The growing problem of widespread obesity and the bariatric interventions aimed at mitigating its impact on health have introduced a fresh approach to managing the weight and nutritional well-being of individuals who have undergone bariatric procedures.

Bariatric methods have proven effective in addressing severe obesity (grades II and III), resulting in a significant rise in the global number of bariatric surgeries conducted [1].While the surgery itself contributes to the desired weight loss, the emphasis remains on food reeducation and physical activity.

Although the Food Pyramid is commonly used as a dietary guide, it doesn’t offer a precise blueprint for composing daily meals for bariatric patients [1].

Regarding the standard approach to managing obesity, the established nutritional plate methods for post-bariatric surgery patients encompass two key aspects: (1) achieving a calorie deficit during the weight loss stage, and (2) ensuring an adequate intake of protein. 

Several nutritional recommendations have been issued for post-bariatric patients, primarily concentrating on short-term dietary advice. It is crucial to underscore that enduring modifications in eating habits and physical activity are essential for achieving effective, long-term weight loss and averting potential complications down the road [2].

In this text we will explore the Bariatric Plate method, a straightforward approach designed to illustrate to patients that underwent bariatric surgery how they can distribute macro and micronutrients in their daily meals.

This helps support their long-term weight loss goals and ensures the preservation of their nutritional well-being [1].

• Caloric restriction

The key to achieving successful weight loss post-surgery largely revolves around effective calorie restriction. However, research has been done, and there is no standard goal of calories that a post-bariatric surgery patient needs to achieve or follow as a rule, every person is different and should have a personal meal method that better suits their needs. Maladaptive eating behaviors have been identified as a primary factor behind excessive calorie consumption and insufficient weight loss after bariatric surgery [1].

In clinical practice, nutritionists should collaborate with patients to calculate the appropriate daily caloric intake, considering factors such as (1) physical activity (which raises overall metabolic rate which means more burnt calories) and (2) protein intake (to optimize this nutrient use and prevent it from being solely an energy source) [2]. The bariatric plate method daily caloric suggests that calorie intake begins at around 500 kcal with liquid nutrition and gradually increases to a solid form, reaching up to 1,200 kcal per day. Nutritional guidelines of post-bariatric surgery are outlined in recommendations that highlight the importance of protein, recommended at a range of 1-1.5 grams per kilogram of ideal weight (approximately 60-80 grams per day, accounting for 25% of the total intake), along with carbohydrates at 45% and fats at 30% [1].

• Proteins

The bariatric plate method highlights proteins as a crucial nutrient to monitor post-bariatric surgery (2). You can find proteins in a wide variety of animal and plant sources . Complete sources encompass meat, eggs, milk, and fish. Legumes like beans, lentils, soybeans, and chickpeas stand out among plant sources for their protein content. While most essential amino acids are present in various foods, specific conditions like bariatric surgery may necessitate supplementation. Whey protein usage is recommended for meeting daily nutritional requirements post-surgery and should be continued over the long term. An advisable guideline is for about half (50%) of the plate to consist of protein sources to maintain a balanced diet [1].

• Vitamins and minerals

In the bariatric plate method, approximately 30% of the plate should contain a mix of vitamins, minerals, and fibers commonly present in fruits and vegetables. These foods, necessitating chewing due to their fibrous texture, should have daily variety. This diversity aids the immune system, supports skin renewal, and helps regulate metabolism. A helpful tactic for ensuring a broad intake of nutrients during meals involves organizing these nutrients by their colors. Yellow and red fruits and vegetables, which are high in vitamin A (a fat-soluble vitamin), are vital for maintaining healthy hair, skin, and nails. Carrots, beets, pumpkin, and bovine liver are examples of these sources.

Green vegetables, such as leafy greens like cabbage, mustard, chard, lettuce, and arugula, are rich in B-complex vitamins and contribute to preventing anemia. Citrus fruits serve as an important source of vitamin C, aiding in iron absorption and boosting immunity. Oranges, lemons, passion fruit, acerola, green apples, tomatoes, and grapes are among these sources. White vegetables like onions, garlic, mushrooms, cauliflower, palm hearts, and okra are particularly effective in preventing cardiovascular diseases and cancer [1].

• Carbohydrates

The rest of the plate should consist of carbohydrates, essential for supplying energy needed for everyday activities. Choosing whole-grain options like whole-grain breads, rice, pasta, and cereals among this group can lower the intake of sugars and fats in bariatric patients.

This promotes heart health and contributes to a greater sense of fullness, which helps manage appetite more effectively [1]. In about 25 to 50% of patients, after a bariatric surgery, there can be alterations in the motor functions of the stomach, luckily only 5 to 10% develop symptoms, this is called the Dumping syndrome, and it manifests as sensitivity to sugar. These symptoms can be managed by dietary modifications, like avoiding simple sugar (e.g. candy, sodas, cookies) intake and replacing them with complex carbohydrates (pasta, fruit, vegetables, etc.)

Summary

The available information indicates that patients undergoing bariatric surgery necessitate a comprehensive method to navigate the changes required post-operation. Customized dietary guidance is crucial both before and after surgery, accompanied by ongoing support to establish healthier eating habits long-term. The bariatric plate method also supports the idea of an interdisciplinary team, which plays a pivotal role in ensuring patients comprehend the surgical process, the necessity for altering eating behaviors and food choices, and in providing robust social support [2]. 

The plate method, an instructional technique for meal planning, possesses multiple qualities that make it appealing for use among adults. Teaching nutrition by advocating simple, wholesome meal structures that emphasize overall dietary quality and offer a clear idea of the ideal food portions on the plate results in a constructive and unified approach in imparting practical dietary advice [3]. 

Overall, a post-bariatric surgery patient must understand that his old alimentary habits need to change because now their stomach has a different structure, therefore works in a different way (primarly due to alterations in nutrients absorption).

The bariatric plate method is a simple yet effective way to address changes in nutrients needs compared to what a normal persons plate looks like. 

Together with this, the water intake, use of supplements and the physical activity must be incorporated in the daily routine of a post-bariatric surgery patient [1].

Contact Us Today

Our team is ready to help you. At LIMARP, patients will always receive warm, sincere and professional
answers. For a free evaluation please call us at (619) 270 8823, fill out a contact form at
our website, or message through any of our social media pages.

References

• Maria Paula Carlini Cambi. Giorgio Alfredo Pedroso Baretta. Bariatric diet guide: plate model template for bariatric surgery patients. ABCD Arq Bras Cir Dig. 2018;31 (2):e1375
• Violeta L. Moize. Xavier Pi-Sunyer. Heidi Mochari. Josep Vidal. Nutritional Pyramid for post-gastric bypass patients. OBES SURG (2010) 20:1133-1141
• Katheryn M. Camelon RD. Karin Hadell. Paivi T. Jansen, MSc. Kaisa J. Ketonen, Msc, Heli M. Kohtamaki, Msc. Sari Makmatilla, MD, Msc. Marja-Leena Tormala, Msc. Raisa H. Valve, Msc. J Am Diet Assoc. 1998; 98:1155-1158

Bariatric surgery is a transformative step for those seeking to combat obesity. It offers hope and a path to healthier living.

However, understanding the complex interplay of our brain’s reward system and how it changes after this surgery is essential.

The fascinating realm of food cravings following bariatric surgery will be examined in this article, along with the neurobiological influences that mold our connection to food.

Cravings Post-Bariatric Surgery

Emotion-based eating and cravings may resurface post bariatric surgery, often due to a lack of consistent support (1). Another reason for the resurgence of cravings post bariatric surgery relates to patients’ dietary patterns and preferences in the first year after bariatric surgery. Patients typically avoid highly palatable foods due to care team recommendations and negative physiological responses (e.g., dumping syndrome) in the months following bariatric surgery. However, these physiological reactions may eventually fade, which could result in a rise in cravings or a rise in the intake of low-quality foods (1).

Additionally, improved emotional states in the short term after bariatric surgery can reduce the desire to use food as an emotional coping mechanism. As negative emotions may return, patients may find themselves craving food to manage these emotions (1).

Cravings: Beyond Willpower 

Contrary to the common belief that willpower alone drives our food choices, our eating habits are predominantly shaped by our neurobiological reward system. This intricate system, which includes several brain regions and gut-brain mechanisms, is largely responsible for regulating our food intake, including cravings (1).

The scientific community largely recognizes that biology, rather than sheer willpower or personal responsibility, is the primary driver of our daily food decisions (1).

Two Key Components: Liking and Wanting

Understanding food cravings requires acknowledging two critical components: “liking” and “wanting.” “Liking” refers to the sensory pleasure or enjoyment derived from consuming food, while “wanting” encompasses the cravings and the implicit drive to consume specific foods. This pleasure-driven eating is associated with weight gain and obesity. Individuals with higher body weights exhibit increased activation in brain regions associated with food reward, impacting food preferences and choices (1).

Post-Bariatric Surgery Changes

Bariatric surgery leads to reduced activation of the brain’s reward system (1). This suggests that food becomes inherently less rewarding for individuals who have undergone a bariatric procedure. Particularly in the first two years following bariatric surgery, there is a significant decrease in cravings. Post bariatric surgery patients often experience changes in taste preferences and reduced food cravings.

Moreover, the dopamine signaling in the brains of those who have had bariatric surgery changes, diminishing the inherent rewarding properties of many foods. These changes in the brain primarily impact highly palatable and energy-dense foods, which consequently lead to a decrease in cravings (1).

Honeymoon Period

During the first few months following bariatric surgery, patients have referred to them as the “honeymoon period”(2). During this phase, “weight loss is easy, and the bariatric surgery does the work,” as appetite, hunger, and cravings diminish (2). However, five years after bariatric surgery, on average, patients’ food preferences and cravings seem to return, despite immediate post bariatric surgery reductions in the pleasure derived from most foods and the continued avoidance of high-fat and high-sugar foods beyond the first year (2).

Strategies for Managing Cravings and Emotional Eating

As we’ve explored, the journey through cravings and emotion-based eating post bariatric surgery can be complex. It’s essential for patients to have a toolkit of strategies to navigate this terrain successfully. We’ll talk about intervention strategies and offer helpful advice in this section for patients who want to keep losing weight and improving their general health.

Consult with Your Healthcare Team

Maintaining open communication with your healthcare team is crucial. Regular follow-up appointments are not only for tracking your physical health but also for addressing any emotional or psychological challenges. Don’t hesitate to discuss your cravings, emotional eating patterns, and any struggles you encounter. Your healthcare team can offer guidance and support, and they may recommend additional resources, such as psychological counseling.

