Post Bariatric Surgery - Results, Impact, Body Contouring, and Risk Factors

Introduction

After bariatric surgery, for the stomach and digestive system to heal, food is not allowed for one to two days. After which, a specific diet is followed for a few weeks. Initially, the diet will begin with liquid only, slowly progressing to pureed and very soft foods, and finally to regular foods. There might be restrictions or limits on how much and what one can eat and drink. After weight loss surgery, there will be frequent medical checkups to monitor the health in the first several months, and laboratory testing, blood work, and various examinations might be needed.

What Is Bariatric Surgery?

Bariatric surgery is a gastric bypass and other weight loss surgeries that will change the digestive system to lose weight. This procedure is usually done when diet and exercise do not work and severe health problems arise from weight gain.

What Are the Results Expected After Bariatric Surgery?

Long-term weight loss is provided with bariatric surgery, and the amount lost depends on changes in lifestyle habits and the type of surgery done. It may be possible to lose half or even excess weight within two years. This surgery may also improve or resolve conditions that are related to being overweight, including:

1. High blood pressure (hypertension).
2. Obstructive sleep apnea.
3. Heart disease.
4. Type 2 diabetes.
5. Joint pain.
6. Gastroesophageal reflux disease (GERD).

It improves the ability to perform routine daily activities and quality of life.

What Is the Impact of Bariatric Surgery?

There are several desirable effects as this surgery restricts food to the stomach; one among them is hanging skin throughout the body. The areas most affected are:

1. Upper arms, which sag, the skin appearing loose.
2. Full, flattening of the breast may occur, which hangs with nipples pointed downward.
3. Extended abdominal area.
4. There might be pockets of skin on the buttocks, groin, and thighs sagging.

How Is Body Contouring Done Post Bariatric Surgery?

Plastic surgeons perform body contouring procedures following massive weight loss to eliminate or reduce excessive skin after post-bariatric surgery. The shape and tone of underlying tissues are improved with body contouring procedures, and excess sagging fat and skin are removed, resulting in smoother body contours and a normal appearance.

Body contouring is performed under general anesthesia in stages. Extra precautions should be taken if the patient has a smoking history, clotting factors, deep vein thrombosis, high BMI, or any other risk factors. Body contouring procedures include a breast lift or mastopexy, arm lift or brachioplasty, stomach lift or abdominoplasty, and lower body lift.

What Are the Risk Factors of Post-Bariatric Surgery?

There are risks involved with all surgeries, and common risk factors of bariatric surgery are infection, bleeding, blood clots, hernias, anastomotic leaks, and small bowel obstruction. Possible complications are dumpling syndrome, malabsorption and malnutrition, bile reflux, and gallstones.

• There might be symptoms of dumping syndrome afterward in 50 % of patients who undergo bariatric surgery. Symptoms include nausea, hypoglycemia, abdominal cramping, and diarrhea, which usually fade with time. During recovery, the healthcare provider team will give dietary guidelines to prevent or reduce dumping syndrome.
• Malabsorption in the small intestine is intentionally induced in many bariatric surgery procedures to reduce the absorption of calories. Still, sometimes malabsorption can lead to loose stools and also nutritional deficiencies. To prevent this complication, nutritional supplements are prescribed by the healthcare provider.
• Bile reflux occurs when the pyloric valve gets affected during surgery, and this will lead to malfunction. When the valve does not close properly, it might result in bile reflux. Bile reflux can erode the stomach lining, leading to gastritis and stomach ulcers.
• A large load of cholesterol is sent to the liver to process due to rapid weight loss. When the liver sends bile to the gallbladder, extra cholesterol is carried along with it. This extra cholesterol can accumulate in the gallbladder and lead to cholesterol gallstones. Gallstones are not at any risk until they get stuck in the bile ducts. The healthcare provider prescribes medication to prevent gallstones.

What Are the Advantages of Bariatric Surgery?

The advantages of bariatric surgery are significant:

1. Sustained weight loss.
2. Blood sugar.
3. Cholesterol is managed.
4. Hunger hormones are reduced.
5. Improved metabolism.
6. Longer, healthier life.
7. Bariatric surgery increases the risk of death by over 40% by any cause.

What Is the Diet Plan for Post-Bariatric Surgery?

Staying hydrated by drinking 64 ounces of fluid or more each day is essential. The amount of protein intake per day should be 2.1 to 3.5 ounces. Patients should start a liquid diet immediately after surgery and advance eventually to solid foods. Foods with high amounts of sugar and starch should be avoided.

• Weeks 1 and 2 should involve the intake of a clear liquid diet.
• Week 3 and 4 should be intake of a pureed diet and begin with protein supplements.
• Month 2 and month 3 should be an adaptive or soft diet.
• Month 4 and lifelong should follow a stabilization diet.

Is Vitamin and Mineral Supplements Essential for Post-Bariatric Surgery?

It is essential to take vitamins and mineral supplements for life after any weight loss surgery, and the surgeon will inform the patient on how much to take. The vitamins typically given are vitamin B12, multivitamins, vitamin D, calcium, and iron. Chewable vitamins or pills are prescribed if tolerated. If the vitamin and mineral levels are low, there can be life-threatening medical problems.

What Is the Importance of Exercise After Bariatric Surgery?

Exercise after bariatric surgery is essential as a part of the weight loss process, and for a good reason. Exercise will help to reduce the risk of dying prematurely from heart disease, reduce the risk of getting blood pressure, diabetes, and colon cancer, healthy bones, muscles, and joints are built and maintained, anxiety and depression feelings are reduced, and control weight. Common exercises are:

• Waking.
• Aerobic exercises.
• Strength training.

Conclusion

Post-bariatric surgery, it is essential to upgrade the texture of the diet at regular intervals, annual review checklist, and healthy lifestyle support by eating healthy and exercising post-surgery. Follow-up care plays an important role in ensuring long-term success and the overall well-being of individuals who have undergone bariatric procedures.