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Weight Loss Surgery Side Effects and Complications in Lebanon: these include the side effects and complications for the gastric sleeve surgery, the gastric bypass surgery, the gastric plication (LGCP) surgery and the gastric band (ring) surgery.

Anorexia, Fear of Gaining Weight
To begin with, you must be very realistic about what your weight should actually be. Do not try to be that skinny person; try instead to be a fit, average, healthy, person. What are the real reasons for your bad eating habits? It is not a weakness to ask for help – in fact it is quite the opposite. The fact that you are taking positive action is a sign of strength.
Constipation
Unfortunately, constipation is experienced by most patients, due to the two-week Optifast diet prescribed pre-surgery, and the low-fiber diet for the 35 days post-surgery. You must drink sufficient water by taking regular sips, to prevent dehydration and constipation. You can add fiber supplements to your constipation prevention regime. On the long term, you should be aiming to increase your intake of high-fiber foods such as fresh fruits, bran, vegetables, prune juice and prunes, cereals, and whole-grain breads. Plus, remember to get enough exercise.
Your Body Is Not Receiving Enough Fluids, Dehydration
You will know if your body is dehydrated because your urine will be a dark yellow and will smell strong. Other symptoms include dry mouth and skin, small amounts when urinating, feeling unwell and tired. You must try to drink at least 1.5 to 2 litres of water per day – sip throughout the day until your urine returns to a normal colour – this should happen within a day.
Irritability, Depression, Poor Tolerance of Other People
Take your prescribed minerals and vitamins – consume a well-balanced diet – get a minimum of eight hours sleep every night – walk and exercise each and every day. You must make positive changes in your new life, so any new change is a great start. Do not be afraid to discuss your worries or concerns with a friend or trusted family member. There may be a bariatric support group you could attend. Gone are the days when you can relieve your stress by eating: you have to develop new strategies to relieve stress. This is going to take some time and instant relief is probably not in sight. You may decide to have counselling, talk to the bariatric nurse or your doctor. You will soon discover new ways to manage life’s problems.
Dumping Syndrome (Only Gastric Bypass Patients)
This occurs if a patient has consumed a meal that is too high in sugar. Your symptoms may include abdominal pain, cramping, nausea, heart palpitations, sweating, and diarrhoea. This promotes weight loss by discouraging patients from consuming these types of foods. In addition, do not eat high carbohydrate solid foods and drink liquids at the same time. Dumping will also occur if you rapidly consume high calorie foods such as milk shakes.
Frequent Bowel Movements
Greatly reduce the amount of sweetened foods like fruit juices, soft drinks, chocolates, candies, cakes, pastries, cookies, or any other sugar-containing foods. Artificially sweetened foods and artificial sweeteners do not cause this problem with bowel movements. You should also limit your intake of fried foods and other high-in-fat foods like potato chips, cheese, cakes, gravy and mayonnaise. Any new foods should be added in small amounts to ensure that you know what foods you can tolerate, and how much, without any resultant problems.
Drinking Milk, Followed by bloating and gas
Should you experience these symptoms then there is every possibility that you are lactose intolerant – meaning you cannot digest the sugar in milk. There are many replacements for regular milk, such as low fat and fat-free milk. Your symptoms could be reduced if you consume smaller amounts of dairy products. Buttermilk, yogurt and cheese are usually tolerated better. Your intolerance of lactose could be temporary; you may be able to re-introduce small amounts of normal milk later. Discuss any of these issues with your bariatric surgery clinic or your dietitian.
Loss of Hair
You may experience hair loss somewhere around 3 – 5 months post-surgery. Continue with your vitamin regime on a regular basis, and make sure you are consuming a minimum of 70 grams of protein each day. Do some research and learn which foods are protein-rich. Drink a minimum of two 236 ml glasses of 1% or skim milk every day. Should the hair loss continue, try a fat and sugar-free protein powder supplement; however, you should discuss this with your bariatric nutritionist.
Heartburn
Heartburn is that horrible burning feeling in your stomach. This is caused by vomiting and food intolerances. Avoid tea, coffee, alcohol, soft drinks, red and black pepper, spicy foods, and any other foods that could create a burning sensation. Do not eat foods that are very hot or very cold, and make sure that you eat regularly. You could, if you prefer, have six very small meals per day. You certainly should not smoke! It will give you a powerful burning sensation in your stomach. If you feel a lot of acidity, try nibbling on some antacid tablets or crackers. Do not take antacids such as Milk of Magnesia more than twice per day. For headaches and pain use Tylenol or other non-aspirin products. If you have articular pains, non-steroidal anti-inflammatory drugs are not recommended, because they can cause ulcers and irritation at the exit of your new, small gastric pouch. These NSAIDs include ibuprofen, celebrex, indocid, aspirin, Naprosyn and novo-defenac, to name a few. If in doubt, consult your doctor.
Hunger
Hunger is a strong urge to eat more than you should. Even if you have not finished your meal, if you start to feel full then stop eating. Your food portions should be measured, and you only eat that amount. Do not rely on guess-work. Count your calories. You do not want to become a nibbler or compulsive eater again. Try to understand why you have these cravings, and engage yourself in another activity to stop the thoughts of food. Only eat regular meals, and do not give in to your cravings. Be kind to yourself, and give yourself rewards when you overcome these feelings. Go to a movie, or something unrelated to food. A lot of women are hungrier before their menstrual cycle, so compare your desire to eat with the timing of your menstrual cycle and see if you can spot the difference between a normal increase in hunger and your old hunger feelings.
