Weight Loss Surgery and Lifestyle Changes

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).

Bariatric Infograph

 

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

 

References:

http://www.nordbariatric.com/en/articles/infographics/different-wls-compared

http://www.mayoclinic.com/health/gastric-bypass-diet/my00827

Hula Hooping for Weight Loss?

This past week I had the opportunity to accompany the exercise physiologist to WVU Jackson’s Mill to State 4-H camp to teach a weighted hula hoop class! Yes, that’s right…the hula hoops are actually weighted, about 3 lbs. There is actually a video and a workout specially designed with these hoops. It involves hula hooping while doing various exercises such as kickboxing, squats, arm movements, and the list goes on. There are also moves designed to incorporate the use of the hula hoop in “unconventional” ways. For example, the hula hoop can be held above the head and used for a shoulder press, tricep press, and used for squats. Now, to give you an example of what in world this new phenomenon looks like I have attached multiple (embarrassing!) videos of my infamous attempts and the various moves for your enjoyment!

I have to admit the day after my hula hoop workout I felt like my ribs, hip bones were bruised! I think you would get used to it if you did if on a regular basis – just like riding a bike! Also, I am not an expert hula hooper and have not tried a regular hula hoop in years…BUT I do have to admit that the weighted hula hoops seem easier to keep up than the super light regular ones! If you are ever in a “work-out slump” and bored with your normal routines maybe you can try this (or if you are just need of a good laugh!)

New Year, New Diet? – Not Again!

With the New Year well under way, fad diets and weight loss pills are hot items! Millions of people are making New Year’s resolutions from everything to losing weight, saving money, spending more time with family and everything in between.

 

 

With large Thanksgiving meals, leftovers, holiday desserts and cookies for Santa, it should not be surprising to find that the last months of the year can lead to most weight gain all year. According to Yvonne Ortega, a registered dietitian and professor at Santa Monica College, Americans tend to gain anywhere between nine and 12 pounds during the holiday season! Holiday meals can account for 3,000 – 5,000 calories not including those leftovers we savor the following week. (Check out my previous post to see how to eliminate some of the calories without sacrificing any of the necessities!)

 

So, what is the best way to combat the extra pounds that continue to accumulate after all these years? Is it the latest weight-loss pill that claims to “clinically proven” or the newest “cleansing” diet? The answer is NO! As humans, we naturally look for the quickest and easiest way to lose weight. The truth is that there is no overnight solution. The weight took time to accumulate and it will take time to get rid of.

 

Those weight loss pills on TV are not even regulated by the FDA and cannot be proven safe or even effective! The ever-popular cleansing diets that involve only drinking lemon juice, vinegar, or even smoothies are really just starvation diets in disguise. Do you even really know what you are trying to cleanse? Those diets eliminate entire food groups and not sustainable. As soon as the “cleanse” ends the pounds will return and you will lucky if you don’t end up gaining more than you lost in the first place.

 

With so much of today’s society’s social events being centered around food and alcohol, losing weight can be a challenge. The secret to weight loss that no one wants to here is long-term, sustainable, healthy living. This involves making every day, healthy choices such as these:

  1. Choose grilled or boiled meats and vegetables instead of breaded and fried
  2. Limit portion sizes
  3. Make half your plate fruits and vegetables at every meal
  4. Reduce or eliminate your intake of sugary drinks like soda and juice and drink more water or unsweetened tea
  5. Limit intake of cream based sauces and soups and chose vegetable or broth based soups

 

Physical activity is also a key component of a healthy lifestyle. Don’t be discouraged if you can’t get to the gym or devote an entire hour directly to exercise everyday – there are other ways to increase your energy expenditure. The key to exercise is to find something that you actually enjoy doing. If you hate running you probably won’t last long if you force yourself and the excuses to not work out will be easy to find. Think outside the box. Have you tried Zumba, kickboxing, spinning class, taking walks, hiking, the opportunities are endless. If you aren’t used to exercising start by taking small steps like taking the stairs, not using the remote, walking the dogs, doing calf raises while doing the dishes. You may be surprised by how all the little things can add up!

 

So please, don’t fall for the latest fad diet and together let’s make it our New Year’s resolution to NOT diet but instead let’s work to make daily healthy choices that will lead to a sustainable, healthy, and enjoyable life.