Frequently Asked Questions:
Gastric Bypass Surgery at CMC
Please feel free to talk with any member of the The New England Weight Management Institute team
at Catholic Medical Center regarding any questions, concerns or comments you may have. To sign up
for a free information session on weight loss surgery at The New England Weight Management
Institute, call 603.663.7377.
QUESTIONS
ANSWERS
Q: Why have I been requested to lose weight prior
to surgery?
A: Losing weight prior to surgery may decrease the
risk of complications, by decreasing the size of the
liver, improving diabetes control and
hypertension. It also demonstrates commitment to
the lifestyle changes necessary to be success postoperatively, i.e. healthy, balanced diet and
exercise.
A: All required tests will be reviewed with you at
your initial appointment, which will include labs
and EKG. Additional testing, including radiology
tests, sleep study, or cardiac testing will be
determined on an individual basis.
A: The hospitalization is typically 2-3 days,
depending on your recovery.
A: You will be seen at 2 weeks by the surgeon’s
office and the RD at the OTC. After the initial visit
you will return in one month, then every three
months with both the dietitian at the OTC and
your surgeon’s office for the first year. You will
then be seen at 18 months, 2 years, and
ANNUALLY FOR LIFE.
We strongly encourage you to stay connected to
the program as much as possible by attending
post-operative support meetings as well.
If you are struggling or have concerns, we
encourage you to schedule an appointment with
your surgeon’s office or the OTC at anytime.
A: Evaluate your eating behavior. You may be
eating too much and/or too fast. It is important to
keep food records to see if this is related to certain
foods. If nausea persists, call your surgeon’s office
or dietitian for recommendations. Occasionally
anti-nausea medication may be needed shortterm.
A: Pain medications are constipating. Try to wean
off pain medication as you can. You may need to
increase your fluid intake. You can also try Milk of
Magnesia, diluted prune juice or stool softener.
A: Gas is common after surgery. Continue to walk
Q: What tests will I need prior to surgery?
Q: How long will I be in the hospital?
Q: How often will I need to come back for followup and continue to follow-up?
Q: What do I do if I am feeling nauseous?
Q: What should I do if I am constipated?
Q: What do I do if I have gas and bloating? What
do I do if I have diarrhea?
Q: Will I be able to take my prescribed
medications?
Q: What will my diet be like after surgery?
Q: What is Dumping syndrome?
Q; Will I ever be able to tolerate “normal” food
again?
Q: Why is it important for me to drink fluids after
surgery?
regularly as per the physical therapy
guidelines/goals given to you at your discharge
from the hospital. Some patients develop lactose –
intolerance and may experience gas, bloating and
diarrhea due to milk sugar called lactose.
Symptoms should resolve by switching to lactosefree products. You can also try anti-gas
medications available over the counter, i.e. gas-ex,
phazyme (chewable or liquid form).
If symptoms do not subside call your surgeon’s
office.
A: You will need to crush pills or open all capsules
the first month. It is important that you continue
all medications as per instructions, and DO NOT
abruptly discontinue any medications, unless
instructed to do so. Check with your surgeon’s
office if you are unclear. After the first month, you
can start taking small pills whole and cut in half
larger pills.
A: The dietitians will carefully instruct you on the
diet stages that you will progress through postoperatively. There are five stages to the diet. It is
important that you follow this EXACTLY for your
healing process and to avoid complications. Diet
advancement may be altered or slowed depending
on each individual.
A: Dumping syndrome occurs when concentrated
foods such as sweets or concentrated
carbohydrates rapidly empty from the stomach
pouch into the intestine. You may experience
nausea, sweating, bloating, cramping and/or
diarrhea. Everyone does NOT necessarily
experience dumping syndrome, but you should be
aware that eating foods high in sugar may cause
this reaction.
A: You will be slowly advanced through the diet
stages to eventually eat a healthy, balanced diet of
whole foods. The difference will be the
quantity/portions. You may have some food
intolerances and need to avoid certain foods.
These may include soft breads, pasta, rice, dry
meats, fruit skins or leftovers/reheated foods. You
should eventually eat a variety of HEALTHY food
options.
A: It is important to maintain your fluid intake of
64 ounces or more to maintain appropriate body
levels of fluid and replace losses due to weight
Q: Why is protein so important in my diet right
after surgery?
Q: Are there any nutritional supplements that I will
need to take after surgery?
Q: What could be causing me to feel a tight feeling
in the middle of my chest while I am eating or right
after I eat?
Q: How often do I need to get my labs/blood work
done?
