Weak, Lethargic, Tired & Depressed After Gastric Bypass Surgery

Question Below Submitted By:  

Mary Ann (a patient from Clayton, DE)

My gastric bypass was done on March 25, 2013. That’s almost five weeks out. I’m writing because I feel weak, lethargic, an over-whelming urge to sleep.

About 7 days out I was severely depressed, I thought due to the trauma. The constant crying went away, but I’m wondering if depression is playing a part in this.

I take Cymbalta 60mg. twice a day, Atenolol, Synthroid, and Omeprazole 40 mg. Before surgery I was on two meds to bring my Triglycerides down, but D/Ced them after surgery because I was told it would regulate itself.

Physically, I think I’m getting all I need. My son sells Herbal Life and that’s the product I use (with my surgeon’s approval). Are all proteins created equal?

I’m taking the recommended vitamins, B-12, D-3, Calcium with D. I’m beginning to wonder if I should be using Unjury.

Ten days out I began to crave meat protein, and ate one chicken nugget, chewed “to death”, which I tolerated well, and lunch meat turkey, one thin slice also chewed well. But when I saw the surgeon a couple weeks ago, he told me to stay on the liquid protein, “follow the rules”, and to add 1 tsp. of sugar per bottle of water I drank. I did that but felt weaker.

I’m seeing my PCP tomorrow for that and another issue un-related to surgery. They’ll do labs, I’m sure, but I just want to know if there are other people who experience these things.

In addition, I feel I’m not losing weight as quickly as I thought (only 15 lbs. in a month). I’m at 165lbs now, but at only 4’10”, I’d like to reach 100 lbs.

I know I’m getting adequate fluids, but my hands which always looked old, look more wrinkled and when I pinch up the skin, it stays, which I’ve heard is a sign of dehydration. I really feel I need real food in the correct amounts.

What is the opinion of a doctor or other professional or patient who has a lot of experience?

Thank you,
Mary Ann


Expert Responses to the Question Above

Bariatric surgeon at CBGSA , Arcadia , California

by: Dr. Troy LaMar

Hi Mary Ann,

You have mentioned multiple things in your question. I'll try to hit on a few...

It is not uncommon to feel depressed after bariatric surgery, even if one was not depressed preop. The "what have I done" question is normal. These feelings almost always will pass with time.

Make sure you continue your antidepressants.

Lethargy can occur due to many things, and you just want to make sure you optimize your ability to lose weight and stay hydrated.

If you are getting at least 80 grams of protein/day, 64 ounces non caloric fluid, and all your supplements, that is the first thing. If you still are having lethargy issues, check with your primary care physician in terms of your BP meds. If your BP has corrected already, you may not need it (e.g. Atenolol can certainly make you lethargic).

Since you are now 3 months out, you should be able to tolerate regular food proteins such as thinly sliced turkey, fish, lean ground beef, etc. We have our patients stay away from steak and pork for at least 6 months. But, checking with your surgeon and his or her plan would be best.

Finally, everyone loses weight at different rates. As long as you are doing everything correctly, it will come off. Usually, you will lose weight for 12-18 months, then your body will reset.

Hopefully, these thoughts have helped some.

Good luck with your weight loss journey.

Troy LaMar M.D.

los angeles bariatric surgeon

(click here for Dr. LaMar's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.


Patient Responses to the Question Above

Weak, Lethargic, Tired & Depressed After Gastric Bypass Surgery

by: Mary Ann Steele

Dear Dr.,

Everything has resolved itself. I'm sticking to the rules and have lost a total of 40 lbs. The only med I'm on is my anti-depressant. I was told by my Dr. to drop all the rest. I DO still have days of depression, but I attribute that to be situational and unrelated to surgery.

Having fought depression since the age of 11, and then being treated from my 30's, about 4 years ago, I finally was prescribed something that helped take the edge off. I don't dare go off it because I've "crashed" before by thinking I could go off. The med is Cymbalta - 60mg, twice a day.

Thank you for taking the time to write to me.

