The 10 Bariatric Surgery Steps to Long-Term Weight Loss - Bariatric Surgery Source

The 10 Bariatric Surgery Steps to Long-Term Weight Loss

Reviewed by:  

John M. Rabkin, MD, FACS

Last Updated:  

09/27/2017

The 10 essential bariatric surgery steps can be thought of as a timeline ranging from "How to Qualify" all the way through long-term weight loss and health improvement.

Click the links below to jump to any step or scroll down to review them all…

01Qualify
  • Body mass index (BMI) of 30 or higher with health problems
  • BMI of 40 or higher with no health problems
  • Click here to calculate your BMI

bariatric surgery steps

Enter your height & weight, then click the button:

Enter your height & weight, then click the button:

30+

Weight Loss Surgery
Required BMI

  • Below 18.5Underweight

  • 18.5 – 24.9Healthy Weight

  • 25.0 – 29.9Overweight

  • 30.0 – 34.9Obese

  • 35.0 – 39.9Severely Obese

  • 40.0 – 49.9Morbidly Obese

  • 50 or higherSuper Obese

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The National Institutes of Health (NIH) has determined that weight loss surgery is appropriate for people who:

  1. Have a BMI of 30 or higher and a serious obesity related health problem such as diabetes, sleep apnea, or heart problems (your insurance company may or may not require a minimum BMI of 35)
  2. Have a BMI of 40 or higher

Most insurance companies also require weight loss surgery patients to have completed a 3+ month medically supervised weight loss program, although many surgeons do not require this.

Use the BMI calculator below to figure out your body mass index…

02Set Expectations
  • Depends on procedure chosen
  • Weight Loss: Lose between 30% & 80+% of your excess weight
  • Health Improvement: Improve/”cure” diabetes, sleep apnea, hypertension, & many other issues
  • Risks/Complications: Extremely low mortality rate, but 1 in 7 patients experience complications/side effects
  • Challenges: Diet, lifestyle & relationship changes, sagging skin, risk of weight regain

Weight Loss

Depending on the type of bariatric surgery you choose, your percentage of excess weight lost could be as high as 80% or more.  While a BMI of 25 is possible, your initial goal should be to get your body mass index below 30 (click here to calculate your BMI and figure how much weight that equates to for you).

Health Improvement

Bariatric surgery may be the best (or only) treatment to improve serious obesity-related health problems including Type 2 diabetes, sleep apnea, heart problems, depression and many other issues.

But it really comes down to this: According to one peer-reviewed study, morbidly obese patients who received bariatric surgery are 89% less likely to die over any 5 year period than morbidly obese individuals who didn’t have the surgery. (1)

Risks & Complications

Just like any surgery, weight loss surgery does carry risks.  The mortality rate (risk of dying) is about 0.135% (2). The risk of complications both during and after surgery range from minor to severe. About 15% of bariatric surgery patients (1 in 7 patients) have some sort of complication, with the most common being nausea and vomiting. (3)

Challenges

Bariatric surgery may be the best tool to make you happier and healthier, but that’s all it is… a tool.

You will be the key to making it successful over the long-term, and there will be many challenges along the way such as a strict diet and exercise regimen, changing relationships as people react to your new weight and sagging skin resulting from the rapid weight loss.

To learn more about each of these areas, see the following links:

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03Compare Procedures
  • Gastric sleeve
  • Gastric bypass
  • LAP-BAND®
  • Duodenal switch
  • Gastric balloon
  • vBloc Therapy
  • AspireAssist

Picture of Procedure

Video of Procedure

Avg Excess Weight Loss

Health Improvement

BMI Needed to Qualify

Covered by Insurance?

Financing Available

Avg Total Cost With Insurance (U.S.)

Avg Total Cost Without Insurance (U.S.)

Procedure Type

Years of Peer-Reviewed Research

Device Placed In Body?

Reversible?

Time Until Removed

Path of Digestion

Procedure Time (Approx)

Complication Rate

Survival Rate

Hospital Stay (Avg)

Recovery Time
(Avg Back to Work)

Difficulty Swallowing?

