Life After Weight Loss Surgery: What to Expect
Written by Shawn M. Garber, MD Last modified on December 21, 2020
Weight loss surgery can be a life-altering experience, but it’s not a quick fix and requires careful lifestyle management both in the short and long term after surgery. Many people considering weight loss surgery are attracted to the health and physical benefits, but wary of some of the changes that the transformation may require.
In this edition of Ask an Expert, Dr. Shawn M. Garber answered some frequently asked questions that we receive from readers looking for information on what to expect in the days, weeks, months and years after surgery.
Q. Can I drink alcohol after weight loss surgery?
A. We recommend patients stay away from alcohol for the first couple of months after surgery. After a couple months, we recommend only drinking alcohol in moderation for two reasons. One is that tolerance will be lower as a result of weight loss, meaning patients will usually get drunk quicker. With the gastric sleeve and gastric bypass procedures, there is less stomach to break down the alcohol before it passes into the intestines. The second reason we advise moderation is because there are a lot of calories and carbohydrates in alcohol. We recommend avoiding carbonation including beer and champagne. Carbonated beverages pull excess air into the newly formed pouch which can cause nausea and excess gas.
Q. How will I know what nutritional supplements I need after my procedure?
A. You need to discuss this important issue with your physician. Depending on which surgery you choose, the requirements vary.
Duodenal switch has the most vitamin requirements because it is a very malabsorptive operation.
Gastric bypass has the second most because it is malabsorptive as well, but less so than the duodenal switch.
For gastric sleeve and banding, we just recommend a good bariatric multivitamin and calcium citrate supplements daily.
Gastric bypass patients usually need B12 and iron in addition to a multivitamin and calcium supplement.
Duodenal switch patients usually need vitamin A, D, E and K in addition to a multivitamin and calcium supplements daily.
For gastric sleeve and band, we simply recommend a good bariatric multivitamin and calcium citrate supplements daily.
Q. What if I overdo it at a holiday party?
A. You will most likely feel sick and possibly vomit. The great thing about weight loss surgery is that most patients have no desire to overeat anymore. However, if you overeat, you can stretch out your stomach over time and sabotage your weight loss efforts. You will learn to stop eating when you feel full.
Q. What is dumping syndrome, and how can I avoid it?
A. Dumping syndrome is only related to gastric bypass surgery because you no longer have a pyloric valve on your stomach. (A pyloric valve is a band of smooth muscle that helps move the contents of your stomach into your small intestine.)
Dumping syndrome occurs when the undigested stomach contents are “dumped” into your small intestine too quickly (because there is no valve). When you eat a large carbohydrate load or excessive sweets, you may get dumping syndrome and experience cramps, abdominal pain, break out into a sweat, have increased heartrate, etc.
Q. Which weight loss surgery is the easiest to adjust to in terms of eating and drinking?
A. I feel that sleeve patients really adjust very quickly to the new anatomy because they are no longer hungry due to a decrease in the hunger hormone ghrelin. Gastric banding patients sometimes have issues with vomiting because of the tight ring on their stomach. Gastric bypass patients usually adjust pretty quickly as well. Duodenal switch patients sometimes have issues with frequent bowel movements early on.
Q. Will I throw up often after gastric sleeve? How can I prevent this?
A. It is very rare to vomit after sleeve if the surgery is performed correctly. If you are vomiting earlier on you should consult with your surgeon to make sure there is no narrowing or strictures in your sleeve. If your surgery was done well and you are vomiting, it could be that you are eating too much or not chewing your food adequately.