Treatment Considerations Before and After Bariatric Surgery

The decision to undergo bariatric surgery will affect your lifestyle for years to come. When you choose to undergo gastric bypass, LAP BAND®, or other types of bariatric surgery, you will need to alter your exercise and diet regimen, both before and after your bariatric surgery operation. This page provides more information about the pre- and post-surgical preparations you will need to consider for bariatric surgery treatment.

Preoperative Preparations for Bariatric Surgery

Before undergoing any type of bariatric surgery, it is important that patients follow their doctors' instructions closely and educate themselves on the risks and potential benefits of the procedure. To mentally prepare yourself for obesity surgery, do the following:

• Understand the surgical process and what to expect afterwards
• Talk to people who have had surgery for obesity
• Start a journal about your experience
• Get your family to write you a letter of support

All patients must undergo preoperative counseling before undergoing obesity surgery. This counseling will help you better understand that bariatric surgery is only one part of a multidisciplinary approach to weight loss. In no way should this surgery be viewed as a "quick fix." Rather, gastric bypass surgery patients will be required to make lifelong changes to their diet and exercise habits to ensure a lasting result after bariatric surgery.

Behavioral Therapy

A thorough psychological evaluation is a crucial part of every obesity surgery patient's surgical preparations. Once you have spoken with a doctor about the possibility of bariatric surgery, you will meet with a behaviorist trained in counseling bariatric patients. The evaluation will include your social, personal, and psychiatric history.

In addition to asking about your reasons for desiring gastric bypass surgery, the behaviorist will also determine whether you are prepared to alter your diet and exercise plan before and after bariatric surgery. The patients with the highest rate of long-term success are those with a strong support system of family and friends who are willing to assist patients physically and emotionally.

Certain physical and psychological conditions can reduce the chance of bariatric surgery success. These conditions include:

• Substance or alcohol abuse
• Undiagnosed, untreated depression
• Schizophrenia or other personality disorders

Evaluation by a behaviorist can uncover these conditions, allowing your doctors to treat them and giving you the best chance of success after bariatric surgery.

Physical Preparation for Obesity Surgery

A careful regimen of exercise and diet must be adhered to before bariatric surgery to ensure that your body is ready for both surgery and for the drastic changes that it will undergo in the months following treatment.

Nutrition and Diet Therapy

Obesity surgery candidates should meet with a registered dietician on a regular basis to determine diet needs both before and after bariatric surgery. Caloric and nutrient needs should be determined based on medical history, actual weight, food preferences, and meal frequency. Individualized meal plans can then be customized to each patient's eating habits, lifestyle, budget, and nutritional needs.

Fitness and Exercise Therapy

Developing an individualized exercise and physical activity plan is one of the most important steps of obesity surgery preparation. This exercise plan should begin well before and should be resumed as soon as possible after bariatric surgery. Even a small increase in exercise can improve a patient's flexibility, range of motion, and balance, as well as decrease the chance of injury and soreness.

All new fitness and diet plans should begin well before bariatric surgery and be closely supervised by a doctor. The doctor will provide the patient with a set of guidelines, which are likely to include the following provisions:

• Drink at least 64 ounces of water each day
• Stop smoking for at least eight weeks before obesity surgery
• Cease consumption of caffeinated beverages
• Take a multivitamin each day, unless you are allergic or your doctor advises you not to
• Keep a detailed written food diary
• Eat at least three meals per day and avoid snacking in between - don't worry about the calories for now, focus on the behavior
• Begin a walking program if possible
• Write down your feelings every day to remind yourself of your commitment to begin a new and healthier lifestyle
• Attend support groups for patients considering gastric bypass surgery or other obesity surgery
• Follow your surgeon's instructions regarding any medications you may be taking to control other health conditions

The Day of Surgery

On average, surgery for obesity takes about two hours and is performed under general anesthesia. When possible, most bariatric surgeons use laparoscopy, a procedure in which a tiny video camera is inserted inside the patient's abdomen. Through the laparoscope, the surgeon can view the procedure on a separate video monitor. The camera allows doctors to perform minimally invasive bariatric surgery that uses only a small abdominal incision. Compared to more invasive techniques, laparoscopy has fewer complications, and patients can return to work and other activities more quickly. There is also a lower risk of infection, and some recent studies have shown that patients experience less pain after laparoscopic bariatric surgery.

Bariatric Surgery Recovery

The average time in the hospital is two days for laparoscopic bariatric surgery, and about three to five days for open bariatric surgery. Recovery time is about two to six weeks, depending on the type of operation, your condition, the type of work that you do, and other factors.

Postoperative Considerations for Obesity Surgery

Healing time and long-term success after gastric bypass surgery depend largely on your diet and exercise habits. After bariatric surgery, following your surgeon's fitness and nutrition guidelines will decrease the risk of complications and increase the chance that you will be satisfied with the outcome.

Diet After Bariatric Surgery

You should expect to make drastic changes to your diet after undergoing bariatric surgery. The stomach will be reduced to a much smaller size and, as a result, the amount of food you can eat is very limited. In order to ensure good nutrition and health, you must also pay very close attention to the types of food you eat. Foods that were well tolerated prior to surgery for obesity may cause discomfort afterwards. Discussing your diet with a nutritionist both before and after bariatric surgery can prepare you to make educated and healthy food choices.

Exercise After Bariatric Surgery

Exercise plays a crucial role after bariatric surgery. Patients take in far fewer calories directly following surgery, sometimes causing the body to react as if it were starving. In its search for more energy, the body can begin to burn muscle instead of fat. To prevent this, it is imperative to begin exercising regularly as soon as possible. This alters the metabolism so that the body begins to burn fat instead of muscle. Exercising also helps patients lose weight more rapidly.

Ongoing Support

Joining a support group is one of the best things a patient can do after bariatric surgery. Bariatric surgery requires many lifestyle and behavioral changes, and patients usually need the support of family, friends, and healthcare professionals to help get through any rough spots.

Discuss Treatment with a Bariatric Surgeon Near You

If you are considering gastric bypass surgery, it is important that you understand how your diet and exercise habits will change both before and after bariatric surgery. The only way to map out an obesity surgery plan that's right for you is to meet with a surgeon in person. DocShop can get you started by helping you find qualified bariatric surgeons in your area who can guide you through the process.