Bariatric surgery: your journey from surgery to recovery

You will be instructed to follow a diet before your surgery, often referred to as the 'Liver Reduction Diet' for a minimum of two weeks.

This is a low calorie, low carbohydrate diet, which reduces the size of your liver and allows the surgeon to better access your stomach.

There are two options: a meal replacement option, and a food-based option.

If you are unsure which option to follow, please speak with your Bariatric team.

Please stop eating by 2.30am on the day of your surgery. 

You may drink water, clear squash, black tea, or black coffee (no milk) up until your arrival time.

Arrival

• Enter via the Kings Treatment Centre (KTC).
  
  
• Head to the Elective Hub on Level 3.
  
  
• Colleagues will guide you through pre-surgery checks. Please be prepared for a considerable wait before going to theatre.
  
  

After the operation

You will wake up in the recovery bay. Once you are stable, we will move you to Ward 309 or the Elective Hub. Our team will encourage you to get out of bed and move around shortly after surgery which helps to speed up your recovery.

Our physiotherapy team will help you to recover after your operation, and may use equipment to help you to take a deep breath in and fill your lungs with air (incentive spirometer).

Discharge

You will be discharged once you have been assessed by the surgical team and can drink fluids and pass wind comfortably. This typically takes one or two nights.

Once you are home, your focus is on healing. Here is what you need to know:

Wound care

Your wounds from surgery (keyhole incisions) are glued or stapled shut and covered with dressings. Keep these dry and clean. You may shower 48 hours after surgery but avoid soaking in a bath until the wounds are fully healed. Dressings are removed once the wounds are dry.

Blood thinning

To prevent clots, you may be prescribed blood-thinning injections for a short period. The ward nursing team will teach you (or a relative) how to administer these before you leave the hospital.

Pain management

Some discomfort is normal. Take your prescribed painkillers regularly. If you experience trapped wind (common after abdominal surgery), peppermint tea, Infacol, or walking around can provide relief.

Bowel function

Constipation is common after surgery due to a reduced food intake and a prescription of painkillers. To help relieve the symptoms, stay hydrated and stick to your fluid goals, use the laxatives provided, or contact your GP.

Incentive spirometry

Use an incentive spirometer as recommend by your physiotherapist. This will be provided to you at your pre-operative appointment. This piece of equipment helps "re-inflate" the tiny air sacs in your lungs that naturally deflate during surgery and anaesthesia, helping to clear out mucus and prevent chest infections like pneumonia, which significantly speeds up your recovery.

The following video demonstrates how to use an incentive spirometer correctly.
 

Mobility

It is important to remain mobile once home to reduce the risk of chest infections and blood clots.

For the first 4-6 weeks after surgery, you will follow a post-operative diet. This gives your body time to recover and gives you time to adapt to a new way of eating. 

In the video above, Liz, Dietetic Assistant, talks about the bariatric post-operative diet.

It is vital that you eat in a way that maintains good health, supports recovery, and long-term weight loss following bariatric surgery.

In the video above, Adam explains the dietary changes you will need to make in the long-term.

Eat three meals daily, following a structured pattern

This will help you to get enough nutrients, manage your hunger, and reduce the chance of snacking out of habit which can slow down weight loss. Skipping meals makes it harder to meet nutritional needs.

Avoid overeating

Try to recognise when you start to feel fullness and stop eating once satisfied. Overeating after surgery can cause discomfort, vomiting, or stretch your pouch. Portion control is essential for weight loss.

Limit unplanned snacking, especially on high-calorie, low-nutrient foods

Ask yourself if you're truly hungry or eating out of habit or emotion. Snacking can contribute a lot of extra calories, and many highly processed snacks are easy to overeat after surgery (e.g. crisps, chocolate, biscuits). For non-physical hunger, look for non-food activities. You may need one or two planned protein-rich snacks after surgery to ensure you are getting enough nutrients.

Eat healthy, balanced meals

Balanced meals ensure you're eating the nutrients you need to stay healthy. Aim for half a plate of vegetables, a quarter plate of lean protein, and a quarter plate of complex carbohydrate (e.g. oats, wholegrain pasta or rice, sweet potatoes, whole meal bread, quinoa). Focus on nutrient-dense foods.

