Digestive Disorders | Bariatric Surgery | Life After Bariatric Surgery

Weight-loss surgery is not a cure for obesity, but rather a tool to help you lose weight to live a healthier, longer and more fulfilling life. Success depends on your ability to follow guidelines for diet, exercise and lifestyle changes.

The UCSF Bariatric Surgery Center offers follow-up care, including a support group, dietitian and continuing education to help patients achieve long-term success. We recommend joining a support group in your community or online. Your chance of maintaining a healthy weight will increase if you have a network of people who can offer encouragement and help you stay on track.

After a bariatric operation, you can't consume whole pills or extended release medicines. For the rest of your life, pills should be crushed and capsules opened. You will likely need adjustments to your medication regime at the time of your operation so you can safely continue taking a comparable daily dose. Remember that you can't take extended release medication since absorption will be blocked.

To help prevent the formation of ulcers, we recommend a daily acid reducer such as ranitidine (Zantac) or cimetidine (Tagamet). These are available over the counter in generic forms.

Do not take non-steroidal anti-inflammatory drugs (NSAID). Examples of NSAID are aspirin, ibuprofen, Advil, Motrin, Naprosyn and Celebrex. These medications could make you prone to ulcer formation along the staple line and in the excluded portion of your stomach and small intestine. After bariatric surgery, ulcers are more difficult to diagnose and treat. Check with your primary care provider or pharmacist, when starting a new medication.

We recommend a daily multivitamin and minerals supplement containing a minimum of 400 mcg of folic acid. Additionally, you should take 1,200 mg daily of calcium and 400 IU daily of vitamin D. Take calcium and vitamin D together at a different time than the multivitamin for improved absorption.

We advise women of childbearing years to use effective birth control for the first two years after a bariatric operation. Your ability to take in normal quantities of a balanced diet and rapid weight loss will impact your nutritional status.

The additional demands of a pregnancy on your body could lead to fetal compromise and birth defects so we strongly recommend against pregnancy for two years after bariatric surgery.

Many patients return to work in two weeks after the operation with no activity restrictions. Some people, however, need an additional two weeks. Your recovery will depend on your general state of health and physical conditioning before surgery. Getting back to full strength will vary and usually takes about six weeks.

Diet guidelines limit calories while providing balanced meals to help prevent nutritional deficiencies and preserve muscle tissue. Tolerance to foods will vary.

Daily calories should be between 400 to 900 initially, and never exceed 1,000 calories a day. Follow a diet low in calories, fats and sweets. The daily protein goal is 65 to 90 grams by two months after surgery. Keep a daily record of food portions and calories and follow up with a dietitian. Be aware that it is possible to stretch your gastric pouch with repeatedly over eating.

Over time, increase the variety and consistency of foods in your diet. Some foods may be poorly tolerated, such as red meats, chicken, breads, high fiber fruits and vegetables. Consume at least 1.5 to 2 liters of fluids daily, unless otherwise restricted by a medical condition.

Alcoholic beverages will have a more profound effect and should be avoided or consumed with caution.

The goal is to exercise for 30 to 45 minutes a day, with cardio or aerobic activity three to five times a week. Initially, we recommend walking five minutes in the morning and five minutes in the late afternoon. You should increase these intervals by 5 minutes at a time as tolerated until you are walking at least 15 minutes twice per day. After that, you can add variety to your exercise, such as a light jog.

If you feel you've reached a plateau, revise your exercise pattern. Trying different activities, adding in more strenuous exercises and increasing duration. Alternating between walking and jogging in two to five minute intervals can help break a plateau and burn fat. For more of a challenge, you can try alternating between jogging and sprinting.

Resistance training will help build muscle and burn calories. This will help in weight loss maintenance since a bigger muscle mass will use more calories even at rest. Start with a light weight, such as 2 to 5 pounds, and do 10 repetitions of the exercise, completing three sets of 10. As you feel your strength increasing, add more weight.

You have undergone a major operation to help achieve weight loss and a healthy body mass index (BMI). That was a big decision and now you have a commitment to a new way of life.

Every day should be a reflection of a new attitude that you're important and your health matters. Be proud of yourself for every day that you keep your calories below 1,000 and that you exercise for a minimum of 30 minutes. Stay involved in hobbies you enjoy, activities and groups. Keep contact with a weight-loss or bariatric support group. The key is to maintain a well-balanced diet and moderately strenuous activity.

Support groups provide weight-loss surgery patients an opportunity to discuss personal and professional issues. Most learn, for example, that weight-loss surgery will not immediately resolve existing emotional issues or heal the years of emotional damage that morbid obesity might have caused.

At the UCSF Bariatric Surgery Center, a support group can help with short-term and long-term questions and needs. The majority of patients find that ongoing support helps them achieve the greatest long-term success.

The long-term effects of bariatric surgery are still being studied. It is known that nutritional deficiencies can arise over time. You will need periodic blood tests to help ensure nutritional balance. We recommend that a series of tests every three months for the first year and then annual tests for the rest of your life.

In addition to a complete bood count (CBC), tests will measure alanine aminotransferase (ALT), albumin, alkaline phosphatase, aspartate aminotransferase (AST), calcium, cholesterol panel, direct and total bilirubin, electrolytes, fasting glucose, ferritin, folate, hemoglobin A1c, iron saturation and transferring, magnesium, phosphorus, total protein and Vitamin B12. Other tests may measure thiamine and vitamin D.

This information is for educational purposes only and is not intended to replace the advice of your doctor or health care provider. We encourage you to discuss with your doctor any questions or concerns you may have.