Digestion & Bowel Movement Problems

Diet Risks

Food Cravings Decreased

Lifelong Vitamins Required

Qualified Surgeons

Patient Guides

The average gastric sleeve patient loses between 65% and 75% of their excess weight within 2 years and has kept most of the weight off after 5 years.
Gastric sleeve surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without
For policies that cover weight loss surgery, gastric sleeve is included
Gastric sleeve financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$19,000

Costs vary by surgeon and hospital.
Most gastric sleeve procedures are performed laparoscopically.
Gastric sleeve surgery is backed by a significant amout of long-term research.
No external device is used (other than materials for "sealing" the smaller stomach).
Not usually reversed
not applicable (gastric sleeve is not usually reversed)
The path of digestion remains the same after gastric sleeve (although part of the stomach is removed).
Gastric sleeve surgery usually takes about 2 hours to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Gastric sleeve mortality risk is equal to that of any other routine surgical procedure.
Most gastric sleeve patients remain in the hospital for 2 to 3 days.
Most gastric sleeve patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
GERD (reflux) in ~1 out of 5 patients after 1 year, drops to 1~ out of 33 patients after 3 year. Some patients experience diarrhea.
Potential problem foods: Dairy
Food cravings may be reduced after gastric sleeve surgery due to fewer hunger-causing hormones being released by the smaller stomach.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of a smaller stomach.
The gastric balloon is a temporary procedure. Depending on the balloon type you choose, it must be removed 3 months, 6 months, or 1 year after insertion.
Gastric balloon patients are more likely to see health improvements than people of similar weight who do not have the procedure.
Between 30 & 40 in U.S. (above 27 elsewhere)
Gastric balloon is not usually covered by insurance
Gastric balloon financing is available, subject to credit approval

$8,150

Gastric balloon is usually not covered by insurance.

$8,150

Costs vary by surgeon and hospital.
Gastric balloon requires no incisions.
The gastric balloon is a relatively new procedure so long-term studies are limited.
An inflated silicon balloon remains in the stomach for 6 months.
The balloon must be removed after 6 months (Orbera and ReShape balloons).
The balloon must be removed after 6 months (Orbera and ReShape balloons).
The path of digestion is unchanged with the gastric balloon.
Gastric balloon usually takes about 30 minutes to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Gastric balloon survival rate is very high since the procedure requires no incisions and since complication risks are very low.
Most balloon patients leave the hospital the same day as the procedure.
Most balloon patients are able to return to work within a few days.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Vomiting possible (but often avoidable with proper habits). “Feeling bloated” reported by some patients.
Potential Problem Foods: Pasta and other foods that might stick to balloon in stomach.
Food cravings will remain the same with the gastric balloon.
The balloon must be removed after 6 months (Orbera and ReShape balloons), so lifelong vitamins are not required.
The average gastric bypass patient loses between 65% and 75% of their excess weight within 2 years and has kept most of the weight off after 5 years.
Gastric bypass surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without
For policies that cover weight loss surgery, gastric bypass is included
Gastric bypass financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$24,000

Costs vary by surgeon and hospital.
Most gastric bypass procedures are performed laparoscopically.
Gastric bypass surgery is backed by a significant amout of long-term research.
No external device is used (other than materials for "sealing" the smaller stomach pouch and establishing the new intenstinal route).
Not usually reversed
not applicable (gastric bypass is not usually reversed)
Part of the small intestines are bypassed after gastric bypass surgery.
Gastric bypass surgery usually takes about 4 hours to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Gastric bypass mortality risk is equal to that of any other routine surgical procedure.
Most gastric bypass patients remain in the hospital for 2 to 3 days.
Most gastric bypass patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Dumping syndrome occurs in ~80% of patients who eat sugar, refined fats, or carbs.
Potential problem foods: Sugars, Refined fats, Carbs, Dairy. Malabsorption will require life-long vitamin supplementation.
Food cravings may be reduced after gastric bypass surgery due to fewer hunger-causing hormones being released by the smaller stomach pouch.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of a smaller stomach and for the lack of absorption resulting from the rerouted intestine.
The average duodenal switch patient loses between 65% and 90% of their excess weight within 2 years and has kept most of the weight off after 5 years.
Duodenal switch surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without (but more common for 50+)
For policies that cover weight loss surgery, duodenal switch is included
Duodenal switch financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$27,000

