Quick Summary
- On the day of bariatric surgery, patients fast overnight, undergo a laparoscopic procedure lasting one to three hours, and begin walking within four to six hours after waking.
- Hospital stays range from same-day discharge for gastric banding to three to four nights for gastric bypass, with a full-liquid diet and protein targets starting at home.
- Knowing what to expect before, during and after surgery, including what to eat, what to avoid, and when to seek urgent care, makes for a calmer and safer recovery.
Feeling anxious before weight-loss surgery is completely normal, and a lot of that worry stems from not knowing what to expect.
From the moment you arrive at the hospital through to waking after surgery and beginning recovery, having a clear understanding of the process can help you feel calmer and more confident.
Melbourne Bariatric and Laparoscopic Surgeon Dr Jason Winnett and the team at Winnett Specialist Group are here to explain what happens before, during, and after surgery day.
What can I eat and drink before bariatric surgery?
Dr Winnett says, ‘To ensure safe anaesthesia and a smooth procedure, it’s important to follow fasting and fluid guidelines carefully unless your surgical team advises otherwise.
Why it’s important not to eat or drink before surgery
‘When you’re under general anaesthetic, the body’s natural protective reflexes temporarily switch off.
‘So if there is food or fluid in the stomach, there’s a risk it could move into the lungs while you’re asleep, which can lead to serious breathing complications.
‘Keeping the stomach empty helps us protect the airway, deliver anaesthesia safely, and perform the procedure in the safest possible conditions.’
The evening before surgery
- Keep dinner light and balanced. Avoid heavy meals and alcohol.
- Stop all solid food from late evening (typically after around 11:00 pm or as instructed).
- After this time, no food should be consumed unless specifically directed by your care team.
Up to 6 hours before hospital arrival
- Do not eat any solid foods.
- Only clear fluids may be allowed if approved by your surgical team (such as water or other approved clear drinks). Avoid milk, smoothies, or thickened beverages.
Within 2 hours of arrival
- Do not eat or drink anything.
- Take only prescribed medications if instructed by your doctor, using a very small sip of water if needed.
What happens on the day of bariatric surgery?
Arriving at the hospital
Once you check in, you’ll be escorted to the pre-operative area where our nursing team will prepare you for surgery.
This includes changing into a gown and having a cannula placed in your hand or arm for fluids and medication during the procedure.
When it’s time, you’ll be wheeled into the operating theatre while your family settles into the waiting area. Your surgeon will update them once your procedure is finished.
During surgery
During the procedure, Dr Winnett will insert fine surgical instruments and a camera through five or six small incisions centred on the upper abdominal cavity.
A camera transmits real-time images of the abdominal cavity to a high-definition screen, allowing the surgical team to see the operating area clearly.
The first few hours post-surgery
Recovery begins the moment you wake. Only a few hours after waking up, patients typically report feeling well, with pain that is manageable and meets their expectations.
Different procedures have different recovery paths and may entail same-day discharge or an overnight or several-night stay.
Many patients are surprised to feel very little hunger immediately after surgery. Thirst is often the more prominent sensation. Some discomfort at the incision sites is normal, and adequate pain relief is promptly provided.
One important note for bypass patients: ‘If you’ve had gastric bypass, you must steer clear of anti-inflammatory medications like ibuprofen as they increase the risk of internal bleeding and ulcers,’ says Dr Winnett.
Movement after bariatric surgery is essential
‘Despite the discomfort of getting in and out of bed,’ says Dr Winnett, ‘patients are encouraged to be up and walking within four to six hours after surgery.’
Our team recommends short, regular walks around the ward, aiming for 10 minutes every 1-2 hours during waking hours. This simple activity helps maintain circulation and supports your recovery in those crucial first days.
When can I go home after bariatric surgery?
Your hospital stay depends on the type of procedure. Scroll to the bottom of this article to learn more about the types of bariatric surgery performed by Dr Winnett.
- Gastric bypass (RYGB): three to four nights in hospital
- Sleeve gastrectomy: one to two nights
- Gastric banding often same day or next, once able to tolerate clear fluids
Before leaving hospital, the fluid goal is 200ml over two hours, sipped slowly.
Going home: what to know before discharge
A follow-up appointment is typically scheduled seven to ten days after discharge. In most cases, this appointment is scheduled before surgery.
Medication instructions
Before leaving the hospital, your surgical team will instruct you on how to restart your regular medications. Take your time reviewing these details, and feel free to ask any questions.
