dehydration is a serious problem after weight loss surgery

Water is much more important than you realize as you read this. We all sit through patient aftercare classes, some quite extensive and just nod about the drinking water part. It’s just water.

Wrong! Dehydration is the leading cause of hospital readmission after bariatric surgery with some practices as high as 37% (and beyond). The degree of sickness caused by post op dehydration is much worse than the surgery itself.

Come on… how serious can it be?
As a three week post op who was riding high, my friend Jo called and was so sick and weak I did not know it was her. In a thin small voice she told me she was dying. When I arrived, her lips were cracked, tongue swollen, she was confused and crying without tears, could barely hold her head up and as I helped her from the sofa I could feel her heart rapidly beating out of her chest. I was afraid she was going to die! She was readmitted and while she was only in the hospital for three days for her RNY surgery, she remained hospitalized for ten days for dehydration and the complications it caused for her heart.

I have never seen anyone go from dancing and singing with happiness to gravely ill in so short a time. This is a largely preventable complication caused because patients do not believe that water can be that important. Once she had a few bags of IV fluids she told me the water was making her feel sick and she stopped drinking it.


After surgery it is difficult to drink 64 ounces of water on your first day, but you must work up to it quickly. Follow these tips for hydration

1. Understand. 64 ounces is just 8 cups.

2. Calibrate. Using a glass measuring cup pour 8 ounces of water into your favorite glass or mug to see just how small an amount it really is. We drink from giant coffee mugs and big glasses and when we were slugging back orange juice all those years, we did not know we were drinking 20 ounces as if it were nothing.

3. Plan. We are awake and moving through life at least 12 hours a day. Pick 8 of those hours and drink a 1/4 cup of water every fifteen minutes. Using your glass measuring cup, see the small dribble that four ounces of water represents. A 1/2 cup of nothing. Small sips complete a goal.

4. Remind.  The HY Hydration App timer can be set to remind you every hour, every 30 minutes, every 15 minutes. Early on you can set it for two minutes and each time you take a sip, hit the timer again. Use it to push yourself. As you empty each 4 ounce measure, raise the level on the app by sliding your fingertip up the glass on the screen.

5. Temperature. If water is making you feel NAUSEOUS, try hot, warm and cold.

– Icy cold nearly frozen
– Room temperature
– Warm and comforting is the winning temp for many as it relaxes the inflamed newly operated on tissues and soothes all the way down

6. Flavor. If water is making you feel NAUSEOUS, try light flavors.

– use a water infuser or big pitcher to make super tasty naturally flavored water – use berries, citrus, cucumber. Think outside the box and use fresh dill with cucumber, fresh ginger with pear for nausea.
– Adding a slice of lemon to either HOT or COLD water makes a big difference
– Add a DROP of sugar free flavorings,  not too much as everything tastes so sweet after surgery
– Keep a pitcher in the fridge filled with water and a handful of frozen strawberries to flavor
– Chicken or beef broth works too – using your glass measuring cup, heat 8 ounces of Swanson Natural Goodness.

7. Broth. If you are really having trouble, get Chinese Takeout Wonton Soup and make it clear you want it without ANY of the stuff in it, no wontons, no greens, no pork. The warm broth is familiar and soothing.

8. Tea. Make Celestial Seasonings Herbal Tea – If you don’t have a tea pot, measure and heat 4 cups of water, add tea bags to steep for one minute off the heat. Remove teabags and pour into your mug to sip. There are special blends to calm a tummy like Chamomile, Mandarin Spice, Chai Spice, Green tea with Lemon. Sometimes hot, sometimes cold, sometimes room temperature.

9. Ice. Flavored ice pops count as water too. Not Frozen Fruit Bars, Not No-Sugar-Added, Not Fudge Pops, Not ‘No-Added-Sugar ‘ Klondike bars… we are talking about old fashioned Sugar Free Ice Pops. Period. Eat them end to end if you would like. A box a day even. It’s fine.

10. Prioritize. Fluids, protein and vitamins are all important, but fluids are more important than protein in these first weeks. They are more important than vitamins too. Often your doctor’s team will have you starting on vitamins immediately and this is what is causing your nausea. Back down to one tablet a day instead of the full dose. If still nauseated, try half a chewable. Once you get used to that crumb of vitamin for a week, then move up to a little larger piece. Make sure you drink some broth or eat a spoonful of smooth yogurt after you chew up the vitamin tablet so it is not in the pouch by itself. Vitamins cause the nausea for many.

Bariatric surgery is not easy nor is it the easy way out. It takes time to get used to these changes and it take strength and dedication. A post op I knew once said that bariatric surgery will slap a backbone in you. True words.