Dietary Sensibility Prevails Even With Weight Loss Surgery

Even though the standard for pre-surgical education has been elevated for bariatric patients seeking treatment for obesity with weight loss surgery a certain silliness prevails among patients and the public suggesting surgery is the easy way to lose weight. Popular perception of surgical weight loss suggests that lifestyle changes including diet and exercise are not necessary for weight loss; the surgery does all the work for the patient by restricting caloric intake.

The truth is, in order to lose weight and maintain the resulting healthy body weight with weight loss surgery (gastric bypass, gastric lap-band, gastric sleeve) one must make significant lifestyle changes that include a following high protein diet, the elimination of processed carbohydrates and carbonated beverages, and avoiding or at least controlling snacking or mindless eating. In addition patients must engage in daily physical activity beyond the physical motions of the routine day. Patients must exercise. A lapse in adherence to the dietary or activity requirements of bariatric surgery will cause weight loss to cease and may potentially cause weight gain.

The notion that simply eating less of the things we were eating at the height of our obesity as a means to losing weight is absurd. Yet I have heard the hearty laugh of a post-surgical patient more than once when they explain, “I can still eat the same things I used to eat, just less!” Okay, how about we check back with that person in a year or so and see how that is working. Chances are the last thing they want to talk about, let alone laugh about, is weight loss surgery. The patients and the public that want to believe weight loss surgery is easy weight loss do not want to hear this simple truth: If the food you ate before surgery made you fat then eating the same food, even less of it, after surgery will continue to keep you fat. It is that simple.

Most bariatric programs explain to their patients that the surgical stomach pouch is “only a tool” for losing weight and some programs make patients sign a contract affirming they will use their tool correctly. To use the tool correctly the patient must follow the prescribed diet and exercise program. Not for just a few weeks or until goal weight is accomplished. The surgery is a permanent alteration of the human digestive system therefore the patient must make a permanent alteration of their behaviors in a conscious effort to use the tool for controlling the metabolic disorder we call obesity.

Even with surgery patients must diet and exercise to lose weight. To maintain that weight loss they will continue to follow the high protein diet and exercise requirements for the rest of their life. Patients who do this are happily successful with their “easy” weight loss surgery. Patients who from the first stitch ignored these requirements hoping the surgery would do the work for them are not laughing much now as they try to fade in the background doing the same things they have always done hoping for different results.

In my work I counsel patients of weight loss surgery who often ask me if it is okay to eat this or that. My job is not to fork feed these people, my job is to give them the power to rule their own fork. So I answer this question like this, “When you are looking at or longing for that deep fried food at the county fair use your dietary sensibility and remember that if it made you fat before surgery it will surely make you fat after surgery.”

Diet, Support, And More: How to Prepare for Weight Loss Surgery

After scheduling weight loss surgery, patients often have questions and concerns about the impending procedure. Your team of healthcare providers will give you specific instructions about what to do to prepare for the operation. Follow physician recommendations carefully to minimize the risk of complications and to ensure that you get the best results possible.

Losing Weight

To slim down after surgery, you will need a strong resolve to stop unhealthy eating habits. Many physicians recommend that patients drop a few pounds prior to surgery. This directive can be an effective way for health care providers to gauge overall commitment to a lifestyle change that will result in improved health. Your doctor may suggest that you lose between 15 and 30 pounds before scheduling your procedure. People who lose weight preoperatively often lose more during the post-op period. Weight loss prior to the procedure often shortens the time you will spend in the operating room, also, because surgeons can perform the procedure more easily. Losing weight also reduces the risk of complications.

Quitting Smoking

Doctors will urge smokers to quit prior to surgery. Smoking cigarettes not only causes serious long-term health issues such as emphysema and cancer, but it also makes it more likely that complications will occur. Patients who smoke are more likely to develop pneumonia after undergoing an operation.

Improving Diet

Health care providers typically refer patients to a nutritionist for dietary counseling. You will learn information about making healthier food choices, serving yourself smaller portions, and taking your time to eat. Making dietary changes prior to the procedure can make it easier to adapt to healthier eating after it is finished.

Psychological Evaluation

Overeating and compulsive eating usually leads to obesity. People who engage in these behaviors often have psychological issues connected with them. To make permanent and positive dietary changes, you may need to explore what led you to overeat in the first place. If you do not understand and resolve these psychological issues, you may not be able to overcome the behaviors after surgery. A psychological evaluation can help you learn about what motivates your behavior so you can make positive changes.

