- 34% – abdominal pain
- 34% – fatigue
- 28% – anaemia
- 16% – gallstones
Women, patients younger than 35 years, smokers, unemployed persons and individuals who had surgical symptoms before undergoing RYGB surgery, had a higher risk of developing negative symptoms after their gastric bypass surgery.
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As would be expected, the more symptoms patients had, the lower their quality of life. Dr Gribsholt points out that these patients may be inclined to depression and has made calls for solutions to improve gastric bypass surgery.
Dietary intake after gastric bypass surgery
According to Mahan and her co-authors (2012), the following dietary progression should be used after a gastric bypass:
a) Liquid diet:
After a gastric bypass most patients should use a liquid diet for 1-2 days. Not more than ½ cup of the following liquids should be taken in total at a time: plain and flavoured water (use only still water), clear broth, unsweetened juices, diet gelatine or jelly, non-carbonated diet drinks (avoid drinks with bubbles), pureed and strained milk soups.
b) Semisolids and pureed diet:
This type of food should be used from day 3 for 3 weeks. No more than ½ to ¾ cup in total per meal should be eaten. Increase the quantity from ½ cup to ¾ cup gradually, 1 teaspoon at a time. Most cooked foods can be blended, such as soft meats, fish, chicken, turkey, fruit and cooked vegetables. Warm cereals cooked in milk, and yoghurt can be included.
c) Soft foods:
These soft foods can be eaten from week 3 to week 6. The patient should gradually increase the quantity from ¾ cup to 1 cup (not more) per meal. Any foods that can be mashed with a fork such as minced, cooked meat, canned or soft fresh fruit and cooked vegetables, soft cooked cereals with milk, yoghurt and soft scrambled egg, can be used.
d) Standard small meals and healthy, non-fattening snacks:
These foods can be eaten from week 6 and thereafter. No more than 1 cup in total per meal, and less per snack. Meat should not exceed 60 g. Foods that no longer need to be pureed or blended can now also be eaten. Avoid foods such as popcorn, nuts, meat gristle and fat, dried fruits, tough fruits and vegetables, carbonated sweetened drinks, bread, crunchy breakfast cereals and muesli (the latter may contain nuts, dried fruit etc., which can cause diarrhoea).
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Because each patient is an individual and may have food preferences and aversions, it is essential that the post-operative diet adaptation should be monitored by your dietitian. The dietitian will also advise you about the use of liquid meal supplements, multivitamins and mineral preparations and amino acid supplements. If your surgeon has not referred you to a registered dietitian, please ask them to do so. The dietitian will guide you through this adaptation period and help you sort out potential problems.
Pitfalls of bariatric surgery
Some patients who undergo bariatric surgery for morbid obesity sabotage their own success by working out a variety of tricks to ingest more food and energy (kJ) and thus slow down or prevent weight loss. For example, even patients who have hardly any stomach capacity will start drinking small quantities of high-energy drinks or eating high-energy soft foods all day long. This is a recipe for disaster.
If you have undergone the discomfort and risks of anaesthesia and surgery to lose weight, don’t sabotage your own progress by over-feeding. At end of the day, it is your body and your health that lose out, and all the expense and suffering will have been in vain.
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The general conclusion is that bariatric surgery can be very successful and help morbidly obese patients achieve dramatic weight loss and reduced risk profiles. It must, however, always be kept in mind that any surgical intervention may have negative side-effects and that the post-operative guidance of a dietitian regarding the types of food and quantities patients can eat, is an important factor in long-term success.
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Gribsholt SB et al, 2016. Prevalence of self-reported symptoms after gastric bypass surgery for obesity. JAMA Surg. 2016 Jan 6: 1-9. doi: 10.1001.
Mahan K L et al (2012). Krause’s Food & the Nutrition Care Process. Elsevier Publishers, USA.