This past week I had the opportunity to spend time at a weight loss center, wound clinic, and also in medical telemetry and ICU. I am sure you all have heard of weight loss surgeries (more appropriately called bariatric surgeries) by now and while it may seem like a quick and easy fix… it is far from that. Even though the majority of these surgeries are preformed laparoscopically, no surgery comes without some risk. At this particular center the surgeons performed three different bariatric surgeries: Laparoscopic Adjustable Gastric Banding (LABG), Laparoscopic Sleeve Gastrectomy, and Roux-en-Y Gastric Bypass (RYGB).
What is the role of an RD when it comes to bariatric surgeries?
Bariatric surgeries all require a dramatic lifestyle change. Dietitians are responsible for conducting an initial nutritional screening to ensure that the client is suitable for surgery. If the patient is not willing to change their diet then they will not be allowed to undergo surgery due to the danger it could cause. Dietitians are also used to explain and educate the patient on the bariatric diet prior to surgery and participate in follow-up appointments with patients as needed. Here is just a brief overview of some of the dietary changes one must undergo after surgery.
- Advance diet as tolerated from clear liquids to puree/soft foods to solids post surgery – this typically takes at least one month.
- Eat slowly – it should take 20-30 minutes to finish a meal!
- Always sip liquids, NEVER chug! You should drink about 1 oz. every 15 minutes.
- Chew slowly and thoroughly before swallowing
- Avoid sugary foods to prevent “Dumping Syndrome”
- Limit fat intake – fats slow the digestion process which can lead to nausea
- REMEMBER the stomach can only hold a few tablespoons immediately after surgery and will eventually hold up to 0.5-1 cup so you will need to eat less
- Drink at least 64 oz. fluid to prevent dehydration
- Do not drink fluid with meals – stop drinking 30 minutes before eating and wait until 30 minutes after to drink again
- Always eat your protein food first to make sure your protein intake is adequate
- Tolerance of dairy (lactose) may be altered so substitute a lactose-free dairy if needed
What does a typical menu look like for the first month after surgery once you are discharged?
Breakfast – 8:00AM:
- ¼ cup unsweetened applesauce
- ¼ – ½ cup non fat cottage cheese
Supplement – 10:00AM:
- ½ cup skim plus with 1 scoop of protein powder
Lunch – 12:00PM:
- ¼ – ½ cup blended soup
- ¼ cup tuna fish with low fat mayo
Snack – 2:00PM:
- ½ cup sugar free yogurt
- 1 sugar free popsicle
Dinner – 6:00PM:
- 1-2 oz. flaked fish
- ¼ cup puree vegetable