup, butternut squash soup)
- Fruit2 O®, water
- Any sugar-free, caffeine-free drink mix, such as Crystal Light, Mio® drops, sugar-free Kool-Aid, Lipton® diet decaf iced tea, or any other sugar-free, caffeine-free drink mix
- Cranberry juice on a diet
- Splash of Diet V-8®
- V-8® Vegetable juice
- Unsweetened, pulp-free juice (no more than 4 ounces per day) o Herbal or decaffeinated hot or iced tea
- Sugar substitute (Stevia,® Equal,® Splenda,® Sweet-n-Low®
Soft solids are soft, moist, blended, and crushed foods low in sugar and fat and can be mashed with a fork. It begins two weeks after surgery and lasts six weeks.
You will only be able to eat extremely modest portions when you first begin this stage (maybe not even a whole egg). You may need to consume numerous little meals each day. Your meals will grow larger as you go through this stage, and you will be able to eat less frequently. By Stage 5, you should be consuming three meals each day, each containing 2 to 3 ounces of protein.
It's essential to keep in mind that you shouldn't eat solids and drink liquids simultaneously. Soft fruits and vegetables are required. At this point, no raw vegetables, such as salad, are allowed. Every day, try one or two different foods to see whether you can tolerate them. Poaching, steaming, boiling, and slow cooking are all approved moist cooking methods.
Foods with a regular texture, low fat, and low sugar content.
Eight weeks after surgery, it begins. This is the last stage of your diet, your "forever" diet. Every day, eat three meals and a planned snack.
Remember to chew your food until it resembles applesauce inconsistency. The majority of your food has been soft and mushy up to this point.
Protein must be included in every snack and meal. Snacking on "slider foods," such as crackers, pretzels, or chips, should be avoided. These are easy to eat, have little nutritious value, and disrupt your weight loss efforts.
Always start with your protein. Don't eat so much that you don't have room for protein.
Raw veggies, such as salad or raw carrot sticks, are now acceptable, but remember to chew them thoroughly. To ensure that you can tolerate each component of a salad, try one at a time. Also, keep in mind that thick skins, such as those on cucumbers should not be peeled until six months after surgery.
You can start drinking coffee at this point if you like, but you should still consume 64 ounces of non-caffeinated beverage per day.
Everyone is different, but some meals, such as chicken breast, steak, rice, or pasta, may be difficult for you to tolerate.
During the first six months, you should consume between 12 to 34 cups of food per meal. You should be able to eat 1 to 112 cups of food per meal after a year.
Other Starches and Breads, and other carbs can now be consumed in small amounts (about 14 cups). They're usually deficient in protein and can lead to dumping. Don't add anything until you've reached your protein goals.
White bread and rolls that are soft and spongy should be avoided.
These are good bread choices:
- Thinly sliced whole-grain slices of bread
- Whole grain wraps
- Whole grain pitas
- Arnold® Sandwich Thins, Pepperidge Farm® Deli Flats
- Whole grain thin bagels are all good options.
- Rice. Brown rice is a better option than pasta.
- Winter squash and peas.
- Whole wheat pasta.
Before consuming, wait six months.
- Fruit and vegetable skins that are thicker (apples, pears, cucumbers). Before you eat it, peel it.
- Raisins, dried cranberries, prunes, and other dried fruits
- Nuts and huge seeds (pumpkin, sunflower), as well as seed clusters
- Popcorn and corn
- Choose carbonated water (seltzer, club soda) or diet soda if you want to drink these
Avoid these foods:
These are difficult to chew and can cause a blockage:
- Vegetables with a lot of string (celery, spinach, asparagus, spaghetti squash). Before eating, cut up or remove strings.
- Orange and grapefruit pieces have membranes between them. Eat only the pulp.
- Dry and hard meat.
Avoid consuming alcoholic beverages.
For a whole year, no alcohol should be consumed. After then, you should only drink alcohol in small amounts and only on rare occasions. The following are some of the adverse effects of alcohol:
- Ulcer formation.
- Increased risk of dumping syndrome.
- Vitamin and mineral deficiency.
- Excessive calorie consumption, which can lead to weight gain.
- Extremely rapid alcohol absorption. In a few minutes, one drink can boost blood alcohol levels above the legal limit.
- Addiction. Some people switch from food addiction to alcohol addiction.
Expected Side Effects
This is more common after a gastric bypass, but it has also been observed after a sleeve gastrectomy. When the intestine fills up too quickly with undigested food, it can cause "early dumping." It is most commonly caused by sugary foods, although it can also be caused by high-fat foods or eating too quickly. Nausea, exhaustion, stomach bloating, vomiting, diarrhea, and sweating are all possible symptoms. It is not harmful, but it is inconvenient. The symptoms usually go away after one to two hours.