• Seek Psychological Support: Professional psychological counseling can be an invaluable resource. Therapists and counselors can help you understand and manage emotional eating triggers, providing you with coping strategies and emotional regulation techniques. 
• Practice Mindful Eating: Mindful eating involves paying close attention to your food choices and eating habits. Focus on savoring each bite and listen to your body’s hunger and fullness cues. Mindful eating can help you develop a healthier relationship with food, reduce cravings, and prevent emotional eating episodes.
• Educate Yourself: Understanding the science behind these challenges can empower you to make informed choices.
• Keep a Food Journal: Keeping a food journal can make you more conscious of your eating patterns and help you spot trends associated with emotional eating and cravings. Keep track of your food intake, timing, and feelings during each meal. This practice can reveal triggers and help you make informed decisions.
• Develop Healthy Coping Mechanisms: Instead of turning to food when you’re experiencing emotional distress, explore alternative coping mechanisms. Engage in physical activity, practice deep breathing exercises, or pursue creative outlets like journaling, art, or music. Finding healthy ways to manage emotions can reduce the reliance on food for comfort.
• Set Realistic Expectations: Understand that cravings and emotional eating may occur occasionally, even after bariatric surgery. Set realistic expectations and view these challenges as part of the journey. The key is to learn from each experience and make healthier choices moving forward.
• Create a Supportive Environment: Surround yourself with a supportive environment. Inform your family and close friends about your goals and challenges. Having a network of individuals who understand your journey can provide encouragement and accountability.
• Plan Meals and Snacks: Preparation is key. To guarantee you have access to wholesome options when hunger strikes, plan your meals and snacks in advance. This reduces the likelihood of making impulsive, less healthy food choices when cravings arise.
• Stay Hydrated: Dehydration can sometimes be mistaken for hunger or cravings. Drinking water can help reduce false signals of hunger and minimize the urge to snack unnecessarily.
• Connect with Support Groups: Consider joining a bariatric support group or an emotional eating support group. These communities provide a platform to share experiences, gain insights from others who have gone through similar challenges, and receive encouragement.

Incorporating these strategies into your daily life can empower you to manage cravings and emotional eating effectively. Remember, the journey post bariatric surgery is about more than just physical changes; it’s a holistic approach that encompasses emotional well-being and lasting health. 

Contact Us Today

Our team is ready to help you. At LIMARP, patients will always receive warm, sincere and professional
answers. For a free evaluation please call us at (619) 270 8823, fill out a contact form at
our website, or message through any of our social media pages.

References

1. Ames, G. E., Koball, A. M., & Clark, M. M. (2022). Behavioral interventions to attenuate driven overeating and weight regain after bariatric surgery. Frontiers in Endocrinology, 13. https://doi.org/10.3389/fendo.2022.934680
2.  Lynch A. “Cuando termina la luna de miel, comienza el verdadero trabajo:” Trayectorias de pérdida de peso y experiencias de cambio dietético de los pacientes con bypass gástrico . Soc Sci Med (2016) 151 :241–9. doi: 10.1016/j.socscimed.2015.12.024

When a patient thinks about the possible complications that can take place during bariatric surgery, or any type of surgery for that matter, they don’t usually have allergy to sutures at the top of their list. In fact, it’s something that many people don’t even take into account and can come as a big, unwanted surprise during their recovery process.

As a patient begins preparing for their surgery, they’re in constant communication with their doctor to ensure that the medical procedure is successful; this means applying some changes to their lifestyle, cutting back on some types of foods and beverages, and going over their allergy list, especially when it comes to how their body reacts to anesthesia.

There are many reasons why a person can have or develop an allergy to sutures and we’ll explore that, as well as other topics, in this article. It’s very important for the patient to be aware if they have an allergy to sutures in order to avoid any complications that can put their health at risk. At LIMARP®, Dr. Liza María Pompa González and her team of qualified doctors ensure that every step of your surgical process is carried out safely. This means providing the necessary information regarding the before and after parts of any surgical procedure; this can include making sure that the patient doesn’t have an allergy to sutures or to any other kind of medication used during this time.

As always, we’d like to remind you that the information in this article is general and that if you have any more questions regarding a possible allergy to sutures, please contact your doctor in order to see if you can get tested and avoid any postoperative complications. Sutures can become infected if they’re not tended to correctly, which is why we highly recommend that you don’t let any uncomfortable feeling or uneasiness pass by.

Now, let’s go over some of the most important points regarding surgical sutures and how some patients can have or develop an allergy to them.

Understanding Surgical Sutures

In order to have a better understanding on why some patients may have an allergy to sutures, it’s important to go over the general definition of what a suture is and how they’re used in a surgical procedure. Sutures are used by a doctor to close wounds to the skin or other tissues, using a needle attached to a length of “thread” to stitch the wound shut. There are a variety of available materials that can be used for suturing. Your doctor will choose a material that’s appropriate for the wound or procedure[1].

There are many types of sutures from which a doctor can choose for closing up a surgical wound.

First, sutures can be absorbable or nonabsorbable, but what does this mean? Absorbable sutures don’t require a doctor to remove them because enzymes found in the tissues of your body naturally digest them. Meanwhile, nonabsorbable sutures need to be removed by a doctor or can be left in place permanently. When it comes to the material, it can be classified by structure:

• Monofilament sutures consist of a single thread, allowing the suture to easily pass through tissues.
• Braided sutures consist of several small threads braided together, leading to better security. However, there’s an increased risk for allergy and infection.

Given this information, we can now delve into the possibility of developing an allergy to sutures and why it can happen. Keep in mind that some people are more susceptible to dermatological complications due to other underlying conditions or hypersensitivity to sutures. Suture hypersensitivity or allergy refers to the clinical entities resulting from an exaggerated immunologic response triggered by the presence of a suture material, which serves as an external antigen[2].

Can a person have an allergy to sutures?

In short, yes. The allergy reaction caused by sutures must be differentiated from true wound infection and contact dermatitis and many factors may contribute to suture allergy. The longer the sutures are in, the more likely for an allergy to occur, as well as the caliber, size, and material of the suture[3]. One of the main signs that can indicate that a person has an allergy to sutures is inflammation, as well as other symptoms that can vary from person to person and how their bodies react to the allergy, such as: redness and swelling around the suture site, itching and irritation, pain and discomfort, bumps or blisters, and drainage or pus.

Other factors that can increase the risk of suture allergy include previous allergic reactions to sutures, history of allergies or asthma, use of certain medications, and, of course, underlying medical conditions. If this allergy goes untreated it can cause serious infections that can put a person’s health, which is already vulnerable post-surgery, at risk.

However, if they do have an allergy, there are several ways to treat it and avoid it from becoming worse, such as[4]:

• Topical creams or ointments to reduce itching and inflammation
• Oral antihistamines to relieve symptoms
• Corticosteroid injections to reduce inflammation
• Removal of the sutures
• Use of alternative sutures made from different materials

So, now that we have this information, the following questions arise: Can a person be tested for suture allergy? If so, what are the alternatives?

For the final part of this article, we’ll talk about testing for suture allergy and the different materials that doctors can use on the patients that test positive for it.

Testing for Suture Allergy

To make sure that a patient has an allergy to sutures, it’s best that they consult with allergists and dermatologists to get the proper diagnosis. If a person doesn’t get tested and undergoes surgery, it can increase hospitalization days and health care costs[5]. A 2017 study proposes that an interprofessional team, like the one we have at LIMARP®, is necessary for the early recognition, diagnosis, and treatment to decrease such complications[6].

However, another study[7] found that “screening panels for surgery-related allergens have not been well established. Some studies have proposed testing for specific allergens in patients with suspected suture hypersensitivity in an attempt to reveal pertinent allergens and prevent future exposure complications”.

One of the solutions some doctors have found is to change the type of material to perform the sutures, but first it’s important to be familiarized with the patient’s case and talk them through the procedure they’re about to get.

Contact Us to Learn More

If you want to learn more about allergy to sutures, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Everything You Need to Know About Surgical Sutures”. https://www.healthline.com/health/sutures#vs-stitches. (Accessed July 20, 2023).
• [2, 5] Titley-Diaz WH, De Cicco FL. Suture Hypersensitivity. [Updated 2022 Sep 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562288/
• [3] “Suture Reactions and Contact Dermatitis and Hypersensitivity”. https://emedicine.medscape.com/article/1128404-overview?form=fpf#a5. (Accessed July 20, 2023).
• [4] “Suture Allergy: Symptoms, Causes, and Treatment”. https://naomedical.com/blog/suture-allergy-symptoms-causes-treatment-nao-medical/. (Accessed July 20, 2023).
• [6] Yagnatovsky M, Pham H, Rokito A, Jazrawi L, Strauss E. Type IV hypersensitivity reactions following Dermabond adhesive utilization in knee surgery: A Report of Three Cases. Phys Sportsmed. 2017 May;45(2):195-198. doi: 10.1080/00913847.2017.1283208. Epub 2017 Jan 25. PMID: 28116947.
• [7] Butler L, Mowad C. Allergic contact dermatitis in dermatologic surgery: review of common allergens. Dermatitis. 2013 Sep-Oct;24(5):215-21. doi: 10.1097/DER.0b013e3182a0d3a9. PMID: 24030369.

Laparoscopic surgery is a minimally invasive type of surgery that allows doctors to perform operations using very small incisions. Laparoscopes, or small cameras, are threaded through the incisions to display video of the internal abdomen on a monitor, allowing the doctor to perform surgery without leaving a large scar (which traditional surgery leaves).

Many doctors opt for laparoscopic surgery because it helps diagnose a wide range of conditions that develop inside the abdomen or pelvis. It can also be used to carry out surgical procedures, such as removing a damaged or diseased organ or removing a tissue sample for further testing (biopsy)[1].

Compared to traditional open surgeries, laparoscopic surgery results in less trauma to the treated area. As a result, patients can recover from surgery much faster and with a lower risk of side effects. At LIMARP® International Center of Excellence for Obesity, located in Tijuana Mx, Dr. Liza María Pompa González can perform a number of bariatric procedures by way of advanced laparoscopic techniques to minimize your risks and to lay the groundwork for successful treatment and fast recovery.

Laparoscopic Surgery vs. Traditional Surgery

In order for the doctor to see and maneuver freely during the surgery, traditional surgeries require large incisions. In the case of bariatric surgery, an incision can be anywhere from three to 12 inches long. A laparoscopic bariatric procedure, in contrast, requires several incisions of less than half an inch.

The laparoscope and surgical instruments are inserted through these small incisions and the surgeon uses them assisted by a special monitor. Because these surgeries are more technically challenging, they require additional skills and training.

Why is Carbon Dioxide (CO2) Used in a Laparoscopic Bariatric Procedure?

The process for laparoscopy surgery starts like all of our bariatric surgeries: our anesthesiologist will first administer the general anesthesia best suited to your case, ensuring that you remain comfortable throughout your treatment.

Once you are under anesthesia, Dr. Pompa will:

• Create tiny incisions between ¼ and ½ inch long.
• Thread narrow tube-like instruments called cannulas through the incision.
• Expand your abdomen using carbon dioxide (CO2) gas to create work space and improve visibility. A tube is inserted through the incision, and carbon dioxide gas is pumped through the tube to inflate your tummy (abdomen).
• Insert the laparoscopic tools through the cannulas.
• Perform the procedure using a magnified view of the stomach and internal organs.
• Remove the CO2 gas.
• Close the incisions.

With these advanced techniques, Dr. Pompa can perform your entire procedure using only three to five small incisions.

