Obesity is a condition that lasts for life if it is not treated, and neither diet, medicines nor surgery can work miracles on their own. Bariatric (weight-loss) surgery is carried out when obesity and its related conditions seriously threaten your health. Good care after the operation and a healthy lifestyle are what matter most for how things go from there.
After surgery, you will need to make changes in almost every area of life, from eating habits and sleep patterns to handling stress and taking medicines. These changes are there to protect your health. The main points are set out below.
1. Solid and liquid food
After the operation, a dietitian draws up a personal eating plan. It moves in stages: liquid, puréed, soft and finally normal food. You will need, among other things, vitamin B12, vitamin D and minerals such as calcium and iron; you may need to take these supplements for life.
Protein-rich foods are important. Depending on the person, about 60 to 80 g of protein a day is recommended. If you do not get enough protein, your body takes what it needs from your muscles, which can leave you weak. Sugary and carbohydrate-rich foods should be limited.
Make sure you drink enough, even if you do not feel thirsty: about 1.5 to 2 litres of water a day. Avoid high-calorie, fizzy and caffeinated drinks during this time.
2. Medicines
Bariatric surgery can have a positive effect on related conditions such as diabetes, high blood pressure and high cholesterol, but you may still need medicines at a lower dose. Depending on the type of operation, medicines may be absorbed differently afterwards. Large tablets and capsules are not recommended; many medicines also come as liquids, chewable forms or injections. In particular, avoid non-steroidal anti-inflammatory drugs (NSAIDs), as they can damage the stomach and cause ulcers.
3. Exercise
Physical activity is very important for managing your weight in the long term. A personal exercise programme helps you burn more calories. About 150 minutes a week of moderate activity, such as walking or swimming, is suitable. You can often start walking straight after the operation. It is too early at first for sports that work the abdominal muscles.
4. Mental health
After surgery, your lifestyle and appearance change, and this also affects you psychologically. Relationships and marriages can change, and so can the balance at work. Professional support can help you cope with these changes. Eating habits are affected by emotions and stress. If you eat when you are not hungry, for example because of worry, loneliness or stress, you may need help.
5. The plateau phase
The genetic, metabolic, environmental and lifestyle factors that lead to obesity set a kind of "set point" in the body, like a thermostat set to a high temperature. The body can react when this balance changes: a period of weight loss is often followed by a standstill. Do not let this discourage you, as this plateau is an expected part of the process.
6. Sleep and stress
Good sleep habits play an important part in losing weight. This includes going to bed and getting up at set times and getting enough restful sleep. Lack of sleep is known to encourage weight gain. Avoid caffeine in the evening, exercise earlier in the day and keep your bedroom quiet and dark.
Handling stress also matters. Ongoing stress can lead to poor choices that make weight loss harder. Regular exercise, calming habits such as meditation or yoga, and stable relationships help you deal with stress. Support groups can also help.
7. Smoking
If you decide to have weight-loss surgery, you should stop smoking straight away. All tobacco products reduce blood flow to tissues and organs and slow down healing. To lower the risk of blood clots and pneumonia, you should stop smoking six weeks before the operation. Many doctors postpone surgery until the patient has stopped smoking.
8. Alcohol
Alcohol should also be stopped while you prepare for surgery. It is not recommended after surgery either: it is very high in calories and provides no nutrients. A gastric sleeve and a gastric bypass can change how alcohol is absorbed; it may be absorbed faster and have a stronger effect. In some patients, drinking increases and dependence can develop. For all these reasons, it is advised to avoid alcohol after bariatric surgery.
9. Pregnancy
It is best to avoid pregnancy for the first 12 to 18 months after surgery. This time is needed to lose enough weight and keep it stable. Fertility can increase soon after the operation, so take care. The contraceptive pill may be less reliable in women with obesity and while losing weight. If you become pregnant, be sure to tell your surgical team, as your diet needs close monitoring and checks for vitamin deficiencies.
In general, pregnancy after weight-loss surgery can be safe for mother and baby. Studies show that the risk of high blood pressure in pregnancy and of gestational diabetes goes down.
10. The 6-month check-up
After surgery, you have a routine blood test at 6 months, which checks your vitamin and protein levels. It is important to have a team you can turn to if you develop new symptoms or worries. Support programmes give you the chance to share experiences.