Prioritise protein at every meal

Protein is crucial for healing, maintaining muscle, and feeling satisfied after a meal. Eat the protein first and choose lean sources like chicken, fish, red meat, eggs, milk, low fat cheese and yogurt, beans, lentils, tofu and vegetarian meat replacements.

Avoid high-sugar and high-fat foods

They can contribute to weight regain and can cause dumping syndrome. Limit sweets, highly refined carbohydrates (e.g. breakfast cereals, white bread, pastries), fried foods, and creamy sauces.

Eat mindfully and slowly

Take 20 minutes per meal, chewing well (20 times per mouthful, mouthfuls the size of a 20p piece). By taking your time, food is less likely to get stuck, and it will reduce the risk of vomiting. Focus on the taste, texture, and smell of your food. This aids digestion and helps you recognise when you feel full.

Be aware of food intolerances

Your digestive system changes after surgery. Note how your body reacts to different foods. You might feel uncomfortable if you eat too fast or don't chew enough. Sometimes, preparing foods in a different way, e.g. toasting bread, casseroling meat, or overcooking pasta, can also help.

Drink enough fluids and choose low calorie options

Aim for at least two litres daily, prioritising water, sugar-free squashes, teas, and coffee. Minimise sugary drinks, full-fat milk, and alcohol due to the calories and risk of dumping syndrome.

Avoid fizzy drinks

They can stretch your stomach and cause uncomfortable gas and bloating. This includes sparkling water and fizzy alcoholic beverages.

Avoid drinking with your meals

Don't drink for 30 minutes before, during, or after meals. Drinking fills your smaller stomach, leaving less room for food and can cause vomiting. Sip fluids continuously between meals.

When it comes to weight management, our mindset matters. Our bariatric psychology videos are full of practical top tips to help you feel more confident, motivated and supported in your weight management journey, whether or not that includes weight loss surgery.

Feel free to watch them all through or skip to the most important bits for you.

Whilst the benefits of bariatric surgery can be huge, there are common side effects that you should be prepared for.

Dumping syndrome and reactive hypoglycaemia

This is a reaction to eating foods high in sugar or fat, or eating too quickly.

It is more common after a gastric bypass. Symptoms can include nausea, sweating, faintness, light headedness, and diarrhoea.

Hair loss

It is very common to experience thinning or loss of hair three to six months after surgery.

This is a temporary reaction to the stress of surgery and rapid weight loss. Regrowth usually begins once your weight stabilises, but it is important to keep eating healthily to support this.

Excess skin

As you lose weight, you may notice loose skin. This varies depending on your age, genetics, and how much weight is lost.

It is important to prepare yourself for this, and you may wish to seek mental health support if this affects your confidence. Excess skin surgery is not available via the Bariatric service.

Not getting enough nutrients in your diet (micronutrient deficiency)

Whilst you are eating less and absorbing less, there is a risk of not getting enough nutrients in your diet (e.g. iron, vitamin B12, folate, vitamin D, zinc, selenium). This is why your regular blood tests and daily supplements are vital.

Surgery is just the beginning of your journey.

To help you achieve the best long-term results, our specialist team will provide support for two years after your operation.

Your follow-up care will include:

Week two

A dedicated bariatric nurse will call you via phone to check your recovery and surgical wounds.

Week three

A dietetic assistant will call you via phone to help guide you through the first stages of your post-op diet.

Week six

You will speak with a dietitian and a physiotherapist via phone at separate calls to review your weight loss, diet, and mobility.

Longer-term care (6, 12 & 24 months)

There will be calls with a dietitian to monitor your weight management, your diet, symptoms, side effects, and to arrange and review your blood test results.

Additional support

While you do not routinely see surgeons, doctors, or psychologists after surgery, they may be available if you are facing specific surgical, medical, or mental health challenges.

 

After two years

Once you have completed the two-year pathway, your care will be transferred back to your GP for lifelong monitoring of your weight and diet.