Although, as mostly surgeries or medical procedures, the patient must have post-surgery indications from their healthcare provider. Also, during the recovery the patient might experience excessive gas due to the carbon dioxide (CO2) that was inserted to expand the abdomen, but these excess gas symptoms should not be longer than three days[2].

What About Gas Pain After The Laparoscopy Surgery?

During laparoscopic surgery, as we mentioned, the abdomen is inflated with carbon dioxide gas to create a space between the organs so the specialist can perform the surgery with enough space between the organs. This inflation allows the surgeon to have a better view and more room to work. The gas also helps to separate the organs and reduce the risk of accidental damage during the surgery.

The presence of carbon dioxide gas in the abdominal cavity can cause several issues that contribute to gas pain, such as gas irritation, pressure on the nerves, abdominal distention, and/or residual gas[3].

The carbon dioxide gas may irritate the diaphragm (the thin muscular sheet that separates the chest cavity from the abdominal cavity) leading to referred pain in the shoulder or back[4]. The gas can put pressure on surrounding nerves, leading to discomfort or pain.

Another effect due to the laparoscopy surgery is bloating: the abdomen may become distended or bloated due to the presence of the gas, which can cause a feeling of fullness and discomfort. After the surgery, some of the carbon dioxide gas may remain trapped in the abdominal cavity, causing ongoing discomfort until the body absorbs it.

However, the gas pain after this surgery is generally temporary and should subside as your body naturally absorbs the carbon dioxide. It might take a few days for the gas to completely dissipate and during this time the patient must follow the post-surgery indications to help alleviate the discomfort.

Although, if you have concerns about the level of gas pain or if it becomes severe and persistent, it’s essential to communicate with your healthcare provider or schedule an appointment as soon as possible to identify your condition and provide appropriate guidance and support. This gas pain can be fully controlled with prescribed pain medication and it tends to disappear during the first few days after surgery. This type of pain is no reason for concern[5].

How to Reduce Gas Pain After The Laparoscopy Surgery

As we mentioned, gas pain after laparoscopic surgery is a common side effect due to the carbon dioxide used to inflate the abdomen during the procedure. This gas can cause discomfort and bloating, but it usually dissipates on its own within a few days as your body absorbs it.

Although each body and patient has different needs, here are some general tips that may help alleviate the gas and its associated discomfort[6]:

• Walking and exercising: Moving around and walking can aid in the movement of gas through your digestive system and help you pass it more easily. Also, changing positions regularly, such as sitting up, lying down, or gently rocking back and forth, may help relieve gas pain.
• Rethink your diet: “Eating certain foods can cause trapped gas” [7]. Avoiding foods that can cause gas, such as beans, broccoli, cabbage, carbonated beverages, and fried or fatty foods, may help reduce gas formation.
• Chew and eat slowly and avoid using straws: Eating slowly and avoiding straws can reduce the amount of air you swallow, which can contribute to gas buildup.
• Heat compresses: Applying a warm compress or heating pad to your abdomen may help soothe discomfort caused by gas.
• Medications for gas pain: Over-the-counter medications, such as simethicone, may help break down gas bubbles and reduce bloating.
• Follow your doctor’s prescriptions: Always follow your surgeon’s post-operative instructions and take any prescribed medications as directed.

If you experience severe or persistent gas pain, or if you have any concerns after your surgery, (as we discussed) it is imperative to contact your healthcare provider immediately. They can provide personalized advice and address any complications that may arise.

Gas pain after laparoscopic surgery is a common side effect due to the specific technique used during the procedure. Laparoscopic surgery is a minimally invasive surgical technique where small incisions are made in the abdomen, but this surgery can lead the patient to have a particular recovery, no matter the regular symptoms we encourage you to keep in close with your surgeon.

Contact Our Clinic Today

At LIMARP International Center of Excellence for Obesity, located at Tijuana, Mexico, we take your health very seriously. After your laparoscopy surgery, we supervise and monitor the evolution of your recovery at our private hospital rooms and we make sure you progress safely into your new, more healthy life. If you have any doubts or questions about gas pain after laparoscopy surgery or are experiencing any suspicious symptoms after your treatment, please call us immediately. We will intervene and guide you through everything you need to know.

At our clinic, we offer different non-surgical and surgical treatments for obesity in an integral bariatric program with a multidisciplinary approach. At LIMARP your medical intervention for obesity includes psychological and nutritional counseling, as well as the guidance of a fitness expert. We also offer all-inclusive packages for patients traveling from abroad, where we include lodging at our clinic’s luxurious next-door hotel, and transportation from the airport to the hotel and back.

If you’re interested in getting to know more about our clinic and services, or if you’re interested in knowing more about gas pain after laparoscopic surgery, please call our phone number (619) 270 8823 or send us a message through this website or any of our social media pages. Our team of experts will be glad to help.

References

• [1, 3] “Laparoscopy (keyhole surgery)”. https://www.nhs.uk/conditions/laparoscopy/ (Accessed July 23, 2023).
• [2] “Laparoscopy: What to Expect at Home”. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zc2174 (Accessed July 23, 2023).
• [4] “Gas and gas pains”. https://www.mayoclinic.org/diseases-conditions/gas-and-gas-pains/symptoms-causes/syc-20372709#symptoms (Accessed July 23, 2023).
• [5] “Abdominal pain after gastric sleeve surgery”. https://www.limarp.com/en/blog/gastric-sleeve/abdominal-pain-after-gastric-sleeve-surgery/ (Accessed July 23, 2023).
• [6] “How to get rid of trapped gas”. https://www.medicalnewstoday.com/articles/321504 (Accessed July 23, 2023).
• [7] “What is the best medication for gas?” https://www.medicalnewstoday.com/articles/best-medication-for-gas (Accessed July 23, 2023).

A post bariatric surgery diet is very straightforward during the first six months of recovery because the body needs time to heal properly before the stomach and other organs can correctly digest all foods. Sure, some post bariatric diets may have some alterations according to the dietary restrictions of each patient, such as allergies, lifestyle choices, or any medical conditions that prevent them from having certain foods. This post bariatric surgery diet plan will be provided as part of our integrative bariatric program, which focuses on different areas so the patients receive well-rounded attention that covers all their needs.

This means that your treatment doesn’t end once you exit the operating room and you’ll receive different types of support, such as physical, psychological, and nutritional. Every bariatric patient needs to change their eating habits before and after their clinical intervention. This is why the nutritionists at the LIMARP® clinic at Tijuana offer a personal diet program along with specific recipes and guidelines to follow at different stages of their treatment. These guidelines are provided by a professional specialized in bariatric nutrition.

For this article, we’ll talk about the post bariatric surgery diet, covering the first months of recovery, as well as the different diet options the patient can follow once they’re cleared by their doctor. At LIMARP®, we know that the solution for obesity cannot rely on a single action such as a surgery. Weight loss surgery is one definite step, for sure, as it accomplishes dramatic results in a very short time, but it is not sufficient by itself for maintaining low weight and staying healthy in the long term. Our team of doctors at the Tijuana clinic, led by Dr. Liza María Pompa González, offers an Integrative Bariatric Program that tackles obesity with a set of different complementary interventions.

As always, we’d like to remind you that the information presented in this article may not apply to all cases, and if you’re currently following a post bariatric diet that’s not working for you, make sure to contact your doctor as soon as possible so they can provide the proper alternatives.

A Deeper Look Into a Post Bariatric Surgery Diet

A post bariatric surgery diet is an essential part of any bariatric treatment. After bariatric surgery, the size of your stomach gets drastically reduced, and a post bariatric surgery diet will help your body get used to its new self. Of course, this diet is also a big part of your weight loss journey. Compliance to your post bariatric surgery diet will help you get on track for your new, healthier, long-term eating habits.

When it comes to post bariatric surgery diets, our specialists provide thorough nutrition planning for patients as part of our integrative bariatric program and these plans will vary based on the type of procedure you receive. Post bariatric surgery diet plans schedule a gradual introduction of foods, from liquids to solids, to allow your stomach ample time to heal properly, which reduces your risk of future complications. Allowing your stomach to heal also increases your odds of achieving your weight loss goals and keeping the weight off in the long-term.

Post bariatric surgery diet plans are essential for all bariatric surgery patients. Those individuals who undergo malabsorptive procedures must learn to choose foods and supplements that ensure they receive the nutrients they need. With our tailored plans, all patients can discover more options that will benefit their health and unique situation.

Stages of a Postoperative Diet

As your stomach heals, you will go through various stages of eating during your postoperative diet. This means that the foods that you can and cannot eat after bariatric surgery will also change.

Liquids

You will only have clear liquids for one to seven days following your bariatric surgery. This includes, of course, water, but also chicken, beef or vegetable broth, popsicles and gelatin. You may only drink two to three ounces of liquid at a time and you must drink them very slowly. When your post bariatric surgery diet allows for it, you may begin drinking non-clear liquids for one week. These include skim milk, unsweetened plant-based milks, soups, sugar-free juices, and decaffeinated coffee or tea.

Pureed Foods

As your body becomes more tolerant, you may start introducing pureed foods to your post bariatric surgery diet. You will eat them exclusively for three to four full weeks. You may also have protein shakes during this time, but should not eat and drink at the same time during this stage because you will not be accustomed to the smaller size of your stomach and will likely be unable to gauge when you are full. Examples of good pureed-consistency foods are scrambled eggs, cooked and smashed vegetables, grounded meat, humus, yogurts and pates.

Soft Foods

After three to four weeks of pureed foods, your post bariatric surgery diet plan will begin to change again, and you may begin to introduce soft foods. You may eat a combination of pureed and soft foods for about two weeks. Soft foods should be cut or shredded into very small pieces and may include foods such as diced fish or chicken or ground meats, canned or soft fruit with no seeds or skin, and cooked vegetables with no skin. Other good options are rice, lentils, tuna and soft cheeses.

Healthy Solid Foods

After about six to eight weeks, you may gradually introduce more solid foods into your post bariatric surgery diet, but you should continue cutting your food into small, easily digestible bites. You may not tolerate some foods right away, such as spicy or extremely crunchy foods. However, you may be able to incorporate them back into your diet at a later time. It is important to continue eating small meals and to make healthy choices that focus on protein, vegetables, and fruits.

Although you’ll be able to eat many different types of food after your recovery, it is still important to remember that you should still avoid certain foods that can lead you on a wrong track from your weight loss goals and away from healthy eating habits, like high-calorie, high-fat and high-carbohydrate foods, junk foods, sugary drinks and alcohol.

Once you’re cleared by your doctor, you’ll be able to follow a post bariatric surgery diet plan that’s more in line with your lifestyle. There are many questions regarding whether a bariatric patient can take up any diet following their surgery and we understand that many people may be nervous or worried to gain back the weight or accidentally hurt themselves because they didn’t watch what they eat.

It’s very important to be mindful of the food you eat while on a post bariatric surgery diet, which is why we recommend that you work alongside your nutritionist to find the right post bariatric diet plan. Next, we’ll talk about some of the dangers of not sticking to the plan provided by your doctor, as well as an example of specific diets and how well they work for bariatric patients.

