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A chronic illness that can be treated

Obesity is recognized as a both chronic illness and a serious health issue. Yet the knock-on impact is far greater than just being overweight: Obesity causes a decline in the quality of life as well as increasing the risk of diabetes, high blood pressure, heart disease, sleep apnea, stroke, arthrosis and some cancers. Daily activities become very difficult or even impossible. Furthermore, it plays a significant role in psychological problems such as low self-esteem and depression.

At around 40%, the UAE’s obesity rate is double the world average, resulting in a significant increase in obesity-related health care costs. Yet unfortunately, there is no quick fix solution. Bariatric surgery alone is not enough. The recommended treatment is a comprehensive lifestyle change program in combination with a surgical procedure, allowing the patient to learn to organize their life in a healthy way and adapt it to the performed gastric surgery.

Frequent health problems associated with (morbid) obesity include:

Infertility, Migraine, Depression, Type 2 diabetes, High blood pressure, Several types of cancer, Gastric reflux (heartburn), Heart and vascular disease, Respiratory diseases (sleep apnea, asthma), Bone and joint damage (arthrosis, back pain, gout)

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Am I eligible for morbid obesity treatment?

At Quro, we focus on patients with morbid obesity. When you come to us, we will compare your circumstances to the approved international guidelines.

  • - If you have a BMI of 40+ you will be eligible
  • - If you have a BMI of 35+ you may still qualify for treatment depending on the co-morbidities that have developed
  • - If you have a BMI of 27+ you are eligible for an orientation meeting.

Our multidisciplinary team of highly trained dieticians, physiotherapists, psychologists, endocrinologists and surgeons is heavily involved in the successful treatments, resulting in strongly improved lifestyle and quality of life.

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Frequently asked questions

General questions

How do I work out my Body Mass Index (BMI)?

To find out your BMI, you need to know your weight in kilos and your height in centimetres. You can then enter the figures in our on-line calculator tool. With the tool, it's quick and easy to find out your BMI.



Am I eligible for surgery?

To receive surgery, you have to satisfy a number of conditions:

  • Your Body Mass Index (BMI) must be more than 40. Or you must have a BMI of more than 35 combined with health problems caused by your weight.

      Examples: diabetes, high blood pressure, sleep apnoea or serious joint problems.

     If you have certain health problems, you may be considered for surgery if your BMI is more than 30.

    You must really want to change your behaviour.
  • You must have tried to lose weight with professional help, and there must be written records of your previous efforts.
  • You must be at least eighteen years old.
  • You must have been morbidly obese for at least five years.


Can I register for treatment on this website?

You are welcome to send us your contact details using the form on the website. We will then contact you to talk about the possibility of a preliminary meeting.



Will my health insurer pay for me to participate in your programme?

Some health insurers will pay for the treatment we provide. We advise contacting your insurer to ask whether the treatment is covered in your case. If anything is unclear, our Care Coordinator will be happy to answer your questions.



Can I register for intake without first attending an introductory interview?

No, that isn't an option. The treatment is intensive and has significant implications. We therefore think it's important to tell you exactly what to expect before you start the programme. You will then be able to decide whether the programme is right for you. So you always have to come to an introductory interview before starting the intake procedure.



How long will I have to wait for treatment?

In principle, there is no waiting time. Once we have got your registration, we will get in contact within two working days. Your treatment programme starts at that point.



Can I be admitted for in-patient treatment at Quro?

No, that isn't an option. We believe that everyone has to learn to cope with the difficult situations they will meet in everyday life. You can of course depend on close support from our team of professionals.



What outcome will the treatment have?

The outcome differs from one person to the next. Most patients lose weight in a responsible way. Our aim is to help you lose at least half of your excess weight. That will improve your health a lot.



Who can I call in an emergency?

In a medical emergency, you should contact the hospital where you had your surgery.





Medical questions

When will I have surgery?

All surgery has to be carefully planned, by us or by the hospital. We will contact you at least a week before the scheduled date.



Where should I go if I develop medical problems after surgery?

During the pre-surgery programme, you will be given information about who to call, when. During office hours, you can discuss the situation with our branch. We may advise you to go to the hospital. Outside office hours, you should call Accident and Emergency.



What medication will I be prescribed after surgery?

After surgery, you will be given discharge information by the hospital. That will include practical information about the period immediately following surgery. You will also be given prescriptions for stomach protection medicine and calcium.

Stomach protection medicine: following your surgery, you will need to take one tablet a day for six months. When you attend for medical checks, the GP will tell you about reducing your stomach protection medicine.

