Northwest Houston Surgical Association

Life After Weight Loss Surgery

faqWhen you meet with any of the NHSA surgeons for a consultation about weight loss surgery in Houston or Cypress, TX, they will carefully consider what will help you attain the best possible outcome for you and your lifestyle. They will educate you until they are convinced that you understand the risks and benefits of the weight loss option you choose. They will also educate you about life after weight loss surgery (bariatric surgery) in Houston or Cypress. Request a consultation online or call our office at 713-426-2400 for more information about how you can take the steps toward improving your life.

HOW CAN I MAXIMIZE THE SUCCESS OF MY WEIGHT LOSS SURGERY?

Guidelines to follow for life:

  • Adequate fluid intake of 6-8 cups (or 48-64 ounces) per day.
    • All your fluids should be calorie and sugar free (unless diluted with water).
    • Continue to avoid carbonated drinks. The bubbles can cause gas, bloating, and stretch the stomach pouch.
    • No drinking with meals (wait 30 minutes before and after). This can potentially stretch the stomach and can cause weight regain in the future.
    • Continue to avoid alcohol. You may choose to incorporate a 4 ounce glass of wine or 1 ounce of liquor a day after about 6 months.
  • Gradually add in regular textured food one at a time to test for tolerance.
    • You might need to hold off on a particular food (especially if it is high in fiber) if not tolerated well at first. Retry in a couple of weeks.
  • Your protein needs remain higher for the initial 2 months after surgery in order to maintain your muscle mass while rapidly losing weight.
    • It is recommended to eat high protein foods first. Then add vegetables and fruits, and low-fat starches (such as beans, potatoes, whole wheat pasta or rice).
    • Chew, chew, and chew your meat!
    • Continue to use a high protein supplement until you can tolerate enough protein from your meals.
  • Take 15 minutes at each meal.
    • It may help to put your fork or spoon down with every bite.
  • Do not skip meals (especially breakfast)!
    • Choose 3 meals and 2 high protein snacks per day.
    • Avoid grazing. If you continue to eat every 1-2 hours, you may end up consuming too many calories.
  • Stop eating when you feel full. Overeating can cause nausea and/or vomiting and may stretch your stomach. Instead of feeling uncomfortable after surgery, you will feel pain in your chest, shoulder, or under your breast bone.
  • Always avoid concentrated sweets, sugary drinks, high fat foods and heavily processed foods (such as sugary coffee drinks, french fries, fried chicken, ribs, milk shakes, doughnuts, cakes, etc.) These may cause dumping syndrome and are dense in calories which can slow down and even hinder your weight loss.
  • Continue taking your daily vitamins and minerals for life! You may choose to switch to capsules.
  • Exercise aerobically every day for at least 30 minutes (one-mile brisk walk, bike riding, stair climbing, etc.). Weight/resistance exercise can be added 3-4 days per week, as instructed by your doctor.
  • dr-fadner-img
    Meet Our Doctors

    Dr. Fadner

    Dr. Fadner is fellowship trained in Advanced Minimally Invasive Surgery and Bariatric Surgery and offers a wide range of general surgery operations to his patients.

  • Dr. Levia
    Meet Our Doctors

    Dr. Leiva

    A certified General Surgeon at the forefront of single incision and robotic general surgery. Dr. Leiva also has a special interest in primary and revision, advanced laparoscopic.






  • Dr. Amir
    Meet Our Doctors

    Dr. Amr

    As a highly skilled and fellowship trained weight loss surgeon, Dr. Amr is skilled in laparoscopic foregut surgery and bariatric (weight loss) surgery.






  • Dr. Ayyar
    Meet Our Doctors

    Dr. Ayyar

    Dr. Ayyar has pioneered minimally invasive surgery in the West and Northwest Houston area. His expertise in minimally invasive and endocrine surgery allow him to perform parathyroid operations.






WHAT’S SO IMPORTANT ABOUT EXERCISE?

When you have a weight loss surgery procedure, you lose weight because the amount of food energy (calories) you are able to eat is much less than your body needs to operate.

WHAT IS THE RIGHT AMOUNT OF EXERCISE AFTER WEIGHT LOSS SURGERY?

