UNC Health Talk

5 Tips to Prepare for Life After Weight-Loss Surgery

If you and your doctor agree that you are a candidate for weight-loss surgery—also called bariatric surgery—you may wonder what to expect.

There are three minimally invasive procedures for surgical weight loss: gastric sleeve, Roux-en Y/gastric bypass and the duodenal switch. The procedure you have will depend on how much weight you need to lose to get down to a healthy weight and the medical problems your surgery needs to address.

These procedures can be an effective way to lose weight and address health issues such as high blood pressure, type 2 diabetes, infertility, high cholesterol or sleep apnea, but bariatric surgery is a life-changing decision that comes with its own challenges, both physical and emotional.

To learn more, we talked to UNC Health dietitian Mary Gray Hixson, MPH, RD, and UNC Health clinical psychologist Clinton Bolton III, PhD, who provide services to bariatric patients with UNC Rex Bariatric Specialists.

They offered these five tips for how to prepare for life after weight-loss surgery.

1. Wean yourself off caffeine, bread, rice and pasta.

Caffeine can irritate your stomach right after weight-loss surgery, so it’s a good idea to work toward eliminating it prior to your surgery.

“While your stomach is healing after surgery, we advise against any caffeine,” Hixson says.

Rest assured, after a couple of months, you can add that favorite cup of joe back to your daily routine.

You may want to try to reduce or eliminate bread, rice and pasta before your surgery, because they are not recommended after surgery. These carbohydrate sources tend to swell and create a heavy, uncomfortable feeling in your stomach.

“I always get the question about, ‘Well, what if it’s brown rice, or what if it’s wild rice,’ and it’s going to swell regardless, so those foods have to be eliminated in preparation for surgery. Practice avoiding bread, rice and pasta, because they’re such a staple in virtually everyone’s diet, regardless of how you grew up or what culture,” Hixson says. “Start working on changes now because you can’t expect to wake up from surgery and know every product in the grocery store that’s going to be appropriate for you.”

Instead, try cauliflower rice, broccoli rice or hearts of palm rice. If you’re craving pasta, try making zucchini noodles (often called zoodles).

2. Reduce your sugar and fat intake.

After surgery, you’ll need to keep your sugars and fats down to less than 5 grams per serving. Excess sugar in your diet after weight-loss surgery can cause a condition called dumping syndrome, which is a rapid emptying of sugars from your stomach into your small intestine.

“Your body doesn’t recognize the sugar in the intestines and you end up with bloating, low blood sugar and diarrhea,” Hixson says. “You want to really try to avoid sugars before surgery.”

You also need to keep your consumption of fat down because weight-loss surgery makes it harder for you to digest and absorb fat. Your dietary focus should be on protein, Hixson says.  The goal is to consume 60 to 120 grams of protein per day. For example, one large egg contains 7 grams of protein, and 2 ounces of chicken contains 14 grams of protein. Greek yogurt has between 10 and 15 grams of protein per half cup.

3. Remember that you’ll fill up fast.

Immediately after surgery, be prepared to feel extremely full, because your stomach capacity has been greatly reduced. You’ll also experience swelling in your stomach after surgery.

“Be prepared to be able to consume one-quarter cup to one-half cup volume of food at one time immediately after surgery,” Hixson says. “We recommend sipping on 1 to 2 ounces of fluid every 15 minutes, apart from meals, to reach fluid goals as well.”

4. Understand that your relationship with food will change.

Often, patients don’t fully understand the role food has played in their lives until after they’ve had the surgery.

“You really don’t know the extent of your relationship with food until after surgery because you have to be a lot more cautious and aware of your eating because of the dietary restrictions,” Dr. Bolton says.

This can lead to dealing with emotions that were previously avoided because food was used as a coping strategy.

“We now can unearth many emotions such as anger, resentment, overwhelming stress, depression … because a lot of times food is used to cope,” Dr. Bolton says. “So one of the things we work on is putting in place healthy coping strategies so that there isn’t that big gap in coping when the relationship with food changes.”

5. Keep in mind it’s normal to feel an array of emotions.

After weight-loss surgery, it’s common to have a wide range of feelings and emotions—often at the same time.

“Whether it’s excitement, nervousness, sadness, grief from the loss of food, or confusion, you’re going to feel something,” Dr. Bolton says.

While mental health treatment and counseling are often part of your treatment plan prior to weight-loss surgery, make sure you are getting mental health treatment and support after surgery, too.

“The surgery may be a few hours, but recognize this is a lifestyle change,” Dr. Bolton says. “And like with any lifestyle change, you have to make sure you are doing your follow-ups and seeing this as a true lifestyle change and not just a moment where you have surgery.”


If you think bariatric surgery may be right for you or to learn more, attend a weight-loss surgery seminar at UNC Rex or at UNC Medical Center.