ABC Back on Track
If you are reading this then you had a bariatric surgical procedure at some point in time and we’re sure you have lost some of your excessive weight, but you wouldn’t be reading this if you were completely satisfied with your total weight loss. We want to help you lose more weight, to get things moving in the right direction, to get you ‘back on track’.
First off, you can now appreciate how easy your excessive weight came off immediately following your bariatric surgery and we’re certain that you know that further weight loss just won’t come so quickly or easily, but we are here to tell you that you can jump start the weight loss process with a few simple to follow steps and we’re all here to help you every step of the way to your goal weight.
Before we begin discussing the basic principles of our Back on Track program we want to make sure that there is nothing going wrong with the surgical procedure that you chose, so the very first step is to touch base with your bariatric surgeon to make sure that your adjustable band and is adjusted properly or that your gastric sleeve or gastric bypass pouch is intact is functioning properly. It is rare for the surgical procedure to have failed to produce the desired restrictive and/or maladaptive goals, but we want to be certain that everything is right with the surgical procedure before we move forward.
Once you have followed up with your bariatric surgeon and have been given the green light to follow our Back on Track program, we want you to re-engage with your bariatric surgeon’s entire team of physicians, nurses, dieticians and exercise specialist. If is especially important that you continue to attend the patient support groups. You’ll gain so much valuable information from others just like you who have and are struggling to lose and keep weight off.
As we turn our attention to the Back on Track program our first concern has to be with total calorie intake and the quality of those calories. You were taught preoperatively about the importance of a high protein, low carbohydrate diet, in fact some of you went through a VLCD very low calorie diet which is essentially an all protein diet just prior to your surgery to help you lose a lot a weight in a very short period of time. That very same diet can be utilized again here after surgery to jump- start your weight loss. High protein diets such as the VLCD put you into a state of mild ketosis, which drives down your hunger even through you, are only taking in 800 kcal daily.
So if you are willing and can commit to a VLCD for 4-8 weeks, let’s give that a try, you are sure to get things moving in the right direction. Before you start a VLCD you must follow up with your primary care physician or your bariatric surgeon so that they can closely follow your progress and monitor for any potential side effects. A healthcare provider should see you at least once a week during the VLCD process. Go to www.americanbariatriccenters.com to pulled down a VLCD diet plan.
Those of you who do not wish to begin the Back on Track program with a VLCD, let’s look at other nutritional options to get things moving along. Regardless of whether you go on a VLCD or any other diet you have just got to make sure your diet is protein rich, if you’ve had an adjustable gastric band surgery you should be taking in 45 grams of supplemented protein each and every day and that’s in addition to the protein that you are taking in from foods. If you’ve had a gastric sleeve or a gastric bypass then you need to make sure you are taking in 60 grams of supplemented protein each and every day. Once you begin to take in the recommended amount of protein through supplement you’ll quickly see your weight begin to drop again, in part that is because your body is fooled by the excessive protein into thinking it has more than adequate amount of calorie and in part because as you increase your protein intake your appetite will diminish and you’ll naturally eat less. You can find a wide variety of great tasting protein supplement at www.americanbariatriccenters.com you will also find the basic vitamins that you need postoperatively. Your body will shut down without these vitamins so please make sure you are taking a good multivitamin, get some extra calcium in the form of calcium citrate with a little Vitamin D to help you absorb the calcium. You all need a little extra Iron and Vitamin B12 with folate. You may have additional vitamin and mineral needs so please follow up with your bariatric surgeon and/or primary care physician to make sure you are getting everything your body needs so it is willing to give up those excessive pounds.
Once we have you nutritionally stable in terms of adequate protein and vitamins, we need to look at frequency and amount of each meal. You should be consuming only three meals a day, no snacks, and especially no high calorie liquids between meals. Test your pouch size my eating cottage cheese, measure how much it takes to make you full, then eat only this volume of food during your meals. Three small meals a day is all you need and should have and remember only eat until your hunger is gone, the signals from the stomach to the brain may take 20 minutes to register and by then most of us have overeaten, so once the hunger pain is gone sit back and wait a few minutes before finishing your meal. And take a lesson from those guys who always win the Coney Island hot dog eating contest, if you want to eat a lot of food drink a lot of water with your meals. The lesson here is no fluid 30 minutes before and after meals period. You’d be surprised at how much less you’ll eat if you just follow this one simple rule. Between meal snacks should only be protein supplements and nothing else. Drink a lot of water between meals and at all cost avoid any carbonated beverage which has been blamed by many for distending the gastric pouch which allows you to eat more volume over time.
Exercise is next; the number one predictor of who is going to keep their weight off is exercise, those who exercise keep weight off those who do not regain weight. You don’t need to be a world class athlete to keep weight off, you just have to move your body 30 minutes a day in some form of physical activity. Make exercise fun, join a club, work out with a friend or someone from your support group or touch base with the exercise staff at your local bariatric center, but just do it.
Medications: weight loss medications are not contraindicated in bariatric surgical patients, in fact that may be just the ticket to getting hunger under control once you have reinstituted your high protein diet. Ask your primary care physician and/or your bariatric surgeon about introducing weight loss medications to your postop treatment.
We are certain that following these very simply and easy to follow guidelines that your weight loss will again be Back on Tack.
American Bariatric Centers®
Dr. Kevin Huffman