On average people who have bariatric surgery lose about 25-35% of their starting weight. This weight loss is substantial and is associated with significant improvements in obesity related illnesses and improved quality of life.
The very low calorie diet (Optifast®) is required for at least 2 weeks prior to surgery, but can vary. You will be advised by your surgeon and dietitian the length of time you need to be on this diet. Optifast® can be purchased from most pharmacies over the counter and the approximate cost is $9 per day. Prices do vary, so shop around.
Bariatric surgery results in a degree of malabsorption (abnormal absorption of food nutrients from your intestines). For this reason, it’s important to be on bariatric multivitamins for life after surgery. While these are usually sufficient, we check your lab work on a regular basis and correct any specific abnormalities promptly. After surgery, you will have blood tests at 3 months, 6 months, 12 months and annually thereafter.
After bariatric surgery, you need to take bariatric multivitamins for life. If you stop taking these, you could encounter some major nutritional issues. Some examples are:
- Iron deficiency can show as fatigue
- Zinc deficiency can cause hair loss and changes in taste
- Calcium deficiency can lead to bone weakness and osteoporosis
The best multivitamins are those that are specific for bariatric surgery. There are many options available for purchase online and our team will provide you the details of these suppliers.
There is a 6-8 week dietary progression period from liquids to solids. Our team will provide more detailed information about this. After this period, you will be able to eat normal food, although your new ‘normal’ will change. Your stomach will be reduced in size and shape so your relationship with food will change. Chew well and eat without distractions so you can tune into your fullness cues. Multiple small meals spread throughout the day will be important so that your body can get the nutrients it requires.
Bariatric surgery is a tool to be used in your weight loss journey. After bariatric surgery people often reach their lowest weight at 12-18 months. During this period it is important to continue with your lifestyle changes and push yourself to live the life you have dreamed of.
Its normal to put on a small amount of weight at 18-24 months after surgery as your body finds its new ‘normal.’ Lifestyle change will help limit this weight gain. For several reasons, some people regain a substantial amount of weight. Our team can talk to you more about this if required.
It is important to get back to 30 minutes a day of cardio exercise, such as brisk walking, as soon after surgery as possible. We do not recommend heavy lifting or strenuous activity for 4- 6 weeks after the surgery. Swimming should be delayed until 4 weeks after surgery to allow your wounds to heal completely and you will be able to start exercising at the gym at 6 weeks.
Although your abdomen will feel comfortable within a week or two, people often find they are quiet fatigued during the first 3-4 weeks. It is for this reason that we generally recommend taking a month off work after surgery and then if you feel up to it, you may choose to return early.
Excess skin is common after bariatric surgery. With time this may improve due to skins elasticity and remodelling. However, for some, this can be a significant problem. Supportive garments can help and there are surgical options if required. Any surgical correction is best done once at your lowest post-operative weight, usually around 18-24 months after bariatric surgery. Our team can refer you to a plastic surgeon if required.
Bariatric surgery significantly improves your overall health and, as a result, changes your regular medications requirements. Some of these changes, such as diabetes, occur immediately and some, such as blood pressure, occur once your weight is decreased. Our team will give advice regarding your regular medication, but we encourage you to keep close connection to your primary health team. Book an appointment with your GP two weeks before and two weeks after surgery and then every few months for the first period of time.
It’s important to be freely moving in the vehicle and be able to perform an emergency stop if needed without restriction. For these reasons, we recommend not driving until 2 weeks after your operation.
We strongly advise against getting pregnant for at least 18 months after surgery. Your body needs to heal and adjust to significant life changes. During the active weight loss phase, it is difficult to eat enough to support a healthy pregnancy. And many woman do not have enough nutrients such as folic acid, vitamin B12, and iron.
We recommend that you speak to your GP about birth control as the oral contraceptive pill may not be as effective after surgery. You may want to consider using other methods of birth control such as an intrauterine device (IUD) or condoms.
If at any point after surgery you do get pregnant, you will require specialist care. You will need to be under a specialist dietitian, your multivitamin regime may need to change and you will require regular blood tests. In addition, you may need to be under an Obstetrician and this should be discuss with you GP.
We recommend no alcohol for 6 months after surgery. After this period, we recommended you only drink small amounts. Alcohol tolerance can decrease markedly after surgery and alcohol is high in calories.
There are several options available and our team can provide a letter of support if required. Most health insurance companies will provide a lump sum payment towards bariatric surgery. Some Kiwisaver providers allow funds to be accessed in certain circumstances.