Costs vary by surgeon and hospital.
Most duodenal switch procedures are performed laparoscopically.
Duodenal switch surgery is backed by a significant amout of long-term research.
No external device is used (other than materials for "sealing" the smaller stomach and establishing the new intestinal route).
Not usually reversed
not applicable (duodenal switch is not usually reversed)
Part of the small intestines are bypassed after duodenal switch surgery.
Duodenal switch surgery usually takes about 4 hours to perform.
Non-severe complications are much more common than severe complications Learn Risks & How to Minimize
Survival rate may be lower than other procedures because DS surgery tends to be performed on heavier patients who have higher risk.
Most DS patients remain in the hospital for 2 to 3 days.
Most duodenal switch patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Might be significant, including frequency, diarrhea, and/or foul-smelling stools/flatulence.
Malabsorption will require life-long vitamin supplementation.
Food cravings may be reduced after duodenal switch surgery due to fewer hunger-causing hormones being released by the smaller stomach.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of a smaller stomach and for the lack of absorption resulting from the rerouted intestine.
Gastric Band surgery has highly variable results, with excess weight loss after 2 years ranging from 45% to 70%.
Gastric Band surgery improves or cures at least 15 obesity-related health problems, including diabetes, hypertension, sleep apnea, and many others.
35 - 39.9 with health problems; 40+ without
For policies that cover weight loss surgery, Gastric Band is included
Gastric Band financing is available, subject to credit approval

$3,500

Actual out of pocket costs depend on your insurance plan.

$15,000

Costs vary by surgeon and hospital.
Most Gastric Band procedures are performed laparoscopically.
Gastric Band surgery is backed by a significant amout of long-term research.
A silicone and silastic band is left around the top of the stomach, and a balloon around the inside of the band connects to a tube that leads to a round half-dollar-sized port just below the skin.
The Gastric Band can be removed.
Gastric Band removal is not required unless the patient develops a device-related complication.
The path of digestion is unchanged with the Gastric Band.
Gastric Band surgery usually takes about 1 hour to perform.
Non-severe complications are much more common than severe complications Learn Risks & How to Minimize
Gastric Band mortality risk is equal to that of any other routine surgical procedure.
Most Gastric Band patients leave the hospital the same day or the day after the procedure.
Most Gastric Band patients are able to return to work within 2 weeks.
Can be caused by eating too quickly, too much or not chewing food enough and can usually be fixed by avoiding these issues.
Reflux and vomiting common if band too tight (can be adjusted). Some patients experience constipation.
Potential problem foods: Dairy. Should not drink anything within 30 minutes before or after eating
Food cravings will remain the same after Gastric Band surgery.
Lifelong vitamins will need to be taken to compensate for patients eating less food as a result of the smaller stomach pouch created by the band.
The average vBloc patient loses 25% of their excess weight within 1 year. Longer-term studies are not yet available.
While studies are limited, vBloc Therapy has been found to improve hypertension, diabetes, and several obesity-related health factors.
35 - 39.9 with health problems; 40 - 45 without (none over 45)
vBloc Therapy is not usually covered by insurance
vBloc Therapy financing is available, subject to credit approval

$18,500

vBloc Therapy is not usually covered by insurance.

$18,500

Costs vary by surgeon and hospital.
Most vBloc procedures are performed laparoscopically.
vBloc Therapy is a relatively new procedure so long-term studies are limited.
The vBloc Therapy device is placed below the rib cage just under the skin. Leads (wires) connect the device to the vagal nerve, just above the stomach.
The vBloc Device can be removed.
vBloc device removal is not required unless the patient develops a device-related complication.
The path of digestion is unchanged with vBloc Therapy.
vBloc implant usually takes less than 90 minutes to perform.
Non-severe complications are much more common than severe complications Learn Risks & How to Minimize
vBloc mortality risk is equal to that of any other routine surgical procedure.
Most vBloc patients leave the hospital the same day as the procedure.
Most vBloc patients are able to return to work within a few days.
Most vBloc patients do not have any issue with swallowing.
Most vBloc patients do not experience digestion or bowel movement problems.
No medical risks, but healthier eating recommended for better results.
The vBloc device was specifically designed to control how often hunger impulses reach the brain.
vBloc device settings should be such that enough food will be eaten to provide the right amount of vitamins and minerals. Your doctor should monitor your vitamin levels.
AspireAssist studies are currently limited, but one study showed 31.5% excess weight loss after 4 years.
Early AspireAssist studies indicate a positive impact on diabetes, hypertension, and hyperlipidemia, but more reasearch is needed to confirm.
35 - 55, regardless of health problems
AspireAssist is not usually covered by insurance
AspireAssist financing is available, subject to credit approval

$10,500

AspireAssist is not usually covered by insurance.