 

Calcium/vitamin D3: you will need to take these for the rest of your life. It is best to take the pills with a meal. If you are taking multivitamins as well, leave a gap of at least two hours between your calcium pill and your multivitamins.



How long will my surgery take?

The surgery takes about an hour. The exact duration depends on the type of surgery you have. Before and after your surgery, you will stay on the surgical ward. Your surgeon can tell you more.



How long will I be in hospital?

You will probably be in hospital for two days and one night.



How soon after surgery can I start eating solid food?

That depends on the type of surgery. Your surgeon can tell you more.



When will the stitches be removed?

If you have stitches, they will be removed after about a week.



When can I take off the adhesive dressings?

You can take off the adhesive dressings after seven to ten days. If necessary, talk to your surgeon. You can remove your adhesive dressings sooner if they come loose or start to smell.



How soon after surgery can I take a shower or go swimming?

While you have stitches or adhesive dressings, you can shower with soap as normal. However, we advise against swimming, taking a bath or using the sauna. It is best to wait with those things until your wound has healed properly.



Are the staples that you insert magnetic?

No, the staples are not magnetic. They will not trigger an alarm if you go through an airport security scanner.



How soon after surgery can I start exercising? And what exercise can I do?

After surgery, you can go for a gentle daily walk. Start with short distances and build up. Once the wound has healed, you can start gentle swimming and cycling. You can get back to more intensive sports and exercise about three weeks after surgery.



How soon after surgery can I drive?

You can drive when you feel well enough and as soon as your insurer allows. Contact your health insurer for advice. Please look at the FAQs about sports therapy as well.



Can I smoke after surgery?

Smoking increases the risk of complications (medical problems). You are more likely to develop a stomach ulcer, for example. We strongly discourage smoking both before and after surgery.



Can I use e-cigarettes, nicotine plasters or nicotine gum?

If these things help you not to smoke, you can use them temporarily.



What painkillers can I use immediately after surgery?

After surgery, we advise you not to use anti-inflammatory painkillers. They can have an adverse effect on the stomach. For details, see the document Medication After Bariatric Surgery. If you have any questions, speak to your GP or surgeon.



What medication do I have to take before surgery?

The anaesthetist at the hospital will tell you about your medication.



Why do I have to take vitamin supplements? Which are the best supplements to take?

After bariatric surgery, there is a risk that you will not get enough vitamins and minerals from your food. It is therefore important to eat a healthy diet. And that you take vitamin supplements. The supplements are suitable for use after the surgery that we provide. Following a gastric sleeve procedure, you should take WLS Optimum. Following a gastric bypass procedure, you should take WLS Forte. You need to take one capsule a day, preferably with a meal. Talk to your GP if you are taking other vitamin supplements.



What should I do about my current medication after surgery?

It may be that, after surgery, it is best to stop taking certain medication. The GP will discuss your medication with you during the pre-surgery programme. Some of your current medical conditions may be due to your obesity. Therefore, if you lose weight, you may not need as much medication as you currently take. If so, you will be able to gradually reduce the relevant medications, in consultation with your medical specialist or GP. When you have your medical check-ups, the GP will review your medication. It is therefore important to take an up-to-date list of the medication you are taking; your pharmacy should be able to help.



Can I get pregnant after surgery?

After bariatric surgery, it is important to wait at least a year before getting pregnant. That is because you will lose a lot of weight after surgery. If you were to get pregnant in that period, the baby might not get all the nutrients it needs. And that could lead to the baby being born with abnormalities. We therefore recommend waiting at least a year before getting pregnant after surgery. If you do get pregnant, please contact your GP.



What should I do if I develop a fever?

If you develop a fever (high temperature) shortly after surgery, it is best to contact your GP or the hospital.



What should I do if I get stomach ache?

If you get stomach ache that worries you, that doesn't go away or gets worse, always contact a GP. Complications linked to surgery can sometimes develop quite a while after the operation. Therefore, when talking to a GP, always say what kind of bariatric surgery you have had.



What should I do if I feel nauseous or if I vomit?

Immediately after surgery, you may feel very nauseous and need to vomit. It doesn't mean that something is seriously wrong. Make sure that you drink plenty (at least 1.5 litres a day), so that you don't get dehydrated. If you need to pass water fewer than three times a day, you are probably dehydrated. In that case, contact a GP. Also contact a GP if you have other problems, or if your nausea and/or vomiting persists.

 

It may be that you are eating too quickly, or too much, or not chewing properly. In that case, your body will produce a lot of mucous to help the food go down. And having a lot of mucous in your stomach can make you vomit. So don't eat too much, eat slowly and chew well. That will help to prevent nausea and vomiting.