The Dangers of Not Following a Post Bariatric Surgery Diet

Eating a lot is not recommended after this surgery and doing so would mean breaking the post bariatric surgery diet your doctor recommended to maintain a healthy weight. Overeating can take form in irregular snacking behaviors or binging during meals despite being full. Because the surgery removes a large portion of your stomach, overeating can result in significant weight gain or plateaus, as well as abdominal pain, cramps, frequent indigestion, and heartburn.

Overeating and ignoring your post bariatric surgery diet can also result in the following symptoms:

• Vomiting and Diarrhea: When the stomach receives more food than it can hold, it’s natural for the body to release the contents through vomiting or diarrhea. Overeating while being on a post bariatric surgery diet can also affect the body’s digestion.
• Dumping Syndrome: This can happen when the food you consume, usually undigested, passes too quickly through the intestine, and it’s usually a reaction that the stomach has when it comes to overeating. Some symptoms may include increased sweating, diarrhea, dizziness, and nausea. However, the most concerning side effect is the sudden drop in blood sugar; if you happen to experience this, seek urgent help immediately.
• Stretching of the Stomach: The stomach stretching to a larger size is the most serious consequence of overeating after gastric sleeve surgery. Repeatedly eating large meals will undo the progress surgery allowed you to make and you’ll regain the weight you lost due to your stomach stretching.

Examples of Post Bariatric Surgery Diets

There are several post bariatric surgery diet plans that help improve the patient’s overall health, not only by helping them keep an ideal weight, but by benefiting their quality of life or helping them reach specific goals. You may have a lot of questions regarding the type of post bariatric surgery diet you can follow once you’ve recovered, and in this section of the article, we’ll give some examples on which diets can be recommended for bariatric patients.

One of these post bariatric surgery diets is the keto diet, which primarily consists in consuming a high-fat, low-carb diet that drives the patient’s body into ketosis, a metabolic state that elevates the ketone levels in their blood systems. Some studies have concluded that the keto diet can be suitable for bariatric patients that are in the preoperative process or any other type of non-surgical procedure.

A 2020[1] study stated that a low calorie keto diet is one of the most frequent methods for “the induction of a preoperative weight loss”, but it still concluded that nutritional counseling was needed “to facilitate the adaptation of the eating habits to the new gastro-intestinal physiology”. It’s important to point out that, while a well-rounded post bariatric surgery diet that’s based on protein is more sustainable for bariatric patients, it’s always better to consult a doctor to discuss the best dietary options.

Another post bariatric surgery diet you can follow is a plant-based diet that “encompasses a wide range of dietary patterns that contain low amounts of animal products and high amounts of plant products such as vegetables, fruits, whole grains, legumes, nuts and seeds”[2]. As you can see, this doesn’t mean that you have to stop eating animal products, but rather focus on plant-based products to make sure you get all your necessary macro and micronutrients.

How can a plant-based diet help a person lose or maintain their ideal weight?

Well, one study[3] found that this type of post bariatric surgery diet can help people who are struggling with being overweight or dealing with other illnesses such as type 2 diabetes., cardiovascular disease, and rheumatoid arthritis. This is due thanks to the increased intake of fiber, polyunsaturated fats, and plant proteins found in this post bariatric surgery diet.

Contact Us to Learn More

If you want to learn more about what a post bariatric surgery diet entails, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] Bettini, S., Belligoli, A., Fabris, R. et al. Diet approach before and after bariatric surgery. Rev Endocr Metab Disord 21, 297–306 (2020).
• [2] Hemler EC, Hu FB (November 2019). “Plant-Based Diets for Personal, Population, and Planetary Health”. Advances in Nutrition. 10 (Suppl_4): S275–S283. doi:10.1093/advances/nmy117. PMC 6855934. PMID 31728495.
• [3] Iraki J, Fitschen P, Espinar S, Helms E. Nutrition Recommendations for Bodybuilders in the Off-Season: A Narrative Review. Sports (Basel). 2019 Jun 26;7(7):154. doi: 10.3390/sports7070154. PMID: 31247944; PMCID: PMC6680710.

In previous articles, we have covered a wide variety of topics concerning nutrition and the types of diets a patient must follow before and after bariatric surgery, as well as what you cannot eat. Sticking to these diets is very important to avoid any complications during and after the procedure, and while there may be some slight changes according to each patient’s case, the diet plans provided by nutritionists during this process are very straightforward. After undergoing bariatric surgery, you will be given a postoperative diet plan to guide you on what you can and cannot eat.

We highly encourage our patients to follow these diets to have a successful recovery, as well as to avoid overeating well beyond their bariatric surgery, especially if they underwent a gastric sleeve or bypass. In this article, we will discuss which foods cannot be eaten after bariatric surgery and some of the consequences of not following the diet given by the doctor.

Our specialists provide thorough nutrition planning for patients as part of our integrative bariatric program. As a patient at LIMARP® International Center of Excellence for Obesity, patients receive specific, individualized postoperative diet plans. These plans will vary based on the type of procedure they receive. Our postoperative diet plans schedule a gradual introduction of foods, from liquids to solids, to allow the stomach to heal properly, reducing the risk of future complications, as well as a list of foods that the patient cannot eat. Allowing the stomach to heal also increases their odds of achieving your weight loss goals and keeping the weight off in the long-term.

Postoperative diet plans are essential for all bariatric surgery patients. Those individuals who undergo malabsorptive procedures must learn to choose foods and supplements that ensure they receive the nutrients they need because they cannot eat certain foods in the first weeks of recovery. With our tailored plans, all patients can discover more options that will benefit their health and unique situation. As always, we’d like to remind you that the information presented in this article is general and may not apply to all cases. If you’ve been following a postoperative diet and start having negative side effects, contact your doctor as soon as possible.

Ver esta publicación en Instagram

Una publicación compartida por Liza María Pompa Gonzalez (@dra.pompa)

Before we learn more about which foods cannot be eaten after bariatric surgery, we would like to provide more information on how your diet will change throughout your recovery process.

Stages of a Postoperative Diet

As your stomach heals, you will go through various stages of eating during your postoperative diet. This means that the foods that you can and cannot eat after bariatric surgery will also change.

Liquids

You will only have clear liquids for one to seven days following your bariatric surgery, meaning that you cannot eat any solid foods. This includes, of course, water, but also chicken, beef or vegetable broth, popsicles and gelatin. You may only drink two to three ounces of liquid at a time and you must drink them very slowly. When your program allows for it, you may begin drinking non-clear liquids for one week. These include skim milk, unsweetened plant-based milks, soups, sugar-free juices, and decaffeinated coffee or tea, but still cannot eat anything more solid than that.

For more information on liquid diets and what you can and cannot consume during this stage of your postoperative diet, we invite you to read this article

Pureed Foods

As your body becomes more tolerant, you may start introducing pureed foods. You will eat them exclusively for three to four full weeks and cannot eat food more solid than that. Pureed foods have a consistency similar to baby food and you may also have protein shakes during this time. You cannot eat and drink at the same time during this stage because you will not be accustomed to the smaller size of your stomach and will likely be unable to gauge when you are full. Examples of good pureed-consistency foods are scrambled eggs, cooked and smashed vegetables, grounded meat, humus, and yogurt.

Soft Foods

After three to four weeks of pureed foods, you may begin to introduce soft foods, but still cannot eat more solid foods. You may eat a combination of pureed and soft foods for about two weeks. Soft foods should be cut or shredded into very small pieces and may include foods such as diced fish or chicken or ground meats, canned or soft fruit with no seeds or skin, and cooked vegetables with no skin. Other good options are rice, lentils, tuna, and soft cheeses. Keep in mind that you still cannot eat harder to chew food during this period of time.

Healthy Solid Foods

After about six to eight weeks, you may gradually introduce more solid foods into your diet, but you should continue cutting your food into small, easily digestible bites. You may find that you cannot eat or tolerate some foods right away, such as spicy or extremely crunchy foods. However, you may be able to incorporate them back into your diet at a later time. It is important to continue eating small meals and to make healthy choices that focus on protein, vegetables, and fruits.

Although you’ll be able to eat many different types of food after your recovery, it is still important to remember that you still cannot certain foods that can lead you on a wrong track from your weight loss goals and away from healthy eating habits, like high-calorie, high-fat and high-carbohydrate foods, junk foods, sugary drinks, and alcohol.

Now that we’ve covered how a postoperative diet works after undergoing bariatric surgery, as well as what you can eat, let’s go over some of the foods that you cannot eat while recovering from your procedure.

What Foods and Drinks to Avoid

There are several foods and drinks that you cannot eat after having bariatric surgery and when it comes to beverages, it’s best to avoid the following[1]:

• Caffeine and carbonated beverages for at least three months
• Alcoholic drinks for at least six months

When your doctor has finally cleared you and tells you that you can drink the aforementioned beverages, make sure to start slow. One of the reasons you’re indicated to avoid these drinks is because they can irritate the stomach and even though you’re healed, you can still feel discomfort. If it becomes unmanageable, your doctor may recommend that you cut them from your diet moving forward.

When it comes to food, you may also notice some intolerance toward dishes that you didn’t have a problem with before, such as red meat, greasy, high-fat foods, spicy food, and food that’s reheated in a microwave. Of course, this doesn’t mean that you cannot eat them, but it’s best if you don’t to avoid irritation in the stomach that can later lead to more serious complications, such as ulcers or ruptures.

Other types of foods you cannot eat after bariatric surgery include[2]:

Food the contains empty calories

After bariatric surgery, your doctor will not tell you that you cannot eat foods that provide little or no nutritional value, but rather avoid them as best as you can. Foods loaded with sugar or that are fried can lead to a condition called “dumping syndrome,” which means that food is dumped in the colon quickly after eating it. Dumping syndrome causes weakness, cold sweats, nausea, and possibly vomiting and diarrhea.

Dry food like cereal and granola

If you’re not consuming many liquids and still recovering from your procedure, you cannot eat foods like nuts or granola because they can be difficult to swallow. This doesn’t mean that you will never be able to eat them, but it’s important to give your stomach enough time to heal before it digests these types of foods.

Rice and pasta

Rice and pasta are starchy and can form a paste in your throat that can be hard to swallow if you’re not drinking liquids. You cannot eat them because, in the worst of cases, they can block the stoma and put you at risk of serious postoperative complications.

Fibrous fruits and vegetables

Your doctor may tell you that you cannot eat certain vegetables, such as celery, corn, broccoli, cabbage, and asparagus, while recovering from bariatric surgery. This is because they are hard to digest and may put your stomach under a lot of stress, which puts you at risk of complications.

These are just some examples of the foods that you cannot eat after bariatric surgery, but keep in mind that they may change according to the way your recovery goes or if you have any dietary restriction.

Your dietitian will create your plan with a list of foods that you can and cannot eat, as well as recommendations on how to make this process easy and comfortable for you. If you’re struggling with following your new diet plan or find that there are other foods that you cannot eat, don’t hesitate to contact your doctor.

