Weight Loss Surgery Basics 10 Things to Know Before the Procedure

Ramsay Health Care UK | 15/09/2014

Weight Loss Surgery Basics 10 Things to Know Before the Procedure

weight-loss-surgery-basics
If you’re planning to have weight loss surgery such as gastric banding, sleeve gastrectomy or a gastric bypass it’s best to get prepared so that you can rest and recover properly following your operation.

The advice below is offered to help you think ahead about what you will need before, during and after your procedure.

Preparing for weight loss surgery

Getting ready for your weight loss surgery can take several months. Being prepared will enable you to be as relaxed as possible before your surgery and with plans in place you will be able to focus on the vital rest required to start your recovery.

• To achieve your target weight you need to make a lifelong commitment to making major changes to your diet and lifestyle. You need to be emotionally ready for your weight loss journey.
• Tell your bariatric nurse/surgeon about any medications you are taking or plan to take throughout recovery. Vitamins, minerals and herbs interact with medications so don't leave anything out. Also make sure you have all the medications you will require after surgery.
• Try to lose 5 to 10% of your excess body weight before your weight loss surgery. Research suggests that this may result in a shorter hospital stay and more rapid postoperative weight loss. Your pre-op diet may help you do this.
• Start a healthy lifestyle in the weeks leading up to your surgery so that you have chance to get used to new routines and a different way of life.
• Practice new eating habits such as eating slowly, chewing food 15 times and putting the fork down between bites will help you do this. Don't drink at the same time as eating as this can overfill your pouch. If you are having a band the fluids can dilute your meals and push them through your band resulting in you being able to eat more and not feel full.
• Mentally prepare yourself and start to analyse your eating behaviour and any triggers for comfort-eating or over-eating, such as particular situations, moods, times. Find alternative ways of coping or other things that you can do at these times.
• Discuss with your bariatric nurse/surgeon a realistic target weight and achievable milestones for you.
• Ensure you have a ready supply of drinks, thin soups and purees for when you come out of hospital. Prepare some meals in advance and freeze them.
• Buy or borrow a blender or liquidiser.
• Prior to surgery you will be asked to follow fasting instructions whereby you won’t be able to eat or drink. It’s important to follow your surgeon's advice.
• The night before your procedure it’s advisable to have a shower or bath as this might be difficult for a few days after your surgery.
• Make arrangements for someone to drive you to and from your procedure. Ask a friend or relative to stay with you for at least the first 24 hours after your operation. You may want to make sure you have someone to help out at home for the first couple of weeks after surgery.
• If you have small children plan for their care during for the first few days following your weight loss surgery.

What should I take into hospital?

You may want to bring into hospital the following items:

• Pyjamas or night dress.
• Dressing gown and slippers with tread.
• Personal toiletries including mouthwash or breath spray. As you’ve just changed your digestive system, even if you’re not prone to get bad breath, you will probably have bad breath and want to resolve this easily.
• Any medication you require for your stay with the original packaging and labels.
• Underwear.
• Comfy, easy to put on clothes that are loose fitting and zip or button up at the front. Your nurse/surgeon will want you on your feet as soon as possible following surgery and the bending required to get into normal clothes may be painful.
• A comfortable flat pair of shoes that slip on to go home in.
• Books and magazines.
• Mobile phone and I-pad or tablet to help you stay connected with your friends or family.

After weight loss surgery

For the first few days after surgery you will have to rest and ensure you don’t put any strain on your operation wound. Even the smallest task, such as opening a jam jar, will be too much.

After your weight loss surgery, you will need to get used to eating solid foods again. Typically you will start with 2 to 4 weeks on a liquid-only-diet, 2 to 4 weeks of semi-solid pureed foods and then solids. Your bariatric nurse/ dietician will recommend a diet for you based on your weight loss procedure, your own circumstances and goals.

Going home

Your bariatric surgeon will allow you to go home once you can take in enough fluids and nutrients by mouth to prevent dehydration, have no fever and you can control your pain with medication. This will vary depending upon your weight loss procedure and your individual circumstances and health.

Typically for a gastric band procedure patients will return home the day after the operation. Gastric bypass / sleeve gastrectomy patients can expect to stay in hospital 2 – 3 nights .

How much time will I need off work?

Recovery time can vary from patient to patient. Being active soon after surgery will help you recover more quickly. If you have laparoscopic surgery, you should be able to do most of your regular activities in 2 to 4 weeks.

In general, depending on your type of work, gastric band patients have 7-10 days off work and gastric bypass or sleeve gastrectomy patients have up to 14 days.

Follow-up

Careful follow up and constant motivation will help prevent problems occurring. You will have a follow-up appointment with your bariatric nurse/surgeon 2 to 6 weeks after surgery. You will see your multidisciplinary team (MDT) several more times in the first year after your surgery. Appointments with a dietitian will help you maintain a new diet for your smaller stomach.

You will need to have blood tests on a regular basis if you are a gastric bypass patient to make sure that your body is getting enough important vitamins and minerals from food after your surgery. These can be organised via your GP.

