I’ll be weighing my food forever: life after gastric bypass surgery

Gastric bypass surgery is not a magic solution for weight loss, it takes resolve and dedication. We compiled the latest research and spoke to a recent recipient of the surgery to shed some light on what it’s like to get gastric bypass surgery in Canada.

The government of Canada reports that 64% of adults over the age of 18 are overweight or obese. As you probably know, obesity is linked with health conditions such as sleep apnea, hypertension and certain types of cancer. Because of that, public health insurance covers gastric bypass surgery (aka bariatric surgery) throughout the country. The surgery can be an effective treatment for many obesity-related conditions, especially type 2 diabetes. Patients with that disease often go home from the surgery and never need to take diabetic medication again. But bariatric surgery is not just about being skinny. It’s a life-changing procedure with many side effects, and some are not as obvious as you might think.

What exactly is it?

Bariatric surgery is for weight loss. There are different types but all involve shrinking a person’s stomach, in effect “bypassing” a large portion of it. Gastric bypass is the most common of these surgeries. It reduces your stomach to a shot glass sized pouch, permanently changing the way you approach eating and drinking.

Eating and drinking post-surgery

Recipients of gastric bypass surgery have a strict dietary regime. They must begin all meals with protein to make sure they’re getting enough of it before they get too full. Doctors discourage eating and drinking together, as this risks stretching the stomach pouch to a much larger size. Patients must also take vitamins for the rest of their lives, as the surgery reduces your body’s ability to absorb what it needs from food. This makes osteoporosis, for example, a major and ongoing concern. Insufficient vitamin intake can also trigger hair loss and anemia.

Doctors also recommend extreme caution when drinking alcohol following the surgery as alcohol poisoning becomes a major risk. After gastric bypass, the stomach is so tiny that alcohol doesn’t have a chance to collect there before absorbing slowly into the body, the way it does with most of us. Instead, it passes almost directly into the bloodstream. This makes the person more intoxicated much more quickly. Something similar called “dumping syndrome” happens when consuming high-fat or high-sugar foods, or eating too quickly post-operation. This is extremely unpleasant and can give the patient nausea, cramping and diarrhea. Dumping syndrome can also induce incontinence, one of the least discussed side effects of the procedure.

Because of all the risk, gastric bypass surgery is only recommended if the benefits outweigh the risks. The guidelines are stringent, and you must pass a number of tests to make sure you are a good candidate. We spoke to Marianne*, a 34-year-old mother of two, who recently had gastric bypass surgery, to see what this procedure is like in Canada.

Why did you decide on gastric bypass surgery?

I’ve struggled with my weight since I was a teenager. I’ve tried every diet and gimmick out there and spent thousands of dollars on diets and I always gain it back.

I had gotten to the point where I was teaching my daughter to ride a bike, and I had to stop because I couldn’t keep up with her. Every morning I was waking up with pain in my ankles to the point where I wouldn’t be able to walk first thing.

I wanted to take my life back. I started researching, and I found out that gastric bypass was covered by my provincial healthcare plan. I knew a friend of a friend who had it five years ago so I started speaking with her and then I went to my doctor.

What did you have to do to prepare?

I went to my doctor on February 1st and she sent the referral to the gastric bypass network. They invited me to my first information session in April. I had to speak twice with a nurse, a dietician and a social worker, to make sure I understood the limits of what the surgery could actually do for me. Once they approved I met with the surgeon. The surgeon gave their approval and then booked me for surgery, and I went in on November 6th.

Can you ever eat again?

I can’t eat as much as I could before — I get full on half a cup of soup now. The hardest thing I find right now is that you have to drink one and a half to two litres of water a day, and you can’t drink for a half hour after eating. You have to eat every two and a half to three hours so it’s tough to fit in all that water, especially because you definitely can’t chug anything.

What have the changes been like so far?

It’s been a major transformation. I’ve lost 17 pounds since surgery three weeks ago, and I lost 10 pounds on the Optifast diet in the week before. So I’ve lost 27 pounds in a month. My weight has started to plateau, I’ve only lost one pound in the last week, but I can’t start working out until my surgeon clears me for that at my six to eight week follow up.

I have zero regrets, but this isn’t a magic cure, and it’s definitely not the easy way out. This is 100% a lifestyle change and you have to prepare yourself for that. I’ll be measuring and weighing the food I eat for the rest of my life. It’s such a long process because they want to make sure you understand how challenging it will be. Even though your appetite is restricted, you have to retrain your brain to look at food differently.

While public perception of these surgeries might be that they’re the “easy way out” when it comes to losing weight, the truth is that gastric bypass surgery is a complete lifestyle change that takes a lot of hard work. Food is central to our lives, from community events to family get-togethers. Recipients of this surgery must navigate challenges on a daily basis, and face serious consequences if they fall back into old habits.

*Name has been changed to protect privacy.