Obese individuals who have failed to lose significant weight following dietary and lifestyle changes and are candidates for bariatric (weight loss) surgery. The surgery either restricts the capacity of the stomach or reduces the absorptive capacity of the digestive tract or both.
Studies have shown that bariatric surgery with dietary modification significantly induces weight loss and also cause resolution or improvement in associated comorbidities. In a safe hand and with appropriate patient selection, the surgical procedure is often adversely uneventful and most patient experience a good post-operative period.
What to expect after bariatric surgery
Immediate post-operative period is the time of recovery. This varies from one type of bariatric surgery to the other. On an average, it takes about 6-weeks to fully return to routine daily activities.
The bariatric surgery has now positioned you to be able to eat and/or absorb less food, with the aim of allowing you to overcome the genetic and environmental risk factors that led to excess weight. However, the weight loss may have a step ladder pattern in which you experience an alternating period of weight loss followed by plateau. Don’t get discouraged as it takes months to see appreciable reduction in weight.
Bariatric surgery will not lead to weight loss or the lost weight may be re-gained if the dietary and lifestyle modification is not followed appropriately. Your doctor/dietician would have established a dietary plan for you before surgery. Post-surgery, you will need to continue this dietary plan to ensure optimal weight reduction. There may be need for nutritional supplements such as multi-vitamin, vitamin D, calcium, iron, vitamin B12, etc. There is need to avoid refined sugars and limit carbohydrate intake.
Although bariatric surgery leads to resolution of comorbid conditions, you still need to take your medications for ailments such as hypertension, diabetes mellitus, heart disease, etc. your doctor will continue to re-assess you and determine when to adjust/stop your medications. The mal-absorptive bariatric surgeries can alter the absorption of certain medications thus, requiring dosage adjustment to achieve efficacy.
Exercise is one of the activities that help obese patient lose weight and maintain a healthy status following bariatric surgery. Regular exercise will ensure that the body utilizes the excess fat and not protein. It also reduces the cardiovascular risks associated with obesity and improves blood sugar control in diabetic patients. You may have to start the exercise on a mild level and as you progress, your body becomes more tolerant and you can gradually increase your physical activities.
The lifestyle changes, the dietary adjustment, and the changes in body appearance (e.g. sagging skin) that accompanies weight loss may positively or negatively affect the mental health of the patient. Some individuals have more self-esteem following bariatric surgery while others experience depression as a result of poor perception of body image, lack of adequate support from families and at work places. It is therefore important to regularly see your doctor and discuss all your worries so as to identify the need for psychotherapy.
One of the benefits of bariatric surgery is in the resolution of comorbid conditions among which sleep apnoea is one. However, before the resolution of this condition, it is important to engage in sleep hygiene practices to ensure quality sleep and improve your quality of life post-surgery.
Although getting pregnant after bariatric surgery is not contraindicated. However, it is better to wait for at least 12-18months before getting pregnant. The initial post-op period may be characterized by nutritional deficiencies such as vitamin B12, iron, vitamin D and calcium. This will prevent healthy growth of the fetus.
The nausea following bariatric surgery may be exacerbated by the nausea and vomiting of pregnancy. Weight stabilization also occurs around this period. To achieve this, you will need to be on contraception. Any form of contraception can be used; however, hormonal methods should be avoided during the phase of rapid weight loss due to high failure rate. Consult your doctor for the best contraceptive device for you.
Always go for check-ups as scheduled by your surgeon and dietician. This will afford the opportunity to promptly identify and correct any abnormality and improve your overall quality of life.