What should I do if I have fatigue problems?

After surgery, you may feel fatigued for quite some time. That is because of the impact of surgery on your body. Losing a lot of weight also has an impact on your body. Make sure that you drink enough (at least 1.5 litres every day) and eat regularly (every 2 to 2.5 hours). Take your dietary supplements on time and be sure to eat enough protein. Doing those things will reduce the risk of fatigue.



What should I do if I have diarrhoea?

In the first weeks after surgery you may get diarrhoea. If your diarrhoea persists, contact our GP of dietitian.



What should I do if I get constipated?

After surgery, it may be a while before you need to empty your bowels. That is because you won't be eating as much as before. It is important that you drink enough, at least 1.5 litres a day. Ask your dietitian whether you should change your eating pattern. If your constipation lasts several days, ask the pharmacist for microlax (klysma). The GP may also be able to prescribe magnesium oxide or lactulose. Alternatives are bisacodyl, psyllium seed or movicolon, but those medications can cause wind and cramps.



My shoulders have been hurting ever since my surgery. Is this normal?

Some patients have pain in the shoulders that goes on for a long time. It is caused by the gas that is pumped into your body during surgery. The problems should clear up without you doing anything. However, if the pain lasts for more than seven days, we advise contacting your GP.



Since my surgery, I have had more dental problems (e.g. cavities). What can I do?

Dental problems following surgery may be caused by frequently sipping fruit juice, vomiting, a dry mouth or drinking too little. Regardless of the cause, you can reduce the risk of dental problems by:

  • Drinking more water
  • Brushing and flossing more often with fluoride toothpaste
  • Eating more cheese, fibre and protein
  • Not eating too frequently
  • Not smoking, or smoking less
  • Eating complex carbohydrates
  • Chewing gum that contains Xylitol, so that you salivate more and keep your teeth cleaner


I'm losing my hair. Is that normal, and what can I do about it?

Hair loss may occur until about six months after surgery. Surgery and weight loss place a lot of stress on your body. Once your weight has stabilised, your hair will start to grow again. In the meantime, there is unfortunately little you can do to prevent the hair loss. However, it does help to take your dietary supplements every day and to eat enough protein.



How likely is it that I will develop gallstones?

After surgery you are at increased risk of gallstones. Gallstones occur in about 20 per cent of cases. The reason is that the composition of your bile is changed by the surgery and the weight loss.



Can I gain weight again after surgery?

Yes, it's still possible to gain weight after surgery. It is therefore important that you follow the dietary advice and get enough exercise. If you have any questions, speak to your dietitian, psychologist or sports therapist.



After my stomach has been made smaller, can it stretch again?

Your stomach can't stretch after a gastric bypass. However, the transition from your stomach to your bowels can stretch if you often eat too much. That can undo the benefit of the surgery. If you have a gastric sleeve fitted, your stomach can stretch if you regularly eat too much. It is therefore important that you follow our dietary advice. Your dietitian can tell you more.



What can I do about surplus skin?

If you lose a lot of weight, you can be left with surplus skin. That is because your skin gets stretched when you are obese. It is then 'too big' for your leaner self and the surplus sags loose. Doing sport is generally good for you, but it doesn't help much with surplus skin. Skin-nourishing creams generally have little effect either. If surplus skin is causing you serious problems, you can ask to see a plastic surgeon. Your GP can tell you more. In the medical sessions document handed out during the pre-surgery programme, there is also information about surplus skin and the circumstances under which corrective surgery is available.



When are blood samples taken and what is checked?

Blood samples are taken to see whether you are lacking vitamins or minerals. Your kidney function and cholesterol level are also checked. Samples are taken during the medical checks that you have six and twelve months after surgery. For the rest of your life, it will be important that you have annual blood tests to check for deficiencies. Blood samples are taken during the medical checks for testing later. If any abnormalities are found, the GP will get in touch after your check-up.



I can't make it to a scheduled medical check and/or weighing and measuring session. Can I reschedule?

If you miss a check-up, you need to attend on an alternative day within three weeks. To make a new appointment, contact the branch.





Psychological questions

Why do I need a psychologist?

We know that losing weight is more difficult than just eating a little less and exercising a little more. The weight loss journey can be a difficult process and the psychologist is there to assist and to help you change your lifestyle behaviour. The psychologist will explain his or her role further at the start of the program. The psychologist will also be part of the multidisciplinary team responsible for screening and advising on the best treatment for you.



Is it a good idea to tell friends and family about the surgery?