Seminars and Support

Many surgeons offer seminars designed to educate patients about what to expect from weight loss surgery. Attend these seminars so you know your options, and you are ready for typical issues. Your physician may also provide opportunities for participation in support groups with other patients. Sometimes seminars and other educational opportunities are required for preapproval from the surgeon and insurance plans.

Learning about Liquids

After weight loss surgery, you will have stringent rules about drinking liquids with your meals. You will not be able to drink beverages until at least one hour after you finish a meal. If you drink with a meal, the liquids could cause food to move through your stomach too quickly, which may cause excessive hunger. Drinking may also fill up your stomach too much, causing you to become malnourished or dehydrated because you are not eating and drinking correctly. Therefore, learn the rules about liquids and begin getting used to waiting to drink after meals.

Follow recommendations for weight loss surgery to ensure that your recovery is fast and successful.

Weight Loss Surgery, Vegetarians and High Protein Diet – Putting it All Together

Vegetarians who are suffering from morbid obesity and undergo Weight Loss Surgery (WLS) for the treatment of obesity are challenged to follow the weight loss surgery high protein diet when they do not partake of red meat, poultry, fish, or seafood. The first rule of a bariatric diet is to eat protein first in an effort to consume as much as 105 grams of protein a day. The balance of dietary intake should be at least 60 percent protein with the other 40 percent food intake being low glycemic carbohydrates and healthy fats. These are the standard guidelines for patients of all gastric weight loss surgeries including gastric bypass, adjustable gastric banding (lap-band), and gastric sleeve.

To the diet savvy, eating a high protein diet is no magical secret. We know that a high protein, low carbohydrate diet prompts weight loss. The body is made of protein. Muscles, bones, skin, hair and virtually every other body part are essentially protein, which consists of basic building blocks called amino acids. Amino acids help the body heal from surgery and fuel metabolic life processes around the clock. With the elimination of animal proteins from the diet vegetarians must turn to plant and dairy food for their protein needs. Legumes, low-fat dairy foods, soybeans and soy products, and nuts and seeds are all viable sources of protein for WLS vegetarians.

Legumes: Dried or canned beans such as kidney, cannellini, black beans and navy beans are nutritional powerhouse foods that may be enjoyed daily. One 7-ounce serving of beans provides 15 grams of protein. In addition beans are an excellent source of dietary fiber and they are mineral rich providing B vitamins, iron, zinc, magnesium and phytochemicals. Beans are versatile and can be added to soups, salads, casseroles and stir fries.

Low-fat dairy foods: Dairy foods are another excellent source of protein, but patients of weight loss surgery must eat dairy with caution. Some surgical procedures affect a state of lactose intolerance in patients: it is wise to consult with a bariatric nutritionist if symptoms of lactose intolerance occur. When dairy is tolerated WLS vegetarians can enjoy a 1 cup serving of skim milk, a 6-ounce serving of low-fat yogurt or a 1-ounce serving of low-fat cheddar cheese each providing nearly 10 grams of protein along with calcium and vitamins A, B, and D.

Soybeans and soy products: Soybeans are protein dense: a 7-ounce serving provides 24 grams of protein as well as iron, zinc, vitamin B, and phytochemicals. But Americans have been slow to make soybeans a dietary staple, perhaps because of a few too many tofu-experiments gone bad. New soy-based products take tofu from the strange health food cart to mainstream meals in the form of veggie burgers and veggie tacos. Calcium fortified soy-dairy products such as milk and cheese are commonly available in most supermarkets and make suitable replacements for animal dairy products without lactose impact.

Nuts and seeds:A small 1-ounce serving of nuts provides about 5 grams of protein and a rich source of antioxidants including vitamin E and selenium. Nuts are high in fat so the portion must be carefully measured. Under these conditions nuts can provide a healthy snack, or a crunchy topping for salads or desserts.

Weight loss surgery vegetarians must mindfully monitor their dietary intake to ensure adequate protein needs are met. When protein intake is not met weight loss will stall or weight gain may occur. WLS vegetarians should eat a wide variety of protein foods each day to supply their amino acid needs. This can be accomplished by keeping a pantry stocked with legumes, whole grains, nuts and seeds and soy products, and a refrigerator filled with low-fat dairy.