$10,500

Costs vary by surgeon and hospital.
The AspireAssist procedure passes a tube through the mouth and down into the stomach. The tube is then pulled through the abdominal wall through a small incision.
AspireAssist is a relatively new procedure so long-term studies are limited.
A silicone “A-tube” connects the stomach to the Skin-Port™ located on the outside of your abdomen. The Skin-Port™ is the opening between your external device and the tube leading to your stomach. An Emergency Clamp component prevents any leakage of stomach contents if the A-tube and Skin-Port become disconnected.
The AspireAssist device can be removed.
AspireAssist removal is not required unless the patient develops a device-related complication.
The path of digestion is unchanged with AspireAssist (although some food is routed out of the body directly from the stomach).
The AspireAssist procedure usually takes about 15 minutes to perform.
Non-severe complications are much more common than severe complications. Learn Risks & How to Minimize
Available studies to date have shown zero deaths as a result of having the AspireAssist procedure.
Most AspireAssist patients leave the hospital the same day as the procedure.
Most AspireAssist patients are able to return to work within a few days.
Most AspireAssist patients do not have any issue with swallowing.
Low risk of vomiting (17% of patients), constipation (4.5% of patients), or diarrhea (4.5% of patients)
Potential malabsorption will require some monitoring and may result in a vitamin regimen
Food cravings will remain the same with the AspireAssist device.
Whether vitamins are required depends on each patient and how they are using the device. Your doctor should monitor your vitamin levels.
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There are 4 established and generally accepted weight loss surgery procedures, each with its own set of positives and negatives:

  • Gastric Bypass
  • Gastric Banding (e.g., Lap-Band)
  • Duodenal Switch
  • Gastric Sleeve

Your individual situation will determine which type of bariatric surgery is best for you, but following is a general summary…

Gastric bypass surgery has a relatively low complication rate compared with its high levels of excess weight loss and significant improvement in co-morbidities. Its popularity also means that there are more surgeons out there with enough procedures under their belt to improve your chances for a good outcome.

However, gastric banding (e.g. Lap-Band) may be a better option for some mentalities. It has a lower risk of serious complications, and for those who are not 100% sure that they’re ready to permanently change their body, it is the only established procedure that is completely reversible; it can be relatively easily converted into a more elaborate procedure at a later date.

Unfortunately, lap band surgery has a very high variability in weight loss from patient to patient, and is associated with more minor and annoying complications. Most concerningly, lap band surgery is much more likely to require reoperation over the long-term as a result of permanent failure.

The duodenal switch is probably the most effective procedure for the super-obese. It has been proven to be successful (result in at least 50% of excess weight loss) for about 85% of patients after 3 years. It may also be the most effective procedure for treating obesity-related health problems. For example, in one study duodenal switch surgery cured 100% of diabetic patients (4).

The amount of long-term weight loss after DS also appears to be better than any other procedure, but that comes with the highest rate of serious complications and the most intensive bariatric vitamin adherence requirements due to the level of malabsorption.

Gastric sleeve surgery is less complicated than gastric bypass and duodenal switch and leads to similar weight loss. While not reversible or easily adjustable like the lap band, it carries a much higher weight loss and much lower risk of reoperation.

Gastric sleeve surgery appears to be a bit safer than gastric bypass in terms of reoperation and complications, but gastric bypass seems to have a better effect on many obesity-related health problems.

Click here for a more detailed explanation and analysis of each procedure

04Cost of Surgery
  • Depends on procedure
  • With insurance: Ranges from $3,500 to $18,722
  • Without insurance: Ranges from $8,096 to $27,324
  • Discounts, Financing, & Tax Write-Offs Available

Without insurance, the cost of weight surgery in the United States can range anywhere from $8,000 to $35,000 or more.

Despite the high price tag, you’re still likely to save money – a lot of money – over the long term.  One prominent study found that as early as 13 months after surgery patients spend up to $900 per month less than if they hadn’t had surgery. The analysis showed that for those receiving laparoscopic bariatric surgery, patients "broke even" then started to come out ahead within 2 years (5).

If you have insurance, you need to figure out:

  1. If weight loss surgery is covered by your plan
  2. The process required to get surgery approved

By far the easiest way to handle each of these is to seek the help of a top surgeon.  Their office should be able to check your insurance for free and do all of the legwork to get you approved.

If you do not have insurance, there are several ways to make surgery more affordable.  For example, many patients are able to get get monthly payments down to under $200 per month by working with their surgeon’s financial partner.

The most common ways patients without insurance are able to afford surgery include (click links for more information):

Discounts and savings opportunities exist in many forms if you know where to look, including:

05Choosing a Surgeon
  • Create initial list
  • Verify credentials
  • Narrow your list
  • Select surgeon

Choosing an experienced surgeon tends to result in better patient outcomes including shorter hospital stays, lower complication rates and lower mortality rates (6).