If you tell your friends and family about the surgery, they will be able to support you. They will also be able to make allowance for what you are dealing with. However, how much you tell them is ultimately a personal decision. You can invite someone who is important to you to attend your individual sessions with you, so that they can learn about the programme and about lifestyle change. During the sessions, we will talk about how the people around you can help.



Who can I turn to if I have psychological problems?

If you suffer psychological problems, it is important to tell your psychologist. You and the psychologist can then see what can be done and appropriate treatment can be started where necessary.



Is surgery the 'easy option', as some people say?

Surgery is definitely not the 'easy option'. For gastric surgery to be successful, you need to make permanent changes to your lifestyle. It is important that you adopt a healthy eating pattern and a healthy exercise pattern. You also need to look after yourself well. Ultimately, it is up to you to make all these changes happen. Surgery does not change that.



Should my family make the same lifestyle changes that I make?

Research has shown that losing weight is easier if you have support from the people around you, e.g. your immediate family. They don't have to eat and exercise the way that you do. But it can help to make healthy choices as a family. You might want to talk about what products to include in the family shopping, for example.



Will my social life change after surgery?

Your social life is bound to change, because you will change. You may become more self-confident, for example. That may lead to you being more open with other people. Even daring to be proud of yourself. It might be that you are more able to define personal boundaries and put yourself first more often. Your friends and family may need to make some adjustments and learn to live with the new you.



Is my relationship with my partner liable to change after surgery?

It might do. The surgery and your lifestyle changes may mean that you feel you have less in common with your partner. Your partner may feel that way too. That can give rise to tension. It is therefore important to keep talking things through with your partner. That will help you maintain a connection. If problems arise, it may help to tell the psychologist who is guiding you on the programme.



Am I liable to experience mood swings after surgery?

That can certainly happen. A lot of things change after surgery. Your body goes through major changes and you have to 'say goodbye' to your old lifestyle. That can lead to mood swings. If you are worried by your mood swings, contact your psychologist.



What can I do if I find myself binge-eating (again) after surgery?

Do you feel that you are losing control of your eating behaviour? Are you binge-eating every week or even several times a week? If so, it is important to contact your psychologist. Together, you can establish whether your eating is problematic and, if so, what you can do about it.



Is there a risk of me losing too much weight?

Excessive weight loss is very unlikely. If your weight loss starts to become unhealthy, your dietary advice can be adjusted in good time. However, it is important that you ask your dietitian for extra advice if you need it.



Following the programme, is plastic surgery considered?

Plastic surgery isn't part of our treatment programme. However, we do talk about how your body will change and how content you are with your body. For information about the circumstances under which corrective plastic surgery is appropriate, read the literature provided by your GP, such as the medical pre-surgery sessions document.



Will I become a different person?

It may be that your weight loss and the changes to your body make you more self-confident, for example. You may become more able to stick up for yourself and define personal boundaries. In other words, the physical changes may change the way you feel and behave. However, you will remain the person you are. It is possible to feel and behave differently without becoming a different person.



Is it possible that I will gain weight again after surgery?

It is certainly possible to gain weight after surgery. If that happens, it is usually due to going back to old habits and eating too much or unhealthily. Sometimes, it is down to never really changing enough in the first place. If you notice that you are gaining weight, it is a good idea to talk to your treatment team about it. They can then help you to identify the cause and appropriate responses. Please look at the FAQs about diet and exercise as well.



Why does the programme consist of group sessions?

In a group, you can support each other with your lifestyle changes. You never have to face the challenges alone. You are all going through the same process and you can all learn a lot from each other's experiences.



I already know what a healthy lifestyle is. Can I receive treatment without doing the pre- or post-surgery programme?

No, surgery is always provided in combination with a lifestyle programme. We believe in a comprehensive approach. We work closely with the hospital. Once you have had surgery there, you are automatically placed on our programme. Experience has shown that patients find it hard to maintain healthy lifestyles and weight loss. Our programme is therefore designed to identify your qualities and the pitfalls in your lifestyle, and to guide you towards a healthy lifestyle. After surgery, we work with you to achieve the best and most lasting outcome. Your input and motivation will make a big difference to the result that can be achieved.





Questions about diet

Do I need to go on a diet before having surgery?

We advise eating healthily and choosing good-quality food that is rich in nutrients. You may also need to go on a diet. Your treatment providers will tell you more when you attend the first sessions.



Do I really have to eat six times a day? Won't that make me fat?