Choose foods low in fat and have no more than 15 grams of sugar per serving to avoid dumping syndrome. Desserts, candies, pastries, honey, sugar-sweetened drinks, syrups, and other foods with added sugar should all be avoided. White bread, white pasta, white rice, and potatoes, which are readily absorbed in refined carbs, can induce dumping.
Hypoglycemia, often known as "late dumping," occurs one to two hours after ingesting sugary foods. A spike causes it in insulin after eating sugar or carbs, which causes the blood sugar to drop too low. Fatigue, weakness, dizziness, shakiness, and/or headache are all possible symptoms.
The 15/15 rule can be used to treat low blood sugar. Wait 15 minutes after consuming 15 grams of sugar (12 cups of juice), followed by a bit of protein, such as a cheese stick or a cracker with peanut butter. If you're still experiencing symptoms, repeat the procedure. Contact your health care provider if hypoglycemia continues to be a concern.
Although sugar alcohols can cause identical bloating, gas, and diarrhea symptoms, artificial sweeteners do not cause dumping syndrome.
Changes in Taste
Following surgery, some foods may taste different, and food odors may be stronger. Tastes change over time, and cuisine you loathe one day may appeal to you the next. It's crucial not to load up on many food or vitamins before surgery because you might not like them afterward.
After a gastric bypass, this is more likely.
Lactose is a naturally occurring sugar present in dairy products. If you lose your capacity to break it down, you'll feel symptoms like cramps, diarrhea, bloating, gas, and nausea after drinking milk.
If you think you might be lactose intolerant, try Lactaid® milk, Fairlife® milk, or soy milk instead of conventional cow's milk. Carnation® Breakfast Essentials should also be avoided because it contains dried milk powder and unaged cheeses like American cheese.
Lactose intolerance can be managed by eating fermented milk products like yogurt or aged cheeses like cheddar and Swiss. Because they don't include lactose, whey protein isolate or soy protein supplements are the ideal options for protein beverages.
Gas and Constipation
Constipation is a common side effect of bariatric surgery, and a variety of factors can cause it:
- Inadequate hydration
- Supplements containing iron
- Low fiber intake
- Reduced exercise
Drink 64 ounces of water each day and eat little amounts of fruits and vegetables at each meal to enhance your fiber intake. Exercise daily. Once you have reached Stage 4, you can add flax meal to yogurt or take fiber supplements like sugar-free Benefiber®.
A magnesium-calcium citrate supplement (Twin Labs,® Liquid Cal-Mag®) may also be beneficial.
If none of these methods relieves your constipation, you may need to use stool softeners or a moderate laxative.
After a gastric bypass, increased gas is more likely to be an issue than after a sleeve gastrectomy. Undigested food in the large intestine encourages the bacteria that are already there to make additional gas.
Asparagus, broccoli, eggs, cauliflower, cabbage, onions, beans, sugar alcohol, pears, apples, dairy products, and carbonated beverages are all known to promote gas production.
Success Habits that Last a Lifetime
- To avoid dehydration, drink at least 64 ounces of liquids every day.
- Aim for a daily protein intake of 60 to 80 grams. Keep track of the amount of protein you consume from your food so you can supplement with protein drinks or bars as necessary.
- Consume a low-carbohydrate diet. They are fine in modest amounts, but they shouldn't be the focus of your meal or snack.
- Eat three protein-rich meals at regular intervals throughout the day. Even if you are not hungry, do not skip meals. If you don't feel like eating, try Greek yogurt or a cheese stick. There will be no grazing (eating small amounts all day long). If you feel like you need a snack at any point during the day, make sure it's a healthy one with protein or some fruits and veggies.
- Avoid slider foods, which are typically starchy meals such as crackers, pretzels, and low nutrition and easy to consume in excess.
- Make preparations in advance. Having the proper foods on hand at home and preparing meals for work or travel can help you avoid making poor decisions.
- Take small chunks and chew your food until it resembles applesauce.
- Thirty minutes before and 45 minutes after consuming solid foods, avoid drinking.
- When you begin to feel full, stop eating. When you eat after you've had your fill, you risk experiencing pain, nausea, and vomiting.
- To avoid dumping syndrome and weight regain, avoid sugary meals, candy, chocolate, ice cream, and sugar-sweetened beverages.
- Foods that are fried or heavy in fat should be avoided. Before cooking, make sure all visible fat is removed.
- Exercise for 30-45 minutes every day. Exercise can help you burn more calories, tone up and maintain muscle mass, and even relieve constipation.
- For the remainder of your life, take your chewable multivitamins, calcium citrate, and Vitamin B12. These are extremely crucial to avoid future vitamin deficits.
- After surgery, stay away from alcoholic beverages for at least a year.
- You will never smoke again! The chance of having ulcers is considerably increased if you smoke.
- Write down or use an app on your phone to keep track of what you're consuming. It makes you more responsible and assists you in making better decisions.