Nutrition After Weight Loss Surgery Gastric Bypass Sleeve Gastrectomy Gastric Banding HOW YOU WILL USE YOUR NEW TOOL SUCCESSFULLY TEXAS CENTER FOR MEDICAL & SURGICAL WEIGHT LOSS
What We ll Cover Today Nutrition guidelines for successful weight loss following surgery Lifestyle and behavior modifications What to expect after surgery
WEPNSS W- water E- exercise P- protein first N- no snacking or grazing S- supplements (vitamins and minerals) S- support group
WEPNSS These are the basic rules to live by. They work. Following them will make you as successful as you want to be. Remember them. Live by them.
(WEPNSS) Water Water Water Minimum 64 oz daily. This is critical. The single most important thing for you to do after surgery is to get in at least 64 oz water daily! Assists in healing process, controls hunger, rinses out waste products It is okay to add a small amount of sugar-free flavoring. Shoot for at least half your water to only contain natural flavorings such as lemon, lime, mint, etc
Spacing Water and Meals Separate water from your meals. Stop drinking at the start of the meal and wait 1 hour after meals to resume drinking. Water during meals can flush your food through faster, making you hungry again sooner. Water Water Water Meal Water Water Water
(WEPNSS) Exercise Burns calories and good for your health Helps to preserve lean body mass. Make it fun use the buddy system. Make exercise a habit. Focus on PURPOSEFUL MOVEMENT Add movement into your day to day activities Take the stairs Increase the number of steps you take Track using a pedometer
Exercise Start walking from day 1 after surgery and progress from there. Cardiovascular + Resistance (weights/bands) Goal = minimum of 30 minutes cardio 5x/wk and 15 minutes strength/resistance 3x/wk Add weights/resistance training. Start light and gradually increase 20 lb maximum for 4-6 weeks
(WEPNSS) Protein 60-80 grams daily Early benefits of protein Helps protect against loss of lean body mass (muscle) Main building blocks of our bodies Late benefits of protein Protein gives a feeling of satiety (satisfied) Fewer calories per gram than fat and more satiety than carbohydrates
Protein Long term your diet is higher protein, low fat and moderate carbohydrate ~35-50% of the diet from lean proteins ~35-50% nonstarchy vegetables Less than 15-20% complex carbohydrates Early after surgery, getting enough protein in every day will be a challenge. Track your protein intake using a food tracking tool Myfitnesspal, sparkpeople, Tap and Track Most people will need to have a protein shake or meal replacement for one meal per day as you are progressing your diet after surgery.
Protein Meal Replacements Shakes must be 15-35 grams of protein with no more than 5 grams of carbohydrate or 5 grams of fat per serving. Bars must contain at least 12 grams of protein with no more than 20 grams of carbohydrate and 7 grams of fat Ready Made Products Powders Clear Liquids Bars
Preoperative Diet Replace 2 meals per day with a Protein Shake Powders must be mixed with water One small meal with a palm size of lean protein (fish/chicken/turkey/egg whites) and non-starchy vegetables (anything other than corn, peas, potatoes) Drink at least 64 ounces of water Avoid snacks. If you are hungry, drink water. Avoid fats/sugars/carbohydrates (bread/rice/pasta/fruit/etc) as much as possible. Take multivitamin every day
Purpose of Preoperative Diet Shrinks the liver Liver sits over the stomach Reduces complications that can happen from the surgery
(WEPNSS) No Snacking or Grazing Eat 2 or 3 meals per day Fasting periods lead to fat-burning. Grazing lessens your body s need to burn its fat stores because you are frequently giving it energy (calories). Snacks are habit-forming and can inhibit weight loss Theoretically, 3500 calories = 1 pound Adding only an extra 100 calories per day could be equivalent to a 10 pound weight gain in a year.
No Snacking or Grazing Our bodies do not differentiate well between hunger and thirst. When you want to snack your body may actually need the water in the food. Drink water instead of snacking. Improving your protein intake at each meal and increasing the amount of water you drink during the day will decrease your desire to snack.
( WEPNSS) Supplements Y O U W I L L N E E D V I T A M I N S F O R T H E R E S T O F Y O U R L I F E, N O M A T T E R H O W G R E A T Y O U F E E L!
Why Will I Need Vitamins? Weight loss surgery can contribute to deficiencies because of: Decreased intake of food Eating different foods Decreased absorption of certain nutrients Deficiencies develop slowly and you may not notice them until they are severe! Protect your health 1. Be consistent with a vitamin program. 2. Get your vitamin levels checked every year!
Which ones will I need? High Potency Multivitamin with Iron: Calcium citrate 1500-1800 mg daily (in 500mg doses) Try to separate 2 hours from iron Vitamin D 3000 IU per day Vitamin B12: 1000mcg under your tongue (sublingual) once a week Oral methylcobalamin Nasal sprays or injections are also an option
Type of Vitamins Vitamin preparations vary a lot in terms of contents, nutrient forms, and nutrient levels. We recommend bariatric specific vitamins because they are delivering the dosage of nutrients needed with your new anatomy as well as in a way that the new anatomy can actually absorb and utilize the nutrients. We see improved vitamin profiles in patients taking bariatric vitamins.
When do I start vitamins? Talk to your provider about any supplements you may need prior to surgery. Start on the bariatric specific vitamins ~1 week post-op Bariatric vitamins that we recommend will be presented at your post-op follow up appointment and you will have a chance to sample them.
(WEPNSS) Support General support groups are once a month. Join us 3 rd Thursday at 6:30 Check the schedule and videos of past support groups at www.texasbariatric.com The people who do the best attend support groups regularly. It s fun and educational. Your attendance, questions, and support, will help other people, even if you think that you don t necessarily need it. You will almost always walk away with something you gained from the meeting.
(WEPNSS) Support Website (www.texasbariatric.com) Smart Phone App Search Texas Center for Medical and Surgical Weight Loss Like us on facebook https://www.facebook.com/texasbariatric Follow us on Pinterest BE CONNECTED as you are not on this journey alone!
Additional Behavior Modifications Take your time eating Take 15-20 minutes to eat a meal (no longer than 30 minutes) Chew food thoroughly Caffeine and alcohol Both must be avoided for 3 months following surgery New anatomy make you more sensitive to alcohol. 1 drink is like 4 drinks. Keep to 1 drink in a 24 hour period. Avoid carbonation, straws, and chewing gum Can cause excess air in stomach bloating, gas pain
Diet Going Home You will be on clear liquids when you go home from the hospital Water, fat-free broth, sugar-free jell-o, sugar-free popsicles, decaf coffee and tea Important to have only these clear liquids to allow your stomach to rest and heal until you return for your 1 week follow-up appointment
1 Week Follow-Up Your follow-up visit will begin at 10am on the Thursday following your surgery. A series of classes will be given, which will cover: Nutrition guidelines and behavior modifications Diet progression you will be able to start on semi-solid protein foods and increase as tolerated Care post-op Exercise Vitamins Following the classes, you will visit with your surgeon.
Congratulations on starting the journey to a new you! TEXAS CENTER FOR MEDICAL & SURGICAL WEIGHT LOSS