The surgery will reduce your appetite. It is therefore important to eat at fixed times and not wait until you feel hungry. Because that time may not come. You may have problems such as trembling, headache, vertigo and fatigue. Those problems may be due to your blood sugar level being too low as a result of delaying eating. Even if you don't feel like eating, your body needs food and drink after surgery. However, you will no longer be able to eat large portions. That is why you need to eat six times a day: three small, healthy main meals and three small, healthy snacks. Your food intake will be spread across the day and won't therefore make you gain weight. You do, however, need to follow the dietary advice we give you.



Will I have to stop eating and drinking certain things?

After surgery, it is best to avoid unhealthy options. That includes soft drinks, sweets, crisps and chocolate. You will not be able to tolerate some foods and drinks the way you used to. Following a gastric bypass, there is a risk of 'dumping' if you eat sugary or fatty foods, or if you eat too much or too quickly. You should therefore choose products that provide the nutrients you need and are important for your health.



Which foods and drinks cause most problems after surgery?

It differs from person to person. Your body might have difficulty dealing with meat, for example. Our experience is that hot meals often go down less easily than cold meals. As time passes after surgery, you will find it easier to tolerate different foods and drinks.



I can't have milk-based drinks. Should I use protein powder instead?

First see whether you can tolerate lactose-free or soya products. If you can't, contact your dietitian. Together, you and the dietitian can work out the best way for you to get the nutrients you need.



Why do I have difficulty eating hot meals, when cold meals aren't a problem?

Hot meals give off more smells, which can be enough to make some people feel full. See whether you can eat a cooked meal after letting it cool. Alternatively, try replacing a hot meal with a salad meal.



Why is eating meat so difficult?

Meat has a tough structure that is harder to digest. Red meat is particularly difficult. It is better to start with chicken, turkey or mince. Those meats are easier to digest.



What can I eat instead of meat?

Fish is easy to digest and is a good substitute for meat. Soft meat, such as boiled chicken, also goes down more easily. Alternatively, consider vegetarian products, such as tofu and Quorn. Those products have soft structures. Other options are grated or diced cheese, nuts and legumes.



Am I allowed fizzy drinks?

Carbonated ('fizzy') drinks can make you feel full. You may then miss out on other food and drink that contains important nutrients. You may also find it hard to tolerate the gas in fizzy drinks, or that it makes you very windy. If fizzy drinks don't cause problems, you can have them in moderation.



How soon after surgery should I be eating the recommended amounts?

You should be able to eat the recommended amounts again about six months after surgery. The recommended amounts are necessary for getting enough energy and for functioning normally. If you haven't managed to start eating the recommended amounts within six months, contact your dietitian.



How can I eat more than before surgery, and still lose weight?

After surgery, it may seem as if you are eating more, because you are eating more often and you feel full more easily. It may also be that you have become more active, as a result of being slimmer and following the programme. If you are more active, you use more energy. If you have doubts about your eating pattern, discuss them with your dietitian.



Why is slimming a bad idea now?

A lot depends on what you mean by 'slimming'. Some people interpret heathy eating as a form of slimming. Information about healthy eating is given in the dietary guidelines. We advise against dieting, because it can lead to shortages of some important nutrients and to muscle wastage. It is also important to eat six times a day. That prevents you getting very hungry and over-eating in response. Regular eating also encourages your body to consume energy.



I don't have a problem drinking with my food. So why shouldn't I do that?

We advise against drinking with your food. It tends to make you feel full more easily, which may cause you to eat less. If you eat less, there is a danger that you will miss out on important nutrients. Also, food passes through more quickly if taken with fluid, so you feel hungry again sooner. Another problem is that some foods, such as bread, swell up in combination with moisture. That can cause stomach ache.



Why do you recommend Fit For Me (FFM) multivitamins?

Fit For Me multivitamins have been developed specifically for people who have had gastric sleeve and gastric bypass surgery. The developers understand what you may be short of following surgery, and FFM multivitamins therefore contain higher doses of the vitamins and minerals in question. Also, they are in the form of capsules that break down easily, enabling you to absorb the multivitamins properly. That is important, because you have less digestive fluids after surgery and your digestive tract may be shorter. In research, patients who took FFM multivitamins had few (if any) deficiencies, while a control group who took other multivitamins did develop deficiencies.



Why have I developed constipation after surgery?

Many factors can lead to constipation, including lack of fluid, fibre or exercise. Some medications can make you constipated as well. It is a good idea to talk to your dietitian or GP. They will be able to help pinpoint the cause and find a solution. Please look at the medical FAQs as well.



Why have I developed diarrhoea after surgery?

Various factors can lead to diarrhoea. Surgery can affect your digestion, and that can have consequences for your bowel movements. Other things that can cause diarrhoea include lack of fibre, eating and drinking at the same time, eating too quickly, not chewing properly, eating fatty or sugary food, excessive calcium and artificial sweeteners. Please look at the medical FAQs as well.



