Life After Bariatric Surgery
Losing weight after bariatric surgery takes time, lifestyle changes and support. Our experienced bariatric experts will help you with every part of your transition to a healthier life. We offer you:
- Rigorous follow-up care from our team of surgeons, nurse practitioners, dietitians, psychologists and physical therapists.
- Coaching on all aspects of your new lifestyle, including diet, exercise and medication.
- Experts who can answer questions and offer support between appointments.
- Long-term monitoring.
- A detailed OHSU notebook with information about mindful eating and a balanced diet, plus lists of specific foods and drinks to choose from.
Some of these appointments may not be covered by insurance. Check with your insurance company.
Surgeon and nurse practitioner: You’ll have follow-up appointments with your surgeon or nurse practitioner at:
- One week
- Two weeks
- Four to six weeks
- Three months
- Six months
- One year
- At least once a year for life
Dietitian: You’ll consult your dietitian at:
- One or two weeks
- Every two to three months for the first year
- Every six to 12 months after that
Psychologist: You’ll meet with a psychologist at:
- Three months
- Then as needed
Primary care doctor: You will meet with your primary care doctor at least once a year for follow-up tests, especially to check vitamin B12, folate and iron levels. Your doctor will also check for anemia (too few red blood cells).
Gastric sleeve surgery at OHSU changed Alisa Brewster's life. Read Alisa’s story.
Discharge to two weeks
First days: Take in only clear liquids such as water, sugar-free juice and broths the first day. Then you’ll transition to full liquids such as protein-rich shakes and yogurt for two weeks. You’ll receive a list of foods to choose from.
Begin permanent changes: Your dietitian will map out stages for the weeks and months after surgery to help you and your body adjust to new habits:
- Eat slowly, take small bites and chew food thoroughly.
- Stop eating as soon as you begin to feel full.
- Include protein with all meals and snacks.
- Choose foods and beverages with less than 14 grams of sugar and less than 5 grams of fat.
- Stop drinking fluids 30 minutes before eating.
- Wait 30 minutes after eating to drink.
- Sip throughout the day to stay hydrated. Aim for 64 ounces of calorie-free, carbonation-free, caffeine-free fluids a day.
- Aim for 60 to 80 grams (about 2 to 3 ounces) of protein a day.
- Avoid alcohol.
- Take recommended vitamin and mineral supplements, which are vital to your nutrition.
Right after surgery: If your surgery was laparoscopic, recovery should be rapid. It is important to walk within several hours. Our Walk to Recovery program will help while you are in the hospital.
At home: You should be able to get around the house, prepare meals and do simple tasks. Recovery is longer after an open operation. Your care team will help you resume activity safely.
First few weeks: You may feel tired for a few days, weeks or even months. Avoid exercise beyond walking short distances for the first two to three weeks. Watch your balance — walk with assistance or near handholds. Stop activities that cause pain, discomfort or significant fatigue.
Resuming medication: Most patients restart all medications within a day or two of surgery. This includes Type 2 diabetes medications, although patients should check their blood sugars at least daily after surgery. Avoid aspirin and nonsteroidal anti-inflammatories such as ibuprofen and naproxen for as long as possible, ideally for at least a month. Check with your primary care doctor within a week of surgery for advice on medications.
Swallowing pills: Problems taking pills are uncommon. Discuss any concerns with your surgeon.
Sleep apnea treatment: Patients with sleep apnea who use CPAP should continue after surgery.
Supplements: You will take vitamin and mineral supplements for the rest of your life, starting right after surgery. We will help you learn when and how to take them, starting while you are in the hospital.
After surgery: Complications are rare after laparoscopic bariatric surgery. Most serious complications occur in the first two weeks. Mild nausea, constipation and moderate pain that improves daily are common and rarely a cause for worry.
Call your surgeon with any concerns, especially:
- Severe or constant pain
- Significant nausea
- Inability to pass gas or stool
- Redness or drainage from incisions (rarely serious but should be looked at)
Caring for incisions: You can shower right after laparoscopic surgery. Allow soap and water to run over incisions, but don’t scrub them. Wait three weeks to bathe or swim. Incisions occasionally open. Less often, they become infected. Both are usually easily treated.
Call your surgeon if:
- Your incision opens, though a bandage is usually enough.
- Your incision develops redness or drains fluid.
Two weeks to two months
Solid foods: Slowly transition to solid foods two weeks after surgery. Start with small amounts of soft foods. Test a small amount and chew carefully. If a food goes down slowly or gets stuck, try others for a few weeks. About one in 20 patients may develop an intolerance and have to avoid certain foods. Call your surgeon if you develop persistent or frequent vomiting.
Dietitian appointments: Your dietitian will work with you to:
- Review your diet.
- Troubleshoot any issues.
- Help you meet protein and fluid goals.
- Make sure you are taking the right vitamins at the right time.
- Advance to the next diet stage, including which foods to add or avoid.
Ease into exercise two to three weeks after surgery. Begin with walking. Reduce exercise if you feel pain, discomfort or significant fatigue. Most patients are back to usual activity levels within four to five weeks.
You may see improvement in obesity-related diseases such as diabetes, hypertension, hyperlipidemia and sleep apnea. It’s important that you work with your primary care doctor to monitor those issues and, if appropriate, slowly reduce medications and use of sleep appliances.
Two months and beyond
Two months after surgery, most patients are eating solid foods. Following a balanced diet — with fruits, vegetables, lean protein and complex carbohydrates — helps patients maintain their weight loss. Refer to your OHSU notebook for guidance and to choose specific foods.
Start regular cardiovascular exercise, such as walking, biking or water aerobics. Combine with weight training. Most days, aim for at least 30 minutes of moderate activity or 10,000 steps measured by a pedometer, smartphone or fitness tracker. Talk with your primary care doctor before starting or increasing exercise, and ease into it.
Persistent problems or complications that show up long after surgery are uncommon.
A few patients develop dumping syndrome, when food moves from the stomach to the small intestine too quickly, causing cramps and diarrhea. It’s less common than thought, however, and usually goes away within a few months.
Other complications may include nutritional deficiencies, hernias, ulcers and gallstones. Tell your surgeon or primary care doctor about any issues.
Returning to work
Your condition, job and surgery type all play a role in when you can go back to work. Most patients return to work:
- One to four weeks after laparoscopic surgery.
- Four to six weeks after an open procedure.
Your energy may be low for a while. You may need to work half-days or every other day your first week back. Your care team will guide you.
Birth control and pregnancy
Women of childbearing age are strongly advised to avoid pregnancy for 16 to 24 months because of demands on the body and the potential for fetal damage.
Most women are more fertile after bariatric surgery, and periods may not be regular. Birth-control pills are less effective in obese women and while you’re losing weight. Instead, it’s important to use an IUD or condoms and spermicide.