Knowing How Much to Eat

This issue is understandably a source of significant concern for Weight Loss Surgery patients. There is no single answer that fits all patients at all times following surgery, so guidelines are going to be laid out instead of a list of amounts and types of food.

First, during the recovery phase from surgery (1-4 weeks) it is normal to have no appetite. During this time you are likely to consume far less food than you would need over the long haul to stay healthy, but in this recovery period it is OK. Your surgeons want you to be sure you consume adequate fluids (zero-calorie) to stay well hydrated, but they do not want you to force food. At this stage, food should be used to begin to teach yourself new eating habits that will help you feel well and lose weight over the following year.

Next, a few teaching points about knowing when you have eaten enough:

• Don't eat until you feel full. The reason has to do with the fact that the nerves of satiety (feeling of stomach fullness and eating satisfaction) are "slow" nerves. There is a delay of around five minutes from the time your stomach pouch gets comfortably filled to the time that your brain becomes aware of that fact. If you swallow even one additional bite then the pouch will be overfilled and you will experience painful nausea. Realistically, every patient will experience this overfilled feeling at least once or twice, and it will not damage your stomach if it does not become a pattern. The goal is to learn from the experience - remember how much was consumed and what kind of food it was. Next time, use your memory and your eyes to know when to stop eating, before you feel full.
  
• An irritated stomach stays that way for a day or so. If you overeat or if you eat something that does not agree with you, the stomach pouch will be irritated for 12-24 hours. While your stomach is irritated it will be less tolerant of food and liquid than usual, and even small amounts of food can cause the overfull feeling to recur. The lesson here is that if you have an overeating episode, give the stomach pouch a chance to recover by taking only clear liquids for the next meal or two, then slowly add soft foods and eventually transition to solid foods. You can apply this principle to any situation where your stomach pouch is irritated - if medications or an illness makes you feel unable to eat, simply consume liquids alone to maintain your hydration...
  

 

(Information from WHMC Gastric Bypass Nutritional Guidelines Handbook)

 

 

Dining Out: Making better choices

By Staci Stone, RD, CDN

 

For the original article go to http://www.obesityaction.org/magazine/oacnews5/nutrition.php

 

These days, dining out has become the norm rather than the exception. Gone are the days when dining out was a

unique event saved for special occasions with the entire family present. With our hectic lifestyle and busy schedules, dining out is sometimes a necessity, and for many it may mean eating out several times per week and for more than one meal in a day. In addition, having an abundance of eateries available, ranging from breakfast carts to fast food chains to high end restaurants, may make even the most health conscious person feel overwhelmed. Usually, when we eat out we are consuming a lot of extra calories, mainly from fats and large portions, not to mention the extra sodium. While not always easy, it is possible to stay on track with a healthy eating plan while still enjoying the pleasures of dining out.

 

General Tips for Eating Out: This list helps individuals make better choices when eating out.

• Plan ahead; try to read the restaurant menu first. The Web site www.menupages.com has many menus
  

  available from major cities. Or, call the restaurant ahead and ask them to fax or email you the menu.
  

• When choosing a restaurant, try to avoid buffets. The multitude of choices will likely cause you to
  

  consume extra unwanted calories.
  

• Don't arrive to the restaurant starving. You will be too tempted to snack on breads, nuts, etc. which will quickly rack up the calories.
  
• Don't be afraid to ask how something is prepared. Broiled fish is better than fried fish, however if it is
  

  broiled in butter then that is not the best choice.
  

• Request sauces, gravies and dressings on the side. Ask how vegetables are prepared and always order
  

  them steamed. For side dishes, ask to double up on vegetables and omit potatoes, rice or french fries.
  

• Omit high calorie toppings such as sour cream, mayonnaise or tartar sauce. Mustard, tomato sauce and
  

  salsa are all lower fat alternatives where appropriate.
  

• Ask the server to remove the bread basket from the table. Avoid rolls, bagels, croissants and pastries which can add 200-400 calories to your meal. For a sandwich, order it on whole wheat or pita bread.
  