Why do I feel nauseous and have to vomit after surgery?

Nausea and vomiting can have various causes. Immediately after surgery, you may feel nauseous from the anaesthetic. If you don't eat enough (or enough carbohydrates), your blood sugar level will drop. That can make you nauseous too. Another possibility is that you ate too quickly or too much. You are less likely to vomit if you chew well and eat slowly and carefully. You may develop 'dumping' problems as well. Please look at the medical FAQs as well.



Why have I become so windy since my surgery and/or why is my wind so smelly?

Surgery changes the digestive processes in your intestines. Chewing well improves digestion and can make you less windy. Another issue is that some foods, including beans, cause more gas to form inside you. Your dietitian can tell you more.



Why am I less tolerant of lactose since my surgery?

Lactose is a form of sugar found in milk products. Lactose intolerance can develop after a gastric bypass, due to nutrients not being digested as well. If you are less tolerant of lactose, it is important to ensure that you still get enough proteins and calcium (by substituting other foods). Ask your dietitian for advice.



Why can I eat more some times than others?

There are various possible explanations. Some days you need more energy than others, because you are more active, for example. How full you feel after a certain type of food (e.g. pasta) can differ from one occasion to the next. Also, if you skip a meal or snack, you may not be able to eat as much at the next meal or snack, or you may eat more to compensate. Stress and excitement can also have a big impact on how much you can eat.



Why can I tolerate something one time and not the next?

There are various reasons why you might find something hard to digest on a particular occasion, including eating too quickly, not chewing well and stress. When you tense, your oesophagus and stomach are tauter, meaning that your food can't go down as easily. Sometimes, food doesn't go well because you skipped the previous meal or snack or haven't eaten for a while.



Why has my sense of taste changed or diminished?

Your sense of taste can change temporarily following surgery, because of the anaesthetic or hormonal changes. You are probably more conscious of what you are eating as well. That is likely to make you more aware of the taste and give you the impression that things taste different.



What is dumping and what causes it?

Dumping is caused by the stomach emptying very quickly as a result of gastric bypass surgery. Because the stomach is smaller and the pylorus is missing, food enters the small intestine sooner. You can develop problems with your small intestine if you eat too quickly or too much, or if you eat sweet or fatty food. Possible symptoms include nausea, vomiting, stomach cramps, sweating, raised heart rate, diarrhoea, vertigo, fatigue, frequent yawning, light-headedness, trembling, a bloated feeling and a general sense of discomfort. Attacks can last for half an hour or an hour. Although the symptoms are unpleasant, they are not dangerous.



How can I prevent dumping problems?

By chewing well, eating slowly, not eating and drinking at the same time, and avoiding very sugary or fatty food.



What influences and causes weight change?

Weight change is mainly about lifestyle: your eating pattern, your exercise pattern, your access to social support and your opportunities for relaxation. Rest and regularity also play a role, along with how you deal with met stress and tension.



Is it possible that I will gain weight again after surgery?

It is certainly possible to gain weight after surgery. If that happens, it is usually due to going back to old habits and eating too much or unhealthily. Sometimes, it is down to never really changing enough in the first place. If you notice that you are gaining weight, it is a good idea to talk to your treatment providers about it. They can then help you to identify the cause and appropriate responses. Please look at the FAQs about diet and exercise as well.



Should I eat more if I start doing sport? If so, what should I eat?

It is important to eat something an hour before doing sport. Carbohydrates are good, because they provide energy. After your activity, it's a good idea to eat a piece of fruit or a sandwich. That will restore your energy reserves and take you through to the next meal. When you do strength training, we suggest eating a protein-rich product afterwards, e.g. low-fat quark. However, it's easy to over-compensate: to eat more than you actually need or have used doing sport. It may therefore be worth asking your dietitian for advice.



I'm losing weight too quickly. Should I start eating more?

The first thing to do is establish whether you really are losing weight too quickly. The GP will be able to tell when you go for your medical check. Then you and the GP will be able to look into the cause together. You may be able to change your eating pattern so that your weight loss doesn't go so quickly. It is best to talk to your dietitian before changing how much you eat or what you eat.



Can I participate in Ramadan?

From the start of the pre-surgery programme until a year after surgery, it is medically inadvisable to fast during Ramadan. Ask your dietitian for more information. After the first year, you can look into healthy ways of participating in Ramadan. Discuss the options with your dietitian.





Questions about exercise

Should I start exercising and doing sport before surgery?

