Below is a list of common problems people face after weight loss surgery, what causes them and what you can do to alleviate or even prevent them.
Constipation is often caused by not getting enough fluids and fiber. Also the use of iron supplements can cause constipation.
Alleviate constipation after weight loss surgery…
Make sure you are getting in at least 48 ounces of calorie free, caffeine free fluids daily — optimal is 64 + ounces fluids daily. Try to eat more fiber-rich foods such as oatmeal and soft fruits and vegetables after you have eaten your protein.
Fiber supplements such as Metamucil®, gummy fiber or any generic “clear and natural®” fiber supplement can be helpful. In addition, make sure you’re physically active daily. Activity helps keep your bowels moving.
If constipation persists, you can use a laxative such a Miralax® or Milk of Magnesia or stool softeners, such as Colace®. Keep in mind that your bowel habits will change after surgery. You may be moving your bowels less often as you will be eating less. A decrease in bowel movements is not necessarily constipation.
Dehydration is caused by not getting enough fluids in on a daily basis. Signs that you may be dehydrated include dark/strong smelling urine, dry mouth, headache and fatigue.
Prevent dehydration after weight loss surgery…
You must get in at least 48 ounces of calorie-free, caffeine-free fluids daily to prevent dehydration. (Optimal fluid is 64 or more ounces daily). All allowable fluids must be sipped constantly throughout the day between meals.
3. Nausea and Vomiting
In many cases, nausea and vomiting after surgery is caused by eating too fast, eating too much and/or not chewing your foods enough.
Control nausea and vomitting after weight loss surgery…
Remember your mindful eating rules:
- Eat very slowly.
- Cut each piece into dime-sized pieces.
- Chew each bite 20-30 times.
- Do not eat and drink at the same time — sip fluids very slowly throughout the day.
It’s also possible that you may not be ready to eat certain foods. If a certain food seems to cause nausea or vomiting, avoid that food few a week or so and try again. If nausea and/or vomiting persist, call your doctor’s office for further evaluation.
4. Lactose Intolerance
Some people after Gastric Bypass surgery become lactose intolerant. Lactose intolerance is when you cannot digest the natural sugar in milk (lactose) and you develop gas, bloating and/or diarrhea after drinking/eating milk or milk based foods.
Control lactose intolerance after weight loss surgery…
Consider switching to lactose free milk and dairy foods or try low-fat soy milk.
5. Dumping Syndrome
If you eat sweets or greasy/fatty foods, you may experience dumping syndrome. This is a common problem post gastric bypass. Sweets and greasy foods set off a reaction in your body that makes you feel shaky, sweaty and very weak or tired. You may also get diarrhea. It usually happens soon after eating an offending food.
Avoid dumping syndrome after weight loss surgery…
It’s important to avoid sweets and greasy/fatty foods, not just because you may experience dumping, but because these foods are also high in calories, low in nutrition and should be avoided regardless of which weight loss surgery procedure you’ve had.
6. Food Intolerance
As you adjust to your new stomach pouch, you may notice there are certain foods that you tolerate better than others. For many patients, dry protein foods such as chicken or over cooked beef or pork do not go down well. Additionally, very “doughy” and starchy foods like rice or pasta feel heavy after surgery.
Tolerate food better after weight loss surgery…
If a food disagrees with you, first try to understand why. For many people after surgery, they realize they did not tolerate a food because they ate it too fast, ate too much and/or need to prepare the foods differently.
- Dry protein needs to be moist to increase the chances of tolerating it.
- Breads need to be toasted and dry, not doughy to be better tolerated.
Learn to eat slowly and pay attention to signs of fullness. Keep in mind this is a learning process and it takes time to get used to your new pouch. If you are really struggling with eating, do not hesitate to call your doctor’s office for help.
7. Hair Loss (Telogen Effluvium)
It is common to experience some hair loss after weight loss surgery. Hair loss usually starts about 3-6 months after surgery and starts to resolve at about 1 year.
The main causes of hair loss are the stress of surgery and the rapid weight loss. This stress causes more hair follicles than normal to shift from the growing phase to the dormant or resting phase. When our hair follicles are in the resting/dormant phase more hair will fall out. Nutritional deficiencies may make the hair loss worse, but usually are not the main reason people lose their hair during the first year post surgery.
Reduce hair loss after weight loss surgery…
Make sure you’re getting in 60-80 grams protein daily and taking all vitamin and mineral supplements regularly and correctly. Get blood work done that includes all vitamin and mineral levels so if you have a nutritional deficiency, it can be detected and corrected.
Although hair loss is upsetting, it is temporary — your hair will grow back.
8. Cannot Keep Fluids and/or Food Down
Though this is not a common problem, it is worth mentioning on this list.
Contact your doctor ASAP
If you’re keeping little or no fluids or food down at any point after your surgery, call the doctor’s office immediately. This may signal a more serious problem.
Our own office in Central New Jersey can always be reached at 732-982-2002.
Dietitian’s Corner by Lori Skurbe
Dietitian’s Corner is a monthly column for post-op and pre-op patients of bariatric surgery in NJ written by Prime Surgicare’s Lori Skurbe. Lori has been a dietitian for over 20 years with an extensive background in weight management, bariatric nutrition and diabetes education.