Making Surgery a Success

A Three-Pronged Approach to Making Your Weight Loss Surgery A Success

(1) Healthy Eating, (2) Regular Exercise, (3) Long-Term Support

Facing life after weight loss surgery can be daunting. If you’ve done your homework, you already know that regardless of the type of surgery you opt for, successful weight loss after surgery still requires significant changes to your daily life that may seem impossible right now. After all, you’ve already tried, unsuccessfully, to lose weight through diet and exercise, so why should dieting and exercising be any easier or any more successful after weight loss surgery?

Weight loss surgery is not the “easy way out”, it’s true. Metabolic and bariatric surgery does require you to commit to extensive changes in your eating habits and exercise routines that may be difficult for some individuals to maintain. But obesity surgery also sparks real changes in your metabolism and anatomy that make healthy eating choices easier, and once the weight begins to come off, exercise becomes easier as well! When coupled with help from a qualified team of weight loss experts, you may find that new, healthy habits take hold even before you realize it!

Board Certified surgeon Dr. Wiljon Beltre at Beltre Bariatrics Center for Metabolic and Obesity Surgery in Maitland, Florida, offers a proven three-pronged approach for long-term weight loss success after surgery:

Healthy Eating Habits

Traditional dieting often means going hungry and constantly fighting cravings. However, the anatomical changes to your body after surgery make you feel full quickly and in some cases control your hunger too. Yes, you will need to avoid unhealthy food choices, but because the body no longer tolerates these foods well, most patients find they simply don’t want them. So restrictions that seem difficult now are much easier than you might believe.

Exercise

Yes, committing to exercise seems impossible now, because obesity and related illnesses sap your strength and your energy. But once weight loss has begun and health problems begin to resolve, exercise becomes easier than ever before, and as you realize how wonderful it makes you feel, sticking to a good exercise routine becomes easier and easier.

Long-Term Support

Scientific studies now conclusive demonstrate that long-term, successful weight loss is nearly impossible for most individuals without support, advice, and medical intervention, even after weight loss surgery. In fact, your chances of achieving your weight loss goals after surgery increase dramatically if you participate in regularly-scheduled follow-up visits with your surgeon and participate in regular support group meetings.

Phase 1: Clear Liquid Diet (1 week): Starting the first day after your surgery, you will begin sipping clear liquids such as clear broth and sugar free juices or drink mixes, avoiding caffeinated or carbonated beverages. The goal is to consume 4-8 ounces per hour without vomiting, for a total of at least 64 ounces per day. Once you return home, you will add two chewable multivitamin with iron, calcium, and B-12. You can expect to begin your vitamin regime with 2 supplements per day, but this number will increase as your diet expands, especially for patients who have undergone malabsorptive procedures.

Stage 2: Full Liquid Diet (1 week): Once you can tolerate clear liquids easily, you may begin adding high-protein liquids such as protein powders mixed with non-fat milk or almond milk. All foods should be sugar free and fat free. Examples include creamed soups, yogurt, pudding, applesauce, and V8.

Stage 3: Transition from pureed to soft foods (1 week): About three weeks after your surgery, you may be ready to begin introducing pureed and eventually soft foods back into your diet. You will need to introduce new foods slowly, one at a time, in order to give your body sufficient time to adjust and to develop a sense of what foods your body can tolerate. Again, stick to sugar free and fat free foods; sweeten with Splenda when necessary. Examples of acceptable soft foods include: canned fruits, baked or mashed potatoes (no butter), eggs, hummus, soft cooked vegetables (avoid celery and asparagus), low fat cheeses like cottage or ricotta, oatmeal, smoothies (be careful of sugar!), and lean meats.

Stage 4: Soft to Regular Diet (beginning around Week 4): Starting about a month after surgery, you will most likely be ready to begin moving towards your new, healthy diet. You can begin slowly introducing new foods one at a time to identify problematic foods and to build up tolerance, always avoiding sugars, fats, fibrous vegetables, tough meats such as steak and pork chops, and fruits with membranes (oranges, pineapple, grapes, etc), and beans if they cause too much gas and abdominal discomfort.

Vitamin Supplements: All metabolic and bariatric surgery patients must be willing commit to life-long monitoring for vitamin and mineral deficiencies, and will most likely be required to take regular vitamin supplements. This is especially critical for patients who have undergone malabsorptive procedures such as gastric bypass and BPD/DS, because the body’s ability to absorb certain vitamins and minerals has been compromised. Calcium, Vitamin D, Vitamin B complexes, and Iron are especially critical and must be taken in high doses, usually requiring multiple pills per day. Chewable supplements will likely start immediately after surgery; after six weeks, you may switch to pill supplements if you would like.

Drink plenty of sugar free beverages, but only between meals. Due to the smaller pouch size, it is important not to drink during meals: avoid all beverages for 30 minutes before and 30 minutes after eating. However, dehydration can be a real danger, so it is critical to sip sugar-free, caffeine free, and non-carbonated beverages slowly throughout the day (except when eating). Your goal should be to consume 48-64 ounces of fluid per day.

Always eat protein first. Because portion size is very small and you will feel full quickly, it is important to begin your meal with protein. You must also limit fats and avoid refined sugars and starchy foods such as while rice, pasta, and bread. These foods may be difficult for your system to tolerate; moreover, they are nutritionally less appropriate than low-fat proteins, so filling up on them first will limit the amount of high-quality, more nutritious foods you can eat.

Eat slowly. Eating slowly will enable you to recognize the signs of fullness before you overeat; it will also help ensure that you chew your food thoroughly before swallowing. All meals should take about 30 minutes to complete. This is especially important for gastric bypass and BPD patients, as eating or drinking too quickly can lead to “dumping syndrome”, in which too much food enters the intestines too quickly, leading to nausea, vomiting, dizziness, and diarrhea.

Cut food into very small chunks and chew thoroughly. Large chunks of food can block the small passages created by your surgery, leading to abdominal pain, vomiting, and nausea. It is critical that food be cut into very small bite-sized pieces, and then chewed to the consistency of a puree before swallowing.

Eat three small meals per day, and unless you have the gastric band, you may also include two snacks. Individuals with gastric band must avoid snacking, and strictly limit eating to three- or-four small meals per day to ensure weight loss.

Participation in Long-Term Support Network

Scientific studies now conclusively show that patients who participate in long-term medical follow-up and regular support group meetings achieve more successful weight loss and are more successful at maintaining their ideal weight. The lifestyle changes required by weight loss surgery can be extensive, and developing good eating and exercise habits can be difficult. We have found that patients who participate in support groups and other support networks have an easier time making and following through on developing positive lifestyle habits and achieve better long-term success. For more information on the support groups offered through Beltre Bariatrics Center for Metabolic and Obesity Surgery, click here.