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.

Mobility

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

For the first four to six 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.

Once you have completed the post-operative diet, you should transition to a long-term approach to eating. We recommend establishing "dietary goals for success" early in your recovery.

How to eat

• Aim for three distinct meals a day. Avoid grazing.
  
  
• Eat mindfully and slowly (aim for 20 minutes per meal). Chew thoroughly.
  
  
• Listen to your body and stop eating before you feel "full." Avoid overeating.

What to eat

• Choose healthy, balanced meals over highly processed options.
  
  
• Always eat your protein source first to preserve muscle mass.
  
  
• Avoid foods high in sugar and fat to prevent vomiting, diarrhoea and weight regain.
  
  
• Limit unplanned snacking. If you snack, choose nutrient and protein-rich options.

Fluids and vitamins

• Do not drink and eat at the same time. Stop drinking 30 minutes before a meal and wait 30 minutes after.
  
  
• Drink enough fluids throughout the day, choosing low-calorie, non-fizzy options.
  
  
• Commit to your vitamin and mineral supplements for life.

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.

Using an Incentive Spirometer

The following video demonstrates how to use an Incentive Spirometer correctly. You will be provided with one of these at your pre-op appointment or on the day of your surgery.
 

Patient information leaflets

View our patient information leaflets on physiotherapy after bariatric surgery >

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.