Obesity is a major public health concerns, it obesity can cause sever diseases obesity can cause many chronic disease such as diabetes, heart disease, high blood pressure, cancer,arthritiscancer, arthritis, fatty liver and depression related to low self-esteem and negative body image.
Studies had showen that Bariatric surgical procedures result into had a result in weight loss studies have shown durable weight loss and lipids and improve self-stem and body image.
Bariatric surgery is not a magical cure, while surgery can be a powerful method tool for helping you lose weight, it is s not the only method tool that you will need.you have to take care of your diet pre and -post bariatric surgery and keep in regular follow up with your bariatric surgery team ( Surgeons, dietitian) to help you with helping you on your weight loss surgery to success your journey.
Many people choose bariatric surgery for different reasons: reasons:
After bariatric surgery patients will experience remarkable big changes in their eating and exercise habits so they need regular follow up specially during the first year, as it is critical to change the old behavioral and form new lifelong habits, which is exactly the reason behind the need that’s why there is a need for /multi-disciplinary team Working as a group( Bariatric surgeons -Dietitian-Psychologist-plastic surgeons) to get success after surgery
American society for Metabolic and Bariatric Surgery (ASMBS) has been established a diet protocol following bariatric surgery that is High in protein, High in fiber, and low in fat and sugar.
low sugarwith 800-1000 kcal intake daily on include 5 stages, stages, Clear liquid(hospital)-Full liquid diet-puree diet-soft diet- that will make up a highly recommended (lifelong diet) Regular diet for the patient who had undergone the bariatric surgery (lifelong diet)
Dietitian Role following bariatric surgery :
Dietitians who help promoting e nutritional education assess, monitor and counsel patients before and after surgery for the following reasons mainly:
- Improve adherence to recommendation maximize weight loss
- Increase motivation
- Help support patient to change relationship with food and eating habits
Post-operative Dietitian follow up consultation:
- Telephone consultation post op include:
- (Any concern or complain)
- EncouragEncouragement and e motivation for new healthy life style
- Clinic Follow up visits:
First visit (one week Post op) recommendation:
- 24 dietary history recall (number of meals-liquid intake).
- To give Gave educational instructional instructions about the next bariatric diet phase and successful habits to build up right from the beginning.
Key success of bariatric diet: WEPNSS
- P-Protein first
- N-no snacking or grazing
- S-Supplements (Vitamins and minerals)
- S-Support group
- Encourage protein shakes intake.
- Encourage exercise lightly at least 30 min daily.
- Discussion about any concern or complain.
- Enforce the need to choose nutrients dense food (high fiber-high protein).
- Enforce the need of behavioral and psychological change.
Second visit (three week post op):
- Introduce patient to the regular bariatric diet phase e.
- Encourage to eating small frequent meals every 2 houra small meals.
- Advising the patient e to start vitamins intake & explain the importance of vitamins intake e.
- Encourage to increasing e walking duration and intensity to 90min/day(five days week).
- Explore and help overcome barriers to compliance with medical advise.
Third visit: (Three month post op visit):
- Advise to practice muscle – weight lifting activity at least 3 times / week.
- Recommendation of grocery shopping list.
- Provide patient with special high protein recipes.
- Discussion about establishing new and healthy life style habits.
- Practice mindful ly eating.
- Practice how to overcome emotional eating.
- Recommendation of the grocery shopping list.
Fourth visit 🙁 6 month post op):
- Discussion instigation lab test.
- Checking the target achieved weight verses targeted weight.
- Discussion about quality of life from all aspects ( psychological & physiological Body image satisfaction and social acceptance).
- Some patients might need to attend support group educational discussion.
Many patients have high expectations for weight loss and improvements in quality of life Therefore
The bariatric team is responsible for guiding patients toward achieving an accurate understanding of treatment outcome and achieving that at high quality can only come from the cumulative effort of the whole team working on the case, before and after the surgery.