Life After Surgery

Average weight loss is about 60-80 percent of excess body weight within the first year after surgery. Weight loss tends to even out about 12-18 months after surgery. Results will depend on how well you follow nutritional guidelines and your exercise intensity.

After losing a lot of weight you may have excess skin, especially around the middle. Cosmetic surgery to remove excess skin is typically not covered by insurance, but you should check with your insurance company about coverage.

First three weeks after bariatric surgery

You should be consuming about one-quarter cup total food each meal. Between now and your three-month post-operative visit, it is normal to consume up to one-third cup total food at one meal.

If you don't follow recommendations for the type and amount of food you should be consuming, you will likely experience dumping syndrome (cramping, nausea and diarrhea). You'll need to learn how to maximize nutrition from a small amount of food. Long-term success depends on making lifelong changes.

Reference your manual: "Protein," "Supplements" and "Medications, Anatomy and Medical Issues"

If you have not already, you may add soft, moist food. Continue with 3-4 meals per day consisting mainly of protein. Within the next few months, start including fruits and veggies. Choose protein first, eat slowly and chew well.

Three months after bariatric surgery

You should be consuming about one-third cup total food each meal. Between now and the six-month mark, you can work up to one-half cup total food at one meal.

Reference your manual: "Physical Activity"

You may experience a weight plateau; this is common. Retrain your body by continuing regular daily physical activity and consistent structured meals. Eventually your body will adjust, and the weight will continue to come off. Respect hunger and fullness cues. Consuming different amounts of food from one day to the next is normal. This is how your body naturally balances the calories you need without consuming too much. Eat meals about the same time every day and avoid snacking or grazing.

Six months after bariatric surgery

You should be eating about one-half cup of total food each meal. Between now and your next visit, a total quantity of three-quarters cup of food at one meal is appropriate.

Reference your manual: "Meal Structure" and "Mindful Eating"

At this stage you are consuming about double the amount of food since right after your surgery. This is normal. The key is gradually increasing calories while concentrating on nutrition. The overall portions you consume will stabilize in about six to nine months.

Keep your meal structure consistent on most days, include a protein at each meal, add fruits and vegetables on a daily basis. Grains and starches should be the smallest portion of your meal.

Nine months after bariatric surgery

Now each meal will include about two to three oz. of meat or protein with one-quarter to one-half cup of fruit or vegetables and about one-quarter cup of starch.

Reference your manual: "Nutrition Basics" (carbohydrate section), "Support System" and "Behavioral Health"

You should be able to tolerate most grains if you choose to include them. To help you feel full and satisfied between meals, for added nutrition and to prevent constipation, choose whole grains or high-fiber grain sources. Continue to avoid foods with refined flours and sugars.

Your weight loss may have slowed down or even stopped. You've passed the phase producing the most dramatic weight loss, however, you should see continued progress. Everyone loses weight differently. Most likely you are losing fat while gaining muscle tissue.

18 months after bariatric surgery

In general, your portions should be fairly consistent. A meal is usually 3-4 oz. of meat, one-half cup fruit or vegetable, and one-half cup starch, or one cup of pasta or casserole with one-half cup fruit or vegetable. If needed, you can have a fruit or dairy serving between meals.

It's a good time to reference your entire manual!

It's also a good time to reflect on setbacks. Everybody has them.

  • Learn from setbacks
  • Acknowledge the problem and identify what triggers a bad habit
  • Brainstorm what could have been done differently
  • Make a plan for next time
  • Make a fresh start

Without lifestyle modifications, weight maintenance will be very difficult. Learning from setbacks will determine your continued success.

Support groups

The Bariatric Support Group shares experiences, provides encouragement and education. Anyone who has had or is considering having bariatric surgery is encouraged to attend support group meetings.

Love + Medicine

Every day, Gundersen Health System delivers great medicine plus a little something extra—we call it Love + Medicine.

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