Before Your Surgery

Prior to having weight loss surgery, it is important to begin making some of the lifestyle changes that will be needed following surgery. Preparing ahead of time will make life less overwhelming after surgery, which can often be challenging enough.

Old habits die hard.  Working to break old habits now can help reduce the stress you  may experience after surgery.

Our surgeon recommends the following for his patients:

1. If you smoke, you need to stop smoking at least one month prior to surgery to decrease your risk of respiratory complications. Smoking can also slow your healing process. If you are considering the gastric bypass procedure you must make the commitment to stop smoking forever.

2. Begin an exercise program now. Losing even 5-10 pounds before your surgery date will be beneficial. After getting medical clearance to do so, begin a walking program, join a gym or begin a yoga or Pilates class. Increase your physical activity each day by doing small things like parking further from the front door at the grocery store and taking the stairs instead of the elevator. Exercising in smaller time increments (three 10-minute sessions, or two 15-minutes sessions) has proven to have health benefits if one 30-minute exercise session can not be achieved. Get to stepping! Exercise is crucial to obtain the best possible weight loss results and for long term weight maintenance. Walking or biking, as well as water aerobics are a great place to start. Everyone has different exercise limitations and start out slowly after checking with your primary care physician first. As you begin losing weight, you should be able to increase your exercise goals. Set small goals that will get you to major goal. Exercise gets easier to do as you begin losing pounds...don't give up!
3. Begin taking an adult chewable multi-vitamin as well as a  calcium supplement containing vitamin D each day, to help prevent vitamin deficiencies and bone loss.
4. Slow down your eating as we exist in a fast-paced society and often consume our meals way too fast. Eating too fast after weight loss surgery may result in food getting stuck, or feeling ill. This could also result in vomiting, complications or additional surgery. You will need to slow down your eating to avoid these unpleasant consequences, or complications.
5. Practice cutting your food into small bites (pinky nail sized). Chew one piece at a time thouroughly before swallowing. This will help to prevent food from getting “stuck” which is uncomfortable and could require a scope procedure to remove whatever is stuck!

6. Practice no drinking fluids while eating your meals, and for 60 minutes following a meal. This will help to prevent premature emptying and over filling of the stomach pouch, which can lead to vomiting and complications. 
7. Learn to eat high-quality protein first at every meal. You will be eating very little food after surgery and every thing you eat will have to count towards optimal nutrition. Protein first! Become familiar with different sources of protein and the number of grams per ounce. Experiment with the different protein shakes and bars. These will be an important part of your diet after surgery when you are unable to eat enough protein starting out. We will wean you off the protein shakes once you are able to eat the required amount of protein needed each day. Adjustable gastric band patients will wean off much protein shakes much sooner than gastric sleeve, or bypass patients.
8. Adequate fluid intake is important . Practice drinking 64 ounces of sugar-free, non-carbonated fluids daily. Water is the best source of fluid, but other calorie-free beverages are acceptable.  A new post-op patient will not be able to drink much fluid and sipping slowly is encouraged. Immediately after surgery, limit consumption of  coffee and tea, which contain caffeine, a diuretic that can quickly lead to dehydration and deplete calcium from your body. 
9. Prior to surgery, patients are required to adhere to a surgeon specific, pre-op low calorie, high protein, low fat, low carbohydrate diet. The purpose of this diet is to help shrink the size of the liver, to keep the surgery as safe as possible. It is not a diet for the sole purpose of losing weight, even though many patients will lose some weight during this time. You will receive a packet which outlines the specifics of this diet prior to starting it.
10. Medication Consideration- Prior to surgery you will need to be prepared to stop, or taper off the following medications as outlined, or as advised by the surgeon. Your primary care physician should guide you in this process to help prevent possible medication withdrawel complications . The surgeon may individualize these requirements based on your specific health history. Typically the following medications are stopped prior to surgery, but always wait until the bariatric surgeon meets with you to discuss before stopping any prescribed medication:
  • Aspirin- stop 10 days before surgery
  • Plavix- stop 10 days before surgery
  • Ibuprofen (Advil, Aleve, Motrin)- stop 7days before surgery
  • Herbal Supplements- stop 30 days before surgery. Herbal supplements are not the same thing as vitamins. Herbal supplements are items such as Kava Kava, St. John’s Wort and Saw Palmetto, to name just a few. Please check with a pharmacist if you are not sure.  

11. Take the time to observe your eating behaviors before surgery. Do you eat out of boredom, stress, mood fluctuations, depression or other emotions? Are you an emotional eater, seeking out sweets or snacks ("mood foods") when a certain mood hits? If so, how will you address these behaviors following your surgery? Devise some alternatives and write them down so you have a written plan as to how you will address these emotions when they occur. Food journaling is an excellent way to identify emotional eating and food trigger situations. Some patients may benefit from pre and post operative behavior counseling.    

12. Make some high protein recipe meal cards and get ready for a high protein way of eating. Get rid of junk food and replace chips with jerky or nuts. Go through your cabintes or pantry and restock.
13. Research protein shake mixes and start experimenting now. Learn how to enhance the protein shake flavor for variety after surgery. Protein shake mix can be purchased at grocery and discount stores, pharmacies and on the internet.
14. Consider the purchase of a food saver so that you can purchase family sized packs of meat and then freeze in individual portion sizes.
15. If you don't already have one, consider the purchase of a crock pot. It will be a great time saver and you can make great protein rich recipes using a crock pot.
16. Learn to relax and take time for yourself. Learn to say no, and schedule yourself for daily exercise. Involve the family in house cleaning (delegate) and other chores to free up some time for yourself.
17. Start attending our free patient support group meetings. Whether you are a pre-op or post-op patient, you will learn from others who have already had surgery. Call our office for the support meeting schedule.
18. Follow-up appointments are required to help you in your goal to optimal weight and wellness.