Many patients are hesitant about exercising after surgery, but exercise is an essential component of success after surgery. Exercise actually begins on the afternoon of surgery-the patient must be out of bed and walking. The goal is to walk further on the next day, and progressively further every day after that, including the first few weeks at home. Patients are often released from medical restrictions and encouraged to begin exercising about two weeks after surgery, limited only by the level of discomfort. The type of exercise is dictated by the patient’s overall condition. Some patients who have severe knee problems can’t walk well, but may be able to swim or bicycle. Many patients begin with low stress forms of exercise and are encouraged to progress to more vigorous activity when they are able.

CAN I GET PREGNANT AFTER WEIGHT LOSS SURGERY?

It is strongly recommended that women wait at least one year after the surgery before a pregnancy. Approximately one year post-operatively, your body will be fairly stable (from a weight and nutrition standpoint) and you should be able to carry a normally nourished fetus. You should consult your surgeon as you plan for pregnancy.

WHAT IF I HAVE HAD A PREVIOUS WEIGHT LOSS SURGERY AND I’M NOW HAVING PROBLEMS?

Contact your original surgeon – he or she is most familiar with your medical history and can make recommendations based on knowledge of your surgical procedure and body.

If you’re ready to improve your life, request a consultation online or call our office at 713-426-2400 for more information.

WHAT HAPPENS TO THE PART OF THE STOMACH THAT IS BYPASSED?

In some surgical procedures, the stomach is left in place with intact blood supply. In some cases, it may shrink a bit and its lining (the mucosa) may atrophy, but for the most part it remains unchanged. The lower stomach still contributes to the function of the intestines even thought it does not receive or process food – it makes intrinsic factor, necessary to absorb Vitamin B12 and contributes to hormone balance and motility of the intestines in ways that are not entirely known. In the BPD procedures, some portions of the stomach are completely removed.

HOW BIG WILL MY STOMACH POUCH REALLY BE IN THE LONG RUN?

This can vary by surgical procedure or surgeon. In the Roux-en-Y gastric bypass, the stomach pouch is created at one ounce or less in size (15-20cc). In the first few months it is rather stiff due to natural surgical inflammation. About 6-12 months after surgery, the stomach pouch can expand and will become more expandable as swelling subsides. Many patients end up with a meal capacity of 3-7 ounces.

WHAT WILL THE STAPLES DO INSIDE MY ABDOMEN? IS IT OK IN THE FUTURE TO HAVE AN MRI TEST? WILL I SET OFF METAL DETECTORS IN AIRPORTS?

The staples used on the stomach and the intestines are very tiny in comparison to the staples you will have in your skin or staples you use in the office. Each staple is a tiny piece of stainless steel or titanium 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 staples and they usually do not cause any problems in the long run. The staple materials are also non-magnetic, which means they will not be affected by the MRI. The staples will not set off airport metal detectors.

WHAT IF I’M NOT HUNGRY AFTER SURGERY?

It’s normal not to have an appetite for the first month or two after weight loss surgery. If you are able to consume liquids reasonably well, there is a level of confidence that your appetite will increase with time.

WILL THERE BE ANY DIFFICULTY IN TAKING MEDICATIONS?

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.

WILL I BE ABLE TO TAKE ORAL CONTRACEPTION AFTER SURGERY?

Most patients have no difficulty in swallowing these pills.

IS SEXUAL ACTIVITY RESTRICTED?

Patients can return to normal sexual intimacy when wound healing and lack of discomfort permit. Many patients experience a drop in desire for about 6 weeks.

IS THERE A DIFFERENCE IN THE OUTCOME OF SURGERY BETWEEN WOMEN AND MEN?

Both men and women generally respond well to this surgery. In general, men lose weight slightly faster than women do.

WILL I HAVE TO STOP SMOKING?

Patients are encouraged to stop smoking at least one month before surgery.

IF I CONTINUE TO SMOKE, WHAT WILL HAPPEN?

Smoking increases the risk of lung problems after surgery, can reduce the rate of healing, increases the rates of infection, and interferes with blood supply to the healing tissues.

HOW CAN I KNOW THAT I WON’T JUST KEEP LOSING WEIGHT UNTIL I WASTE AWAY TO NOTHING?

Patients may begin to wonder about this early after the surgery when they are losing 20-40 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.

WHAT CAN I DO TO PREVENT LOTS OF EXCESS HANGING SKIN?

Many people heavy enough to meet the surgical criteria for weight loss surgery have stretched their skin beyond the point where it can “snap back.” Some patients will choose to have plastic surgery to remove loose or excess skin after they have lost their excess weight. Insurance generally does not pay for this type of surgery (often seen as elective surgery). However, some do pay for certain types of surgery to remove the excess skin when complications arise from these excess skin folds. Ask your surgeon about your need for a skin removal procedure.