But you also want to work with a team that "just feels right," both on paper and in person.  After all, the team you choose will be your go-to for any and all issues or questions, and it’s important to feel comfortable with them as people.

There are 4 steps to finding the right surgeon for you:

1.  Create your list of surgeons

Click here to search the Bariatric Surgery Source surgeon directory of top surgeons around the country and world.

You can also ask your primary care physician or other trusted physician for a referral.  If you have insurance, check to see which surgeons are included among their list of "in-network" physicians.

2. Verify credentials

Use the Administration in Medicine’s (AIM) DocFinder web site for your surgeon’s license status.

If any surgeons on your list have an outdated license, have public record actions listed against them or are not board certified, be on the safe side and remove them from your list.

3. Narrow your list

Your next step is to determine which surgeons on your list are worthy of face-to-face interviews.

To figure this out, call each surgeon’s office and sign up to attend their next free seminar.

Print out our Bariatric Surgeon Questionnaire (one for each surgeon on your list). While attending the seminar, take notes on the printed questionnaire, and be sure to ask any of the questions that are not covered.

4. Choose your surgeon

To begin Step 4, attend each surgeon’s next patient support group and ask questions to learn other patients’ experience with your surgeon’s team (the surgeon won’t be present). 

Then schedule a face-to-face consultation with the surgeon and ask any and all questions that come to mind. Good surgeons will be glad that you are doing your research and will be happy to provide answers.

After your interviews, go with your gut.  Maybe one office was more relaxing and their staff more welcoming. Maybe one of their aftercare plans seemed more well-planned and thorough. Maybe one surgeon’s former patients seemed more pleased with their experience. Maybe one surgeon “just felt better.”

Regardless of which one you choose, you should now feel confident that you have chosen a great surgeon.

Click here for a more in depth review of each step in the surgeon selection process.

06Preparing for Surgery
  • Essential checklists

Effectively preparing for weight loss surgery will reduce stress, save money, minimize your risk of complications, increase the amount of weight you will lose and make you much more likely to keep the weight off over the long term.

For example, one study found that for every 1% of weight lost before surgery, patients can expect to lose 1.8% more weight at one year post-op. (7)  Another study found that the more weight patients lost before surgery, the less likely they were to experience complications. (8)

The other big reason for preparing for weight loss surgery early is reversing poor habits. Habits take time to change, and if you go back to your old ways following surgery, you will gain the weight back and you will experience a relapse in your obesity-related health problems.

3 to 6 Months Before Surgery – 2 Essential Checklists

1. Medical, Payment & Logistics Checklist

  1. Attend your surgeon’s next free seminar to learn your options and better understand what to expect
  2. Understand payment options and savings opportunities
  3. Schedule pre-surgery tests and consultations/physicals to confirm that you are a good candidate for surgery
  4. Arrange and begin your physician-supervised diet program (if required by your insurance company or surgeon)
  5. Schedule your initial consultation with your surgeon and find out what paperwork and medical history you’ll need to move forward
  6. Ensure that surgeon has obtained pre-authorization from your insurance company (if applicable)
  7. Join an in-person weight loss surgery support group (your surgeon can recommend one).  In addition learning what to expect first-hand and building relationships that will make the tough times easier, regular support group participation has also been proven to result in significantly more weight loss and a lower body mass index.  Click here to learn more about support groups.
  8. Participate in other preparatory steps or educational meetings as advised by your surgeon’s team

2. Lifestyle Changes Checklist

For long-term weight loss and health improvement following surgery, you must start living as if you’ve had the surgery at least 3 months in advance:

  1. Begin eating for health and not just flavor and pleasure
  2. Eat protein, LOTS of protein
  3. Eat slow, chew each bite and watch the portion sizes
  4. Start taking a multivitamin
  5. Don’t drink anything with your meals 
  6. Ditch the sugared beverages and drink more water
  7. Careful with the coffee
  8. Stop drinking alcohol 
  9. Exercise just a little bit more
  10. Stop smoking
  11. Start attending in-person support group meetings

Click here for more information about each of the 3 to 6 month to-do’s.

2 Weeks Before Surgery – Your Essential Checklist

  1. Plan for time off from work – at least 4 to 6 weeks is best
  2. Have your child care worked out
  3. Have someone to take you to and pick you up from the hospital
  4. You’ll need someone to be with you for at least the first week of your recovery.  That person should be there to help you 24/7 if needed, so be sure they’ve requested the time off work as well.
  5. Prepare the food and vitamins that you will eat after surgery
  6. Set up a comfortable sleeping arrangement for when you get home
  7. Prepare comfort items to take to the hospital

Click here for a more detailed list of each of these items.

