Bariatric Surgery: Everything You Need to Know (Including What Your Doctor Might Not Be Telling You)

  • Causes of Morbid Obesity
  • What is Bariatric Surgery?
  • Mental & Emotional Preparation
  • Advocating for Yourself
  • Building Support
  • Planning
  • Pre-Surgery Weight Loss
  • In the Hospital
  • The First Few Days at Home
  • Physical Issues
  • Emotional Issues
  • Other Issues
  • Emotional Challenges
  • Health Problems
  • Relationships

Understanding Weight Loss Struggles & Bariatric Surgery

Getting Ready for Surgery

  • Decide what you want. Believe in yourself!
  • Know the facts. Educate yourself about bariatric surgery and potential issues.
  • Plan. You need a strategy for recovery and ongoing lifestyle changes.
  • Gather support. It’s helpful to have family, friends, and people who have similar issues on your side.
  • Target your efforts. Find the best medical practitioner. Find the right person at your insurance company to plead your case to.
  • Express yourself clearly. Tell doctors and insurance agents that you are interested in surgery and why you feel you need it. Stick to the point, and don’t give up if they say “no.” It may help to role play scenarios with a friend or family member who supports your decision.
  • Assert yourself, but don’t lose your temper. Respect the rights of others, but ask for what you need, and then listen.
  • Finally, don’t give up. Be firm and persistent. Follow through on what you promise. (Those six months of weight-loss records, for example.)

After Surgery Is Approved

  • Someone to care for your children and pets while you’re in the hospital and perhaps during recovery at home
  • Help cooking meals and cleaning the house
  • Someone to accompany you to the hospital and be your advocate when you can’t do that yourself
  • Help dealing with the inevitable emotions and stresses of major surgery and a major lifestyle change

Immediately After Surgery

  • Follow your doctor’s orders. Ask questions when you have them and express concerns, but trust your doctor’s recommendations and prioritize your physical health.
  • Keep a journal. You can use this to keep track of the foods you eat, as well as whether or not you are emotionally eating, but you might also choose to express what you’re thinking and feeling. This will be a private record, just for you. Remember, you are more than your diet and weight.
  • Write down realistic goals and expectations. Celebrate when you meet them!
  • Reflect on the past. Remember why you decided to make this change, and honor how far you’ve come.
  • Take plenty of photos and keep your old clothes. This will help you physically see your immense transformation.
  • Call on that support team you’ve created.
  • Look forward to living life to the fullest!

