What can I do before surgery to improve my outcomes from surgery?

Getting a comprehensive blood test before surgery can be useful to correct any deficiencies and monitor any changes.

Reflecting on your eating and seeking advice about your diet can significantly improve your surgery experience.

Weight loss surgery is a big decision and unfortunately is not a 'magic bullet' for weight loss; it still requires long term commitment. Gradual changes to your lifestyle BEFORE surgery can make the transition a lot easier and more successful.

Seeing a dietitian prior to surgery and for follow up afterwards has been shown to improve nutrition status and maximise long-term weight loss.

Should I be using a meal replacement in the lead up to surgery?

The use of meal replacements (e.g. shakes) before surgery is largely up to the surgeon and what they deem appropriate for you. Having meal replacements or a very low energy diet (VLED) before surgery has been shown to reduce complications during the operation itself. In most cases, if meal replacements are used correctly, this process will also result in some weight loss in the lead up to surgery. Talk to your surgeon and dietitian about whether meal replacements may be suitable for you.

What could I expect from a visit to a Dietitian before surgery?

Your first visit to a dietitian will likely include collecting information about your medical history, discussing your motivations for surgery, talking through your current eating patterns and answering any questions you may have about nutrition. If needed, it may involve addressing any dietary habits that may impact on the success of your surgery. Follow up visits will discuss your progress, pre and post surgery dietary requirements and ongoing support for symptoms that may arise.

What do I eat straight after surgery?

For the first 1-2 weeks following surgery, usually a liquid diet is required. This allows your stomach to recover from surgery. Following this, you would start on a pureed diet then progress to a soft food diet. From approximately 7 weeks after surgery, you will gradually reintroduce solid foods and increase the variety of foods eaten. The exact time frames will be explained by your surgeon. It is important to have adequate protein in your diet to avoid muscle loss after surgery.

Do I really need multivitamins after surgery and which one is best?

This is something that depends on the type of surgery you have, the types of foods you are eating after surgery and any signs/symptoms you are showing that point to deficiency.

Generally, all people having a gastric sleeve or gastric bypass procedures will need to take a multivitamin lifelong. It is best to start a chewable bariatric-specific multivitamin soon after surgery and have follow up blood tests. You can talk to your dietitian about how to take multivitamins, what to ask for as part of your blood tests and how long you need your multivitamin for.

Transformed has BN Multi chewable multivitamins available for purchase.

I have heard I should be avoiding all carbs. Is this right?

It is a common misconception that carbs (carbohydrates) need to be avoided by everyone.

In some cases, reducing or carefully selecting specific types of carbs is important but rarely do they need to be avoided all together. In fact, avoiding all carbohydrates could affect your energy levels and concentration.

The key here is to choose mostly unrefined, wholegrain carbohydrates that look brown and 'grainy' as these provide better nutrition and fill you up for longer.

Are there any foods I should completely avoid after surgery?

Foods that give you severe reflux or cause regurgitation should be avoided initially and can be re-trialled later. Common foods that do this are stringy meats, doughy bread and hard vegetables. If you are symptom free, there are no particular foods to avoid. However, high calorie food and drinks should be left for special occasions as they can affect your overall weight loss if consumed frequently.

How much should I be drinking to stay hydrated?

This can vary depending on your pre-surgery weight and medical conditions, but 2 litres is a good goal. Remember, it is important to avoid drinking 30 minutes either side of meals to avoid discomfort and avoid larger portions than needed.

What do I eat straight after surgery?

For the first 1-2 weeks following surgery, usually a liquid diet is required. This allows your stomach to recover from surgery. Following this, you would start on a pureed diet then progress to a soft food diet. From approximately 7 weeks after surgery, you will gradually reintroduce solid foods and increase the variety of foods eaten. The exact time frames will be explained by your surgeon. It is important to have adequate protein in your diet to avoid muscle loss after surgery.

If I don't feel hungry, should I avoid eating?

Probably not. Some people don't get hungry very often at all after surgery, but this doesn't mean they don't need to eat. It is important to get enough protein and nutrients to support your body.

If you don't feel hungry, aiming to have 3 meals a day is a good guide, with snacks added only if you need them. Also aim to have protein at all 3 meals (for example: meat, eggs, dairy, nuts or legumes) as well as a range of fruit and veggies.

I feel hungry constantly; what do I do?

Make sure you are recognising the difference between true hunger and eating in response to emotions.

If it is true hunger, are you grazing on food across the day instead of having 3 main meals? This can make you hungry all day; try to re-structure your meals. Are you eating foods that are high in fibre? High-fibre foods can keep you full for longer. Are you restricting any food groups? Consider increasing the variety of foods you eat; your body may be telling you it's missing something!

If you are eating in response to emotions, speak to your dietitian and/or psychologist about managing this.

I find it difficult to have breakfast as I often feel sick of a morning if I eat; what can I do?

Try having a sip of water or a hot drink before breakfast. This can clear any mucus sitting at the top of your stomach.

Also try different types of breakfast: eggs or yoghurt are good places to start. Still having trouble? Check in with your surgeon or dietitian.

What do I do if I feel dizzy/shaky/sick after meals?

You may be experiencing dumping syndrome, which most commonly affects those with a gastric sleeve or bypass more than with a band.

How long after meals does this happen? Have you noticed a pattern of which foods/drinks cause this? Create a list and talk to your surgeon or dietitian.

My bowel habits have changed; should I be concerned?

This is quite common after weight loss surgery because of the change in type and amount of foods eaten.

It could be from not having enough fibre in your diet or not having enough fluids. If you increase the amount of fibre in your diet, make sure you are well hydrated! If your bowel habits are really affecting your life, get it checked out by your surgeon or GP.

My weight loss has started to slow down/plateau; what do I do?

This can happen for a number of reasons. It can be useful to step back and see how far you've come. Are you happy with your weight loss? Do you have better control over your medical conditions (if you have any)? If not, are you eating suitable portions? Are you incorporating exercise into your week? If you need further support, talk to your GP or dietitian.

How long until I can exercise following surgery?

This will mostly depend on any conditions you had before surgery and how well your body has adapted to the surgery. Speak to your surgeon about this one.

If you feel concerned or nervous about any aspects of eating before or after your surgery, a bariatric-trained dietitian can help to navigate and guide you as well as pick up on potential nutritional problems.