Frequently Asked Questions

What if I can't eat a few days after gastric bypass surgery?
It is hard to eat much 5 days, or even a week or 2 after surgery. Your small stomach pouch, and the opening between the pouch and your intestine are swollen and almost closed off. You also are recovering from major surgery, and don't feel like eating much. Concentrate on taking liquids so you don't become dehydrated, and eat simple pureed and soft foods as you are able to. The problem up till now has been too many nutrients. You probably have great nutritional reserves, and can go for some time without depleting your stores. As you feel better and the swelling goes down, and you learn what agrees with you, you will take more. As you begin to take more, try to lean toward high protein foods and supplements, bearing in mind that some people can't take dairy products or dairy based supplements. Do let your doctors know how you are doing, especially if you have diabetes, so that they can adjust your medicines as your intake goes up and down.

What do I do if I want to eat in a fancy restaurant?
The rule of thumb is always eat protein. Most will gladly grill or roast a piece of chicken, fish or steak. Even if not mentioned on the menu restaurant's menu most willingly makes substitutions of permitted vegetables spinach, green beans etc., instead of potatoes or rice. If the restaurant simply will not prepare a dish which you are permitted to have order something with fish, poultry or steak and a separate plate. Take the protein and scrape off the offending sauce, breading, etc. and place it along with any permissible vegetables on your "keeper" plate and give the "Fattening Stuff" back to the waiter (you don't need the temptation to sneak a taste and no-one in your party needs extra fat or calories). If there is one food you can eat with impunity it is protein. At the dinner party load up on salad and protein (push the gravy or sauce to the other side of your dish) and dig in! Although you may not be following the program 100% it won't be too bad or hurt your progress that much.

Can I eat fast food?
Many patients worry about where they can get meals in fast food chains or restaurants. It is very easy to get the types of food you need at many of the fast food chains such as Burger King, Wendy's, or McDonald's. (These are good choices to make even if you have not had the surgery.) All three offer salads that are low in calories and fat. Both Wendy's and Burger King offer Chunky Chicken Salads. Unfortunately, Long John Silver's offers fish and chicken entree's which are both fine (remember no rice, cole slaw or bread sticks) and they will be happy to substitute a salad for the starches you are not permitted to have. Hardee's offers a grilled chicken sandwich, which will be permissible for lunch if you eat only one slice of bread and request it without mayonnaise. Arby's offers the only turkey sandwich in the fast food circuit, which is fine with only 1 slice of the bread. Mrs. Winner's offers broiled chicken with green beans. Remember the old standby at any of these fast food places. You can always order a garden salad and a hamburger pattie with mustard. This is a quick meal that is available at all the fast food chains.

What about exercise?
It's important to exercise while trying to lose weight. Walking is the key. The bike manufacturers and gym owners would like you to think that heavy exercise is the key, but, research is recommending less vigorous and stressful physical activities for those of us who wish to lose or control our weight. Most patients have adequate amounts of lean body mass. In many overweight individuals this mass will be very close to or exceed their ideal weight range. This means that they do not need additional muscle and need to lose fat. Remember you cannot exercise fat and can only exercise muscle. Our body responds to exercise by increasing muscle size and thereby increasing lean body mass. Adding additional lean body mass to an individual who is trying to loose fat undermines the whole process. It is quite likely that you will gain weight if you exercise extensively. This will be more pronounced if your protein intake is increased while dieting.

What is a Bariatrician?
A Bariatrician is a licensed physician (Doctor of Medicine [M.D.] or Doctor of Osteopathy (D.O.) who, as a member of the American Society of Bariatric Physicians (ASBP), has received special training in bariatric medicine the medical treatment of overweight and obesity and its associated conditions. Bariatricians address the obese patient with a comprehensive program of diet and nutrition, exercise, lifestyle changes and, when indicated, the prescription of appetite suppressants and other appropriate medications. (The word bariatric stems from the Greek word barros, which translates as heavy or large.)

