Your guide after weight-loss surgery

Pain is worst in the first hours, and you receive intravenous pain relief in hospital. It eases a lot on days two and three and is nearly gone by the end of the first week. Walking and moving reduce pain.

New, sudden pain, or pain that gets worse instead of better: call us.

Common in the first days and may last two weeks, due to anaesthesia, medicines, acid, dehydration, or eating and drinking too fast.

• Drink in small sips, the way you'd sip a black coffee.
• Stop immediately when you feel full or sick.
• Don't wait until you're very thirsty or hungry.
• Avoid acidic and spicy food, and don't eat and drink together.
• Take your stomach medicine regularly, and the anti-sickness tablet when needed.
• If you vomit after moving to a new stage, go back to the previous one.

Repeated vomiting that stops you drinking for a whole day, or comes with numbness or confusion: call us immediately, as it can cause severe vitamin B1 deficiency.

Walking straight after surgery helps clear trapped wind. Trapped wind often goes with constipation, so treating constipation helps. Rumbling comes from the bowel adjusting to the new diet and is normal.

With so little food, opening your bowels every two or three days is normal.

• Drink water regularly between meals; it is the best remedy.
• Walking and moving stimulate the bowel.
• If it continues beyond 6 weeks, add more vegetables and fruit and ask us about a suitable laxative.

• Don't drink while eating.
• Cut down caffeine, tea and instant coffee, and stop smoking.
• Avoid sugars, fats and spicy food.
• Lactose in milk may be the cause; try lactose-free milk.
• If it starts after moving to a new stage, go back to the previous one.

Diarrhoea lasting more than a few days, or with fever or dehydration: call us, you may need a stool test.

• Take your stomach medicine regularly; it protects against inflammation and ulcers.
• Stop smoking; it increases acid and ulcer risk.
• Avoid caffeine, chocolate and spicy food, and very hot or very cold food.
• Don't eat right before bed.

Normal in the first weeks because of low calories, dehydration and the strain of surgery. Energy returns gradually with the soft-food stage. Drink regularly, sleep early, and keep up your protein and vitamins.

Signs: tiredness, dizziness, headache, passing little urine, and dark urine. Carry water wherever you go and sip constantly, especially while walking.

Common for a short while due to low fluid intake. Drink steadily and keep your mouth and teeth clean. If a white coating appears on your tongue, tell us, as you may need treatment for thrush.

The stomach makes more mucus while it heals, and some may come up for a while. It usually settles by the third month. Drinking warm water half an hour before eating helps.

If you cannot swallow your saliva at all, this is not normal: call us.

Usually caused by eating too fast, not chewing enough, a large bite, or dry food. You feel pain high in the abdomen, extra saliva, and sometimes vomit.

• Stop eating, relax and breathe slowly.
• Sip warm water in small amounts.
• Don't eat for 4 to 6 hours.
• Next time: chew each bite for about a minute and avoid dry or tough food.

If symptoms continue or you can't swallow your saliva: call us.

Some people get numbness in the legs in the second or third month from inactivity or long sitting, and it can also be a sign of low B vitamins. Keep taking your vitamins, move regularly, and avoid sitting cross-legged.

Numbness with repeated vomiting, confusion or difficulty walking: call us immediately. Swelling and pain in one leg: call us immediately, it may be a clot.

Periods coming early or late is common after any major operation and rapid weight loss, and settles gradually. Note that fertility rises as weight falls, so read the pregnancy question in the FAQ.

Weight falls gradually over the first year, fastest in the early months. The operation isn't a miracle; it's a tool that makes it easier to stick to your diet and change your lifestyle.

Yes. From around week 7 you eat normal food, but portions will be much smaller and you'll feel full after a few bites. Some harder foods like tough meat, dry bread and nuts may take up to 3 months.

Tell your doctor about all your medicines. Blood-pressure and diabetes medicines are often reduced or stopped after surgery, so don't change them yourself and monitor your blood pressure and sugar. Large tablets may need a liquid or chewable alternative in the first weeks.

Usually after a week, as long as pain doesn't limit your movement and you aren't taking painkillers that make you drowsy.

One month after surgery, because swallowing it by accident could block the narrow stomach passage.

We recommend waiting 12 to 18 months until your weight is stable and your vitamin levels have recovered. Fertility rises after weight loss, so use effective contraception. The contraceptive pill may be absorbed less well, especially after bypass, so a coil (IUD) or condoms are preferred.

Yes, loss of appetite doesn't last forever. Drink between meals, start eating at the first sign of hunger rather than waiting until it's strong, and cut down on sugars and white starches, as they cause sudden hunger soon after.

12 to 18 months after surgery, once your weight is stable. Regular exercise from the start reduces loose skin.

About 70 to 85% of the stomach is removed laparoscopically through 4 to 5 small incisions under general anaesthesia. The part that produces the hunger hormone (ghrelin) is removed with it, so you eat less and feel less hungry.

A narrow tube is made from the stomach and joined to the small bowel 150 to 200 cm from its start. You eat less, and part of the food isn't absorbed. It gives strong improvements in type 2 diabetes and blood pressure.

The upper stomach is divided to make a small pouch joined to the small bowel, with a second join between bowel loops. It reduces how much you eat and changes gut hormones to increase fullness and reduce hunger, and helps treat diabetes and reflux.

A previous operation may need revision if it didn't succeed, such as a gastric band, stomach stapling or gastric plication, or because the stomach has stretched. These operations need a surgeon specialised and experienced in obesity surgery.