Contact Us to Learn More

If you want to learn more about which foods cannot be eaten after bariatric surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “What Foods and Drinks Should You Avoid After Bariatric Surgery?”. https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2020/january/foods-drinks-to-avoid-after-bariatric-surgery (Accessed June 20, 2022).
• [2] “Eight foods to avoid after bariatric surgery”. https://www.phoenix-health.co.uk/foods-to-avoid-after-bariatric-surgery/ (Accessed June 20, 2022).

Bariatric or weight loss surgery is now considered the most effective weight loss treatment method there is and it can offer the greatest chance for long term weight loss. This type of surgery can reduce your risk of obesity-related medical conditions, which is one of its many benefits, and an indicator that you may be eligible is if you have a body mass index (BMI) over 35. Your BMI may be aggravated by one or more health issues such as type 2 diabetes., high blood pressure, sleep apnea, cardiovascular disease, high cholesterol or triglycerides.

Once our team determines that you are a candidate for weight loss surgery, we can determine the most effective type of surgery for you. Weight loss surgery is a serious procedure, with the potential to change your life. Our multidisciplinary team will do both physical and psychological evaluations to determine your possibility of undergoing surgery.

Once your surgery is given the green light, it’s important to know that the process begins up to two weeks before the actual bariatric procedure. You must be prepared, both mentally and physically, to undergo this invasive treatment, meaning that you must cut back on unhealthy habits and start following the recommendations set by your doctor. This includes following a strict liquid diet that can begin up to six weeks[1] before your bariatric surgery.

At LIMARP®, we ensure that our technology is always up to date, to provide our patients with the highest quality care. Through these tools, we can help provide more personalized treatment with less health risks to each and every patient. Our surgical and medical teams also dedicate themselves to continued education on how best to implement these technologies, ensuring safe and effective treatments. Our multidisciplinary team includes expert nutritionists that will guide you before and after your bariatric surgery, making sure that you remain strong and healthy while following a liquid diet.

What’s a Liquid Diet?

A liquid diet mostly consists of liquids or soft foods that melt at room temperature[2]. It usually provides sufficient hydration, helps maintain electrolyte balance, and is often prescribed for people when solid food diets are not recommended, such as before undergoing bariatric surgery. This type of diet should not be carried out without medical supervision since some negative side effects include fatigue, nausea, dizziness, hair loss, and dry skin.

During this type of diet, your food options before bariatric surgery will be reduced to water, natural fruit juices, nonfat plain yogurt, soup broth, liquid supplements, and unsweetened tea or coffee. This is just a general list and your nutritionist will assign a liquid diet plan personalized to your needs.

Now, you may also wonder about the difference between the liquid diet we just described and a clear liquid diet, and it’s very important to learn more about their distinctions.

A clear liquid diet is medically prescribed for short periods to rest and clean out your digestive tract while providing adequate short-term hydration and some energy. Just like it sounds, the diet consists of clear liquids and foods that melt into clear liquids. It excludes solid foods and liquids that you can’t see through. Clear liquids are easily absorbed by your digestive system, and they also allow technicians to see clearly into your digestive tract during an imaging test[3].

These types of diets must be implemented for two weeks before undergoing bariatric surgery and it’s necessary that they are carefully followed to avoid any complications during the procedure. Many patients may worry that they’re not getting enough energy from their food, but a liquid diet is designed so that they can get enough protein, fat, vitaming, and minerals, while lowering their calorie and carbohydrate intake[4].

What to Expect

In the two weeks before your bariatric surgery, your body will adjust to the liquid diet, and while you may feel very hungry at first, it’s a small hurdle to ensure a successful surgery. The liquid diet serves several purposes, like helping you lose some weight before surgery, which “reduces the risk of your laparoscopic surgery having to be converted to open surgery. It also reduces your liver size, intra-abdominal fat, comorbidities, operating time, recovery time, and post-operative risks”[5].

Of course, there are some side effects that may present themselves while your body is adjusting to the liquid diet, such as bad breath or a dry mouth, constipation, diarrhea, dizziness, and fatigue. If you’re experiencing any of these symptoms, make sure to contact your doctor so that they can provide adequate recommendations or make changes to your liquid diet plan. It’s important that you’re healthy and in your best shape before undergoing bariatric surgery, so don’t hesitate to communicate your needs with your doctor.

What to Eat and What Not to Eat

We previously mentioned some appropriate foods you can consume while on a liquid diet before undergoing bariatric surgery. However, it’s also important to learn what not to eat or consume before surgery. According to the University of Florida Health[6], it is important to include a protein shake multiple times daily to help ensure good nutritional status prior to surgery. You should aim for a goal of 60 to 80 grams of protein per day and also add a general multivitamin and calcium supplement to meet basic nutrient needs. While swallow form of supplements will be acceptable long-term, initially chewable forms are recommended for optimal digestion and absorption.

When it comes to which foods to avoid before bariatric surgery, it goes without saying that solid food is completely off limits, but so are liquids such as carbonated beverages, alcoholic drinks, drinks with a high calorie count, and dairy smoothies. Only your doctor will be able to confirm which liquids are adequate for your diet before undergoing bariatric surgery, and if you have any questions, make sure to contact them.

More Information About Liquid Diets

Aside from preparing your body for bariatric surgery, going on a liquid diet before your procedure will also prepare you for the postoperative process. While you’re in recovery, you’ll also be on a liquid diet for up to 4 weeks, so being familiar with this type of diet will make this period easier. A liquid diet is relatively simple because it allows patients to consume meal replacement drinks, as well as clear liquids like water and broths. The calories needed, which are up to 1,200 a day, come mostly from these meal replacement drinks. The goal is to offer complete nutritional balance while avoiding high-fat and high-sugar products[7].

Contact Us to Learn More

If you want to learn more about going on a liquid diet before undergoing bariatric surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1, 4] “Preparing for Bariatric Surgery: Liquid Diet”. https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-prep-bar-surg-liquid-diet.pdf (Accessed June 19, 2023).
• [2] “Full liquid diet”. https://medlineplus.gov/ency/patientinstructions/000206.htm (Accessed June 19, 2023).
• [3] “Clear Liquid Diet”. https://my.clevelandclinic.org/health/treatments/21764-clear-liquid-diet (Accessed June 19, 2023).
• [5] “Pre-Op Liquid Diet: Two Weeks Before Bariatric Surgery”. https://www.kelsey-seybold.com/medical-services-and-specialties/bariatric-surgery/pre-op-liquid-diet (Accessed June 19, 2023).
• [6] “Liquid Diet Before Bariatric Surgery”. https://ufhealth.org/sites/default/files/media/Weight-loss-center/Liquid_Diet_Before_Bariatric_Surgery.pdf (Accessed June 19, 2023).
• [7] “Pre-Op Liquid Diet”. https://www.winthropbariatrics.com/bariatric-surgery/getting-started/pre-op-liquid-diet.php (Accessed June 19, 2023).

Weight loss surgeries like bariatric surgery imply going through certain processes, running various tests, evaluating the patient’s health, identifying any medical conditions, and determining the suitability for the procedure. The specific tests may vary depending on your surgeon’s preferences, but there are some common tests that you will need in order to get bariatric surgery.

Weight loss or bariatric surgery has gained great acceptance in recent years and it seems that we all know someone who has gone through it or is in some way considering it. Bariatric surgery is part of a treatment with the potential to change your life, but you will have to make drastic changes for it to work and it is essential that you choose the right time to do it.

Therefore, if you decide to undergo bariatric surgery, there are some tests you will need to get before going into the operating room. Here are some specific requirements that may be necessary to start your process.

General Consideration and Researching Bariatric Surgery Centers

Look for reputable bariatric surgery centers or hospitals in your area that offer the procedure you are interested in. Consider factors in surgery center experience, success rates, and patient reviews.

• Inform yourself: Attend informational sessions or seminars. Many bariatric surgery centers conduct informational sessions or seminars to educate potential patients about the procedure, risks, benefits, and lifestyle changes associated with surgery. Attend these sessions to gather more information and have an opportunity to ask questions.
• Schedule your appointment with a bariatric surgeon: During this consultation, the surgeon will assess your medical history, and current health condition, and determine if you meet the criteria for bariatric surgery. Depending on the surgeon’s recommendation and your health condition, you may need to take certain medical tests before the surgery. These can include blood tests, imaging studies, psychological evaluations, and consultations with specialists to address any underlying health issues.
• Insurance verification: If you have health insurance coverage, you might need to contact your insurance provider to determine if bariatric surgery is covered and what the requirements are. Insurance companies often have specific criteria that patients must meet before they will cover the procedure. Understanding your insurance coverage and any potential out-of-pocket costs is important.

Once you have completed the necessary assessments that your doctor required and you met the criteria set by the surgeon and your insurance company, the bariatric surgery center will assist you in obtaining pre-authorization from your insurance provider. This process ensures that your insurance will cover the surgery. After this, you will be able to schedule the surgery. The availability of surgery dates may vary depending on the center’s agenda and the availability of the surgical team.

It’s important to note that even with these steps, there may still be some waiting time involved due to the demand for bariatric surgery. The process can also vary depending on the healthcare system and the specific requirements of the center you choose. Make sure you are up to date with all the tests and assessments in order to set the appointment when you and your clinic are ready. Now, as we mention some tests to be done before having the surgery, here are a few examples of these:

Tests Done Before Bariatric Surgery

First, your doctor must start with a physical examination to assess your general health status, including vital signs, body mass index (BMI), and any physical abnormalities that may affect the surgery.

Blood tests come second and are performed to evaluate various aspects of your health, such as complete blood count (CBC), liver function tests, kidney function tests, lipid profiles, blood sugar levels (including fasting glucose and hemoglobin A1c), and hormonal assessments.

Nutritional evaluation is another test because it helps determine your current dietary habits, nutritional deficiencies, and potential risks related to malnutrition or nutrient deficiencies post-surgery. It may involve dietary interviews, analysis of eating patterns, and blood tests to check for nutrient levels like iron, vitamin D, and vitamin B12.

Electrocardiogram, CXR, and abdominal ultrasounds might be necessary to evaluate the structure and condition of your liver and other abdominal organs, and identify any abnormalities or signs of liver disease and cardiac conditions.

Last, but not least, sleep and psychological studies. Having sleep apnea or a history of breathing difficulties during sleep, you might need a sleep study. This test helps diagnose and evaluate the severity of sleep-related breathing disorders. Also, psychological study is needed mostly because insurance companies are involved and may require it. Most psychologists will evaluate your understanding and knowledge of the risks and complications associated with weight loss surgery and your ability to follow the basic recovery plan.

It’s important to remember that these are only a few tests you will need to get before having bariatric surgery and the specific tests and assessments may vary depending on your individual circumstances and the requirements of your doctor. Your bariatric surgeon and their team will guide you through the necessary evaluations and tests based on your unique situation.

