Can I get pregnant after weight loss surgery?
In case you have wondered how safe it is to have a baby after bariatric surgery, the answer is that pregnancy is actually safer after mom has lost a considerable amount of excess body weight following Gastric Bypass or Adjustable Gastric Banding.  It is best to wait to conceive 12 to 18 months after your surgery or at least until your weight has started to stabilize.  Bariatric surgery, in general, decreases complication risks for both mom and baby.  However, there are still some potential risks that you should discuss with your bariatric surgeon and your OB/GYN provider.

Pregnancy within three to six months after surgery can present major challenges that may require aggressive feeding methods and should be discussed with your doctors to ensure that the fetus is receiving adequate nutrients.

How much weight should you gain during pregnancy?
The amount of weight you should gain depends on how much you weigh when you become pregnant.  Ask one of your healthcare providers or find a BMI calculator to determine your BMI at the beginning of your pregnancy.  Here are the guidelines concerning adequate weight gain; however, be sure to discuss these numbers with your bariatric team and OB/GYN provider.

BMI less than 19.8            Gain 28 to 40 pounds
BMI 19.8 to 26                   Gain 25 to 35 pounds
BMI 26 to 29                      Gain 15 to 25 pounds
BMI greater than 29         Gain 11 to 20 pounds

Studies have shown that adequate fetal growth is still achieved with very little to no weight gain in women who still have a significant amount of weight to lose (BMI greater than 40).  Close communication with your obstetric and bariatric teams is absolutely essential.

Negative Calorie Balance

Weight loss is primarily achieved through negative calorie balance.  Negative calorie balance refers to burning more calories than you eat in a day.  Your body can naturally burn roughly 1,000 calories per day but that number can be very different from person to person depending on height and gender, so do not assume that that is your own magic number.  The natural amount of calories your body burns just from being alive plus the number of calories you burn during exercise should be greater than the number of calories you eat per day.

If you are trying to lose weight, cutting the number of calories your body uses to maintain weight by 200 per day and exercising for 30 minutes on most days of the week is an excellent goal.  In general, gastric banding patients are told to eat no less than 1,000 calories, but please speak with your dietician to ensure that this is an adequate number for you.  If you are shorter or taller than average, this number is probably different.  Eating less than 1,000 calories per day will inhibit your body from being able to burn adequate calories for weight loss.

For our patients, remember that you will see the dietician at each of your appointments.  Should you have any questions about your calorie intake she will be able to assist you.

For those patients who choose a Gastric banding procedure, adjustments will be necessary. As you may remember, the gastric band is “empty” when it is originally placed around your stomach. By “empty” we mean that there is not any saline in the portion of the bag that can change size and taper the upper portion of your stomach.

When you go in for adjustments, saline will be inserted into the gastric band through the port in your abdomen. The saline fills the expandable portion of the gastric band and changes the size of the upper portion of your stomach, thereby helping you to control your food intake. You will be scheduled to come in for your first gastric band adjustment four weeks after your surgery, unless your doctor tells you otherwise. In general, gastric band adjustments will be performed when you come on for a checkup with us. You will have multiple adjustments over the first year or two, until we work together to target the best fit for your body. Do not worry: the process is fast, easy and pain free. Our experienced staff performs gastric band adjustments regularly so you are in good hands.

After an adjustment you will need to expect some things. Nothing major, just guidelines that you will need to follow to stay on track.

Diet

Immediately after an adjustment you will have to follow a specific diet. It will remind you of the diet you followed initially after surgery, but it will move much faster from a time standpoint. Follow this diet exactly so that your body has time to adjust to the change in the size of your gastric band.

• Liquid Diet (first two days)- This stage begins immediately after your adjustment. For the first few hours (or up to a day) you will want to drink clear liquids. Soon you will be back to your favorite bariatric liquids until the end of this stage. Remember to drink 64 ounces a day and to include your proteins. Skim milk and doctor approved protein shakes are great choices.
• Soft Foods ( days 3 and 4)- The next stage puts you back on soft foods. You will be eating three meals a day and still drinking your 64 ounces of liquid in between meals. Remember to include protein, so have a shake if you need to. Try some tasty soft foods like:
  • Avocado
  • Sweet Potato
  • Egg Whites
  • Cottage Cheese
  • Skinless Steamed Veggies

Keep in mind that your stomach may still be adjusting in general. Stick to foods that you know agree with you. If you want to try a new food, we suggest adding the new food into your diet slowly. We also suggest that you wait until in between adjustments to expand your diet; you do not want to give your stomach too much change all at the same time.

Make Sure the Adjustment was Correct

Once the band is adjusted, you will need to pay attention to ensure a good fit. A band that is too tight can make you uncomfortable. Come back and see us for a readjustment if you are experiencing:

• Difficulty swallowing
• Regular heart burn
• Regurgitation
• Coughing fits that wake you up

Most often the adjustments you will receive are correct. Keep in mind that band adjustments are a process that takes time and communication between you and your medical staff. Every person is a little different, and as a result every adjustment is, too. With time and communication, your doctor will find the right saline levels for your comfort and weight loss goals.

Time for Another Adjustment

After your adjustment you will need to watch for some changes that tell you it is time for another. When you see these signs, you are in the “Green Zone” as we like to call it.

• Feeling hungry in between 3 balanced meals even though you are still drinking 64 ounces of fluids a day
• Increased ability to eat larger quantities of food without feeling full
• You stop gradual weight loss of 1 to 2 pounds a week

If you have any questions about maintaining weight loss after your bariatric surgery or if you would like to find out more about the procedures and how they can help you visit us.

Sources:
University of California San Diego Medical Center
Lap Band Surgery Site.com

Related Posts:
Maintaining Weight Loss
Avoiding Unexpected Sickness after Surgery
Signs You May Need a Gastric Band Adjustment