Q: Can I eat foods that are high in fat and/or sugar
after surgery?
loss. Symptoms of dehydration may include
lightheadedness, fatigue, nausea, and dry skin.
A: After gastric bypass surgery we initially focus on
meeting protein needs first. Protein is an
important building block for healing, maintaining
lean muscle and organ function. Your goal is 60-80
grams per day. Please keep food logs to track your
intake and review with the dietitian. You may
require a protein supplement, i.e. shake or bars,
long-term to meet these needs.
A: Due to the limited capacity of your new
stomach pouch and bypassing of the upper portion
of your intestine (duodenum), you will not be able
to get adequate amounts of some vitamins and
minerals in your diet. You are REQUIRED to take
vitamin and mineral supplements FOR LIFE.
Compliance with these supplements is important
to avoid vitamin/mineral deficiencies.
At a minimum you will be taking TWO complete
multivitamins daily, 1200-1500mg calcium citrate
with added vitamin D, and vitamin B12 1000mcg
sublingual tablet once weekly.
Additional supplements may be recommended
based on your lab results.
A: A tight feeling after or while eating is usually a
warning sign that something about your eating
behavior or food consistency is not right. Carefully
re-evaluate your eating. Refer to your food
records.
If this feeling persists, call your surgeon’s office.
A: You will need to have labs done every 3 months
the first year. These are typically done prior to
your follow-up appointments with the surgeon’s
office, so they can be reviewed with you at your
visit. You will then have labs done at 18 months
and ANNUALLY FOR LIFE.
Please be sure to return to your surgeon’s office to
have these monitored. Your primary care physician
will likely not be aware of the specific labs that
need to be monitored long-term after gastric
byass.
A: Foods high in fat and sugar are also typically
high in calories, and not part of a healthy, wellbalanced diet that you will need to follow to
achieve and maintain weight loss. Sugars and fats
may not be tolerated after gastric bypass and may
cause symptoms such as nausea, vomiting, pain
and diarrhea.
Q: When am I allowed to drive after my surgery?
Q: When can I return to work?
Q: When can I start…?
1. Walk?
2. Swimming?
3. Lifting weights?
4. Aerobics?
5. Abdominal crunches?
Q: How much weight will I lose the first month?
Q: How big will my stomach be after surgery?
Q: Why am I losing so much hair? Will I go bald?
Q: I often hear that people experience vomiting
after surgery. Should I expect to vomit?
A: You are allowed to drive once you are no longer
taking narcotics (pain medication), and you have
enough mobility to react behind the wheel. This
may take a week or two.
A: You can return to work as soon as you feel able
to perform your job duties. You will not be able to
lift/pull/push more than 10lbs for 6 weeks.
Typically recovery time is 2-4 weeks.
A: Always check with your clinician before
beginning any exercise program.
1. Immediately! You will be discharged from
the hospital with a daily walking plan.
2. Do not start swimming until you have had
your initial check with the surgeon’s office
to ensure adequate healing and get
clearance to start swimming.
3. You cannot lift more than 10lbs for 6
weeks post-operatively.
4. We encourage cardiovascular exercise
immediately. Depending on the specific
activity always ask first. Start slowly.
5. No abdominal exercises for 6 weeks postoperatively.
A: Weight loss depends on many factors, including
starting weight, age, gender, activity level, caloric
intake and adherence to diet guidelines.
A: Approximately 1 ounce or the size of a golf ball.
A: Most patients will experience some “hair
thinning” after surgery. This typically occurs
between 3-9 months post-operatively during your
rapid weight loss. This is your body’s response to
the stress of rapid weight loss and significant
caloric reduction. It may be accelerated if you are
not compliant with your supplements or not
meeting your protein goals. Hair loss usually
slows/stops around 9-12 months post-operatively
when your weight loss starts to slow.
You will not go bald and hair loss is usually not
permanent. Regrowth will occur.
A: Vomiting is not a common or expected
occurrence. If you are vomiting, please evaluate
your diet, eating habits and food consistency.
Please adhere to the dietary guidelines given to
you. If you do not tolerate a particular food, please
leave it out of your diet for at least a month before
retrying it or discussing it with the dietitian.
Remember to chew, eat slow, take small bites, sip
your liquids and make sure foods are moist. Drink
fluids separate from your meals. Do not eat and
drink at the same time.
Any early vomiting is concerning. This can be a sign
of a more serious problem or cause complications
as you are healing. Call your surgeon’s office
immediately if you have vomiting.