Ongoing Recovery

  • One to three days after surgery. Leave hospital, manage pain, drink clear liquids, and do basic exercise
  • One week. Transition to over the counter pain meds. Liquid and smooth foods.
  • Two weeks. Pain should be gone. Eat pureed and soft foods. Return to work.
  • Three weeks. Start solid foods.
  • Four to six weeks. Incisions healed. Heavy lifting OK. Start normal diet. Weight loss should be noticeable.
  • Body aches. Hot baths with Epsom salts and heating pads may help.
  • Feeling fatigued and ill. This may be a sign of a vitamin or mineral (micronutrients) deficiency. Check to be sure you are getting enough essential vitamins and minerals.
  • Feeling cold. Between 20 and 40% of gastric bypass patients have iron deficiency, which may cause cold intolerance. Address this possibility with your doctor. Meanwhile, dress in layers, wear socks to bed, and keep yourself warm!
  • Dry skin. Make sure you are drinking enough water. Check with your doctor and dietician about specific vitamins and minerals to maintain skin cells.
  • Sagging skin. Surgery is possible for excess skin, though it’s expensive, and your insurance may not cover it. Insurance companies consider most forms of this surgery cosmetic and not reconstructive. However, because stomach folds may get infected, health insurance may cover it.
  • Hair thinning and hair loss. The stress of surgery and weight loss may cause the loss of 5 to 15% of your hair follicles. But unless you have a chronic illness or genetic reason for hair loss, it will grow back. Investigate whether you are getting the necessary nutrients to support hair growth,
  • Inability to handle iron, vitamin B12, folate, calcium, and vitamin D. Consult your dietician about how to get the vitamins and minerals you need to be healthy.
  • Give yourself time to get used to your new body. After they get thin, formerly overweight people may still see themselves as obese (body dysmorphia). Exercising may help you accept and connect with your thinner shape.
  • It’s important to set realistic expectations for yourself. Losing that excess weight will improve your overall health and quality of life, but it won’t solve all your problems.
  • Keep weight loss in perspective. During the honeymoon phase, after dramatic weight loss, you may feel empowered. But if you start gaining weight again, down the road, you may feel depressed, defeated, and ashamed. Know that it’s okay to have setbacks. Stay committed to your diet and lifestyle changes, and if you hit a plateau or roadblock, talk to your surgeon.
  • Plan ahead by researching the menu online. This can also help you plan the other meals in your day.
  • Select a balanced meal, with attention to the proportions of protein, fiber, and healthy fat. Many restaurants provide nutritional information on the menu or online.
  • Create your own dish. Don’t be afraid to ask for substitutions or modifications, or even for a half-portion.
  • Consider combining two healthy appetizers to make one nutritious, filling meal.
  • Avoid high-calorie drinks, such as sugary lattes and sodas.
  • Order first so you’re not swayed by others’ more indulgent choices.
  • Leave leftovers. Restaurant meals often include two, three, or even four servings, and enough calories to fill up a whole day. It might be smart to package half of your meal before you even begin to eat.
  • Chew every bite thoroughly. Don’t swallow until the food is smooth.
  • Eat slowly. Take about a half hour per meal to avoid vomiting or pain.
  • Eat six small meals a day instead of three big ones. Don’t snack between meals.
  • As soon as you feel full, stop eating.
  • Drink eight cups (two liters) of water every day. Don’t drink while you’re eating or for 30 minutes afterwards. Take small sips; don’t gulp. Avoid using a straw, which could make you swallow air. Avoid carbonated beverages, which can stretch your stomach pouch.

Potential Issues After Weight-Loss Surgery

  • Missing the food. I mentioned “food grief” above. Food does more than nourish us physically. Weddings, funerals, birthday parties — socializing revolves around food. Each holiday has its special foods. When you can’t participate as you used to, you can get the blues.
  • Old habits. We used food to deal with our emotions for all the years we were gaining weight. It’s hard to break that habit. The emotions are still there, but we can’t use food to make ourselves feel better.
  • We have other reasons for our depression than our weight. Those don’t go away after surgery.
  • We’ve just undergone the stress of surgery, which can lead to depression. But, as bariatric patients, taking antidepressants post-surgery is difficult.
  • Post-operative complications may send us back to the hospital. This happened to me, and it was depressing!
  • Borrow clothes or shop at thrift stores.
  • Shop your closet. Now’s the time to wear those too small items you just couldn’t part with when you were heavier.
  • Don’t buy too much. Get exactly what you need until the next size change.
  • Buy just a few practical basics and splurge on accessories.
  • Don’t buy for the future. Clothes that fit and flatter now are better for your confidence.
  • Alter. If you can’t alter your own clothes, find someone who can and get items altered as you lose weight. Most things can be taken in.
  • Exchange Clothing. If you’re in a support group, consider swapping clothes with other group members.
  • Create a support system
  • Take care of your body
  • Believe in yourself

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“Carol Adkisson, M.A., LMFT The Trauma and Healing Foundation Carol Adkisson, LMFT is an author, speaker, teacher and Licensed Marriage and Family Therapist.

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Carol Rose Adkisson

Carol Rose Adkisson

“Carol Adkisson, M.A., LMFT The Trauma and Healing Foundation Carol Adkisson, LMFT is an author, speaker, teacher and Licensed Marriage and Family Therapist.