Expectations after surgery:

The weight loss results of gastric bypass surgery are generally good. Most patients lose an average of 10 pounds per month and reach a stable weight 18 - 24 months after surgery. Often, the greatest rate of weight loss occurs in the very beginning (just after the surgery when you are still on a liquid diet).

Losing enough weight as a result of surgery can improve or even relieve many medical problems, such as:

• Asthma
• High blood pressure (hypertension)
• Obstructive sleep apnea
• Stress incontinence

After the surgery, you will need to follow up with your doctor fairly often during the first year. During those visits, your physician will be checking your physical and mental health, including any change in weight and your nutritional needs. You will likely see a dietitian during those visits as well.

The surgery is not a solution by itself. Although it can train you to eat smaller amounts of food and feel full more quickly, you still have to do much of the work. To lose weight and avoid complications from the procedure, you must exercise and eat properly -- according to important, healthy guidelines that your doctor and nutritionist will teach you.

Recovery:

Most people stay in the hospital for a few days or less after gastric bypass surgery. Some may need to stay 4 - 5 days. Your doctor will approve your discharge home once you can do the following:

• Eat liquid and/or pureed food without vomiting
• Move without too much discomfort
• No longer require pain medication given by injection

You will remain on liquid or pureed food for several weeks after the surgery. Even after that time, you will feel full very quickly, sometimes only being able to take a few bites of solid food. This is because the new stomach pouch at first only holds a tablespoonful of food.

The pouch eventually expands. However, it will hold no more than about one cup of chewed food (a normal stomach can hold up to one quart).

Upon follow-up, your doctor will determine if you need replacement of iron, calcium, vitamin B12, or other nutrients. Supplements, such as a multivitamin with minerals, can provide any nutrients that you may not be getting from your diet. This lack of nutrients can occur because you are eating less and because the food moves through your digestive system more quickly.

Once your diet begins to consist of more solid food, remember to chew each bite very slowly and thoroughly.

You will be instructed to eat small meals (usually six meals) often throughout the day, rather than large meals that your stomach cannot handle.

Your new stomach probably wonâ ' t be able to handle both solid food and fluids at the same time. You should separate fluid and food intake by at least 30 minutes and only sip what you are drinking.

You wonâ ' t be able to tolerate large amounts of fat, alcohol, or sugar. You should reduce your fat intake, especially:

• Deep-fried foods
• Fast-food meals
• High-fat foods
• High-sugar foods such as cakes, cookies, and candy

Exercise and the support of others (for example, joining a support group with people who have undergone weight-loss surgery) are extremely important to help you lose weight and maintain that weight loss after gastric bypass.

You can usually start exercising again 6 weeks after the operation. Even sooner than that, you will be able to take short walks at a comfortable pace, with the approval and guidance of your doctor. Exercise improves your metabolism, and both exercise and attending a support group can boost your self-esteem and help you stay motivated.