Obesity is a lifelong disease and there is no operation, diet or medication that can by itself offer a permanent cure. Surgery with good aftercare and moderate lifestyle changes can give wonderful long- term results for health and weight.
Bariatric surgery is not a magical prescription for weight loss. It is an excellent tool to help the patient to limit his food amount and facilitate weight reduction. It is only the first step towards a major re-adjustment in life style, where the patient needs to adapt a healthy diet and a physical activity plan that suits him the best. The healthy diet aim for starts from choosing healthy foods to the way the patient eats those foods to achieve maximum success and help him lose weight safely.
The Primary Nutrition Goals After Surgery
» Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight.
» Consume adequate amounts of protein to minimize loss of lean body mass and hair loss, facilitate healing and maintain skin elasticity.
» Take adequate amounts of fluids to maintain hydration.
» Obtain adequate nutrients for optimal health through supplementation.
Diet recommendations after bariatric surgeries may vary between medical centers. Most commonly, the diet has five phases, which serves many objectives. First, to allow stomach to heal without being stretched by the food intake. Second, to get the patient used to eat smaller amounts of food that can be digested comfortably and safely in smaller stomach. Finally, to ease the way back to eating solid foods after surgery.
The 5 phases in the meal plan: started with clear liquid diet for one day (24 hours) then high protein full liquid diet, progress to puree (blended) diet, then move to soft moist food (each phase will take from 1-2 weeks as patient tolerated) and then progress to regular balanced diet. The meal plan will be high in protein to help the healing process, promote weight loss and preserve lean body mass (muscle), also be low in fat (5 grams or less per serving) and low in sugar (14 grams or less per serving).
Healthy lifestyle choices give the best results for health and Quality of Life after surgery. Protein-rich foods are important, patients advised to take 60-100 g of protein daily. Protein should be taken in multiple doses, across multiple meals or healthy snacks. The body cannot absorb more than approximately 30 grams at once. Also, protein is a nutrient that helps us feel fuller, longer. The body needs additional protein during the period of rapid weight loss to maintain muscle mass. Protein is also required for the metabolism to occur. If the patient doesn’t have enough protein in the diet, the body will take its protein from the muscles and the patient will become weak. For the first 6 months following surgery, the calorie intake should be between 600 and 800 calories a day. Daily caloric intake should not exceed 1,000 calories for the first year. For successful weight loss, caloric intake may range between 800- 1200 calories each day.
The American Society for Metabolic and Bariatric Surgery (ASMBS) warns patients to avoid excessive carbohydrate intake, such as starchy foods (breads, pastas, crackers, refined cereals) and sweetened foods (cookies, cakes, candy, or other sweets). Limiting carbohydrates to 50 grams per day or less helps avoid rebound hunger problems which can lead to weight regain. It is a good idea to avoid caffeine (Diuretic) for at least the first thirty days after surgery while the stomach is extra sensitive. Dehydration occurs when the body does not get enough fluid to keep it functioning at its best. Also fluids are required to burn its stored fat calories for energy. Carry a bottle of water all the day even there is no feel of thirsty. Signs of dehydration can be thirst, headache, hard stools or dizziness upon sitting or standing up. It is important to know that following surgery, stomach size is very small – less than 1/4 cup, or about the size of an egg. The opening that allows food to pass out of the stomach is also very narrow. For this reason, it is important to take only two to three sips or bites at a time of any new food and then wait 10 minutes before taking more. This will help to learn the limits and tolerance. Liquids will empty faster from the stomach than soft solids. If overeat or eat too quickly, may experience nausea or pain.
Important Tips to Remember Forever
» Protein is the priority, Most be eaten first, Must be eaten at each meal
» Stop at the first sign of fullness, Listen to the body and don’t overstuff the pouch
» Intake at meals should be ½ – 1 cup
» For better portion control, advise to use smaller plates.
» Patient should eat slowly, allow 30-60 minutes/meal. Take small bites and chew until liquid, Aim for 30 chews for each bite.
» Eliminate high fat and high sugar foods
» Avoid high caloric beverages
» Patient should not drink with meals, Liquids must be separate from meals by 30 minutes before and after eating
» Drink at least 6 to 8 cups (1 to 2 liters) of fluids a day to prevent dehydration, constipation, and kidney stones.
» Patient should take prescribed supplements daily. (Vitamins/ Minerals)
» Weight re-gain is probable if not following the diet guidelines
» Exercise regularly
» Attend regular follow-up appointments
» Follow all the diet instructions.