The first year after weight loss surgery brings big changes, most of them good. Knowing what is normal at each stage helps you stay on track and know when to call us. Everyone heals at their own pace, so use this as a general guide and follow the instructions your care team gives you.
The first week
- Going home: most sleeve patients go home the same day or after up to 1 day in the hospital. Most bypass patients go home in 1–2 days.
- Moving: get up every hour while awake and walk a few laps around the house. Use your breathing exerciser as instructed. This eases gas pain and lowers the risk of blood clots.
- Drinking: aim for at least 48 ounces of fluid a day for women and 64 ounces for men, sipping slowly all day.
- Eating: clear liquids for days 1–3, then full liquids such as protein shakes through day 14.
- What is normal: soreness, some nausea, and chest or shoulder pain from the gas used during surgery.
Weeks 2 to 6
- Most patients return to work within about a week. Physical jobs may need more time or light duty.
- No lifting more than 10 pounds for the first 2 weeks.
- Wear your abdominal binder for the first month, except while sleeping.
- Move to pureed foods in weeks 3–4 and soft foods in weeks 5–6.
Months 2 to 3
Most patients start regular, solid foods around week 7, in small portions with protein first. Weight usually comes off fastest in these early months. It is common to feel tired at times while your body adjusts to eating much less.
Some patients notice hair thinning around 3 to 6 months after surgery. It is usually temporary, and getting enough protein and taking your vitamins every day helps.
Months 4 to 6
This is a good time to build an exercise routine: about 30 minutes of moderate exercise, four days a week, mixing cardio with strength training to protect your muscle. You will also notice the changes in daily life: climbing stairs, buying smaller clothes, and often needing fewer medications for conditions like high blood pressure.
Emotional changes are common too. If food was a way of coping with stress, you may need new ways to deal with it. Talk with our team if you are struggling. You do not have to manage it alone.
Months 6 to 12
Weight loss gradually slows. Plateaus, when the scale does not move for a few weeks, are normal and are not a sign that surgery has stopped working. Most patients reach their lowest weight 12 to 18 months after surgery. Women who may become pregnant are usually advised to wait 12 to 18 months after surgery, so talk with us about birth control.
Your follow-up visits
In the first year, follow-up visits usually take place at 1 week, 1 month, 3 months, 6 months and 12 months after surgery. After that, visits are yearly or as needed. These visits track your progress, check for vitamin deficiencies and adjust your diet and medications.
Setting realistic expectations
- Weight loss is not a straight line. Some weeks you will lose more than others.
- Loose skin can develop after major weight loss. Some patients later choose body contouring surgery.
- Old eating habits can creep back over time. Regular follow-up and support help you stay on track.
- Vitamins and a protein-focused diet are for life, not just the first year.
When to call us
Call 281-653-6544 right away if you have a fever above 100.1°F with chills, severe belly pain that pain medication does not relieve, chest pain or shortness of breath, vomiting that does not stop, or pain and swelling in a leg. See the full list in our discharge instructions.
Related reading
- Gastric Sleeve vs. Gastric Bypass
- GLP-1 Medication vs. Weight Loss Surgery
- GLP-1 Medication vs. Surgery: Which Costs Less?
- Does Insurance Cover Weight Loss Surgery in Texas?
- Weight Loss Surgery and Type 2 Diabetes
- How to Prepare for Weight Loss Surgery
- Diet After Bariatric Surgery: What You Need to Know
- Am I a Candidate for Weight Loss Surgery?
Sources
- Mechanick JI, et al. Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures, 2019 Update (AACE/TOS/ASMBS/OMA/ASA). Surg Obes Relat Dis. 2020;16(2):175-247.
- American Society for Metabolic and Bariatric Surgery (ASMBS), Life After Bariatric Surgery, asmbs.org.
- Houston Surgical Weight Loss After Surgery, Discharge Instructions, Pre-Op and Post-Op Diet and Exercise Regimens pages.
This article is general information, not medical advice. Talk with your doctor about what is right for you.