If you have a gastric band these will need to be adjusted on a regular basis in clinic. These adjustments (fills) are carried out to ensure the band is not too tight or too loose to encourage continued weight loss. Your stomach needs to heal from surgery before the first fill so this won’t be until around six weeks after surgery.

How much weight will I lose?


Successful weight loss will be entirely down to you making good dietary choices and being as physically active as possible. On average bariatric surgery can result in a 50 to 70 percent reduction in excess body weight over three years. The amount of weight lost after surgery depends on the type of operation, but more importantly on changing your lifestyle and eating habits. In general, gastric bypass patients will lose around 70 percent of their excess weight, sleeve gastrectomy patients will lose around 60 percent and gastric banding patients will lose around 50 percent¹.

If you lose more than 50% of your extra (excess) weight and you don’t put it back on again this will be classed as a success. In general weight loss is faster after gastric bypass and sleeve gastrectomy surgery with most of the weight lost within the first 6 months and stabilising after 12 to 18 months. Gastric band surgery causes a slower more gradual but steady weight loss.

How much exercise will I need to do to lose weight?

You will need to develop your own exercise routine that allows you to get out and be active, swapping computer and TV time with time to improve fitness and energy levels.

If your bariatric nurse/surgeon says it is okay, you may start an exercise program 2 to 4 weeks after surgery. You don’t need to join a gym to exercise. If you have not exercised or been active in a long time, you must start off slowly to prevent injuries. A 5 to 10 minute walk every day is a good start. You can increase this until you are walking 15 minutes twice a day.

Eating after bariatric surgery

In the initial period after surgery you will only be able to eat very small portions and you will probably not feel hungry, but this may change with time.

Here are some eating guidelines for weight loss patients:

• Keep to 6 small meals a day and avoid snacking between meals unless you are genuinely hungry. Eating regularly stops you getting overly hungry and eating too fast and results in more weight loss than if you eat irregularly, graze and snack all day.
• Eat small portions. After surgery, if you overeat it will stretch your stomach pouch and cause discomfort and may make you vomit. It will take a while for your brain to adjust to the small size of your pouch. Using a side plate can help you keep your portions under control.
• Put a small amount of food in your mouth, eat slowly and chew very well.
• Don’t drink with meals². Make sure you have at least 2 litres of fluid a day. Avoid all fizzy drinks.
• Choose foods that have texture to satisfy your stomach rather than high calorie liquids or foods that ‘melt’ (crisps, chocolates, ice-cream, cakes and biscuits). These foods slip straight through, don’t make you full and result in a very high calorie intake.

Certain foods can be a problem for some people. These can include chewy meats, soft white bread, rice, fibrous fruit and vegetables, nuts and seeds. These should be avoided initially and re-introduced slowly once a ‘normal’ diet has been established. Everyone is different and you will need to find out what is right for you by trial and error.

Your multi disciplinary team will give you lots of help and information about post-operative diets.

Will I be left with saggy skin if I lose a significant amount of weight?

After significant weight loss it is likely that your skin will start to sag in some areas of your body. This may be around your tummy, under your arms, thighs and your breasts. Whether or not your skin sags after surgery depends upon several things including how much weight you lose, your age, your genetics and whether or not you exercise³.

This excess skin may or may not bother you. Occasionally the skin folds can become infected or sore if they are difficult to keep clean and dry.When your weight stabilises you may choose to look into cosmetic surgery to remove or lift the sagging skin (apronectomy). It is best to discuss with a consultant plastic surgeon your cosmetic surgery options such as a tummy tuck and breast uplifts. Ramsay Health Care offers cosmetic surgery options for patients who have lost a large amount of weight.

Here you can find our guide prices for weight loss surgery procedures.

Here you can find our guide prices for cosmetic surgery procedures.

Read our post - "Cosmetic surgery after weight loss surgery" to find out more

Read more weight loss surgery blog poststo find answers to the most common questions including: pros and consof gastric balloon and gastric sleeve, how to choose a weight losssurgeon, exercise after weight loss surgery etc.

About Ramsay Health Care Weight Loss Surgery Services

Ramsay Health Care is a leading provider of weight loss surgery in the UK.

Whether you are considering a gastric balloon, gastric band, sleeve gastrectomy, or gastric bypass, Ramsay offers bariatric surgery procedures performed by the highest qualified and experienced bariatric surgeons in the UK. These consultants are all qualified as weight loss surgeons, and have undergone specialist training in their speciality. Read our post on How to Choose a Weight Loss Surgeon in UK

Your surgeon will work in a multidisciplinary team who liaise with each other to provide the best plan of action for you. They include a dietitian who will meet with you and produce a bespoke eating plan, and specialist trained nurses who will be by your side during your journey to offer support and guidance to ensure that you achieve your goals.

Contact us for more details.

Weight Loss Surgery - Your Main Options - post compares all 4 treatments.

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References

¹ http://www.obesityaction.org/educational-resources/resource-articles-2/weight-loss-surgery/choosing-the-right-weight-loss-surgery-procedure
² http://www.nlm.nih.gov/medlineplus/ency/patientinstructions/000350.htm
³ https://asmbs.org/patients/bariatric-surgery-faqs

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