Life After Weight Loss Surgery: Effects From Head to Toe

Weight loss surgery can change just about every aspect of your life. You'll look different, your health will improve, and you'll probably feel better.

But the changes run deeper than that. Many of your old habits -- behaviors that you've adopted over the decades -- will have to change, too. Weight loss surgery -- also called bariatric surgery -- can alter your relationships with other people, your feelings about yourself, and your whole way of living. It's a surgery with a profound and sometimes surprising impact.

So if you're considering weight loss surgery, it's crucial to know what to expect -- and what you're really committing yourself to. Here's a rundown of some of the important changes you might face after weight loss surgery.

• Initial recovery. How long will it take to get back to normal? That depends on the sort of surgery you had. Recovery from adjustable gastric banding (like LAP-BAND surgery) tends to be quicker than recovery from more involved surgeries like gastric bypass. Ask your doctor what you should expect.

• Post-surgical risks. Like any surgery, weight loss surgery has risks and side effects. The risks of weight loss surgery include infections, blood clots, pneumonia, and leakage around the reconnected stomach. Late complications occur, too. Later complications can include the development of a hernia or bowel obstruction. Band slippage and erosion around the band site are uncommon complications, but can occur.

In general, these risks are lower for minimally invasive procedures and when the surgery is performed by an experienced surgeon. Follow your doctor's advice for recovery, and find out what symptoms merit an immediate checkup.

• Eating. Weight loss surgery will radically change how you can eat. Meals that might have seemed tiny in the past will quickly make you full -- even uncomfortably full. You'll find that you need to eat small amounts slowly, and chew well. Be especially cautious at the beginning as you get the hang of eating with your smaller stomach.
  
  Doctors usually recommend eating a number of small meals a day, with a special emphasis on foods high in protein. Usually, drinking during a meal isn't recommended. It can wash food out of the stomach too quickly and interfere with your feeling of fullness.
  
  
• Nutrition. Before surgery, when you ate more, getting the nutrients you needed was easy. But after weight loss surgery, you must eat less, so it's crucial to make the foods you eat count. Talk to your doctor or a dietitian for advice on a healthy post-surgery diet.
  
  Gastric bypass and other surgeries that affect the body's ability to absorb food pose a special risk. It's much harder for your body to take in the nutrients you need after this kind of weight loss surgery. Depending on the operation, you run the risk of deficiencies in iron, calcium, vitamins A, B12, D, E, and K. To reduce the risk of problems, you will need to take dietary supplements for the rest of your life.
  
  
• Weight loss. Obviously, you'll lose weight after surgery. But make sure you know exactly what you should expect, so you're not disappointed with (or alarmed by) the results. The type of weight loss surgery makes a difference in your results, too. Surgeries like gastric bypass that affect digestion tend to result in faster and greater weight loss than adjustable banding procedures.
  
  Many people find that their weight loss ebbs and flows over months, dropping, then leveling off, and then dropping again. Depending on the procedure, you might keep losing weight for up to two or three years after surgery.
  
  
• Health benefits. After malabsorptive/restrictive surgeries, like gastric bypass, the health benefits often appear quickly. For instance, your diabetes might improve dramatically or completely resolve. The same might be true of hypertension, arthritis, sleep apnea, high cholesterol, and other ailments.  Improvements in health after adjustable banding procedures may be more gradual.  You'll need to schedule regular checkups after surgery, so your doctor can keep a close eye on your health as you recover.
  
  
• Health risks. After the initial post-surgery risks have passed, you'll still need to watch out for complications. Again, the risks depend on the weight loss surgery you received. After gastric banding, the band itself may shift position or leak. Either of these problems will require more surgery to correct.
  
  Since surgeries like gastric bypass affect how you absorb food, these types of weight loss surgery pose a special risk of nutritional deficiencies. They can also cause "dumping syndrome." This may result from eating sugary or high-carb foods. The result is food that moves too quickly out of the stomach, causing nausea, pain, weakness, and sweating. Other ongoing problems may include constipation or diarrhea. Dietary changes can often help.
  
  
• Changing habits. If you're considering weight loss surgery, know this: Surgery is not a cure for obesity. In fact, many people do regain weight despite their surgery. They may start eating in ways that evade the restriction on their stomach size. The body itself can learn to adapt to surgeries that interfere with the absorption of food; so, over time, your digestive tract might begin to take in more calories again. The size of a surgically reduced stomach can gradually expand. So remember: weight loss surgery won't solve your problem. To keep off weight, you need to work at it.
  
  
• Physical activity. After surgery, regular physical activity is key. In fact, it might be the most important way of maintaining your weight loss in the long term.
  
  If you've never been a particularly active person, it can be hard to get started. Ideally, you should begin mild exercise before surgery -- to lower the risk of complications -- and then increase it gradually after you've recovered. Talk to your doctor about easy ways to begin. You may also benefit from working with a physical therapist or trainer.
  
  
• Physical appearance. As they start losing after weight loss surgery, many people are thrilled to see the changes in how they look. But there are some downsides too. As your body shrinks, you may find that your skin doesn't shrink as much. It may start to look loose and baggy. Some people choose to have plastic surgery to remove this excess skin.
  
  
• Social interactions. You may find that some of your relationships with friends and family are altered by your surgery. One common problem is that many of us rely on eating and drinking -- sometimes to excess -- as a way of socializing. That becomes harder after weight loss surgery. So you might want to think of new ways of meeting up with family and friends that aren't so focused on food.
  
  Unlike many other surgeries, the results of weight loss surgery are obvious and public. People will notice, and whether you like it or not, they might ask you about your appearance. It's worth thinking about how you want to handle these questions.
  
  
• Psychological health. Since the effects of weight loss surgery are so profound and far-reaching, you might find life afterwards to be disconcerting at times. You might feel odd, like you don't look or feel quite like yourself. You might get overwhelmed by all of the changes you have to make -- and maintain -- for the rest of your life. You might also realize how much you relied on food for comfort in the past, something that's just not possible after surgery.
  
  These are perfectly natural reactions. Talking to a therapist can be crucial in guiding you through this complicated period. You can also ask your doctor if there are support groups in the area for people who have had weight loss surgery. Meeting people who are going through the same adjustments could be tremendously helpful to you -- and to your long-term weight loss success.