nutrition for bariatric surgery
TRANSCRIPT
JENNIFER SHOBERT, RD, LDREGISTERED DIETITIAN
NATIONAL NAVAL MEDICAL CENTER(301) 295-4454
Nutrition for Bariatric Surgery
Weighing Your Options
Restrictive
Restrictive and Malabsorptive
Adjustable Gastric Band
Gastric Sleeve Resection
The Basics: “How do I eat to live not live to eat?”
Protein is the priority Must be eaten first Must be eaten at each
mealSTOP at the first sign
of fullness Intake at meals should
be ¼- ½ cup (4-8 Tbsp)Eat/sip slowly, take
small bites, and CHEW until liquid
Limit snacking
12
3
The Basics: “How do I eat to live not live to eat?”
Eliminate high fat and high sugar foodsBeverages must be sugar free (<10
calories/serving), non-carbonated, and caffeine free. No straws
Liquids must be separate from meals by 30 min before and after eating
Vitamins/minerals must be taken daily for the rest of your life
Weight re-gain is probable if you do not follow the diet guidelines Exercise is also essential to get to goal and prevent re-gain
Diet Stages: Pre-Surgery
Pre-Surgery Liquid Diet - 2 weeks You MUST resist the temptation of having a “Last
Supper”. Doing so will enlarge your liver and make your surgery more difficult.
Diet Stages: Post-Surgery
Post-Surgery:Clear Liquid Diet – while in hospitalFull Liquid Diet – 2 weeksPureed Diet – 1 weekSoft Diet – 1 weekRegular Diet
Beyond the Food
Surgery will not “fix” your eating problem. It is only a tool, albeit a powerful one, to help you do that yourself.
Weight loss and maintenance still takes work.Some things to think about:
What will I do when I cannot turn to food for comfort? How will I deal with those underlying emotions/memories?
Am I willing to sacrifice the foods I currently like and a “normal” eating pattern for the benefits of weight loss?
Will my family and friends support my changes? Do I think that just because I am finally thin, all my
problems will be solved? What if they aren’t?
Working with Your Dietitian (RD)
3 required pre-surgery nutrition appointments Goals:
Know what is expected of you Education about the necessary dietary restrictions and
modifications associated with weight loss surgery Show that you understand and are willing to follow
guidelines Initiate weight loss. 10# weight loss is required prior to
scheduling your first appointment with the surgeon. Do not worry. If you lose enough weight for your BMI to be <35, it will not affect your approval for surgery.
Adopt as many of the post-surgery guidelines as possible before surgery
You are required to bring a daily food and exercise log to each nutrition appointment. If you do not bring it, you will need to reschedule your appointment
Working with Your Dietitian (RD)
Periodic post-surgery appointments Follow-up with an RD is very important for success with
weight loss and prevention of malnutrition Gastric Band
2 weeks Monthly x 12 months Every 2-3 months
Sleeve and Bypass 2 weeks 3 months 6 months 9 months Every 6 months x 2 years Yearly
While You Wait…
Start aligning your diet to the recommendationsStart keeping a food and exercise diaryMaking changes now helps you to determine if
the benefits of surgery are worth the necessary sacrifices Eliminate beverages with sugar, caffeine, and carbonation Do not drink with meals Eliminate fried food, processed meats, and other fatty foods Start listening to hunger and fullness cues Take smaller bites and chew 20-30 times before swallowing Eat a protein source at each meal (3 meals/day) Start an exercise/walking program (if physically unable, a
note from your doctor is required stating such) What else?
Dietitians
National Naval Medical Center Jennifer Shobert
Walter Reed Army Medical Center Beth Triner
Malcolm Grow Medical Center (Andrews AFB) Lt Sarah Mueller
DeWitt Army Community Hospital (Ft Belvoir) Judy Hart and Becky Campbell
Andrew Rader Health Clinic (Ft Myer) Patrice Williams
Woodbridge and Fairfax Family Health Centers Karen Vonderhaar and Liz Bonometti
Kimbrough Ambulatory Care Center (Ft Meade) Nancy Reed (also at Aberdeen)
Annapolis Jane DeVane
VISIT US ON THE WEB:
HTTP://WWW.BETHESDA.MED.NAVY.MIL/PATIENT/HEALTH_CARE/SURGERY_SERVICES/BARIATRIC_SURGERY/INDEX.ASPX
Questions?