George had been called “big” all his life. Growing up, he was always bigger than his peers.
He tried fad diet after fad diet—from 1200 calories a day to keto dieting and intermittent fasting. You name it, he tried it. He would lose 20 pounds, only to regain it a few months later. The weight never seemed to stay off permanently.
In his 30s, his BMI climbed to 35 kg/m², and he was diagnosed with obesity. He struggled with poor self-image and low self-esteem. Moving around became difficult, and he avoided going out in public or attending social gatherings.
He dreaded the stares and whispers.
At his sister’s suggestion, he visited a GP, who referred him to a bariatric surgeon. After several consultations, he decided to undergo bariatric surgery. The doctor explained the procedure. The outcomes of weight loss are promising, and a more fulfilling life.
On the day of the surgery, George woke up feeling nervous but hopeful for the first time in a long while.
Could this truly be the light at the end of the tunnel?
After years of feeling out of place in his body and facing the dejection of failed weight loss attempts, could this finally be the solution? It felt surreal to George. When he woke up groggy after the surgery, he was greeted with happy news: the surgery had gone well!
After an uneventful stay and recovery, his surgeon said, “You’re free to go home! I’ll see you at your next appointment.” George happily packed his bags, eager to begin a new chapter of his life.
But then came the million-dollar question: How do I keep the weight off?
Weight Loss after Surgery
Weight loss after bariatric surgery is relatively easy in the first year. The weight melts away, and the numbers on the scale drop effortlessly. This happens because your appetite is significantly reduced after the surgery.
However, it’s also easy to start regaining weight a year after surgery.
How Will My Diet Look Like Post Surgery?
You may resonate with George and decide to leap to undergo bariatric surgery.
You may be asking, ‘What’s next?’
Week 1 and 2
You may be put on a full liquid diet consisting of water and fluids. These fluids should be high in protein and low in sugar and fat, such as milk (if tolerated), yoghurt, broths and soup.
Week 3 and 4
Your doctor will transition you to a pureed diet consisting of soft foods such as yoghurt, mashed potatoes, scrambled egg whites, and tofu.
Other options include baby foods and blended items like carrots, cauliflower, and canned tuna.
Week 5 to 8
Your doctor will encourage you to eat semi-solid foods gradually. These should be easy to chew and swallow, such as cooked vegetables, soft chicken, fish, and eggs. Foods like bread, rice, pasta, and noodles are typically avoided, as they tend to stick together and may cause nausea.
From Week 8
Gradually introduce “harder” foods into your diet, such as salads, raw vegetables, and other types of meat.
This stage allows for an increased variety of foods and is often considered a process of trial and error. The ultimate goal is to transition back to a normal, well-balanced diet.
Food Won’t Taste the Same as Before
A study conducted at the Hospital of Leicester found that 97% of patients experienced changes in their perception of food:
- 73% reported changes in the taste of food.
- 50% noted changes in their sense of smell.
Some individuals also reported heightened sensitivity to sweet, sour, and salty foods. While the exact cause remains unclear, scientists suspect that changes in gut hormones may influence the nervous system.
Why Am I Gaining Weight After Surgery?
Multiple reasons contribute to this:
- An increase in appetite
- Failing to maintain healthy habits.
As the saying goes, “Rome wasn’t built in a day,” and old habits die hard. Many individuals are diligent with their diet and exercise routines during the first year after surgery, but often, these efforts wane over time.
- Poor eating habits
Common issues include binge eating, having a highly processed diet, and eating continuously throughout the day.
- Reduction in metabolism
Weight loss causes a reduction in metabolism. When you weigh more, your body burns more calories. As you lose weight, your metabolism slows down. You require fewer calories per day. Consuming the same amount of calories pre-surgery contributes to weight gain as well.
Staying on Track after Bariatric Surgery
1. Adopting Healthy Habits
Discipline and motivation can take you far, but habits are the key to success.
- Eat slowly, chew thoroughly, and savour your food. Limit distractions at the dinner table.
- Don’t skip meals—aim for three balanced meals daily, with one or two healthy snacks in between.
- Avoid waiting until you’re ravenous to eat, as this can lead to overeating, eating too quickly, and choosing unhealthy options, which may result in nausea or vomiting.
2. A Balanced Diet
- Avoid rice, bread, pasta, bagels, noodles, fast foods and highly processed foods. Stay away from sugar! Foods high in sugar and fat can cause dumping syndrome. It’s a condition where food empties rapidly from the stomach into the small intestine. Instead of sweet treats like ABC kacang or cendol, opt for fruits.