It is definitely a good idea to start exercising (more) and possibly doing (more) sport before your surgery. The fitter you are before the surgery, the faster you will recover.



How much exercise should I do?

We recommend getting some exercise every day. You might walk or cycle gently for an hour five days a week, for example. In addition, you can do some more vigorous sport a couple of times a week. Ask your sports therapist any specific questions you may have.



How soon after surgery can I start exercising and doing sport?

After surgery, you can go for a gentle daily walk. Start with short distances and build up. Once the wound has healed, you can start gentle swimming and cycling. You can get back to more intensive sports and exercise about three weeks after surgery. When you do, listen to your body. You can also use the strength plan provided by your sports therapist. Please look at the medical FAQs as well.



I'm not sporty. So what is the point of me doing the exercise sessions?

The purpose of the sessions where the sports therapist introduces the group to exercises is to gain exercise experience. Everyone can participate at their own level. Your sports therapist will always invite you to join in. Then you can explore your capabilities together and arrive at a personal exercise plan.



I'm not sporty. Where can I get help?

You can get personal coaching from a physiotherapist or exercise therapist. A therapist can help you build up strength and stamina. You and your sports therapist can find a suitable therapist or clinic together.



Should I be doing sport alongside the programme?

The exercise and sports activities in our programme are to provide you with new exercise experiences under the guidance of a sports therapist. We advise you to exercise daily when you're not with us. It's good for your health. It's also a good idea to do something more intensive a couple of times a week to build up your strength and stamina. In the pre-surgery programme, we'll tell you more about regular exercise and discuss the possibilities.



If I have questions about physical problems, who should I ask?

Within our clinic, you can talk to the sports therapist or your GP. Outside the clinic, you can ask your physiotherapist.



How soon after surgery can I go back to work?

That depends on the sort of work you do. After surgery, you can start gentle walking and exercise straight away. You can start doing sport again after three weeks. Therefore, if you have an office job, you can go back to it sooner than if you do heavy manual labour. Regardless of the kind of work you do, it is important to build up gradually. We recommend discussing the situation with your manager and company doctor.



Do I need to enrol at a gym?

If you like going to the gym and it feels right for you, you can certainly enrol. However, there are lots of other ways to get exercise. We advise getting plenty of exercise after your surgery. If you do strength training, you will lose less muscle mass and shed more fat. You can do strength training at a gym, but you don't have to do it there.



Will I be given a training plan by the sports therapist as part of the programme?

Your sports therapist won't give you a training plan, but can help you create your own exercise plan. Your needs will be central to the assistance provided, along with your personal wishes and preferences. What you will receive as part of the programme is a strength plan, setting out exercises you can do at home.



Will my physical problems get better after surgery?

That depends on what is causing them. Some physical problems may actually increase as a result of doing more exercise. Your posture will also change as you lose weight. That can sometimes lead to problems as well. That is why is it important to keep exercising and training sensibly. A sensible approach can prevent or minimise exercise-related and posture-related problems. Ask your sports therapist for help if you need it.



How soon after surgery can I drive?

You can drive when you feel well enough and as soon as your insurer allows. Contact your health insurer for advice.



Can the seam of the gastric sleeve or gastric bypass break if I do heavy lifting after surgery?

No, it would require extreme strain to cause a problem. Nevertheless, heavy lifting in the early stages is not good for your recovery. Wait three weeks before resuming strenuous activities and sports, then build up gradually.



How am I going to find the self-discipline needed to keep up a regime of regular sport?

It is all about motivation. The exercise goals you set yourself should be realistic. And you need to choose a form of exercise that suits you and that you enjoy.



I get a lot of exercise at work. Does that mean I have a healthy exercise pattern?

You can count the exercise that you do at work towards your daily exercise goals. However, we recommend that you try out other forms of exercise as well. That will improve your health and will train other muscle groups. That will help you lose weight and prevent you gaining it again.



How do I build up my exercise after surgery?

Make sure that you exercise regularly. Then you can gradually increase the amount you do. For example, you might make your daily walk or bike ride a little longer each week. If you find it hard to build up on your own, consider doing some form of coached or supervised sport. The strength plan includes advice on building up gradually.



How soon after surgery can I go swimming?

You can go swimming as soon as your surgery wound has healed completely.



What exercises can I do to prevent surplus skin developing?

Surplus skin is common in people who have lost a lot of weight. Unfortunately, nothing has so far been scientifically proven to prevent or correct the problem. The skin isn't a muscle, so you can't condition it by training. However, if the muscles beneath the skin are well-conditioned, the skin is likely to sag less. Exercise and healthy eating will help you condition your muscles.



