Living with Bariatric Surgery: Managing your mind and your weight

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Bariatric surgery is often done only after you've tried to lose weight by improving your diet and exercise habits. Who it's for As you figure out what foods your body can digest well, continue to explore solid food options and find a diet that is sustainable for you — one that lets you still enjoy your favorite foods, desserts, and drinks in moderation without resulting in pain, nausea, digestive discomfort, or vomiting. As with any major procedure, bariatric surgery poses potential health risks, both in the short term and the long term.

More long-term risks are associated with the changes made to your stomach. According to the Endocrine Society, these may include: Kingma JS, Burgers DM, Monpellier VM, Wiezer MJ, Blussé van Oud-Alblas HJ, Vaughns JD, et al. Oral drug dosing following bariatric surgery: General concepts and specific dosing advice. Br J Clin Pharmacol 2021;87:4560-76

Risks

Consider staggering the doses of drugs, particularly liquid formulations, due to the reduced capacity of the stomach. Use higher concentration liquid formulations to reduce the volume of each dose. Oral contraceptives may not be reliable after bariatric surgery. This is due to lower absorption and bioavailability after gastric bypass and concerns about effectiveness following all types of bariatric surgery. 4, 9 Alternative contraceptive methods should be considered, in particular long-acting reversible contraception. NICE CG189 guidance on obesity emphasised the importance of regular post-operative follow-up with a minimum of two years in the bariatric surgical service. Following discharge from the bariatric surgical service, “there should be at least annual monitoring of nutritional status and appropriate supplementation according to need following bariatric surgery, as part of a shared care model of chronic disease management”. Some examples of possible shared care models can be found here.

comorbidities (such as hypertension, hyperinsulinaemia, dyslipidaemia, type 2 diabetes, psychosocial dysfunction and exacerbation of conditions such as asthma)It is not possible to predict how much weight you will lose. Weight loss tends to be fast in the first 4 months, about 1 stone per month. This then slows down and be stable within the year. It is unlikely that you will reach a BMI of 25 or less. The operation aims to improve your health and weight is only part of this. To achieve the best results, it is important to follow advice about long-term food and lifestyle changes. Commitment After weight-loss surgery, you generally won't be allowed to eat for 1 to 2 days so that your stomach and digestive system can heal. Then, you'll follow a specific diet for a few weeks. The diet begins with liquids only, then to pureed and very soft foods, and eventually, to regular foods. You may have many restrictions or limits on how much and what you can eat and drink. She explained that surgery is about appreciating both the positive aspects and the challenging aspects, so patients comprehend that surgery and the subsequent weight loss is not going to solve all of their problems and make them appreciate that patients will encounter some unexpected challenges and problems along the way. not getting enough vitamins and minerals from your diet – you'll probably need to take supplements for the rest of your life after surgery European Association for the Study of Obesity (EASO) – Tips for weight loss maintenance after bariatric surgery European Association for the Study of Obesity.