You had the gastric sleeve and got pregnant, what will happen to your weight loss? Do you require special care?

A very common concern from female patients who are considering gastric sleeve surgery is usually whether it is dangerous to become pregnant after gastric sleeve has been performed.

In this article we discover why there is no risk of developing problems with your pregnancy if you had surgery as long as you watch properly the quality of your food intake.

If you want to know what's best, pregnancy before gastric sleeve surgery or pregnancy after gastric sleeve check our article on this topic.

How should I go through my pregnancy if I previously had the gastric sleeve?

Here we present the most important points to consider if you get pregnant after gastric sleeve

Weight regain during in pregnancy after gastric sleeve surgery

It is expected that an internal battle and concern arise in relation to your body image since certainly you have lost several pounds thanks to the surgery and you know that pregnancy will lead you to gain weight.

In this case the key is to know that you are in control of how much weight you will gain during pregnancy and that if your diet is adequate it won’t have to be more than 18-24 pounds which is the recommended approximate amount of weight gain for all women with a normal weight during pregnancy.

What will happen to the weight you have already lost?

Probably because of this weight loss you were able to become pregnant as it is proven that weight loss positively affects fertility in a positive way.

The explanation of what happens to your lost weight being about to gain a few extra pounds because of pregnancy and what are the recommended steps to have an uneventful pregnancy is very simple:

First of all, it is important to define when the pregnancy occurs after gastric sleeve surgery and I personally think is the most crucial factor to take into account because of the following:

• The period of maximum weight loss after a bariatric procedure is in the first 18 months, after this time, weight loss slows down gradually. This does not mean you cannot keep losing weight but it will be slower and harder to lose, requiring more dedication on your part.

• If your pregnancy after gastric bypass or after gastric sleeve occurs before this 18 months you run a greater risk of being in a "learning" stage and acknowledgement of your own new body along with your new eating habits, so the chances on not losing all the weight you were destined to lose are slightly higher, nevertheless this is completely preventable if even after being pregnant you watch the quality and quantity of your food, achieving with this not only increasing the strictly necessary amount of weight but also being well nourished for your baby.

Even if you had not finished this learning and adaptation process to the sleeve or bypass, the procedures are still there, so there is no real excuse for not retaking the path once your pregnancy has come to its term.

Independently if you had lost a lot of weight or not at the moment of becoming pregnant, after the pregnancy, you can see this as a “new beginning” but that you will need to be even more focused and committed with your surgery in order to achieve optimal results.

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Pregnancy should not be synonymous of carelessness in your diet

At least in Mexico and I have no doubt that in many other countries, unfortunately it is quite common that pregnant women let themselves go for their "condition" and believe that they can eat whatever and as much as they want since it is "OK" because they are pregnant, this concept could not be more wrong because as we saw in our article on gastric sleeve and pregnancy having obesity during pregnancy leads to a variety of unfavorable circumstances for both mother and baby.

Even when women get pregnant under normal weight, they neglect their eating quality and quantity so much that for the term of pregnancy they can gain even more that 40 pounds! This is common, but does not make it less unfavorable or inappropriate since according to experts in the field, the maximum weight gain throughout pregnancy should be up to 24 pounds in order to consider it as a healthy increase in a woman with average initial normal weight (BMI of 24.9 or less).

Close monitoring of your nutrient intake

Although there are described nutritional complications during pregnancy after bariatric surgery according to the American Journal of Medical Science, your chances are much lower when we talk about gastric sleeve postop patients, however it is worth mentioning that it is possible to develop deficiencies of: vitamin B12, iron, calcium and Vitamin D as well as protein, caloric malnutrition and malabsorption.

All this is much more common in patients undergoing gastric bypass (or Roux en y), duodenal switch, or any other malabsorptive procedure, remember that the gastric sleeve is a pure restrictive procedure.

Therefore, another common concern that women becoming pregnant after gastric sleeve surgery is the fact whether they can eat enough to be well nourished and therefore provide the necessary nutrients to their baby throughout pregnancy, the answer is that of course they can be well nourished.

The only way this is not possible is if you got pregnant within weeks of the procedure when you have not even yet reached the stage of being able to feed normally in relation to the type and consistency of foods allowed for your recovery.

We say that is the only way, because it is the only situation in which it would be out of your hands the possibility to decide what to eat being in the need to comply a diet of specific consistency depending on postoperative stage in which you are, but this only lasts 4 to 5 weeks.

Proper nutrition for your baby will depend entirely on you (with the help of your gynecologist) if the gastric sleeve is restricting the amount of food that you can eat (main objective of the procedure) is essential that as you would do even if you were not pregnant, you should focus on eating good quality food, leaving those known as junk food completely aside since for example if what you eat is half a bag of chips or bread, you've come to feel early satiety but at the cost of low nutritional value food and there will be no room in your stomach for those foods high in protein, vitamins and minerals which you and your baby need.

When we speak about pregnancy after gastric bypass, it is an entirely different subject in which you must take an even closer follow up to your nutritional status with frequent monitoring to ensure that you are absorbing enough nutrients not only for you but for your baby being the bypass a malabsorptive procedure. In this case it is even more important to avoid getting pregnant if you are not at least 18 months after your bypass surgery.

It is important to tell your gynecologist that you have the gastric sleeve

Speaking of food supplementation, there is no contraindication to follow the advice of your gynecologist regarding the type of supplement and its dosage, so you can have them with no problem and probably the gynecologist will suggest you to take them along with the ones you were using because of the gastric sleeve.

Expectations after your pregnancy in relation to gastric sleeve

Finally, talking about the stage after the birth of your baby, expectations should be the same, as we have explained, it is probable that if before becoming pregnant you required 100% of your effort to achieve your goal weight, after being pregnant, especially during the period of maximum weight loss (first 18 months after surgery) the effort should be 110% but it continues to be completely possible to reach the goals you have settled when you decided to have surgery, so do not see pregnancy as a setback but as what it is, a blessing!

Now, you will definitely want to avoid pregnancy if you do not want to actually become pregnant, so this is why after gastric sleeve surgery you must be very careful with your birth control method because, as we explained in our post about the gastric sleeve and pregnancy, your fertility will be greatly favored after losing weight.

As you can see pregnancy and gastric sleeve surgery are two very well related concepts and there is no reason to believe that it is a bad idea to get pregnant after weight loss surgery.

Final recommendations about getting pregnant after gastric sleeve

Our main recommendation would be for you to plan your weight loss surgery in a way in which the pregnancy happens at least 18 to 24 months after your gastric sleeve procedure in order that when the moment comes, you are completely ready mentally (with adequate changes in your eating habits and lifestyle) and physically (in a healthy weight or close to it) and you can have an uneventful and smooth pregnancy for you and your baby.

The use of prenatal vitamins is a great complement to ensure that you get all the nutrients necessary for the healthy development of your baby.

Another recommendation I insist on, is that once you discover you are pregnant you should let your gynecologist know that you had the gastric sleeve surgery (or any other bariatric procedure) since despite the growing popularity of weight loss surgery, it is relatively new, at least on the scale in which it presents today and it is likely that your gynecologist is not fully aware of how to guide a pregnant patient with previous weight loss surgery, and this will give him/her time to learn and get guidance by other colleagues who do have experience in the subject.

Your turn, tell us (whether you are our patient or not) do you plan to get pregnant? or are you pregnant? What has been your experience?

Written by: Gabriel Rosales

Dr. Gabriel Rosales is a highly skilled, board certified surgeon in constant pursuit of learning the latest innovations in the weight loss surgery field to give his patients the best care possible.

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