Once your test and results are done, you will be one step ahead of the process and the signs that suggest that your moment to have bariatric surgery has come are the following:

• You have tried other methods to lose weight, even with medical supervision, and you have failed.
• You have developed illnesses associated with obesity such as high blood pressure, sleep apnea, fatty liver or type II diabetes, among others.
• Your BMI (body mass index) puts you within the range of obesity.
• You find it difficult to move around and are less involved in social and family activities.
• You are ready to change your way of eating forever.
• You know the operation is not a magic solution and are willing to do the necessary work.
• You can organize your schedule to fit in exercises 5 to 6 times a week.
• You believe you are emotionally stable and willing to undertake a change of life.
• You know that it is possible to gain weight back and are willing to commit to a permanent change of habits to prevent this from happening.
• You’ve researched bariatric surgery and have found a doctor who offers comprehensive care, including the follow-up needed to make your process a success.
• You feel that you can be completely open with your doctor and he or she has taken the time to answer all your questions.
• The facility you chose has a full staff, is properly accredited, and provides you with printed or digital support material to keep you well-informed about every step of your process.

Please keep in mind that you should not let anyone pressure you into having weight loss surgery. This is not a decision to be taken lightly or in a moment of sheer despair; it is a lifelong decision, which you have to prepare for.

Now, as well as the preparation for the surgery, there are also steps to follow after you had your bariatric surgery. As we mentioned, it might include some life-changing actions and routines that you must follow in order to stay away from complications.

After Bariatric Surgery

Recovery time

This will depend on the type of surgery you need. The chances to start walking the very same day of your surgery are normal because most patients do. However, there are still several weeks ahead in which you must take special care of yourself and will have to hold back on lifting heavy objects, driving, or performing strenuous exercise.

You should choose a time in which you can take a break from your job and social commitments. This pause may be brief, but if your job requires that you lift heavy objects, live in an upper level with no elevator with no help or you have to carry bags or packages, you will need to make the necessary arrangements.

Contact Us to Learn More

If you want to learn more about bariatric surgery and when it’s the right time to get it, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1] “Bariatric Surgery”. https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258. (Accessed June 14, 2023).
• [2] “Diagnostic Tests for Bariatric Surgery”. https://stanfordhealthcare.org/medical-treatments/b/bariatric-surgery/procedures/diagnostic-tests.html. (Accessed June 14, 2023).
• [3] “Patient Guide to Bariatric Surgery”. https://www.cedars-sinai.org/programs/weight-management/patient-guide.html. (Accessed June 14, 2023).
• [4] “Requirements for Bariatric Surgery”. https://stanfordhealthcare.org/medical-treatments/b/bariatric-surgery/procedures/requirements.html. (Accessed June 14, 2023).
• [5] “Preparation for Bariatric Surgery”. https://www.ecommunity.com/services/community-bariatric-and-medical-weight-loss-services/faq/preparation-for-surgery. (Accessed June 14, 2023).
• [6] “Bariatric surgery and insurance FAQs”. https://uihc.org/health-topics/bariatric-surgery-and-insurance-faqs. (Accessed June 14, 2023).

Smoking is one of the most common addictive habits around the world, with the latest polling signaling that nearly one-in-four adults in the world smoke tobacco[1]. Given those metrics, we can also know that giving up smoking is very hard, especially for people who have been doing it for most of their lives. There are many reasons why tobacco users want or need to stop smoking; for women, it may be that they found out that they’re pregnant or to prevent their children from being exposed to second-hand smoke. 

For others, it may be due to health related issues. Smoking can cause or worsen many medical conditions and researchers estimate that every year around eight million people die an early death due to smoking. According to the CDC[2], smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.

Patients from all different backgrounds arrive at LIMARP® because they’re looking to improve their quality of life and embark on a healthier path. Our multidisciplinary team, led by Dr. Liza María Pompa González, offers different health services to help you reach your weight goals and beat obesity: from diet and exercise plans, to psychological guidance and bariatric surgery. When it comes to bariatric surgery, a doctor will determine which procedure is right for you and if you qualify, they will provide a series of instructions for before and after the surgery.

One of those indications will be to stop smoking and in this article, we’ll discuss the dangers of smoking following bariatric surgery and the complications it can bring.

Smoking is bad for your health no matter the circumstance, but it’s especially important to kick this habit if you want to ensure a healthy and successful recovery.

Can a Patient Smoke after Bariatric Surgery?

The short answer is no and prior to surgery, you’ll be instructed to stop smoking up to six weeks prior to bariatric surgery. This is to avoid complications during the surgery and prolong the recovery process; smoking can also cause problems in the heart and in the lungs, which are organs that must be healthy in order to have a successful bariatric surgery. There are many things a patient can do to ensure fast healing and great results after weight loss surgery. When preparing for bariatric surgery and recovery from the procedure, avoiding tobacco products is crucial. In fact, smoking has a number of negative effects on your overall health and wellness. 

Following the surgery, the doctor will provide instructions for the recovery period, from dietary suggestions to the gradual inclusion of physical activity to the patient’s lifestyle.  Smoking and using any sort of tobacco products prior to a surgical procedure can lead to an increased risk of infection and poor healing times.

Link Between Smoking and Obesity

While many people believe that smoking can help people lose weight or keep excessive weight off, there’s been some evidence that smoking can actually cause people to put on weight.

A study published in the April 2014 issue of the journal Obesity found that people who smoke tend to have worse diets than non-smokers. The study found that women who smoke are more likely to have fatty foods or diets that are high in carbs. Even if the smoker is not necessarily obese, their diet can contribute to weight gain as well as a number of serious health problems.

The Dangers of Smoking After Bariatric Surgery

After bariatric surgery, the dangers of smoking persist. Smoking after any sort of surgical procedure can lead to problems with healing and recovery, and while it doesn’t have a direct impact on weight loss outcomes, it can increase the risk of other complications, such as infections and ulcers. It can also increase the patient’s possibility of developing diabetes and heart disease, which are conditions that are commonly solved or treated with bariatric surgery.  

Like pre-op prep for surgery, it’s crucial that smokers avoid tobacco products of any kind for a few weeks after surgery. This is particularly important in those early weeks of healing as you are getting used to your new dietary needs. According to one study[2], “smoking is highly associated with long-term, post-operative complications, marginal ulceration, and bone fracture to name a few”. 

When it comes to specific types of bariatric surgeries, smoking can affect the body differently according to the type of procedure the patient underwent. During a gastric bypass, a new stomach pouch is formed in your body, and if the patient continues to smoke after the surgery, it can cause the narrowing of the entrance of this pouch. The result will be severe pain, vomiting, and nausea.

Tobacco causes a decrease in the blood flow to your stomach pouch because it shrinks the blood vessels. The carbon monoxide produced when smoking affects your blood cells’ ability to carry oxygen and as a result, the slow healing after bariatric surgery becomes a long-term concern.

Other Complications

• Pulmonary Complications

The lungs of smokers are already damaged and it takes up to 12 months for them to function normally. After weight loss surgery, the patient might experience breathing difficulties and a compromised immune system. If they smoke after surgery, even if not instantly after the procedure, the lungs are at the risk of infections, pneumonia, or other respiratory complications.

• Ulcers

Ulceration is already a risk for smokers and bariatric surgery is one of the factors that increase the risk of ulcers in all individuals. This means that the probability doubles in smoking patients. The body heals ulcers usually by pumping blood to the stomach, but if after the gastric sleeve or gastric bypass surgery, the stomach is smaller than its original size which decreases your body’s ability to heal ulcers.

Smoking also causes ulcer medication treatment dysfunction, so the use of medications is also discarded.

• Blood Clots

The poor blood circulation resulting from weight loss surgery increases the risk of blood clots for gastric bypass patients. Less than 1% of patients experience the entrance of blood clots into the lungs and heart, and eventually, pulmonary embolism.

The ability to pump blood is even less in smoking patients which increases this number for them. Blood clots in smoking bariatric patients cause blood pressure, strokes, and heart attack more than in non-smoker patients.

• Infections

The blockage of veins causes decreased blood flow in smokers. As a result, the healing process after the bariatric procedures slows down, bringing a lot of concerns for wound infections in smoking patients.

This is a logical concern because if there is not enough oxygenated blood pumped into the surgical wound, the healing does not go as usual and will cause infections in the sections where intestines were cut and stapled, which is a matter of concern in gastric bypass and sleeve surgery patients.

Making Healthy Lifestyle Choices Following Surgical Weight Loss

Bariatric surgery is all about changing your habits and your lifestyle for the better. We recommend to many of our patients that they quit using tobacco products after they have undergone a surgical weight loss procedure. This helps with healthy living overall. 

A healthier diet, more exercise, and a smoke-free life all signal the turning of the page and the start of a new you.

Contact Us to Learn More

If you want to learn more about the dangers of smoking after bariatric surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

[1] “Smoking”. https://ourworldindata.org/smoking. (Accessed May 21, 2022).

[2] Chow, A., Neville, A. & Kolozsvari, N. Smoking in bariatric surgery: a systematic review. Surg Endosc 35, 3047–3066 (2021). https://doi.org/10.1007/s00464-020-07669-3

A healthy and successful recovery following bariatric surgery can open countless doors when it comes to new experiences or following through with activities you gave up due to health concerns. Whether it’s returning to work and exploring new professional settings or taking up hobbies in your free time, being at your best is essential for thriving in your new lifestyle. 

One of the most important aspects of having a successful postoperative journey is exercise, since adding a workout to your daily routine, as well as a healthy diet, is key to ensuring that you don’t regain the weight that was lost after your bariatric surgery. It’s no secret that exercise has proven to show positive effects on a person’s overall health, both physically and mentally, regardless of their current weight or fitness goals. These benefits can be achieved through different types of exercise routines, such as weight training, cardio workouts, resistance training, or pilates. 

Another goal some patients may have tends to be more oriented toward aesthetics rather than strength, and that can be seen when they start or retake the journey toward activities such as bodybuilding.

Bodybuilding is possible for patients to carry out, but it’s important to constantly communicate with your doctor or nutritionist so that you do so in a safe and effective way. Our multidisciplinary team at LIMARP® is equipped with the knowledge to help you reach your bodybuilding goals, from workout guides to diet plans, we want to make sure that you have all the necessary resources.

This article will focus on bodybuilding and how it can be achievable following bariatric surgery through hard work, consistency, and a balanced plan that prioritizes health and fitness.

Be sure to be mindful of your body and to not put your well-being at risk; in case of any emergency or if you’re experiencing unmanageable pain, contact your doctor as soon as possible.

A Deeper Look Into Bodybuilding

Bodybuilding differs from weight training and powerlifting in the sense that it primarily focuses on physical appearance instead of physical strength, and although it’s still competitive and has gained wide recognition over the years, it’s ultimately considered a lifestyle. In order to develop the muscle, or “build” it, one must focus on resistance training to maxify muscle hypertrophy. 

Muscle hypertrophy refers to the increase of skeletal muscle by increasing the size of its component cells[1] and it can be achieved through strength and/or anaerobic training. There are two types of hypertrophy, sarcoplasmic and myofibrillar, and in bodybuilding, the former is favored because of its effectiveness when it comes to increasing muscle; while the latter is more useful for building strength.

Those who practice bodybuilding tend to stick to rigorous resistance training, as well as a very specific diet plan and a necessary amount of rest so that the body can recuperate between workouts. 

The fitness plan that bodybuilders follow is intense in order to cause micro-tears to the muscle, and although this may sound painful, it’s the healing of these tears that encourage and increase muscle growth[2].

