- Check-ups at 6, 12 and 18 months, then yearly to 5 years (Vitalys).
- Blood tests at every check-up.
- Lifelong WLS multivitamin and calcium with vitamin D.
- No NSAIDs; paracetamol is usually allowed.
- After five years, yearly blood tests remain important.
What does aftercare after a bypass or sleeve involve?
During aftercare you are in contact with a nurse and a nurse specialist, physician assistant or doctor. Vitalys schedules medical check-ups at 6, 12 and 18 months and at 2, 3, 4 and 5 years, each with blood tests to detect deficiencies of iron, vitamin B12, folic acid and vitamin D early.
Besides the medical check-ups, a dietitian and psychologist support you, especially in the first year. The Elisabeth-TweeSteden Hospital describes a five-year care pathway in which appointments become less frequent after the intensive first year. You also fill in the OBESI-Q questionnaire for the national DATO register every year.
Vitamins and medication during aftercare
You take a WLS multivitamin and calcium with vitamin D for life: at least 1,500 mg after a bypass and at least 1,000 mg after a sleeve, at least two hours apart. These are not reimbursed. NSAIDs such as ibuprofen, naproxen and diclofenac are no longer allowed. After a bypass the contraceptive pill may be less reliable; discuss contraception with your GP.
When should you contact your centre yourself?
Between check-ups, contact your centre with increasing or sudden cramping abdominal pain, persistent vomiting, fever, black stools, or symptoms that point to a deficiency such as severe fatigue. After a bypass, cramping pain can point to an internal hernia, even years later.
You can also get help with doubts, low mood, or problems with eating or alcohol; that is what the psychologist in the team is for. If your weight rises significantly, discuss the options early: guidance, medication or sometimes revision surgery.
What makes aftercare succeed
Advantages
| Advantage | Explanation |
|---|---|
| Keeping all appointments | deficiencies found early |
| Daily vitamins | prevents anaemia and bone loss |
| Seeing the dietitian | keeps your eating pattern on track |
| Peer support | help through difficult phases |
Points of attention
| Point of attention | Explanation |
|---|---|
| Stopping vitamins | deficiencies develop slowly |
| Using NSAIDs | risk of ulcers |
| Skipping later check-ups | regain and deficiencies missed |
| Ignoring complaints | hernia or ulcer found too late |
Cost and insurance (2026)
Aftercare at the centre is part of the covered pathway, but counts towards your deductible in any year you have not used it.
| Item | Amount or arrangement |
|---|---|
| Check-ups at the centre | covered; deductible may apply |
| Vitamins and calcium | €10-€15 a month |
| Skin surgery | not always covered |
Aftercare: key figures
| Feature | Value |
|---|---|
| Duration of aftercare | at least 5 years |
| Check-ups Vitalys | 6, 12, 18 months; 2, 3, 4, 5 years |
| Calcium after bypass | at least 1,500 mg a day |
| Calcium after sleeve | at least 1,000 mg a day |
| Vitamin cost | €10-€15 a month |
Aftercare by phase
| Phase | Focus | Who |
|---|---|---|
| First months | food build-up, recovery | dietitian, nurse |
| First year | fast weight loss, deficiencies | doctor, dietitian, psychologist |
| Years 2-5 | keeping weight off | nurse specialist |
| After that | preventing deficiencies | GP or centre |
Step by step
- First weeks. Thrombosis injections, building up food, phone contact.
- 6 months. First medical check-up with blood tests.
- 12 and 18 months. Check-ups; weight loss slows.
- Years 2-5. Yearly check-ups and OBESI-Q.
- After 5 years. Yearly blood tests via GP or centre.
Read next
- Recovery in the first weeks — timeline
- The full treatment pathway — start to finish
- Revision if results decline — second operation
- Patient experiences — life afterwards
Pregnancy, sport and work during aftercare
If you want to become pregnant, wait the first year, when you lose weight fastest. Then take 400 micrograms of folic acid from four weeks before conception until week ten, alongside your calcium and WLS multivitamin, and do not switch to standard pregnancy vitamins on your own. Inform your bariatric centre about the pregnancy.
Sport and work are built up gradually. If weight loss stalls after the first two years or weight rises, aftercare is exactly the moment to review eating habits and behaviour with the dietitian and psychologist.
Aftercare if you move or travel
If you move to another region or country, ask your centre for a summary of your operation and recent blood results. Continue yearly blood tests via your new GP and take enough WLS vitamins with you when you travel.
Keep a simple record of your blood results and supplements, so any new doctor quickly sees what you take and why. That is especially useful if your new GP is not familiar with bariatric aftercare.
Frequently asked questions about aftercare
At least five years at the centre. After that, yearly blood tests remain important, for example through your GP.
At Vitalys at 6, 12 and 18 months and then at 2, 3, 4 and 5 years. Other centres use a similar schedule.
Your weight, complaints, eating pattern and blood, including iron, vitamin B12, folic acid and vitamin D. Your wellbeing is discussed too.
A nurse and a nurse specialist, physician assistant or doctor, plus a dietitian and psychologist, especially in the first year.
Yes, as part of the pathway. They can count towards your deductible in the year of the check-up if you have not used it yet.
Make a new appointment as soon as possible. Deficiencies develop slowly and only show up in blood tests.
Most medication, yes, but no NSAIDs such as ibuprofen. The pill may be less reliable after a bypass. Always check new medication with the prescriber.
Contact your centre, especially with cramping abdominal pain, persistent vomiting, fever or black stools.
The check-ups at the centre usually do, but you take vitamins for life and yearly blood tests remain sensible.
Discuss it early. The team looks at eating habits and guidance, and in some cases at medication or revision surgery.
Call +31 6 38048347 (Mon–Fri 09:00–17:00) or email info@maagverkleining-info.nl. This page is also available in Dutch.
Sources
- Vitalys (Rijnstate): aftercare and FAQ
- Elisabeth-TweeSteden Hospital: five-year care pathway
- DATO Annual Report 2024, DICA: OBESI-Q
- WeightWorks: gastric bypass
Search terms leading here: aftercare weight loss surgery Netherlands, follow up after gastric bypass, vitamins after bariatric surgery, check-ups after gastric sleeve.
Author: Gijs Bodenstaff. Last reviewed: September 2026.