Weight Loss Surgery Aftercare
After surgery we want the focus to be on healthy and sustainable eating and exercise habits, and maintenance of nutrition by eating healthy food, taking vitamin supplements and having regular follow-ups with our team and support group.
While every person is different, you will find below some consistent advice that we give to most patients after the majority of weight loss surgeries.
Exercise Following Weight Loss Surgery
Exercise fads are like fad diets; people often ignore basics and go for complex regimens based on unproven theories. The best advice for both is always to go for simple and sustainable methods.
From day 1 after your operation, we will ask you to walk. Get in the habit of moving around and filling your spare time with activity. Exercise is going to be part of your rehabilitation back to health but aim to make it part of your everyday routine rather than something extra.
We want you to make exercise an automatic part of your life so it can be something you can do regardless of how you feel and how busy you are. The 3 main components are Incidental exercise, Aerobic exercise and resistance exercise.
- Incidental exercise: Stop taking the lift. Use stairs where possible. Walk around during the day. Walk during your leisure time and before/after work as a way to de-stress. Consider getting a dog if your household can manage it.
- Aerobic exercise (raising your heart rate): for 20–40 minutes, two-three times a week. This will increase your fitness and ability to tolerate stress. Jogging/running, cycling, aerobic classes, swimming etc.
- Resistance exercise: 30-40 mins 2-3 times per week. This aims to build strength to protect you from injury. Light weights, yoga, Pilates, Circuit classes etc.
Very intensive or prolonged exercise is usually unsustainable because it takes so much time and can lead to injury and mental or physical exhaustion. Intensive exercise can be useful in the short term to get people to meet certain goals or get through a weight plateau, but it should be tapered down to something manageable once goals have been met.
‘Fat-burning’ exercises are usually associated with gyms and people selling a product. They promote interval training and other heavily supervised methods, which may be effective in the short term but cannot be integrated into normal life and continued for years.
A successful and traditional approach is to use community sports that are known to lead to both weight loss and health. The best forms of fat-burning exercise make use of the fact that we start using fat for fuel only after we have exercised for more than half an hour (between 30 minutes and three hours). Distance walking, cycling, distance swimming and social sport activities are ideal. Cycling in particular is an excellent way to burn fat.
Diet and Vitamins After Weight Loss Surgery
There are three phases of dietary change after surgery:
- Early postoperative phase (first 6–8 weeks)
- Weight loss phase (2–18 months)
- Weight maintenance phase (18 months and beyond)
Each phase requires different advice in order to get the best results.
Early Postoperative Phase (first 6-8 weeks)
The aim of this phase is to maximise the speed of your recovery and set you up for the next phase of sustained weight loss. The key elements are:
- Hydration: Aim for over 1-1.5 litres of fluids per day including fluid-like foods (eg soup). Any less than this will lead to dehydration, which will cause nausea. You will not be discharged from hospital until you have shown that you can drink this much.
- Firstly liquids, then purée, then soft foods: Until you have healed internally (one month), eating solid food will be uncomfortable and can cause injury.
- Nutrition, in order of importance:
- You should have between 1 and 1.5 litres of fluid daily. A minimum of 25 grams of protein is needed for health but aiming for 50+ grams is reasonable if you can manage it. Liquid fibre supplements or gentle stool softeners will prevent constipation, which otherwise can be very uncomfortable. We start you on chewable multivitamins, but fluid and protein are more important for how you recover early on. If someone is having problems with tolerating a wide range of foods, multivitamins become very important for safe recovery. Foods include yoghurt, soups, protein drinks and purées for main meals. Soft food can start at 2–3 weeks.
Weight Loss Phase (2-12 months)
- Regular meals: Three meals per day (usually two simple and one complex meal). Meals should occur when you need them (often your appetite will determine the most appropriate time to eat). The morning meal doesn’t have to happen when you wake up, but most people need something by 11 am. Your afternoon meal should occur between 12 noon and 3 pm, and your evening meal can be your social meal. If you go to bed late, do not have an early evening meal because you will simply eat again before you go to bed. Patients who skip too many meals end up grazing and snacking, which will lead to weight regain.
- Avoiding liquid calories: fruit juice, soft drinks, yoghurt, milky drinks, alcohol and other forms of between-meal snacks. Liquid calories are important in the first few weeks after surgery, but once solid food is back on the menu the only liquid foods should be soup or meal replacement drinks.
- Protein: 25 grams minimum, but aim for 50+ grams. Protein is an excellent appetite suppressant and a far better base for a meal than pasta, bread and other carbohydrate items.
- Low-starch vegetables, salads and fruit: These are excellent components for meals, in addition to protein. Try to avoid snacking on fruit between meals. Snacks contain pointless calories and usually increase your hunger.
- Vitamin and mineral supplements: You need to support your body during this time by making sure you don’t miss out on important nutrients while losing weight. Everyone needs a multivitamin daily. Some patients will benefit from vitamin D, iron, calcium, vitamin B12 or other mineral supplements such as zinc, magnesium, selenium, chromium or silica.
Weight maintenance phase (18 months and beyond)
This is the most crucial period, and the one where many patients will run into trouble. If the habits that led to you becoming overweight return, your weight problem will return. We are aiming for 1000–1500 calories a day. Key elements are:
- Three meals a day. Patients who have not settled into a regular pattern by this stage are in real danger of weight regain, as they will compensate for missed meals with snacks and liquid calories.
- Habitual avoidance of snacks except on special occasions. Most patients who regain weight do so by eating between meals. It is hard to say no to snacks when other people seem to get away with eating them, but this is what you must do.
- Daily multivitamin, and blood tests every six to 12 months to determine other requirements (iron, calcium, vitamin D, vitamin B12).
- Avoiding or keeping control of problem foods like cheese, carbohydrates, alcohol and milky drinks.
We keep our blog up to date with different hints and tips for not only losing weight but maintaining that weight loss over time, you can view them online here.
Do you need more information?
If you would like to speak to one of our specialised team or enquire about making an appointment at our clinic,
please call 02 9553 1120 or submit an enquiry.