07Hospital Stay
  • Depends on procedure
  • From outpatient (return home same-day) to 3 days
  • 5 steps, from Pre-Op to Discharge

It’s normal to be nervous before the big day.  But you have chosen your team of doctors and hospital well and you have everything in place, so please try to relax.

Here’s a high level overview of what to expect…

1. Pre-Op

At least 2 hours prior to surgery, your team of nurses will prepare you to go to the operating room.  You will meet with the anesthesiologist and your surgeon before surgery.  The nursing staff will talk with you and let you know what to expect and will check your vital signs.

2. Operating Room

The anesthesiologist will give you the anesthesia that will keep you fast asleep during surgery. Your surgery can last from 1 to 4 hours depending on your procedure and individual circumstances.

3. Post-Op 

During your initial 2 to 3 hours of recovery, you will receive one-on-one attention to manage your pain and monitor your vital signs.  You will likely not remember this part much, if at all.

4. Recovery

Some procedures, like the gastric balloon, vBloc Therapy, and AspireAssist, can be performed on an outpatient basis. In other words, the procedure should take less than an hour and you should be home on the same day.

Other procedures like the gastric sleeve or duodenal switch will require some recovering time in the hospital. During your 1 to 3 nights hospital stay following surgery, you can expect to have some pain at your incision sites, and your muscles may be sore from lying on the operating table. 

Your surgeon will prescribe pain medications through your IV and will probably order nothing to eat or drink for the first 24 hours.  You can also expect to have antibiotics, IV fluids, plastic tubes that will deliver oxygen through your nose, a urinary catheter to drain your urine and an abdominal binder to help your incisions heal.  Your nurses may have you wear compressive devices around your legs to help prevent blood clots. 

You will have get up and walk after surgery, usually within the first 8 to 10 hours and then several times per day thereafter to prevent blood clots, wake your body up from anesthesia, get your intestines to start working again and improve breathing.  Your nurses will also help you through other exercises to reduce the risk of complications such as breathing, coughing and leg exercises.

Your doctors will check in on you every day to make sure you are healing properly.  As soon as you’re able to start sipping water, your IV will be removed. The day after surgery, many surgeons will order a “leak test” for you to make sure your digestive system is functioning well.  Once you pass this test, you can begin drinking clear fluids.

5. Discharge

Congratulations… you did it!  You’re on the road to recovery and your new life.

Any pain will slowly diminish and you’ll start feeling a little better each day. Don’t forget to pick up your pain medications on the way home if you don’t already have them.   If your ride home is a long one, stop at least once every 2 hours to get out and stretch.

Click here to learn more about what to expect during your hospital stay.

08Recovery
  • Depends on procedure
  • Timeline Range: from 3 days to 6 weeks to full recovery
  • Back to Work: from 3 days to 3 weeks
  • Pain Range: from mild discomfort to manageable with medication
  • Diet Range: from no restrictions to slow transition from clear liquids to solid foods
  • Activity Range: from no restrictions to slow transition back to regular activity and exercise

A successful, complication-free bariatric surgery recovery requires close adherence to your surgeon’s advice, a strict dietary regimen and proper incision care…



Diet During Recovery

In order to let your stomach heal, you won’t be able to eat for the first few days following bariatric surgery. Your doctor will start you on a liquid diet and have you slowly transition back to solid foods.  

Following are key points to know about your recovery diet:

  • Your calorie consumption will be about 1/4 of what it used to be
  • Drink a lot of fluids… between 48 and 64 ounces per day
  • Do not drink any liquids during your meals or within an hour afterwards
  • From the 2nd through the 6th weeks your liquid meals will get thicker and thicker (but still completely pureed with no small bits remaining)
  • Some time between the 4th and 8th week after surgery, your surgeon will slowly transition you to solid foods and on to your permanent long-term diet. 

Caring for Your Incisions

A simple process of gently washing your incisions with soap and water (no scrubbing) then drying them gently but thoroughly is recommended.  After the wounds have completely closed (usually takes about 2 weeks), you can start applying special lotions and sunscreen to minimize the scarring. 

Slowly ease back into your normal routine, and don’t start any strenuous exercising until you have fully healed on the inside and out (talk with your surgeon to be sure).

