It is strongly recommended that women wait until at least one year after the surgery and until they have reached their goal weight before a pregnancy. Approximately one year after surgery, your body will be fairly stable (from a weight and nutrition standpoint) and you should be able to carry a normally nourished fetus. During the first year you are losing weight rapidly and that environment represents special risks for a growing fetus. You should consult your surgeon as you plan for pregnancy.
The staples used on the stomach and the intestines are very tiny. They are much smaller than the staples you will have in your skin or staples you use in the office. Each staple is made of stainless steel or titanium and is so small it is hard to see other than as a tiny bright spot. Because the metals used (titanium or stainless steel) are inert in the body, most people are not allergic to them and they do not cause any problems. The staples are non-magnetic, which means they will not be affected by MRI. Patients with the adjustable gastric band are discouraged, but not prohibited, from having an MRI the first six months after placement. The staples will not set off airport metal detectors.
Patients can return to normal sexual intimacy when their wounds have healed and they feel physically ready. Many patients experience a drop in desire for about 6 weeks.
Both men and women generally respond well to this surgery. Men tend to lose weight slightly faster than women do.
Patients are encouraged to stop smoking at least two months before surgery. Smoking increases the risk of lung problems after surgery, increases the risk of infection, slows the rate of healing, and interferes with blood supply to the healing tissues.
There is good evidence from scientific research that if you have type 2 diabetes or other serious obesity-related health conditions, are at least 100 pounds over ideal body weight, and are able to comply with lifestyle changes (daily exercise and low-fat diet), then bariatric surgery may significantly prolong your life.
Research has shown that weight loss surgery can improve or resolve associated health conditions:
|Condition||Percentage found in preoperative individuals||Percentage cured 2 years after surgery|
|Diabetes or insulin resistance||34%||85%|
|High blood pressure||26%||66%|
|Sleep apnea||22% in males, 1% in females||40%|
If you have an ID number to access the portal, or if you've been asked to fill out your new patient information online, register at the Memorial Health Bariatrics portal.
Your doctor will determine whether medications for blood pressure, diabetes, etc., can be stopped as your health improves after weight-loss surgery. For medications that must be continued, the vast majority can be swallowed and absorbed after weight-loss surgery. Usually no change in dose is required. Two classes of medication that should be used only in consultation with your surgeon are diuretics (fluid pills) and NSAIDs (most over-the-counter pain medicines). NSAIDs (ibuprofen, naproxen, etc.) may create ulcers in the small pouch or the attached bowel. Most diuretic medicines make the kidneys lose potassium. With the dramatically reduced intake experienced by most weight-loss surgery patients, they are not able to take in enough potassium from food to compensate. When potassium levels get too low, fatal heart problems can occur.
Milk contains lactose (milk sugar), which is not well digested. This sugar passes through undigested until bacteria in the lower bowel act on it, producing irritating byproducts and gas. Depending on individual tolerance, some people find even the smallest amount of milk can cause cramps, gas, and diarrhea.
No, your salt intake will be unchanged unless otherwise instructed by your primary care physician.
Most patients are able to enjoy spices after the initial six months following surgery.
It's normal not to have an appetite for the first month or two after bariatric surgery. If you are able to consume liquids reasonably well, there is a level of confidence that your appetite will increase with time.
Snacking, nibbling, or grazing on foods, usually high-calorie and high-fat foods, can add hundreds of calories a day to your intake, defeating the restrictive effect of your operation. Snacking will slow down your weight loss and can lead to regain of weight.
Most patients say no. In fact, for the first four to six weeks patients have almost no appetite. Over the next several months the appetite returns, but it tends not to be a ravenous "eat everything in the cupboard" type of hunger.
In the Roux-en-Y gastric bypass, the stomach pouch created is 30 cc (one ounce) or less in size. About six to 12 months after surgery, the stomach pouch expands slightly, but it will always remain smaller than the normal stomach. Many patients end up with a meal capacity of three to seven ounces.
Most pills or capsules are small enough to pass through the new stomach pouch. Initially, your doctor may suggest that medications be taken in liquid form or crushed.
Patients may begin to wonder about this early after the surgery when they are losing 20 to 40 pounds per month, or maybe when they've lost more than 100 pounds and they're still losing weight. Two things happen to allow weight to stabilize. First, a patient's ongoing metabolic needs (calories burned) decrease as the body sheds excess pounds. Second, there is a natural progressive increase in calorie and nutrient intake over the months following weight-loss surgery. The stomach pouch and attached small intestine learn to work together better, and there is some expansion in pouch size over a period of months. The bottom line is that, in the absence of a surgical complication, patients are very unlikely to lose weight to the point of malnutrition.
Many patients experience some hair loss or thinning after surgery. This usually occurs between the fourth and the eighth month after surgery. Consistent intake of protein at mealtime is the most important prevention method. Also recommended are a daily zinc supplement and a good daily volume of fluid intake. Most patients experience natural hair regrowth after the initial period of loss.
You can, but you will need to be very careful, and we recommend that you avoid it for the first several months. Red meat contains a high level of meat fibers (gristle) that hold the meat together, preventing you from separating it into small parts when you chew. The gristle can plug the outlet of your stomach pouch and prevent anything from passing through, a condition that is very uncomfortable.
Adjustable Gastric Band
The adjustable gastric band shrinks your stomach size to about 20 to 30 cc (approximately an ounce).
The band works by providing restriction. Large capsules or tablets can get stuck in the band. It is recommended that you crush tablets and open capsules and mix with food. Please check with your medical doctor or pharmacist to ensure this is okay with your particular medications.
The laparoscopic adjustable gastric band works by restricting outflow of food from the area above the band. This small piece of stomach stretches and you feel full and lose your appetite. The band only works if this exit is narrow. If you are properly adjusted, meats or bread will get stuck in the band, causing vomiting.
If your band is appropriately adjusted you will eat only small amounts of food. That food will stretch your stomach, resulting in your feeling full and losing your appetite. If you feel hungry after eating, your band probably needs an adjustment.
Several studies have shown that regular exercise helps you build muscle, replacing muscle lost during the period of rapid weight loss in the first six months after surgery. Patients who exercise feel better and manage their weight loss better.
Exercise is good in so many other ways that a regular exercise program is recommended. Unfortunately, some patients may still be left with large flaps of loose skin.