Aftercare

After an obesity operation (bariatric surgery) the aftercare in the first year should be regular and continuous. Later the number of medical examinations can be reduced. Problems or lacks of vitamins can thus be diagnosed and treated promptly. A team of experts helps with all the life style changes.

Nachsorge-Ernährungsberatung
Consultations about nutrition is very important before and after bariatric surgery. (Photo: IFB Adiposity)

After a surgical intervention (bariatric surgery) a lifelong aftercare in the obesity outpatient clinic of the IFB or via a cooperating resident doctor is necessary. The aftercare includes a schedule with six medical appointments in the first year after the surgery, two appointments in the second year and afterwards an annual consultation. In the aftercare appointments different investigations regarding complaints, deficiency signs, weight progression, medication, eating behavior and so on are conducted and documented. Moreover, patients can discuss the option of further surgical steps such as plastic surgery in case of a fat apron after weight loss (pendulous abdomen).

Diseases associated with obesity such as type-2-diabetes mellitus , high blood pressure, fatty liver, or metabolic disorders can improve or even vanish in the months after the bariatric surgery due to the weight loss. These illnesses should be monitored and their treatment, e. g.  by medications, should be adapted by a physician.

The IFB prepares patients what, how much and in which form eating and drinking are advisable before and after baritric surgery. (Photo: IFB Adiposity)

Nutrition and nutritional supplements after bariatric surgery

The success of a bariatric operation also depends on the patients' adaption to the new circumstances and requirements. It can be necessary to take vitamin and mineral supplements if the intake through food is insufficient or deficiency symptoms occur. Especially after operations that reduce the intestinal nutrient absorption (malabsorptive operation) supplements are necessary.  Spplemented can be e. g.  the vitamins B12, B1 or B6 and the minerals calcium, zinc, iron, folic acid, as well as a gastric acid blocker or a drug against the development of gallstones. Furthermore, the manner of food intake has to be adapted to the respective operation method. This takes place in three stages:

First post-operative stage:  liquid stage - finely pureed diet

In the first two weeks after the bariatric operation the patient may only eat small quantities of liquid or finely pureed food. Thereto belong for example milk soups without sugar, yogurt and junket, strained and pureed fruits, fine vegetable soups, thin potato mash or pureed poultry meet and pureed fish. As beverages non-carbonated mineral water, herbal and fruit teas, thin black tea and eventually thinned vegetable juices and broths are recommended. The meals should be restricted to four up to a maximum of five per day with a maximal amount of 100 to 150 ml food per meal.

Second post-operative stage: Light and balanced diet

In the subsequent two weeks thorough chewing of the food is particulalrly important. This is the major challenge in the transition from finely pureed diet to a light balanced diet, because only mushy  food can be swallowed. Moreover, new individual incompatibilities of food can occur. Generally, a light balanced diet is characterized by a choice of easily digestible foods like bread and pastries, light milk products, lean meat, vegetables, fruit and mild herbs and spices. Choose gentle preparation methods like steaming, stewing, boiling in kitchen foil, in a clay pot or in an oven bag. Strong roasting, deep frying and grilling should be avoided.

Long-term nutrition: general rules for the eating behavior

Within the transition to long-term nutrition the frequency of meals should be adapted to the individual’s needs. Nevertheless, not more than three meals per day should be eaten to avoid a shortage of protein and micro-nutrients. The food mentioned in stage two can serve as an orientation for an ideal choice of food. Sugary or fatty food and alcohol should only be consumed carefully in small quantities. In case of discomforts or deficiency symptoms the nutrition or the vitamins and minerals supplements have to be adapted.

The IFB AdiposityDiseases also offers cooking courses for bariatric patients.Regular physical activity to support fat reduction and to maintain the muscle mass is also important. The training units should be built up slowly over weeks.

Patients get an aftercare pass when they leave the hospital. The booklet offers tables to note appointments, the progress of weight loss, eating behaviour, afflictions and further information. Moreover the pass contains helpful details about the aftercare measures mentioned here.

Nachsorgetermine
Bariatric patients come regularily to the aftercare exams at the IFB outpatient clinic. (Photo: IFB Adiposity)

Aftercare contact details at the IFB and University Hospital Leipzig

In case of further questions regarding aftercare following obesity treatment or if there are health problems patients can contact the experts of the IFB or the University Hospital. The emergency room of the University Hospital is available for severe afflictions.

IFB Obesity Outpatient Clinic for Adults

University Hospital Leipzig
House 4 (Internal and Operative Medicine, Neurology, Radiology)
(area of "Ambulanzen")
Liebigstr. 20, 04103 Leipzig

Patients’ coordination, inquiries and appointments
Phone:  +49 (0)341 97-12418
E-Mail: ambulanz [at] ifb-ambulanz [dot] de
Leitung: Prof. Dr. Matthias Blüher, Prof. Dr. Mathias Fasshauer

Section Bariatric Surgery

University Hospital Leipzig
Inquiries and appointments for bariatric issues:
Birgit Tappendorf (secretariat)
Phone:  +49 (0)341 97-17230

IFB Study Clinic  (If patients participate in an IFB study)

IFB AdiposityDiseases
House M / Red House
Philipp-Rosenthal-Str. 27, 04103 Leipzig

(appointments are given by the heads of the studies)
Phone:   +49 (0)341 9715333
Head of Study Clinic: Prof. Dr. Anja Hilbert

Nutrition Consultation

University Hospital Leipzig
House 4 (Internal and Operative Medicine, Neurology, Radiology)
(area of "Ambulanzen")
Liebigstr. 20, 04103 Leipzig
Head: Lars Selig
Lars [dot] Selig [at] uniklinik-leipzig [dot] de

Wound Consultation

University Hospital Leipzig
House 4 (Internal and Operative Medicine, Neurology, Radiology)
(area of "Ambulanzen")
Liebigstr. 20, 04103 Leipzig
Phone:  +49 (0)151 12234123
Konstanze Miehle MD / nurse Gisa Bausch