Bariatric Surgery Myths – BUSTED (Part 1)
Myth #1: you have to do a liquid diet for weeks prior to surgery. FALSE
The dreaded “bariatric pre-op diet.” This is commonly understood to be at least 2 weeks of an all liquid diet prior to surgery. This is FALSE at our practice. For the vast majority of our patients, an all liquid diet is not required before surgery. Instead, our patients adhere to a high protein, low calorie, low fat diet prior to surgery. This often includes meals of protein drinks and salads, or protein drinks and chicken breast. We avoid fast foods or fried foods and try to stay low calorie.
The purpose of these pre-operative diets is mainly to reduce the size of the liver. Previously, especially when operating laparoscopically, large livers were very problematic and could lead to a cancellation of surgery intra-operatively. However, these all liquid diets were not benign, as many people would actually become dehydrated or hypoglycemic. Our patients do NOT need to incur this added risk. Since we do all our surgery robotically, we can operate in much smaller spaces and therefore can be more tolerant of the variety of liver sizes. Therefgore, our less stringent pre-operative diet still accomplishes the required reduction in the liver sizer without all the complications associated with an all liquid diet.
Myth #2: you can never have alcohol after surgery. FALSE
There are so many things to celebrate after bariatric surgery. Patients can absolutely have a glass of wine or a beer if they choose to help celebrate!
Initially after surgery, we do tell patients to avoid alcohol, as their bodies are just adjusting to their new anatomy and we need to ensure that everything that goes down is a protein packed nutrient. However, after the initial healing period is over, patients are allowed to slowly reintroduce alcohol back into their lives. However, many bariatric patients find themselves to be a “lightweight” after surgery, in that alcohol affects them much faster and stronger than previously. This is because the body will metabolize the alcohol faster, there is less body mass, and there is also less int eh stomach to help absorb the alcohol. Therefore, patients should try alcohol again for the first time after surgery at home and in a controlled environment. Given the higher effect of alcohol, there is a higher chance of alcohol abuse after bariatric surgery, so moderation is key. However, a toast to all your bariatric successes is absolutely allowed!
Myth #3: NSAIDs are not allowed after any kind of bariatric surgery. FALSE
Nonsteroidal anti-inflammatory drugs (NSAIDs), like Motrin or Aleve, are actually allowed after the majority of bariatric surgery types. In patient with a Roux-en-Y gastric bypass (RYGB), NSAIDs are never allowed. This is due to the increased risk of ulcer formation in a RYGB patient.
However, any patient with a sleeve gastrectomy, a SADI-S, or BPD-DS is ALLOWED to take NSAIDs after the initial healing process. Patients can typically resume NSAIDs in moderation about 6 weeks after surgery. Moderation is again key, as NSAIDs can still cause stomach irritation if taken too frequently or in too large doses. However the occasional NSAIDs for minor aches is completely fine after a sleeve gastrectomy. This is great news, as many of our patients have arthritis or back pain.
Stay tuned for the more myth busting. The above represents the opinions and protocols of our practice based on research and our patient experiences. This above may not match the protocols of your surgeon so always consult your individual bariatric surgeon first!