Can’t Keep Liquids or Foods Down
You cannot over-eat or drink too much. Chew slowly; overcook your vegetables, rice and pasta. Do not drink liquids and eat solid foods at the same time. Your vitamins and medications should be crushed into a powder if they are larger than the size of a normal aspirin. Take them with some unsweetened apple sauce. If you are unable to eat food, sip some bouillon, water, fruit juice or any liquid at all to ensure you do not become dehydrated. Get help if you are having problems keeping liquids down. Should you vomit blood, immediately go to the hospital.
Not Losing Weight
Avoid at all costs foods that contain only calories and no other good nutrients, and stay away from junk food. Be aware of what and how much you are consuming. Limit your portions; do not just swallow your food without tasting and enjoying it, and remember to chew your food thoroughly. Avoid snacking, and exercise regularly. Do whatever it takes to keep your motivation strong, and remember your weight loss goals. Have you worked out why you overeat? You can make a change this very day. Try talking to a counsellor or going to a bariatric support group. Taking any kind of positive action like these suggestions is a great step forward. Your band may require an adjustment if you have had Adjustable Gastric Banding surgery, because you will be losing weight around the upper stomach area.
Leg Cramping
Consume a well-balanced diet. Vegetables and milk products are essential. Take your vitamins each and every day. Do not sit in the same positon for a long period of time. Do not ever cross your legs, and should your legs become swollen, rest on a bed or sofa with your legs elevated above your heart.
Feeling Light-Headed
This may occur when you have skipped a meal or if there has been a long delay between meals. It is really important that you eat regularly. Do not consume alcohol. If you are starting to feel shaky, or a little dizzy, eat some soda crackers. Do not eat chocolate or candy. Try a starch and protein snack, like cheese and crackers or half a meat sandwich. Remember to chew it really well.
Monotonous Diet
It is important that you maintain a positive attitude, and try to always remember that this weight loss strategy will be successful. Continue eating a well-balanced diet and your appearance will change: this in turn will affect your self-esteem. Read anything you can find for new recipes and different ideas for food preparation. Most importantly, talk to others who have been successful – how did they cope when they felt discouraged?
Nausea or Chest Heaviness Following Eating
You should only eat until you feel full. When you first feel nauseous, do not drink anything at all. Nibble on some dry soda crackers, and when you feel a little better you could have some chicken soup with soda crackers, and warm tea.
Bloating After Eating
Only eat until you reach the point of feeling full, and do not drink with your meals. Try out different foods in very small amounts. As soon as you begin to feel uncomfortable, eliminate the new food that caused the problem, and then proceed cautiously. Exercising is very important and should be continued on a regular basis: exercising helps eliminate gas that could be building up. If this specific problem continues occurring after each meal then you should make an appointment to visit your bariatric surgery team.
Feeling Overly Weak or Tired
Again, it all comes down to a well-balanced diet. Try increasing your protein intake and vegetables and fruit. You should plan to include iron in one serving of food in your daily eating schedule. Continue taking the minerals and vitamins that were prescribed. Caffeine consumption should be limited to 1 or 2 cups per day, and this includes tea, regular coffee, cola drinks and chocolate. Ensure that you are getting a full eight hours sleep each night. Most importantly, do not try to be superwoman or superman. Do not try to resolve other people’s problems, and be realistic about your own capabilities at this time. You need all your energy to take care of yourself.
Abdominal Pain and/or Cramps, Very Tired Following a Meal, or Watery Stools
For any of these issues you should avoid consuming food high in sugar and fat. If you have diarrhoea, avoid milk products, sweet drinks and foods, fruit juices, fatty foods, and spicy foods. Your liquids should be slowly sipped, quarter to half cup per hour. Start eating the foods that you ate following your operation. Some examples of easy-to-eat foods are cream of wheat, oatmeal, bananas, rice, toast and tea, and applesauce. Once you begin feeling better go back to the liquid meals, and when you feel ready again, advance your diet.
Infection of the Wound
If you are experiencing any issues with your wound, such as pain, redness, heat when touched, you could have an infection in your wound. This occurs with about 4% of patients who have adjustable gastric banding. If you notice that your port site incision is quite painful, hot to touch, or quite red, you may have a port site infection. More seriously, if your wound is oozing smelly liquid or blood, or your temperature is more than 38.5 degrees Celsius, get in touch with your bariatric surgery team immediately.
You Cannot Eat Like Everyone Else
Remember that you cannot eat like other people, and that is just how the surgery works. You know that your operation will restrict the amount and types of food that you can eat, and that if you stretch your new stomach you will not achieve your weight loss goals. This will happen if you consume more food than will comfortably fit in your new, small stomach. Try to stay focused on your new outward appearance and your goal of a fit and healthy body.
THE FIRST TWO WEEKS DANGER SIGNS
  • Abdominal pain that is not relieved by Tylenol
  • A temperature of over 38.5 degrees Celsius
  • Vomiting blood
  • Being very short of breath while doing minimal activity
  • Warm and painfully swollen calves
  • General feeling of uneasiness