WILL EXERCISE HELP WITH EXCESS HANGING SKIN?

Exercise is good in so many other ways that a regular exercise program is recommended. Unfortunately, most patients may still be left with large flaps of loose skin.

WILL I BE MISERABLY HUNGRY AFTER WEIGHT LOSS SURGERY SINCE I’M NOT EATING MUCH?

Most patients say no. In fact, for the first 4-6 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.

WHAT IF I AM REALLY HUNGRY?

This is usually caused by the types of food you may be consuming, especially starches (rice, pasta, potatoes). Be absolutely sure not to drink liquid with food since liquid washes food out of the pouch.

WILL I HAVE TO CHANGE MY MEDICATIONS?

Your doctor will determine whether medications for blood pressure, diabetes, etc., can be stopped when the conditions for which they are taken improve or resolve after weight loss surgery. For meds that need to be continued, the vast majority can be swallowed, absorbed, and work the same as before weight loss surgery. Usually no change in dose is required. Two classes of medications 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, it can lead to fatal heart problems.

WHAT IS A HERNIA AND WHAT IS THE PROBABILITY OF AN ABDOMINAL HERNIA AFTER SURGERY?

A hernia is a weakness in the muscle wall through which an organ (usually small bowel) can advance. Approximately 20% of patients develop a hernia. Most of these patients require a repair of the herniated tissue. The use of a reinforcing mesh to support the repair is common.

IS BLOOD TRANSFUSION REQUIRED?

Undesired blood clotting sometimes occurs in veins, especially of the calf and pelvis. It is not completely preventable, but preventive measures will be taken, including:

  • Early ambulation
  • Special stockings
  • Blood thinners
  • Pulsatile boots

WILL I LOSE HAIR AFTER SURGERY? HOW CAN I PREVENT IT?

Many patients experience some hair loss or thinning after surgery. This usually occurs between the fourth and eighth month after surgery. Consistent intake of protein and vitamins including Folic Acid, Iron, Zinc, and B – Vitamins can ensure that your hair will regrow.

DOES HAIR GROWTH RECOVER?

Most patients experience natural hair re-growth after the initial period of loss.

WHAT ARE ADHESIONS AND TO THEY FORM AFTER THIS SURGERY?

Adhesions are scar tissues formed inside the abdomen after surgery or injury. Adhesions can form with any surgery in the abdomen. For most patients, these are not extensive enough to cause problems.

WHAT IS THE CANDIDA SYNDROME?

Some patients have a type of yeast present on the surface of their skin, intestine or vagina at the time of surgery. This leads to overgrowth in certain circumstances. A whitish coating may occur on the tongue or throat. This syndrome is associated with a frothy mucous, nausea, difficulty swallowing, sore throat, loss of taste and appetite and occasionally, abdominal bloating and diarrhea.

WHAT CAUSES THIS YEAST TO APPEAR?

It is promoted by the use of most antibiotics and some other medications, by stress, by reduced immune response and by diabetes.

CAN CANDIDA BE CURED?

There are several effective medications now available for treating the overgrowth of Candida.

WHAT IS SLEEP APNEA (SA)?

It is the interruption of the normal sleep pattern associated with repeated delays in breathing. Sleep apnea often shows rapid improvement after surgery. In most patients, there is a complete resolution of symptoms by six months following surgery.

If you’re ready to improve your life, request a consultation online or call our office at 713-426-2400 for more information.

Obalon Balloon System Surgery

The Obalon Balloon System helps facilitate weight loss by taking up space in your stomach so you eat less.






....Learn More....
Gastric Band

As one of the more popular procedures, LAP-BAND® surgery gives patients the ability to control their weight by allowing them to feel fuller, sooner.






....Learn More....
Gastric Bypass

Gastric bypass is successful at helping patients achieve and maintain a healthier weight by using sectioning and malabsorptive techniques.






....Learn More....
Sleeve Gastrectomy

A sleeve gastrectomy procedure involves removing about 85% of the stomach and reshaping the remaining portion into a tube or sleeve.






....Learn More....
Duodenal Switch

The Biliopancreatic Diversion with Duodenal Switch (BPD/DS) is a popular procedure for small stomachs combining a lower form of restriction and a high level of malabsorption.






....Learn More....