What happens after the gastric bypass surgery?
After your Gastric Bypass surgery, you will begin to awaken in the post-op recovery room, in what may seem like just an instant. Many patients will have little or no recollection of being there, a normal side effect of the medicine given to you during anesthesia. Ordinarily, your breathing tube is removed from your throat as you begin awakening — usually before you are aware of it being there. You will be started on pain medication by the nurses in recovery as soon as you need it. The IV line for fluids and medications that was started in the operating room will remain with you for your entire stay in the hospital and will take care of your required fluid intake.

Although you won't be allowed to drink water for the next day or so, you will be allowed to suck on ice chips after the first day if your mouth is dry. About 4 hours after surgery, the nurses will ask you to sit up again, only this time, you will dangle your legs off the side of the bed and put your feet on the ground. We check to see that your vital signs are ok, your pain medication is ok and that you are recovering normally in preparation for your first walk. The nurses will get you up again in preparation for your first walk about 5 hours after surgery. Along with your deep breathing and coughing exercise, walking is essential to your recovery. For your entire stay in the hospital, the nurses will get you up and make you walk around the floor about every 2 hours. As your recovery continues, we monitor your pulse, your temperature, and your blood count carefully. If you are showing good medical progress, we start you on swallows of water, followed by Jell-O and broth — your meals for the next few days. Don't worry about finishing your meals. When you feel full or just don't feel like eating — stop. Depending on the patient, on the second or third day you will be instructed in preparation for leaving the hospital. If you are taking fluids well, can tolerate Jell-O and broth, don't have a fever and are breathing and walking well, we will send you home.


What should I eat after gastric bypass surgery?
Follow these four simple rules faithfully and the weight will come off and stay off. Break these rules continually — and long term you will gain weight. Your surgery is a tool to be used with these four rules and experience shows that unless you follow them, we cannot predict any weight loss results. When patients reach a 'plateau' and stop losing weight, it is usually because they are not following these simple but very important rules!

Protein first every meal: Eat the protein portion of your meal first, very meal! One to three meals per day. Eating protein helps the body to feel 'full' and sends a signal to stop eating. Protein is very important to building tissue in the body — muscle, your organs, your brain — everything is built with proteins. Now, the body does not need three meals a day, so listen to your hunger cues and don't worry about the clock. It the beginning - after you can tolerate solid food - most patients only eat one or two meals a day.

No snacking between meals: Eating anything flavorful or containing calories in between meals is considered snacking. Do not eat between meals at all! If you absolutely have to snack, the only snack that is acceptable is protein. In the beginning, turkey jerky is a good protein — and you must work at it a little to eat it! Later on, after 6 months, beef or venison jerky is acceptable — but only if you just have to eat something. The main problem with snacking on flavorful food is that it contains glucose or some other sugar. We feel good when we eat sugar and when that sugar is gone — one to three hours later — our brain sends a message to snack again! Snacking actually makes us hungrier! Do not open the door to snacking. Snacking will slow down or even stop your weight loss! And depending on how much or how often you snack, you can actually gain weight! Not good! You can get this big again. Remember, the surgery has only changed your digestive system and not your eating habits. Your commitment to a change in lifestyle is the key to making the surgery work for you for the rest of your life.

Drink water: Drink water, drink water, drink water! Especially in the beginning, when you can only tolerate a mouthful at a time, it is so important to continually sip water all day - and make sure you drink 48 to 64 oz. a day minimum - that's 2 to 3 quarts per day. Eventually, you will able to drink 2 to 4 oz. at one time. No tea, soda (with or without sugar), coffee, or juice are allowed. There are a couple of problems with drinking flavorful liquids in between meals. First and most importantly, it encourages snacking — not good! Second, flavored drinks with any sugar can cause dumping — making you very sick!

Exercise: Exercise every day for at least 30 minutes. Walking is fantastic exercise and is probably the easiest way to get started exercising. We understand that in the beginning you may struggle with a simple walk down the hall and that your energy level can be very low. Your job is to move your body a little more every day. At 4 to 8 weeks (everyone is different) you will mostly feel back to normal. After you have been cleared by your physician, you may begin other forms of exercise. Eventually, incorporating both aerobic and resistance training into your daily exercise routine will help you remain healthy - at a healthy weight - for the rest of your life.