Updated September 2020 | Written by the Public Education Committee

Exercise

 

When can I start exercising after surgery?

Right away! To start, you will take easy, short walks while you are in the hospital. The key is to start slow. Listen to your body and your surgeon. If you lift weights or do sports, stay “low impact” for the first month.

Will I have to exercise after the procedure?

Nutrition

 

Will I have to go on a diet before I have surgery?

Yes. Many insurance companies require patients to be on a weight loss program before qualifying for surgery.

Many bariatric surgeons put their patients on a special pre-operative diet, usually 2 or 3 weeks just before surgery. The reason for the pre-operative diet is to shrink the liver and reduce fat in the abdomen. This helps during the procedure and makes it safer.

Some insurance companies require a physician-monitored diet three to six months prior to surgery as part of their coverage requirement. These diets are very different from the short-term diets and usually are more about food education and showing a willingness to complete appointments and to learn.

Will I have to be on a diet after the surgery?

Is weight loss surgery a ‘cop-out’? To lose weight, should people with obesity just go on a diet and exercise?

Pregnancy

 

When can I get pregnant after weight loss surgery?

Most groups advise waiting 12-18 months after surgery before getting pregnant.

Most women are much more fertile after surgery, even with moderate weight loss.

Birth control pills do NOT work as well in patients who are overweight. Birth control pills are not very reliable during the time your weight is changing. For this reason, having an IUD or using condoms and spermicide with ALL intercourse is needed. Menstrual periods can be very irregular, and you can get pregnant when you least expect it!

Will the baby be healthy?

Lifestyle

 

How long after weight loss surgery will I have to be from work?

After surgery, most patients return to work in one or two weeks.

Will I lose my hair after surgery?

Will I need to have plastic surgery after weight loss?

Do most people who have weight loss surgery regain their weight?

Vitamins & Medications

 

Can I go off some of my medications after weight loss surgery?

Many patients are able to stop using some medications.

Will I have to take vitamins after surgery?

Do weight loss surgery patients have serious health problems caused by vitamin deficiency?

Mental Health

 

Is obesity caused by food addiction, similar to alcoholism or drug dependency?

“Food addiction” as a cause of obesity is extremely rare.

Although some people with obesity have eating disorders, such as binge eating disorder syndrome, most people have obesity caused by many factors. When treating addiction, such as alcohol and drugs, one of the first steps is to stop using drugs or alcohol. This does not work with obesity as we need to eat to live. Also, there may be other issues causing a person’s weight gain. Weight gain generally occurs when the amount of food eaten is greater than the number of calories burned. There are other conditions, however, that affect weight gain that do not involve too much eating or a less active lifestyle including:

* Poor sleeping habits
* Eating foods that may increase body fat (sugar, high fructose corn syrup, trans fat, processed meats and processed grains)
* Low intake of fat-fighting foods (fruits, vegetables, legumes, nuts, seeds, quality protein)
* Stress and mental distress
* Many types of medications
* Pollutants

Obesity also leads to more obesity, which is one of the reasons why the disease is considered progressive. Weight gain causes a number of signals (hormones) in the body that increase the risk for even greater weight gain and obesity. To make matters worse, obesity affects certain body functions that control appetite and hunger in a manner that can cause an increase in the amount of food eaten at any given meal and the desire to eat more often. There are many causes for obesity and the disease of obesity is far more than just an ‘addiction’ toward food. The treatment of obesity only as an addiction may help for a very small percentage of individuals whose only underlying cause for obesity is excessive and addictive eating, but would be unlikely to benefit most people, particularly those individuals affected by severe obesity.

Does weight loss surgery increase the risk for alcohol abuse?

Does weight loss surgery increase the risk for suicide?

Risks

 

Is the chance of dying from weight loss surgery more than the chance of dying from obesity?

No. Weight loss surgery is very safe and decreases the chance of dying from obesity. In fact, weight loss surgery is safer than removing the gallbladder or having a knee replacement.

A recent study of 209,116 patients found the risk of death from weight loss surgery was 0.16%, or approximately 1 in 600.(4) This rate is considerably less than most other surgeries, including gallbladder and hip replacement surgery. Large studies find that the risk of death from any cause is considerably less for patients after weight loss surgery than for those who have severe obesity and have never had the surgery. Patients who have weight loss surgery have a reduction in their risk of death by 40%. Death related to diabetes is reduced by more than 90% and from heart disease by more than 50% for patients after weight loss surgery.(3) The benefits of weight loss surgery far outweigh the risks. As with any serious surgical operation, the decision to have weight loss surgery should be discussed with your surgeon, family members, and loved ones.

References

1. Herman KM, Carver TE, Christou NV, Andersen RE. Keeping the weight off: Physical activity, sitting time, and weight loss maintenance in bariatric surgery patients 2 to 16 years postsurgery. Obesity Surgery. 2014;24(7):1064-72.
2. Puzziferri N, Roshek TB, Mayo HG, Gallagher R, Belle SH, Livingston EH. Long-term follow-up after bariatric surgery: A systematic review. JAMA. 2014;312(9):934-42.
3. Courcoulas AP, Yanovski SZ, Bonds D, Eggerman TL, Horlick M, Staten MA, et al. Long-term outcomes of bariatric surgery: A National Institutes of Health symposium. JAMA Surgery. 2014;149(12):1323-29.
4. Broderick RC, Fuchs HF, Harnesberger CR, Chang DC, Sandler BJ, Jacobsen GR, et al. Increasing the value of healthcare: Improving mortality while reducing cost in bariatric surgery. Obesity Surgery. 2015;25(12):2231-8.
5. Thivel D, Brakonieki K, Duche P, Morio B, Boirie Y, Laferrere B. Surgical weight loss: Impact on energy expenditure. Obesity Surgery. 2013;23(2):255-66.
6. King WC, Chen J-Y, Mitchell JE, Kalarchian MA, Steffen KJ, Engel SG, et al. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA. 2012;307(23):2516-25.
7. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. New England Journal of Medicine. 2007;357(8):753-61.
8. Tindle HA, Omalu B, Courcoulas A, Marcus M, Hammers J, Kuller LH. Risk of suicide after long term follow-up from bariatric surgery. American Journal of Medicine. 2010;123(11):1036-42.