Short-Term Difficulties and Side Effects

At first, you may experience discomfort in a number of areas which may sound unpleasant, but these side effects will usually pass with time or changed behavior…

  • Nausea or vomiting
  • Body aches
  • Weak or tired feeling
  • Feeling cold
  • Constipation
  • Diarrhea or loose stools
  • Gas
  • Dumping syndrome
  • Gurgling noises
  • Thrush (yeast infection)
  • Feeling more "emotional" than usual
  • Skin changes
  • Temporary hair loss

You likely won’t experience all of these issues, and – for those that you do experience – it typically takes anywhere from two to six weeks for them to start to wear off. 

Click here for more information about recovering from surgery.

09New Diet
  • Depends on procedure

In order to maintain your weight loss and health improvement after weight loss surgery, you’ll need to develop proper long-term diet and exercise habits. Otherwise, you will gain your weight back.

Some procedures, like the duodenal switch, medically require significant changes in your diet, while others do not. However, no matter which procedure, if you do not make an effort to eat healthy you will gain back weight. So, regardless of which procedure you’ve had, you should work to adopt all of the following diet guidelines.

Long-Term Diet for Weight Loss Surgery Patients

Healthy eating for weight loss surgery patients has two angles… what you eat and how you eat. 

As you can imagine, diet is a huge topic of conversation, so we’ll only touch on some key points here.  Click here for detailed information.

In general, there are 7 food principles to live by:

  1. Eat healthy
  2. Protein first
  3. Keep your blood sugar stable
  4. Drink the right amount of water at the right times
  5. Don’t snack
  6. Be religious about taking your vitamins
  7. How you eat is as important as what you eat

Eating healthy means that your diet should consist primarily of FOG foods…

  • Farm – The food is raised on a farm (i.e. chicken, turkey, eggs, dairy products)
  • Ocean – It comes from the ocean (i.e. fish)
  • Ground – It is grown in the ground (i.e. fruits, vegetables, nuts, whole grains) 

When possible, avoid anything that was modified by humans in any way. 

Regarding what NOT to eat, food intolerance affects different patients in different ways, and certain foods may upset your digestive system following surgery.  Click here for the full list of foods that may give you problems.

How you prepare your food is as important as what you buy…

  • When cooking, bake, grill, poach or broil…don’t fry.
  • Use skim milk instead of whole milk.
  • Use chicken or vegetable broth instead of oil.
  • Replace oil in recipes with applesauce or yogurt.
  • Add spices or lemon juice to add flavor instead of olive oil or butter.

Eat your protein first. Protein is one of the most important nutrients for your body, and you need a lot of it in order to stay healthy… up to 80 grams a day.

With your old stomach, this was no problem. But now that your stomach is down to the size of a golf ball, 80 grams is a big percentage of the available space.

Stable blood sugar leads to stable hunger and stable relationships (no mood swings).  Avoid simple carbohydrates and eat "good" carbs in small portions.

Drink a lot of fluids… between 48 and 64 ounces per day. That’s equal to about 8 cups or 1/2 a gallon. This may be tough to do considering the size of your new stomach, but its extremely important to avoid problems.

Don’t snack… Snacking between meals is the quickest way to halt your weight loss progress and to gain your weight back after you hit the low point.

Be religious about taking your vitamins – After surgery, you will be at much higher risk of serious vitamin deficiency if you don’t take your prescribed vitamins and supplements.  Click here to learn which vitamins you’ll need and how to avoid problems.

How you eat versus what you eat – The right eating techniques can prevent complications and weight regain and ensure that your body gets the nutrients it needs. Follow these guidelines to stay on track…

  1. Consider preparing your own food to avoid harmful ingredients and help make your new diet taste good!
  2. Stop eating before you feel full to avoid vomiting, diarrhea, constipation and difficulty swallowing and to prevent stomach stretching and weight regain.
  3. Eat slowly and chew your food thoroughly
  4. Do not drink during meals or up to an hour afterwards

Click here for the tell-tale signs of a problem with how you’re eating.

Click here for in-depth information about what and how to eat after weight loss surgery.

10New Exercise Regimen
  • Leads to measurable improvements in weight loss and health improvement
  • Should slowly ramp up for 3 to 6 weeks after surgery
  • Should become a routine: 30 minutes per day, 2 to 3 days per week
  • Does not need to be overly rigorous to be effective
  • Should focus on rounding out endurance, flexibility, & strength

Exercise is often the first part of a patient’s long-term plan to get skipped following surgery. However, several studies have found regular exercise to be 2nd only to diet towards achieving and sustaining long-term weight loss and health improvement goals.

