Going back to work

Your ability to resume pre-surgery levels of activity will vary according to your physical condition, the nature of the activity, and the type of weight loss surgery you had.  Many patients who have had laparoscopic surgery may be able to return to full pre-surgery levels of activity within 1 to 2 weeks of their procedure, around the time of the transition to solid food. However, recovery period varies greatly from patient to patient and can extend up to six weeks after uncomplicated LAGB for people who are adjusting slowly to their new eating habits. For patients who require conversion to open surgery or who experience complications, recovery time to return to work may extend beyond six weeks.

Our standard recommendation is for up to six weeks of medical leave following surgery to allow sufficient time to recover and become used to maintaining adequate hydration and calorie intake after gastric banding. Most patients find that it is easier to return to work sooner than expected rather than trying to extend a shorter period of leave an extra week.

Weight Loss after Surgery     

Weight loss should occur steadily in the first three months following surgery but will slow as you start to increase solid food intake. For most patients, weight loss is not constant but has peaks and valleys. Eventually your weight loss will stabilize somewhere between 2 and 4 years after surgery. At this point it may fluctuate plus or minus 10 percent, largely dictated by your eating and activity patterns.  Intermittent weight gain is best controlled with a combination of appropriate daily eating habits, regular exercise, and participation in a weight loss support group which may help avoid returning to behavioral eating patterns which led to gaining excess weight in the past

Exercise after Surgery

You can begin moderate aerobic exercise as early as 1 week after uncomplicated laparoscopic surgery. This includes walking, swimming, water aerobics, and similar activities. You should check with your surgeon prior to beginning a strenuous exercise program in the first month after surgery.

Vitamins and Supplements after Surgery

Vitamins and supplements are used by the general public to avoid nutritional deficiencies caused by taking in too little of the essentials in our diet. Because of decreased food volumes and the anatomy changes after gastric bypass, it may be even more difficult to maintain healthy levels of vitamins and minerals without the use of supplements. We generally recommend taking a multivitamin beginning immediately after surgery, then supplemental calcium beginning at one month. Many of our patients also choose to take additional B complex vitamins, folic acid, iron, and/or other supplemental minerals. There are many types and brands of vitamins and supplements, some made specifically for bariatric surgery patients (www.bariatricadvantage.com and www.bariatricsupplementsystem.com are two examples).  

Medications after Surgery

For the first 4 weeks after LAGB, you should plan to crush all your medicines or take them in liquid form. Many medicines today are in time release capsules or tablets designed to make it more convenient to take. Immediately after gastric bypass and even long-term, many of these time release formulas are difficult to take because of their size or inability to crush them. In planning for surgery, you should obtain a 3 week supply of crushable pills or liquid forms of your regular medicines from the physician who normally prescribes them. You will be given a prescription for liquid pain reliever from your surgeon to be used after surgery.

Diabetes medicines

Some patients have reduced requirements for diabetes medications immediately after surgery. You should be careful to watch for signs of low blood sugar in the first few weeks after surgery. If you take diabetes medicine, you should make arrangements to see the doctor who prescribes these medicines within one week after discharge from the hospital. It may be helpful to arrange this visit prior to the day of surgery.

High Blood Pressure medicines

You will leave the hospital without any change in your blood pressure medicines unless you take a diuretic (a water pill). We generally stop diuretics to avoid dehydration. You should make arrangements to see the doctor who prescribes your blood pressure medications within one month after discharge from the hospital.

Emotional life

Any major change in life is associated with stress. The significant weight loss that will occur in the first year after surgery may be a change for the better, but it will still represent a tremendous stress in your life. We recommend:

• Try to avoid adding other major stressors to your life at this time. Examples would include changing jobs or careers, making major changes in family relationships, buying a new house, or taking on a major new project.
• Ongoing participation in an organized program of counseling or support group affiliated with a weight management program during the first year after surgery.

Sex and pregnancy

Significant weight loss may affect many aspects of your sexuality, including fertility for women. Pregnancy in the first year after gastric bypass is possible, but represents a significant emotional and physical stress to our patients. We recommend:

• Women of child-bearing age must use the most effective forms of birth control immediately preceding and during the first 16 to 18 months after weight loss surgery. Weight loss in women can make it physiologically easier to become pregnant.
• It is of paramount importance that any woman who may become pregnant after any weight loss surgery be taking adequate nutritional supplements. Specific concerns of folic acid deficiency and neural tube defects occurring during early pregnancy are important.

Regarding emotional issues related to sexuality and body image, we recommend ongoing participation in an organized program of counseling or support group affiliated with a weight management program during the first year after surgery.

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