Mary Ann

Related Pages:
- Bariatric Diet (What you eat)
- Bariatric Eating (How you eat)
- Bariatric Vitamins
- Life After Weight Loss Surgery
- Weight Loss Surgery Support
- Exercise After Bariatric Surgery

To Bariatric Girl (update)

by: Mary Ann

I just read your comments. Herbal Life sells protein mix similar to Unjury, plus other weight loss products. My surgeon looked at it and said it was fine to use. I'm losing, so I guess it's ok. But I want to compare labels between Unjury and Herbal Life.

My son lost 40 lbs w/o surgery in about four months and maintains by having a shake a day and eating healthier. I ended up having my family Dr. order labs. They were fine and I no longer have to take two meds for my high cholesterol and extremely high triglycerides (I'd been on meds for 10 years and was told it was hereditary). So I'm really pleased about that. Primarily I drink the shakes and make them more palatable by adding sugar free popsicles or diet Jello powder in various flavors.

Actually, it's so much easier to drink shakes than it is to worry about all the food you have to buy to get proper and adequate nutrition. My body seemed to tell me that the chicken nugget I ate was fine and the Dr. said as long as I chewed well I could have two (but I haven't). Each week I'm feeling stronger and better.

I think I may have failed to mention tat there was a family situation going on that was about to kill me emotionally (I suffer from depression anyway). That alone could have been zapping my strength. Or I may just have thought I'd bounce back as fast as I did 30 years ago, but at almost 60, guess it just doesn't work that way. I didn't keep putting sugar in my water because I'd finally gotten "sugar free" and didn't want to go backwards. Thanks for your comments and when I have time I want to visit your site and some support groups also.

Mary Ann

stomach like a babies

by: Anonymous

After weight loss surgery I think you have to look at your stomach like a baby... slowly graduating from liquid to 1 solid at a time over time until your body accepts the different solid. You may not accept certain foods and have to reintroduce at a later time. Some foods you may never be able to eat again.

It's tough... you have to make sure you don't eat too fast, eat too much, chew well enough and know when to stop (when you're full). This is a major life style change. Stay with the program and know that it's a learning experience that's different for everyone.

For Mary Ann

by: Yvonne McCarthy

I'm not a doctor so I'll comment on the things I'm familiar with. I had WLS 12 years ago and I've volunteered in the community from the beginning.

I'm sorry you weren't aware of what was happening to you right after surgery. Many of us have used food as a coping mechanism for so long that when it's taken away we actually go through withdrawal. After surgery we cannot use food that way so we tend to freak out a bit.

I'm concerned about a few things you said. I have no idea what's exactly in Herbal Life but protein after WLS is SUPER important and I would switch to shakes made by some well known bariatric supplement company just to see if it makes a difference. This isn't something to take lightly. I'm also a little worried that you weren't told how serious it is to stay on your liquid diet so that you wouldn't have allowed yourself a chicken nugget. If you aren't told why these things are important you are less likely to follow the rules. It's very important to form new habits so that they become the new normal.

Are you still on liquids??? I'm confused about adding processed sugar to the water too. This is generally the time when we are trying to break the hold processed sugar had on us. Other questions....Are you involved in any support group, even one online? The surgery is really the smallest part of this journey.

I saw the list of vitamins but I don't see iron. Iron is very important and you shouldn't take it with your calcium (I take calcium and all the other things in the morning and iron at night). Again I'm not a doctor but iron deficiency would account for the fatigue.

You can't compare your weight loss to others. When I was two months out I didn't lose a pound for 6 weeks straight. Everyone is different. If you are following the rules you will be fine. Stressing will also slow weight loss. You may be dealing with depression but see what your labs say, switch your protein, and make sure to take iron.

I have a blog at bariatricgirl.com that has a lot of information that might help you too. This first year is so important to get right so that you lose the maximum weight you can before the honeymoon period is over.

There is so much more to say but let's start with this.

Mini gastric bypass

by: Sarah


Im one week post op now and still on liquid diet. Im abit concerned because im always feeling weak after each meal.
I have no energy to walk, i feel discomfort after i drink any soup etc. and feel i need to lay down and rest.

Is this normal ?

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