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Dietitians Dish: There are nutritional requirements after weight-loss surgery

July 5, 2010 at 2:05 a.m.
Updated July 6, 2010 at 2:06 a.m.

Kendra Blaschke

By Kendra D. Blaschke, MS, RD, LD

According to the American Society for Metabolic and Bariatric Surgery, more than 220,000 weight-loss surgeries were performed in 2009.

Weight-loss surgery is suggested to be the most effective and long-lasting treatment for morbid obesity. Studies have shown that weight-loss surgery can improve or resolve many medical conditions including type 2 diabetes mellitus, hypertension, high cholesterol, heart disease, non-alcoholic fatty liver disease and obstructive sleep apnea.

The American Diabetes Association even recommends people with type 2 diabetes who have a BMI of 35 or greater, consider bariatric surgery.

Weight-loss surgery is a general term that includes Roux-en-Y gastric bypass, adjustable gastric banding, sleeve gastrectomy and biliopancreatic diversion with or without duodenal switch.

Weight-loss surgery works by limiting the amount of food a stomach can hold, and, therefore, providing fullness off of a very small amount of food. Despite thinking that bariatric surgery is the "easy way out," patients are required to make many diet and lifestyle modifications to lose the weight and keep it off.

Some of the nutritional requirements after weight-loss surgery include the following:

Drink water - Dehydration can occur due to limited ability to consume water rapidly (a small stomach can only hold so much); therefore, sipping on water or a low-calorie water alternative, like Crystal Light, throughout the day is the key to consuming the recommended 60-80 ounces per day.

Take vitamins - Life-long vitamin supplementation is necessary because of decreased food intake and some malabsorption of the vitamins and minerals found in foods. Bariatric surgery patients should be counseled by their surgeon and dietitian regarding the exact vitamins required.

Get power from proteins - Protein is essential for maintaining lean body mass and preventing muscle loss during periods of rapid weight loss. After weight-loss surgery, one can only eat a very small amount before becoming full; therefore, a high-protein food (think meats, eggs, cottage cheese, beans, etc.) should always be eaten first at each meal.

No snacking - Snacking allows you to consume extra calories that are not necessary. By making the right food choices at meal time, you should be full until the next meal. Snacking alone can make or break long-term weight-loss success.

Skip sweets - After gastric bypass surgery, many experience dumping syndrome after consumption of high sugar or high fat foods. This occurs when the new "pouch" dumps the foods into the intestine rapidly, which can lead to nausea, vomiting, diarrhea, dizziness and/or heart palpitation. Dumping syndrome is a great deterrent from eating empty calories.

Slow down - Listen to your body's signals, and stop eating when full. It is possible after surgery to eat until the point of vomiting, which can lead to many serious medical consequences if done repeatedly.

Avoid liquid calories - Liquids do not provide the long-term satiety like solid foods, and thus will allow hunger to return before the next meal. Choose low-calorie beverages, like unsweetened tea or no-calorie flavored waters.

Kendra Blaschke is a Registered and Licensed Dietitian with a Master's of Science Degree in Nutrition. Send questions or comments to dietitians@vicad.com.

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