It’s also very important to follow up with your primary care doctor within 2-4 weeks to manage your medications. Please set this up prior to surgery.
Your post-surgery diet
Upon discharge, you’ll be placed on the Phase II Full-Liquid diet for the next 2 weeks unless your surgeon tells you otherwise.
Your body needs fuel to heal, and protein is the building block of recovery. We recommend aiming for 60 to 80 grams of protein daily, which usually means two or three protein shakes spaced throughout the day.
Staying hydrated is equally important; work towards 1.5 to 2 litres each day, sipping consistently rather than in large amounts.
How to drink fluids after bariatric surgery
Learning to drink again after surgery takes practice. Take tiny, frequent sips rather than big mouthfuls.
Make sure to drink directly from a cup; straws can introduce extra air into your new stomach pouch, leading to uncomfortable bloating.
If you feel pressure building beneath your breastbone, that’s your signal to pause and let things settle.
Returning slowly to physical activity
The first few weeks at home are about letting your body heal. Here’s what to keep in mind.
Lifting and physical strain: Avoid heavy lifting, pushing, or pulling for the first four to six weeks. No shopping bags, no moving furniture, and no picking up children. Anything over 5kg is off limits during this period.
Exercise: Hold off on core work like sit-ups and crunches for four to six weeks, and avoid running or gym workouts for at least four weeks. After that, return gradually and listen to your body.
Driving: Do not drive while taking prescription pain medication. You can get back behind the wheel once you no longer need pain relief and can perform an emergency stop comfortably. For most patients, this is around five to seven days after surgery.
Movement at home: Avoid spending all day in bed. Getting up and walking gently from day one helps reduce the risk of blood clots and supports your recovery.
Returning to work: A desk job can usually be resumed within one to two weeks. Physical roles typically require four to six weeks off.
Intimacy: Sexual activity can resume when you feel comfortable, which is usually around one to two weeks post-surgery.
Warning signs after bariatric surgery
Today, bariatric surgery is a safe, effective procedure, with a similar safety profile to a knee replacement.
Normal side effects include mild abdominal pain, shoulder tip pain, mild nausea, fatigue, reduced appetite, and bruising at the wound site.
However, it is important to call our rooms or seek urgent care if you notice:
- Shortness of breath
- Increasing redness or swelling at the wound site
- Worsening severe abdominal pain (some pain in the first few days is normal, but this is usually controlled with analgesia)
- Fever
- Severe and persistent vomiting
- Confusion, dizziness or fainting
- Racing heart rate, which can be an early sign of a staple line leak, or bypass anastomotic leak
Types of bariatric surgery performed by Dr Winnett
Dr Winnett commonly performs the following procedures:
Sleeve gastrectomy (laparoscopic sleeve gastrectomy)
Dr Winnett says, ‘This involves cuttings and stapling along the greater curve of the stomach, removing approximately 75-80% of the stomach and leaving a narrow, banana-shaped gastric pouch.
‘It uses special surgical staplers that cut and seal simultaneously, ensuring safety.’
The gastric sleeve is the standard procedure of choice for most surgeons because it’s less complex than a gastric bypass.
Following a 2022 update to BMI eligibility guidelines*2, it is now recommended that patients with a BMI of 30 with comorbidities, or 35 without, be considered for bariatric surgery, meaning more Australians are eligible for bariatric surgery than ever before.
Roux-en-Y gastric bypass
‘This is where a small stomach pouch is created, and it connects directly to the middle section of the small intestine, bypassing most of the stomach and upper small intestine,’ says Dr Winnett. ‘This both restricts food intake and reduces nutrient absorption.’
Bypass is often more suitable for patients with unstable type 2 diabetes or gastric reflux, and also usually achieves the highest long-term weight loss of all procedures.
Adjustable gastric banding
‘This is a less invasive procedure. We place an adjustable silicone band around the upper part of the stomach, creating a small stomach pouch and a controlled outlet,’ says Dr Winnett.
‘This is more suitable for patients with a lower BMI. It is not a metabolic surgery like gastric sleeve or bypass, so there’s typically less weight loss.
‘It’s ideal for patients who are anxious about irreversible surgery, such as the sleeve, or for younger patients unsure about permanent change, or patients who have less weight to lose.’
Support beyond the operating theatre
Weight-loss surgery is a foundation for lasting change, not a temporary fix.
The team at Winnett Specialist Group is with you, from your first consultation through to long-term follow-up care.
If you have any questions about preparing for bariatric surgery, contact us.
This article provides general guidance only. Always follow the specific instructions given by your surgical team.
