Bariatric surgery - gastric bypass; Roux-en-Y gastric bypass

The weight loss results of gastric bypass surgery are generally good. Most patients lose an average of 10 pounds per month and reach a stable weight between 18 and 24 months after surgery. Often, the greatest rate of weight loss occurs in the very beginning (that is, just following the surgery when you are still on a liquid diet).

After the surgery, you will need to follow up with your doctor fairly often during the first year. During those visits, your physician will be evaluating your physical and mental health status, including any change in weight and your nutritional needs. You will likely see a dietitian during those visits as well.

The surgery is not a solution in and of itself. While it can train you to eat smaller quantities and feel full more quickly, you still have to do much of the work. To achieve weight loss and avoid complications from the procedure, you must exercise and eat properly -- according to important, healthy guidelines that your doctor and nutritionist will teach you.

Most people typically stay in the hospital for a few days or less after gastric bypass surgery. Some may need to stay 4 to 5 days. Your doctor will approve your discharge to home once you can do the following:

• Move without too much discomfort
• Eat liquid and/or pureed food without vomiting
• No longer require pain medication given by injection

You will remain on liquid or pureed food for several weeks after the surgery. Even after that time, you will feel full very quickly, sometimes only being able to take a few bites of solid food. This is because the new stomach pouch initially only holds a tablespoonful of food. The pouch eventually expands. However, it will hold no more than about one cup of thoroughly chewed food (a normal stomach can hold up to one quart).

Upon follow up, your doctor will determine if you need replacement of iron, calcium, vitamin B12, or other nutrients. Supplements, such as a multivitamin with minerals, will be prescribed to provide any nutrients that you may not be getting from your diet. This lack of nutrients can occur because you are eating less and because the food moves through your digestive system more quickly.

Once your diet begins to consist of more solid food, remember to chew each bite very slowly and thoroughly.

You will be instructed on eating small meals frequently throughout the day, rather than large meals that your stomach cannot accommodate.

Your new stomach probably won’t be able to handle both solid food and fluids at the same time. So, you should separate fluid and food intake by at least 30 minutes and only sip what you are drinking.

You won’t be able to tolerate large amounts of fat, alcohol, or sugar. You should reduce your fat intake, especially fast food meals, deep-fried foods, and high-fat foods, as well as high-sugar foods like cakes, cookies, and candy.

Exercise and the support of others (for example, joining a support group with people who have undergone weight loss surgery) are extremely important to help you lose weight and maintain that loss following gastric bypass. You can generally resume exercise 6 weeks after the operation. Even sooner than that, you will be able to take short walks at a comfortable pace, with the approval and guidance of your doctor. Exercise improves your metabolism, while both exercise and attending a group support can boost your self-esteem and help you stay motivated.