Long-term regular exercise after weight loss surgery has been shown to:

  • Increase life expectancy
  • Reduce abdominal fat
  • Strengthen heart, muscles, bones and lungs
  • Reduce risk of heart disease
  • Lower blood pressure
  • Reduce triglycerides
  • Increase good cholesterol and reduce bad cholesterol
  • Improve blood sugar control
  • Improve insulin control
  • Reduce risk of cancer
  • Increase energy
  • Improve balance
  • Improve appearance
  • Improve motivation and mental “sharpness”
  • Improve libido

When Can You Start Exercising?

Check with your surgeon to be sure, but exercise can generally begin within three to six weeks following surgery…

  1. Immediately after returning from the hospital – Start walking slowly 20 to 30 minutes per day (not necessarily all at once), gradually increasing the speed at which you walk as your endurance improves
  2. 3 to 6 weeks after surgery: Build up to three 10 minute walks per day while walking at a relatively quick pace.
  3. 6+ weeks after surgery: Continue building strength, endurance and flexibility through regular exercise 

Exercise Guidelines

A solid foundation for safe and effective exercise for weight loss surgery patients includes…

  • Consistent exercise is more important that rigorous exercise.  
  • Start slowly and work your way up
  • Prevent skin problems caused by sagging skin from rapid weight loss by applying lubricating gels and wearing supportive clothing
  • Drink plenty of water while exercising
  • Wear good shoes
  • Warm up before exercising and do a cool-down routine afterwards
  • Keep your heart rate within the proper range using a heart rate monitor or manually taking your pulse
  • If you feel pain, stop immediately (but having sore muscles is okay!)

Which exercises are best?

There is not necessarily a "best" exercise routine as long as your routine focuses on all 3 essential elements:

  1. Endurance – Walking, marching, riding a stationary bike, hoola-hooping (yes, hoola-hooping) and swimming are all great options.
  2. Flexibility – Stretching and yoga (yoga is – by far – our favorite recommendation for improving mental strength, physical strength and flexibility – please trust us and try a beginners yoga class)
  3. Strength – Yoga, exercise balls, the Bodyblade and (light) weights are good beginner tools for building strength.

Click here for more details about exercising the right way after weight loss surgery.

11How to Get Started
  • Option 1: Attend a Free Online or In-Person Seminar with a Top Surgeon (see surgeon directory below)
  • Option 2: Attend a Local Weight Loss Surgery Support Group Meeting
  • Option 3: Send Us Your Questions

Congratulations on making it through all 10 Steps to a Successful Weight Loss Surgery Experience!  We’ve covered a lot, and you should now feel confident in your knowledge of what it takes to succeed before, during and after weight loss surgery.

So where do you go from here?

Option 1:  Attend a Free Online or In-Person Seminar with a Top Surgeon

Whether you’re confident that weight loss surgery is for you or if you’re still on the fence, the best thing you can do is:

  • Contact a top surgeon
  • Register to attend their next free online or in-person seminar

Most surgeons hold regular (weekly) seminars to talk about your options, introduce themselves and their staff and allow you to interact with others who are also considering surgery.

Be sure to ask about a free insurance check (most practices offer this), financial review and, if applicable to your situation, financing options.

Click here to find and connect with a top surgeon.

Option 2: Attend a Local Weight Loss Surgery Support Group Meeting

If you’re still on the fence, attending a local support group will give you a much better understanding of the benefits and challenges of weight loss surgery from actual patients.

Contact a local surgeon and ask if you can attend their next support group meeting.

Option 3: Send Us Your Questions

If you have any specific questions that you want to have answered before contacting a surgeon, please reach out.   We’ve built a Question & Answer section at BariatricSurgerySource.com where you can interact with our team and receive specific feedback and advise.

Please click here to submit your questions.

We hope this email series has been helpful, and we look forward to staying in touch!

12Find a Top Weight Loss Surgeon
  • Ask for a free insurance check /seminar /webinar /cost quote
  • Schedule a phone or in-person consultation

Find A Top Weight Loss Surgeon

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* Disclaimer: The information contained in this website is provided for general information purposes and your specific results may vary depending on a variety of circumstances. It is not intended as nor should be relied upon as medical advice. Rather, it is designed to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician(s). Before you use any of the information provided in the site, you should seek the advice of a qualified medical, dietary, fitness or other appropriate professional. Read More