Bariatric surgery helps morbidly obese individuals -- those with at least 100 lbs. of excess weight -- lose significant amounts of weight. Although the procedure facilitates weight loss, you must make long-term dietary and lifestyle changes to prevent gaining weight back and to maintain optimal health. Successful weight loss surgery patients need life-time nutrition care including education, support and monitoring for vitamin, mineral and protein deficiencies.
Bariatric Surgery
Bariatric procedures help patients lose weight through restriction, malabsorption or a combination of both mechanisms. Restrictive procedures such as adjustable gastric banding and sleeve gastrectomy reduce the size of the stomach and restrict the amount of food intake. Malabsorptive procedures such as biliopancreatic diversion block some calorie absorption by rearranging the digestive system to bypass part of the small intestine. Gastric bypass procedures combine restriction and malabsorption by reducing the stomach and rearranging the digestive system
Pre-Operative Nutrition Care
Nutrition care begins well before your surgery. To prevent post-operative complications, the surgeon and the nutritionist evaluate your nutrition status, correct deficiencies, if necessary, and provide education about what to eat after surgery. During this phase, you learn about the vitamin, mineral and protein supplements you will need after surgery and the importance of regular monitoring and follow-up.
Recovery Phase
Although surgeons' guidelines vary, most instruct patients to follow a four-stage diet progression after surgery -- clear liquids, full liquids, pureed food and soft food -- regardless of the type of surgery performed, according to Linda Aills, R.D., lead researcher in a study published in the September 2008 issue of "Surgery for Obesity and Related Diseases." The diet progression allows the body to heal before the begin to eat small amounts of regular food that is low in sugar, fat and calories but high in protein.
Long-Term Nutrition Care
You generally visit your surgeon and a nutritionist frequently during the first year, including the first one to two weeks, then one, two, three, six and nine months after surgery, then annually for the rest of your life, says Aills. Post-operative nutrition care includes education, trouble-shooting, support and monitoring for nutrition deficiencies. You may also benefit from attending bariatric support groups to help you adjust to your new lifestyle.
Supplements
All bariatric surgery patients need to take vitamin and mineral supplements for the rest of their lives but the types and amounts vary according to the type of surgery. Adjustable gastric band patients need only multivitamins because the surgery does not cause malabsorption. Gastric bypass patients, on the other hand, need multivitamins, calcium, iron, vitamin D and vitamin B-12, notes Aills. BPD patients need multivitamins, calcium, iron and vitamins A, D and K.
References
- "Obesity Surgery"; Nutritional Consequences of Adjustable Gastric Banding and Gastric Bypass: A 1-Year Prospective Study; Muriel Coupaye, et al.; January 2009
- "ACSM'S Certified News 14"; Nutritional Care of the Bariatric Patient; Susan J. Kraus; January/February/March 2009
- "Surgery for Obesity and Related Diseases 4"; ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patients; Linda Aills, et al.; September 2008
- West Penn Allegheny Health System: How to Be a Successful "Loser" After Gastric Bypass Surgery
- "The American Journal of Clinical Nutrition"; Nutritional Deficiencies After Roux-en-Y Gastric Bypass for Morbid Obesity Often Cannot Be Prevented by Standard Multivitamin Supplementation; Christoph Gasteyger, et al.; May 2008
- "Obesity"; Best Practice Updates for Multidisciplinary Care in Weight Loss Surgery; Caroline M. Apovian, et al.; May 2009
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