How long should my cardio-exercise sessions be?

Cardio-exercises are exercises designed to improve your stamina. The length of the sessions needs to be tailored to your current level, otherwise you risk injuring yourself. It is good to keep challenging yourself. You can do that by regularly making what you do a little harder. That will lead to your stamina gradually increasing. And that will have health benefits.



Will I be able to start running after surgery?

Running is a strenuous activity. You should therefore ask your sports therapist whether you are ready to start running yet. It is often helpful to consult a professional coach or to join a running club. If those options don't appeal, look for a training plan designed to help you build up gradually.



I do a lot of lifting at work. Do I need to do strength training as well?

Lifting at work will certainly help you keep up your strength. However, it is good to condition all your muscle groups, not just the ones you use at work. Regularity and variety in your training are important for conditioning and strengthening your muscles. Strength training will make everyday activities at home and at work easier. It will also help you retain muscle mass throughout your body.



How will I know if I am losing muscle mass?

If activities that used to be easy seem more difficult, you may be losing muscle mass. Is it harder to open a food jar, for example? Loss of muscle mass may be due to not eating enough protein or not doing enough exercise and training. If you suspect that you are losing muscle mass, talk to your treatment providers about it. Please look at the FAQs about diet as well.



Is it correct that it is best to do low-intensity sport, because I will burn more energy?

No, that's not true. You use more energy doing high-intensity sport. However, with a low-intensity activity, you are able to keep going for longer. So the total amount of energy used up may be more. Our advice is to choose an activity that you enjoy, rather than focusing on the calories you burn. If something is fun, you are much more likely to keep doing it for years to come.



Should I eat more if I start doing sport? If so, what should I eat?

As you become more active, your body uses more energy. Healthy eating is important for physical recovery. A healthy diet will also help you improve your strength and stamina. Contact your dietitian or sports therapist to find out whether your eating and exercise patterns are in balance. Please look at the FAQs about diet as well.





Questions about losing weight

I'm doing enough/plenty of sport and exercise, but I'm not losing weight. Why?

Your body is made up of fat, fluids and muscles. You may be losing fat, but gaining muscle. When that happens, you don't lose weight. Weight isn't always the best indicator to watch, therefore. Your health, fitness, strength and measurements say more about your wellbeing.



I've reached my target weight. Can I stop doing sport now?

No, if you don't want to gain weight again it is the important that you maintain your new exercise pattern. Exercise will help you stay healthy and improve your health.



Is it possible that I will gain weight again after surgery?

Yes, that's possible. Various factors could lead to you gaining weight. Doing less sport and exercise will certainly influence your weight, for example. Please look at the medical, psychological and dietary FAQs as well.



What can I do to reduce the fat on certain parts of my body, e.g. my belly or legs?

When you burn fat, you burn it all over your body. Therefore, the only way to get rid of the fat in a certain area is to burn fat from your body as a whole. You can't pick and choose where to lose fat.



I'm losing weight too quickly. Should I exercise less?

No, sport and exercise are not just about losing weight. They also influence your physical and mental health. Doing sport and exercise will give you more energy, for example. We therefore recommend that you remain active. Please look at the FAQs about diet as well.



Why is the programme based on group treatment? Can I choose individual treatment instead?

Group treatment is our preferred option because sharing experiences and supporting each other within a group will make you feel you are not alone on the weight loss journey. Being overweight can be hard and people who are not overweight may not understand what you are going through. Furthermore, other patients might ask questions that you haven’t thought about or that you are embarrassed to ask.



What type of surgery is best for me?

Based on our multidisciplinary screening, our surgeon will discuss which procedure is best for you during a surgical consultation. Our experienced team will provide you with personal advice based on many different factors, such as your medical history and your eating behaviour.



Can I have surgery without following the programme? Why do I need to do the programme?

We only offer surgery in combination with an intensive lifestyle programme, because surgery alone won’t bring long-term results. Without a lifestyle change programme, surgery is liable to result in you losing a lot of weight at first, then putting weight back on again. Combining surgery and lifestyle change is the best way to get results. 



It is possible that I will regain weight in the future?

Without a lifestyle change programme, surgery is liable to result in you losing a lot of weight at first, then putting weight back on again. Combining surgery and lifestyle change is the best way to get results. In the Netherlands, where surgery is combined with a lifestyle programme, percentages of weight regain are much lower than in the UAE, where many clinics offer surgery without a proper lifestyle programme.



How long will I be in hospital? When will I be admitted to hospital?

You will normally be in hospital for two days and the surgery will take place on the day of admission.





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