- Make fibre—found in vegetables and fruits—a staple in your diet. Fiber helps prevent constipation and is packed with essential minerals and micronutrients, while also promoting a healthy gut microbiome.
- As you gradually return to your original diet, don’t forget to prioritise protein. Choose lean meats like poultry and fish over red meats like beef and lamb.
3. Stay Hydrated
- During recovery, avoid drinking water 30 minutes before for 1 hour after eating to prevent dumping syndrome. Aim to drink 1.5–2L of water a day.
- Avoid alcoholic beverages and sugary drinks such as fruit juices, sodas, and local drinks like sirap bandung. Refrain from consuming caffeinated drinks for the first 2 weeks.
4. Multivitamins
- After surgery, your doctor may recommend taking multivitamins to prevent nutrient deficiencies. Multivitamins typically contain vitamins C, B, A, and K, potassium, magnesium, calcium, iron, and more.
- You may also be advised to take a Vitamin B12 complex and calcium supplements to help prevent bone diseases like osteoporosis.
5. Activities Post Surgery
- Right after surgery, you’ll be encouraged to go easy on physical activity. Going up and down stairs and walking short distances is fine, but vigorous activity can delay recovery.
- Avoid sexual activity for the first 2 to 4 weeks and swimming for the first 2 weeks. Also, avoid activities involving core muscles, such as Pilates, golf, yoga, and badminton, for the first 6 weeks.
- Start with slow walks and gradually incorporate low-impact exercises into your routine after 6 weeks. Over time, you can introduce more intense exercises based on your doctor’s guidance.
- Strength training is important for building muscle, as muscle burns more calories than fat.
- Fun fact: studies show that racquet sports can increase your lifespan by 47% compared to those who are inactive!
6. Surround yourself with a Healthy Community
You are the company you keep—birds of a feather flock together. Surrounding yourself with people who strive to live a healthy lifestyle can greatly accelerate your ability to cement and maintain your health and weight loss goals.
Consider joining a run club or a Zumba class, or make pickleball friends. Have a group of people you can swim or play badminton with.
Being around others who are passionate about staying healthy will support you tremendously. Plus, you can make new friends and build meaningful relationships.
You should join a support group with peers who have undergone bariatric surgery. Sharing stories and experiences post-recovery can be incredibly helpful.
7. Go for your Check-Ups
Lifelong check-ups are essential after surgery. Be diligent about attending your appointments.
Don’t miss any check-ups, and if you have questions or concerns, don’t hesitate to share them with your doctors. You are not alone! Your doctors are here to help you and want to see you succeed in maintaining your weight loss.
Everyone’s journey is different, and there is no one-size-fits-all approach. You’ll receive a personalised plan tailored to your lifestyle—considering factors such as work, age, underlying health conditions, gender, and goals.
Regular check-ups include weigh-ins, blood tests, blood pressure monitoring and more.
8. A Decluttered Mind
We may not realise it, but the connection between our eating habits and emotions is more intertwined than we think.
Bariatric surgery doesn’t change eating habits or psychological triggers, so working with a therapist can help address emotional eating.
9. Avoid NSAIDs
Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and naproxen, can cause gastric ulcers.
Check with your doctor to see if there are other medications you should avoid.
Is Bariatric Surgery for Me?
Bariatric surgery is life-changing and offers numerous health benefits. Schedule a health checkup with your doctor today to determine your eligibility for surgery.
References
- Life After Bariatric Surgery https://www.ucsfhealth.org/education/life-after-bariatric-surgery#:~:text=Weight%2Dloss%20surgery%20can%20start,diet%2C%20exercise%20and%20lifestyle%20changes. [Last accessed 12 December 2024]
- Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality: a cohort study of 80 306 British adults https://bjsm.bmj.com/content/51/10/812 [Last accessed 12 December 2024]
- How To Keep the Weight Off After Bariatric Surgery https://www.orlandohealth.com/content-hub/how-to-keep-the-weight-off-after-bariatric-surgery#:~:text=Incorporate%20daily%20exercise.,for%20post%2Dsurgery%20bariatric%20patients. [Last accessed 12 December 2024]
- Weight loss maintenance after bariatric surgery https://pmc.ncbi.nlm.nih.gov/articles/PMC10337010/#sec3 [Last accessed 12 December 2024]
- Differential Changes in Dietary Habits after Gastric Bypass Versus Gastric Banding Operations https://link.springer.com/article/10.1007/s11695-008-9769-3 [Last accessed 16 December 2024]
- Dietary Guidelines After Bariatric Surgery https://www.ucsfhealth.org/education/dietary-guidelines-after-bariatric-surgery [Last accessed 17 December 2024]