This muscle repair takes place during rest days and it’s recommended to rest 72 hours a week with an adequate amount of sleep when it comes to bodybuilding.

A specific diet is also vital for bodybuilding and those who are planning to begin their journey should expect lots of protein and supplements.

A bodybuilder goes through a process of bulking and cutting, which means increasing your calorie intake during a period of time before reducing it to lower their body fat without losing muscle mass. The amount of calories you need to consume can change according to your goals, as studies[3] have found that the “bulking and cutting strategy is effective because there is a well-established link between muscle hypertrophy and being in a state of positive energy balance”. 

Bodybuilding After Bariatric Surgery

As we’ve mentioned before, bodybuilding is possible for people who have gone through any type of bariatric surgery, it will just take longer and the diet plan may be stricter according to the type of procedure that was performed. The amount of calories needed for body building may sound scary for someone who just underwent surgery to lose weight, but with the correct guidance and discipline, you shouldn’t worry about regaining what you lost during bariatric surgery. 

So, where to start?

First of all, you must wait to get the green light from your doctor before carrying out any physical activity after recovering from bariatric surgery. The postoperative process looks different for every patient, but your surgeon may recommend that you wait at least six weeks before performing any strenuous activity and once they give you the go-ahead, they will advise that you start slow.

Try using light weights or bodyweight exercises before slowly incorporating heavier loads and progressively increase your resistance until you can fully follow a bodybuilding workout style.

It’s important that you listen to your body and to not push yourself to unbearable pain, you not only risk injury, but you can have negative side effects following your bariatric surgery. At LIMARP®, we have fitness experts that can help you in your bodybuilding journey and answer any questions about how to take care of your body. 

You’ll also have to wait before starting any diet that’s recommended for bodybuilding, since what you can eat changes throughout your recovery process. It’s hard to integrate the necessary caloric foods when you’re on a liquid diet, but protein supplements can be of help during the time period where you can’t consume solid products.

Once you’ve reached that part of your recovery, we recommend that you get your protein from clean sources, which can also be known as clean bulking. Although this technique may take longer, it’s healthier because you don’t consume a lot of fat and this is ideal for bariatric patients that wish to begin their journey toward bodybuilding. 

Clean bulking means having a diet with a moderate amount of carbs, moderate amount of protein, and a low amount of fats[4]. In order to gain the expected muscle required for bodybuilding, it’s necessary to reach the daily macronutrient intake in relation to the amount of exercise needed to increase the body’s muscle mass. Supplements can be a good option if you’re limited to certain foods, but be sure to speak to your nutritionist first so that they can recommend the right portions. 

Until now, everything sounds good, but you’re probably wondering if there’s any downsides to bodybuilding after bariatric surgery, and while it is safe to do so, it can hinder the results from your surgery if you’re not careful with the process. Gaining weight after any bariatric procedure is possible, but the probabilities may rise if you exceed the calories in your bulk phase. Other side effects from the surgery, such as acid reflux, can also hinder your exercise routines because it can make working out uncomfortable or even painful.

You should contact your doctor if any type of pain becomes unmanageable or if you’re not seeing the desired results. It’s always best to be in touch with them so they can guide you in a safe way. 

Contact Us to Learn More

If you’re interested in bodybuilding following a bariatric surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1]  Baechle TR, Earle RW, eds. (2008). Essentials of strength training and conditioning (3rd ed.). Champaign, IL: Human Kinetics. ISBN 978-0-7360-5803-2. 
• [2] MacDougall, J.D., Elder, G.C.B., Sale, D.G. et al. Effects of strength training and immobilization on human muscle fibres. Europ. J. Appl. Physiol. 43, 25–34 (1980). https://doi.org/10.1007/BF00421352
• [3] Schoenfeld, B. (2016). Science and Development of Muscle Hypertrophy. Pp. 139-140. 
• [4] Giblin, Chris. “Clean Bulking: for Frustrated Hard-Gainers, Clean Bulking Is Attainable If You Focus Your Diet Accordingly with the Right Foods and Strategy.” Joe Weider’s Muscle & Fitness, vol. 75, no. 8, 2014, p. 89.

The human body, as the complex and perfect machine that it is, needs all its “gears” to be in place and well-oiled to function properly. But what would happen if one piece were to be missing? Most likely, the machine’s components would fail, generating a chain reaction that could cause successive damage, ultimately disabling the machine. 

Vitamin B12 is that piece, as it is an essential element in various processes in the body. For example, vitamin B12 is involved in the production of red blood cells—responsible for transporting oxygen throughout the body—in keeping nerve cells healthy—ensuring that signals travel efficiently throughout the body—in the conversion of food into energy—contributing to better cardiovascular health, and even in the DNA production, supporting the growth and repair of cells. 
Such is the importance of vitamin B12 in the body’s performance that a deficiency could lead to serious health problems.

Bariatric Surgery and Vitamin B12: Why is Vitamin B12 prescribed to Bariatric Patients That Underwent Gastric Bypass Surgery? 

Understanding the relation between bariatric surgery and vitamin B12 absorption is crucial, especially if you are considering getting Gastric Bypass Surgery. Here’s why…

The main goal of a gastric bypass surgery–or any other bariatric surgery–is to support the patient’s weight loss and address other health issues that may be affecting their quality of life. There are multiple factors that help determine the type of bariatric surgery a person needs, such as their medical history, their health goals and needs, or the amount of weight they need to lose. For this, you should seek the help of a bariatric Doctor, who, after evaluating your case in depth, will advise you on the bariatric surgery you are a candidate for, and will design a post-surgery treatment plan adapted to your needs, helping you avoid a possible vitamin B12 deficiency.

But, why is a bariatric surgery patient, especially those who got a gastric bypass surgery, more likely to suffer from vitamin B12 deficiency? This is the reason behind…

Vitamin B12 Deficiency in Bariatric Surgery Patients

A Gastric Bypass is a type of Bariatric Surgery that reduces the size of the stomach by dividing it into two sections. The smaller section, called the “gastric pouch”, cand hold only a limited amount of food, reducing the patient’s food intake. Subsequently, the bariatric surgeon will connect the gastric pouch to a specific part of the small intestine, so that the food passes directly into it. Thus, reducing the absorption of calories. 

Even though a bariatric surgery such as the gastric bypass surgery is highly effective for weight loss and the improvement of comorbidities, there are some adverse post-surgery situations that may arise, even if the gastric bypass surgery was successful. Vitamin B12 deficiency is one of those. 

Due to the nature of gastric bypass surgery–the intestinal tract is modified or “diverted”–, less space is left in the stomach for calorie absorption, but also for the absorption of nutrients like vitamin B12. Therefore, although gastric bypass surgery is beneficial for weight loss, it also can cause vitamin B12 deficiency. 

This is the reason why bariatric surgery patients who underwent gastric bypass surgery are more susceptible to developing a vitamin B12 deficiency. Studies show that around 68% of people who underwent a bariatric surgery such as gastric bypass reported a vitamin B12 deficiency.

However, although gastric bypass surgery–or any other bariatric surgery where the digestive process is modified–makes you more susceptible to a vitamin B12 deficiency, it is not the only thing that can cause it. 

Other people may be at risk of developing vitamin B12 deficiency, besides bariatric surgery patients, such as: 

• People with vegan or vegetarian diets, since B12 can be found in products of animal origin like eggs, meat, fish and dairy. 
• People with conditions that complicate the vitamin B12 absorption, such as Crohn’s disease. 
• Older adults, as vitamin B12 absorption becomes more difficult as we age, leading to a deficiency. 

Symptoms of Vitamin B12 Deficiency in Gastric Bypass Surgery Patients

While it is true that a bariatric patient, especially gastric bypass patients, are more likely to suffer from B12 deficiency, it does not mean it will occur in 100% of the cases. As we mentioned earlier, a poor diet, malabsorption problems, some medications or medical conditions can also cause a vitamin B12 deficiency. 

Learning to identify early symptoms of B12 deficiency related to bariatric surgery can help address them accurately and appropriately. 

Some of the B12 deficiency symptoms are: 

• Fatigue: feeling tired while recovering from a bariatric surgery such as gastric bypass surgery is completely normal and even expected, but experiencing fatigue might be a symptom of vitamin B12 deficiency.

• Pale or yellowish skin: B12 deficiency can cause anemia, the main sign of which is pale or yellowish skin. If you underwent gastric bypass surgery or other bariatric surgery, and exhibit this symptom, consult a bariatric doctor immediately. 
• Depression: vitamin B12 also plays a key role in the central nervous system, therefore, it can influence the bariatric patient’s mental health. Thus, a person who got a bariatric surgery such as gastric bypass surgery, and developed a B12 deficiency, can suffer from depression symptoms. 

Other B12 deficiency symptoms related to bariatric surgery and gastric bypass surgery can be: gastrointestinal disorders, difficulty to focus, memory problems, mouth swelling and tingling sensation in hands and feet. 

We must emphasize that, if left untreated, vitamin B12 deficiency can escalate into long-term health problems. 

Bariatric Surgery and Vitamin B12: How Long After The Gastric Bypass Surgery a deficiency manifests?

The answer is simple: it depends on the patient’s reserves of the vitamin, and the type of diet they are on after the gastric bypass or any other bariatric surgery. 

For this reason, it is very important to choose a professional and certified medical team that specializes in bariatric surgery such as gastric bypass surgery. Only they can dictate the ideal post-surgery treatment, food plan and new healthy habits that a patient must follow to prevent a B12 deficiency after gastric bypass surgery.

Even though a B12-rich diet is recommended in almost all of the cases, you must consider that a person who underwent gastric bypass surgery–or any other bariatric surgery in which the intestinal tract was modified–is not be able to absorb this nutrient anymore, meaning vitamin B12 supplementation will be mandatory. 

Treatment Options for Bariatric Patients with B12 Deficiency

Although supplementing is mandatory for gastric bypass surgery patients, and it can also be for other bariatric surgery patients, it is critical to attend to regular check-ups with a bariatric doctor to determine the right treatment plan for you. Among the alternatives to prevent vitamin B12 deficiency are: oral supplements, B12 injections, and sublingual pills. Let’s talk about all of them…

• Oral supplements: taking pills may work for some, but for bariatric surgery patients, especially those with a gastric bypass, it may not be the best option due to the fact that their stomach lost its capacity to absorb vitamin B12, which may lead to a deficiency. 

• B12 injections: as this option delivers the nutrient directly into the bloodstream bypassing the area of the stomach unable to absorb it, it may be a good option for bariatric surgery patients who underwent gastric bypass to prevent a vitamin B12 deficiency. 

• Sublingual pills: since these pills never reach the stomach but dissolve in the mouth, it can also be a good option for bariatric surgery patients seeking to avoid vitamin B12 deficiency after their gastric bypass. 

It is crucial to point out that only a Bariatric Doctor can indicate the proper treatment to prevent a vitamin B12 deficiency after a gastric bypass surgery. A patient must not self-medicate under any circumstances. 

Supplementation After Bariatric Surgery: How Long Should a Gastric Bypass Patient Take Vitamin B12 to Avoid a Deficiency? 

