Early one February morning, a guard rang the doorbell to David Mustiga’s cell at Rikers Island. Soon the 43-year-old was chained and put on a bus to Bellevue.

Rikers inmates often have difficulty obtaining even rudimentary medical care. But Mr. Mustiga and 10 other prisoners underwent elective bariatric surgery at Bellevue, often spending weeks in the hospital.

Even in the best conditions, recovering from bariatric surgery is difficult. Trying to recover is especially difficult in prison, where inmates have little control over what they eat or how quickly they eat it.

Mr. Miller said Rikers patients were “screened and evaluated like everyone else” and were kept at Bellevue until they were ready to eat the types of food available at the jail.

Mr. Mustiga, who was later convicted of drug trafficking, weighed more than 300 pounds and suffered from high blood pressure. He had been excited a few months earlier when a staff member at Rikers Medical Clinic first told him about the benefits of bariatric surgery. He said no one warned him about the challenges of healing while he was incarcerated.

Mr. Mustiga received a flyer from Bellevue advising him to try a Zumba dance class.Credit…via David Mustiga

When Mr. Mustiga boarded the bus to Bellevue, he thought it was for a brief visit to have blood tests for surgery. Instead, he was admitted to the hospital’s locked prison room and put on a liquid diet.

There he met another patient awaiting bariatric surgery, Luis Perez. The men bonded over their diet orders and teamed up to steal leftovers from their neighbors’ hospital trays.

Mr. Perez, who was awaiting sentencing for drug possession, first underwent surgery. Afterwards, he told Mr Mustiga the pain was worse than when he was hit by a car and lost his arm above the elbow.

Mr. Mustiga panicked. He said he tried to recover from the surgery, but a doctor told him it was his only chance to get the procedure and that if he didn’t follow through, he would be immediately returned to prison.

Mr. Mustiga said he often used the same pressure tactics on his drug clients. “Tell someone it’s their last chance, and they’ll find their wallet pretty quickly,” Mr. Mustiga said.

I decided to have surgery.

After surgery, patients are supposed to consume small meals rich in protein.

Luis Perez said he suffered complications after his operation.Credit…via Annette Martínez

Back at Rikers, Mr. Mustiga traded cigarettes for protein powder. I looked at a brochure from Bellevue outlining the do’s and don’ts after surgery. He suggested she eat fat-free Greek yogurt or drink eight cups of Crystal Light. Exercise tips included trying a Zumba dance class.

Mr. Mustiga was not receiving adequate nutrition. He said he lost more than 100 pounds in less than six months — a rate of weight loss that can be dangerous. His hair fell out in clumps, and his medical records show he was receiving iron supplements to treat anemia.

This summer, Mr. Perez was transferred to Franklin Correctional, a prison near the Canadian border, to serve a four-year sentence.

During an August visit with two Times reporters, Mr. Perez’s skin was yellowish. He said he wasn’t getting enough protein and couldn’t eat without throwing up. He feared the operation had made him a target in prison, where size matters for protection.

Two months later, Mr. Perez was severely beaten. He said his attackers stole the protein powder he had saved.

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