• Avoid these cooking methods: au gratin, fried, cream sauces or soups, "cream of," breaded, alfredo, battered and parmiagiana. Instead, choose healthier preparations: au jus, steamed, poached, grilled, baked, lightly sautéed, barbequed and roasted.
  
• Be careful of mayonnaise based salads such as potato salad, macaroni salad, cole slaw, etc.
  
• Don't waste your calories on drinks. Choose water, diet soda, unsweetened iced tea, etc. Monitor your
  

  servings of alcohol as well.
  

About the Author:Staci Stone, RD, CDN, is a registered dietitian who works for Columbia University in NY with the Center for Advanced Surgery. She specializes in working with the bariatric population, providing nutrition counseling both pre and post surgery.

B-12 Deficiency

B-12 absorption may be altered to some degree after gastric bypass surgery, which can lead to B-12 deficiency and pernicious anemia in some people. Multivitamins typically contain B-12, but this may not prevent B-12 deficiency in all people after surgery. Treatment for B-12 deficiency will likely include B-12 supplemented sublingually or in some cases shots (usually monthly). Your doctor will let you know when you need this.

Prevention:

-Take your vitamins as directed.

-Be sure to come to all your scheduled follow-up appointments for lab tests. (lab tests can detect B-12 deficiency)

-Be sure to have your B-12 levels tested at least yearly after the first year following surgery.

(Information from WHMC Gastric Bypass Nutritional Guidelines Handbook)

 

Daytime Support Group Today

Come out and join us for the Daytime Support Group
In the General Surgery Clinic @ 1130-1230
No appointment needed - just show up!

FOOD FOR THOUGHT

Dr. Cynthia Alexander, in her book, The Emotional First Aid Kit; she reminds patients that weight loss surgery consists of two entirely separate components: The surgery itself, and the lifestyle changes.

She suggests six things patients might do pre-operatively to address lifestyle changes:

1. Prepare your environment.
   
2. Prepare your Support System
   
3. Emphasize activity instead of food
   
4. Begin to learn to structure your eating habits
   
5. Control emotional and recreational eating
   
6. Become more active.
   

By embarking on this journey before surgery, patients avoid the outdated way to thinking; waiting until after the surgery to start lifestyle changes. Alexander believes healthy habits start prior to surgery.

Reference:

Matrix Medical Communications, Bariatric Times. Volume 4, Number 5, June 2007

Jacques, Jacqueline, ND, Protein Basics Bariatric Times, Matrix Medical Communication, Volume 4, Number 4, May 2007.

(Information from WHMC Gastric Bypass Nutritional Guidelines Handbook)

Iron Deficiency

If you don't take in enough iron, you may become iron deficient.

Prevention:

--Be sure to include low fat meats when you are at stages 3 and 4. They are your best food sources of iron.

--Take a multivitamin with iron as instructed.

--Don't take your vitamins or eat your high iron foods with coffee or tea. The coffee and tea can bind iron and prevent absorption.

No one can guarantee you won't develop iron deficiency, even if you follow these guidelines, but you can minimize your risk for iron deficiency.

(Information from WHMC Gastric Bypass Nutritional Guidelines Handbook)

 

 

Agreement expands AF beneficiaries' access to bariatric surgery

Agreement expands AF beneficiaries' access to bariatric surgery


by Sue Campbell
59th Medical Wing Public Affairs

1/7/2009 - LACKLAND AIR FORCE BASE, Texas -- According to the Centers for Disease Control, two-thirds of all Americans are overweight or obese. Thanks to a resource sharing agreement between the Nix Health Care System and the 59th Medical Wing, Wilford Hall Medical Center doctors are providing increased services to bariatric patients.

An agreement was initially implemented in 2007, allowing Wilford Hall providers to perform surgeries in Nix operating rooms, using Nix equipment and support staff. In December 2008 the agreement was modified to include bariatric surgeries. 

Read this article at the link above or cut and paste the following url 

http://www.whmc.af.mil/news/story.asp?id=123130372