After a bariatric surgery like the gastric bypass, the digestive tract changes forever, unless the patient reverses their gastric bypass surgery–an unlikely scenario–. Therefore, the patient’s stomach will not be able to absorb the B12 again, no matter how much time has passed since the surgery. With that in mind, we could say that B12 supplementation for bariatric patients must be for life. Otherwise, the risk of a deficiency is high, and it can cause serious health problems in the long-term. 

After a gastric bypass or any other bariatric surgery, it is essential to receive regular check-ups by your bariatric doctor to monitor your vitamin B12 levels and treat any deficiency if detected. 

Habits That Can Aggravate B12 Deficiency in Bariatric Patients After Surgery

A gastric bypass surgery or any other bariatric procedure is just the first step in a patient’s weight loss journey. To achieve a significant improvement, both physically and in their quality of life, the process must be complemented with new healthy habits, like a well-balanced eating plan, physical conditioning routines, psychological therapy, among others. 

However, as healthy habits can prevent a vitamin B12 deficiency, unhealthy ones can aggravate it, such as:

• Smoking: smoking damages the stomach cells and difficult vitamin B12 absorption, which for a bariatric surgery patient is already reduced. 

• Drinking alcohol: drinking can also affect the body’s capacity to absorb B12, which can lead to a deficiency for gastric bypass surgery patients. 

• Lack of follow-up care: not receiving periodic check-ups from your bariatric doctor can prevent you from detecting a vitamin B12 deficiency. Follow-up care after a gastric bypass or any other bariatric procedure is a must. 

Vitamin B12 deficiency is very common, and identifying its symptoms promptly makes all the difference. At LIMARP, our multidisciplinary team of experts, led by the renowned Dr. Liza María Pompa, provides you with all you need to avoid a vitamin B12 deficiency after bariatric surgery. Also, we will support you in every aspect related to bariatric surgery, and guarantee you a successful recovery from gastric bypass surgery. 

As part of our Comprehensive Bariatric Program, we offer not only bariatric procedures such as gastric bypass, but also nutritional guidance, psychological support, personalized fitness plans and long-term follow-up care. 

For our bariatric patients from abroad, we provide hospital stay of 1-2 days, accommodations, and airport transfers to make your experience hassle-free. 

Contact Us For More Information About Gastric Bypass Surgery

If you are considering gastric bypass, or any other bariatric procedure, and are looking for a professional, experienced, and board-certified medical team to support you, you are in the right place. 

Book a consultation online or call (619) 373-0229. We will be happy to answer all the questions you may have about bariatric surgery or vitamin B12 deficiency. 

References

• [1] “Gastric bypass surgery”. https://medlineplus.gov/ency/article/007199.htm. (Accessed September 20, 2022). 
• [2] “Understanding Vitamin B12 Deficiencies after Bariatric Surgery”. https://www.vipsurg.com/blog/understanding-vitamin-b12-deficiencies-after-bariatric-surgery/. (Accessed September 20, 2022).
• [3] Ankar A, Kumar A. Vitamin B12 Deficiency. [Updated 2022 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441923/
• [4] Tardy AL, Pouteau E, Marquez D, Yilmaz C, Scholey A. Vitamins and Minerals for Energy, Fatigue and Cognition: A Narrative Review of the Biochemical and Clinical Evidence. Nutrients. 2020 Jan 16;12(1):228. doi: 10.3390/nu12010228. PMID: 31963141; PMCID: PMC7019700. 
• [5] Young LM, Pipingas A, White DJ, Gauci S, Scholey A. A Systematic Review and Meta-Analysis of B Vitamin Supplementation on Depressive Symptoms, Anxiety, and Stress: Effects on Healthy and ‘At-Risk’ Individuals. Nutrients. 2019 Sep 16;11(9):2232. doi: 10.3390/nu11092232. PMID: 31527485; PMCID: PMC6770181.

The road to losing weight looks different for everyone, even though the final destination may be the same or similar. Everyone wants to be healthy and feel great about their body, but there’s not a single one size fits all method; for some, just following a healthy diet can be enough, while others include a physical activity routine. However, people who are struggling with obesity or other weight related problems may struggle to lose weight if they only stick to these kinds of programs. We’re not saying it’s completely impossible, but patients can grow impatient with the lack of results. 

If you’re dealing with obesity, it’s possible that you’re also experiencing some comorbidities, such as diabetes, osteoarthritis, or sleep apnea; if so, bariatric surgery may be the best choice for you. Of course, this can only be decided by a certified doctor that will determine if you’re a candidate for bariatric surgery and which procedure is best for you. Your needs and expectations, along with your medical history, also come into play.

LIMARP® is an internationally recognized bariatric surgery center with a well-rounded medical and surgical team that’s led by Dr. Liza María Pompa González, whose experience, along with the state of the art technology available at the clinic, ensures that every patient who comes through our door gets the best attention possible. We offer integral treatment plans that are created based on the patient’s profile and some of them may include bariatric surgery.

Surgery can be a scary thing, the idea of being put under anesthesia and being cut open may deter some patients from even considering it as an option, but bariatric surgery can also bring forth many benefits. This article will focus, mainly, on those benefits and we’ll also talk about the different types of procedures and what makes you a candidate. If you still have doubts or need more information, contact your doctor or schedule an appointment with us, we’ll be happy to answer any of your questions.

To begin, we’d like to discuss what makes you a candidate for bariatric surgery.

Bariatric surgery is now considered the most effective weight loss treatment method there is and it can offer the greatest chance for long term weight loss.

This type of surgery can reduce your risk of obesity-related medical conditions, which is one of its many benefits, and an indicator that you may be eligible is if you have a body mass index (BMI) over 35. Your BMI may be aggravated by one or more health issues such as type 2 diabetes, high blood pressure, sleep apnea, cardiovascular disease, high cholesterol or triglycerides. 

Once our team determines that you are a candidate for bariatric surgery, we can determine the most effective type of surgery for you. Bariatric surgery is a serious procedure, with the potential to change your life. Our multidisciplinary team will do both physical and psychological evaluations to determine your possibility of undergoing surgery. 

During the discussion with your doctor, they will bring up the benefits of undergoing bariatric surgery and while the results of each procedure may look different for every patient, the benefits can be pretty universal. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), surgery can be the most effective treatment for people battling with severe obesity or other medical problems like heart and kidney disease[1]. Aside from obesity, bariatric surgery benefits the patient by treating other conditions like diabetes, heart disease, high blood pressure, arthritis, and acid reflux.

Ver esta publicación en Instagram

Una publicación compartida por Liza María Pompa Gonzalez (@dra.pompa)

Some of these conditions can be life-threatening and bariatric surgery has been proven to expand the patient’s life expectancy[2], as well as shown to lower a person’s risk of death from any cause by over 40%.

Other studies have highlighted that modern bariatric procedures have “strong evidence of efficacy and safety” and that it can benefit patients with type 2 diabetes[3]. 

Bariatric surgery works by changing the anatomy or position of the stomach and small intestines and can cause changes in appetite, satiety, and metabolism[4]. These anatomy changes depend on the type of procedure that’s performed on the patient, which are divided into three[5] groups: 

• Restrictive: The procedure consists of creating a small gastric pouch with a narrow outlet that restricts the amount of food that the patient can eat at one time. Some examples are the vertical banded gastroplasty and laparoscopic adjustable gastric banding.
• Malabsorptive: These procedures, like the duodenal switch, bypass a segment of the small intestine so that less food is absorbed.
• Combination: These use both mechanisms to achieve weight loss. For example, Roux-en-Y gastric bypass can be performed either laparoscopically or as open surgery. 

By limiting the food intake and restricting the nutrient and calorie absorption, the patient is able to lose weight at a rate that they hadn’t been able to achieve prior to the surgery. This is one of the main goals for many patients because of different factors that range from personal to societal and studies have shown that “more than 90 percent of people who have bariatric surgery are able to maintain at least 50 percent of their weight loss following the procedure”[6]. Of course, this can only be achieved if the patient sticks to a diet and exercise plan that can help them keep the weight off and reap the benefits. AS part of the integral treatment plans offered at LIMARP®, we ensure that they have the necessary tools and guidance. 

Bariatric Surgery Benefits

Description

A patient discusses the bariatric surgery benefits she is experiencing thanks to LIMARP International Center of Excellence for Obesity in Tijuana, MX. A strict diet and therapy with the resident nutritional psychologist helped prepare her for the surgery. Since her procedure, she has not only lost weight, but also regained energy and a more active lifestyle.

View Transcription

I found Dr. Pompa from a friend of mine who had surgery, and so we she recommended, she had a great experience, and I had a lot of medical issues, so she recommended that I come and see Dr. Pompa. The follow-up that she gives you after pre and after surgery were crucial to me versus a lot of my friends that have had surgery in other clinics. She made it very human to me. She really made it a point to get to know me. Although I know the surgery is the same surgery that she does on a lot of patients, it felt very unique to me. First of all, I received the pre-surgery treatment, which was basically a diet. I also had therapy with the psychologist here, who really helped me to understand where I wanted to be, where I’d been with my weight. It’s a big, life-changing moment for you understanding how that affects you socially, with your friends, with your family, with your children. And then, of course, then I had received the surgery. I had the surgery and then post-care. So I came here for about four months of care, then a couple of sessions afterwards. Before, I was very let’s go the movies versus now let’s go to the park, let’s do other like hiking and other things that I never did for years.

Another benefit is that the patient develops a faster metabolism, which may allow them to be more physically active than they were before[7]. This is because it improves the body’s ability to burn fat in a more efficient way. Hormones, like insulin and cortisol, are also reduced, which helps lower the body’s storage of fat. Overall, there are many benefits to having bariatric surgery and it’s important to be informed on all the options available to you.

Contact Us to Learn More

If you want to know more about the benefits of bariatric surgery, schedule an appointment with one of our doctors. We can help determine the right treatment for you. Contact us online anytime or give us a call at (619) 373-0229.

References

• [1, 4] “Benefits of Weight Loss Surgery”. https://asmbs.org/patients/benefits-of-weight-loss-surgery. (Accessed on August 15, 2022). 
• [2] Arterburn DE, Olsen MK, Smith VA, et al. Association between bariatric surgery and long-term survival. JAMA. 2015;313(1):62–70. doi:10.1001/jama.2014.16968
• [3] Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults: A Review. JAMA. 2020;324(9):879–887. doi:10.1001/jama.2020.12567
• [5] Brethauer, Stacy A., Bipan Chand, and Philip R. Schauer. “Risks and benefits of bariatric surgery: current evidence.” Cleveland clinic journal of medicine 73.11 (2006): 993.
• [6] “Benefits of Bariatric Surgery”. https://www.ucihealth.org/medical-services/bariatric-surgery/bariatric-surgery-benefits. (Accessed on August 15, 2022). 
• [7] Morton JM, Ponce J, Malangone-Monaco E, Nguyen N. Association of Bariatric Surgery and national medication use. Journal of the American College of Surgeons. 2019;228(2):171–179. doi:10.1016/j.jamcollsurg.2018.10.021