Please see website section… “Is Bariatric surgery for you?”
Any weight loss achieved after being referred to our service, will be looked upon favorably, and demonstrate your commitment to the process.
Losing weight before surgery will make the procedure safer and easier, lowering the risk of complications following surgery.
The milk and yogurt diet is low in calories and carbohydrate. It is followed for 10 days before surgery. People who are obese often have fatty livers. The size of the liver can be shrunk by following milk and yogurt diet and therefore will make the surgery safer.
You will be given the information about the diet at your pre-operative assessment appointment, with written clarification via post, along with your admission date.
As you will lose a lot of weight, loose (excess) skin is inevitable following weight loss surgery. Diet and exercise can help with this, but will not get rid of it completely. We would encourage you to do exercises that may help tone your muscles and to make sure you are eating plenty of protein foods (such as meat, chicken, fish, eggs, beans and pulses, tofu, dairy foods) to help with your skin. For many, the amount of excess skin depends on your skin type/ genetics.
Plastic surgery for excess skin removal is not included as part of this operation and may not be available on the NHS.Plastic surgery has to be agreed and funded by your primary care trust, through your GP. If plastic surgery is something you are considering you may have to fund it privately.
Your BMI (body mass index) needs to be 28(or below) and maintained for 1 year for you to be considered for funding for skin removal surgery on the NHS.
Weight loss can increase fertility and certain types of contraception (such as the pill) may be less effective after surgery, especially the gastric bypass. We recommend you speak to your GP to discuss the most suitable form of contraception for you.
Ideally you should wait 18 months after surgery before getting pregnant. This is to allow your body time to lose your excess weight and to adjust to the changes this will bring. You may not get adequate nutrition both for you and your baby if you become pregnant sooner.
If you do become pregnant it is important that you book an appointment to see our specialist dietitian so that they can fully support you throughout this journey
If you become pregnant and have a gastric band in place we recommend it is emptied for the duration of your pregnancy to allow you to eat a nutritious diet. Please contact us on sth.bariatricteam@nhs.net to arrange your band emptying if you are under our service. If you are no longer under our service, please ask your GP to refer you in via the e-referral service.
Your stomach will be sore and swollen following bariatric surgery. If you have a sleeve gastrectomy/ gastric bypass operation the internal staple lines will need time to heal. You will need to follow a modified diet for a few months. You will start off on a low calorie/smooth puree diet after your operation; you will then progress on to a soft, mushy, crispy diet. With guidance from your bariatric surgery team you will gradually be able to move onto a solid textured diet. Your stomach will be much smaller, meaning you will only be able to eat small amounts.
Everyone is different after surgery in terms of the foods they can and cannot manage. However, there are a few common foods that people tend to struggle with:
Eating will be different after surgery because your new stomach is smaller, and this may take a while to adjust to. There are a few things you can do to make this easier and minimize complications:
If surgery is performed laparoscopically, you will typically spend three days, two nights in hospital. Currently we perform NHS operations at the Northern General and Thornbury hospitals in Sheffield. It takes most patients about 3 to 6 weeks to get back to work. If you have open surgery or complications, recovery time may take longer.
After surgery all medication will be reviewed by the doctors and you will be advised to take all prescribed medications.
No whole tablets (larger than the size of a paracetamol) should be taken for four weeks after surgery, or until you can tolerate soft mushy crispy foods. All medication should be in liquid, crushable or dissolvable form. Please see your GP to arrange this before you come into hospital for your surgery.
Diabetes medication may be stopped or reduced depending on your blood sugar readings after surgery; your blood pressure tablets may be stopped if you lose sufficient weight to reduce your blood pressure.
You are advised to get your blood pressure and blood sugar monitored regularly after surgery by your GP.
You may be advised to avoid taking aspirin and other non-steroidal anti-inflammatory pain relievers because they may irritate the stomach.
It is very common to suffer from constipation after surgery due to the reduction in fluid and fibre intake. We advise you see your GP to obtain a prescription of laxatives or buy an over the counter product from a pharmacy such as Senna liquid/optifibre/benefibre.
Wound healing can vary from person to person; usually take 2 to 6 weeks to heal completely. Closing your wound surgically (with stitches, clips, staples or glue) encourages your wound to heal faster.
If you have had a gastric bypass or sleeve gastrectomy your hair may thin. This can occur particularly for ladies and is due to change in hormones after rapid weight loss.
Evidence suggests that bariatric surgery can put type 2 diabetes into remission in a high percentage of cases. Many of those who stayed on medication or insulin after surgery found their dose reduced.
For those that have had type II diabetes for longer than ten years – you are less likely to have any remission.
Please wait until we have reviewed you in clinic after your surgery. Your wounds need to be checked to ensure they have healed before you swim or attempt exercise.
It is important to do as much as you feel able. You should move around/walk at regular intervals in order to reduce the chance of any post-operative complications, such as deep vein thrombosis and chest infection. Exercise needs to be gradual and confined to cardiovascular activity such as walking, in the first few weeks post surgery. Please avoid abdominal and vigorous exercise at this time.
You will notice that your ability to exercise improves very rapidly after the surgery. Apart from speeding up the weight loss by burning off more calories, exercise reduces blood pressure and blood cholesterol and improves muscle tone, which can help with the problem of sagging skin.
Even small changes to your activity levels built into your daily routine will help. This might include walking or cycling to work or parking further away, using the stairs, walking across the office rather than emailing, gardening, domestic chores, or an exercise video at home. You could also try researching local walking or exercise groups in your area.
Check with your car insurance provider when they will provide cover and inform them of the procedure you have had. Having a general anaesthetic may affect your insurance.
Pain killers can make you drowsy and affect reaction times.
Ensure you have no abdominal discomfort and if you drive a manual car, ensure you can effectively perform an emergency stop.
The bariatric team will see you in our outpatient clinics at Northern General hospital every few months for the first 2 years after your operation .You will then be discharged to your GP for long term follow up. If you have any problems after then your GP can refer you back into our service if necessary.
We recommend you take 2 multivitamin and mineral A to Z supplements once a day for life if you have had a gastric bypass or sleeve gastrectomy. If you have a gastric band, then this is one A-Z multivitamin and mineral a day.
If you have had a gastric bypass or sleeve gastrectomy we recommend you have a Vitamin B12 injection every 3 months for life.
We will check your vitamin/mineral levels by blood tests at your clinic appointment and will inform you of any other nutritional supplementation you may need. Some people may need additional supplementation.
Yes, many people order a child’s portion at a restaurant or have a starter instead of a main meal.You won’t be able to eat the volume of food you previously did.
Alcohol enters the blood stream quickly and can cause unwanted effects. We recommend avoiding alcohol completely for the first year after surgery. After this keep to within sensible limits and have several alcohol free days per week.
It is common for weight loss to slow down around 12 -18 months post surgery. It is important that you continue to follow a healthy diet and take regular exercise to keep your weight off.
The survival rate is over 99.9%.
The hospital mortality rate after surgery is much lower than that for many other planned operations such as taking out tonsils or appendix.
The complication rate overall for 2014 was 2.9%.
The average post-operative hospital stay was 2.7 days
(National Bariatric Surgery Registry Report 3/2014)