Friday, January 10, 2020

Understand

“Not everyone will understand your journey. That’s fine. It’s not their journey to make sense of. It’s yours.” (Zero Dean)

In 2013, 179,000 bariatric surgeries were performed in the U.S. As the obesity epidemic continues to grow, more and more individuals are considering bariatric surgery as a treatment option. While most patients see significant weight loss immediately after surgery, continuing to lose weight (and keeping it off) can be a challenge.
According to the American Society for Metabolic and Bariatric Surgery upwards of 50 percent of patients lose their excess body weight and keep it off. So what can be done to increase the success rate of  bariatric surgery? Surgery is only the first step. The secret to weight loss is to make lifestyle changes that are permanent.
After you have bariatric surgery, you will follow a special diet and lifestyle program that your surgeon will discuss with you. It’s important to note that the surgery is a tool to help you lose the weight and control your hunger — but it’s not a “cure-all” for being overweight. Bariatric surgery patients have to do some work to lose weight and achieve long-term success. Here are ways to avoid falling into old habits and stay on the road to weight loss success.
Avoid simple carbohydrates-Simple carbohydrates are highly processed foods such as white bread, pasta, sugar, and white rice. The rule is this if it is white it may be a simple carbohydrate. You are better off with more wholesome alternatives such as brown rice that contain fiber and nutrients that white rice does not. Simple carbohydrates can also elevate blood glucose levels, triggering hunger pangs and cravings. Add minimally processed foods, such as fresh fruit, vegetables, and protein, to your diet as much as possible. Avoid processed foods, such as canned and boxed items, when a fresh alternative is available.

Avoid sugar- Sugar is the ultimate empty calorie. Sugar will make your blood sugar climb, cause hunger pangs, provide no nutrients and, for patients of certain types of gastric bypass, cause dumping syndrome. Avoid sugar and any foods that list sugar in the first three ingredients, whenever possible. Dumping Syndrome includes cramps, nausea, diarrhea, and dizziness that occur when food or liquid enters the small intestine too rapidly.

Be careful with milk- If you must drink calories, skim milk is an excellent option. Be aware, though, that many weight-loss surgery patients develop lactose intolerance after surgery even if they didn’t have it before. Go easy on the dairy products until you know how your body will tolerate lactose. Consider low-fat dairy products to increase the protein you get without too much fat.

Chew your food- Chew and then chew some more. Chewing your food thoroughly is essential to preventing nausea and vomiting during and after your meal. Large chunks of food can have trouble passing through the digestive tract after surgery, and if it gets stuck along the way, it can cause pain.

Don't  take over-the- counter (OTC) drugs without approval- Over-the-counter drugs can pose risks after surgery that were not a concern prior to surgery. Pain relievers like ibuprofen and acetaminophen increase the likelihood that you will develop an ulcer. Remedies for constipation shouldn’t be taken without physician approval, as constipation can be a sign of complications or a need for a change in diet.

Don't drink calories- Your caloric intake will be very limited after surgery, which should help you lose weight immediately after surgery. Don’t work against your surgery by taking in liquid calories like soda that provides no nutrition and slows your weight loss. Make every calorie count by focusing on protein, fruits, and vegetables. In the first few days after surgery, you may be encouraged to drink smoothies and other protein-rich drinks, which is an exception to the rule. The bubbly nature of carbonated drinks such as soda can cause gas pain and increase the pressure in your stomach, which can be harmful to staples and sutures especially in the months immediately after your surgery. Avoid soda, even diet sodas which can increase sugar cravings, after surgery.

Don't snack- Snacking is a habit that can slow your progress and hurt your long-term success. Stick to high-quality meals and avoid junk foods. If you are hungry, have a meal, but don’t snack between meals.

Exercise- From the moment you are able to after surgery, exercise. Even if you can’t walk far or for very long, get started. Your results will be better, and you will be encouraged by how quickly your stamina improves as the pounds shed. Walking also helps prevent serious complications, such as pulmonary embolus and blood clots if you start immediately after surgery.

Find healthful coping skills- If you need bariatric surgery, the chances are high that you used food as a coping mechanism for stress. It is time to find a new way to cope, whether it is exercise, reading a book, talking to a friend on the phone, or whatever works for you other than eating.

Keep taking medications-Don’t stop taking any medications without your surgeon’s approval. Many diseases can improve with surgery and weight loss, but that doesn’t mean you should stop taking your medication. Talk to your physician prior to stopping any medications. Don't start medications without your surgeon's approval especially in the weeks following surgery.

Keep your follow-up visits- After surgery, your progress will be closely monitored. Skipping appointments may mean that a nutritional deficiency, surgical complication, or other issues may not be discovered in a timely manner. Appointments are a good motivator for staying on track with your goals.

Keep your support system close-Fill your inner circle with supportive friends, family members and other bariatric surgery patients who encourage you to continue on the path of health and wellness. Building and maintaining a healthy lifestyle is difficult so it's important to have a support system. There are more than 140,000 people having weight-loss surgery each year. Not only do support groups offer emotional support, but they can also provide advice on the wide range of changes you are facing as you lose weight. Support groups are available in most areas that have a bariatric surgeon and are plentiful on the Internet.

Know when to call your surgeon- In the weeks after surgery, you should call your surgeon if: You develop a fever over 101 degrees. You have uncontrollable pain. You cannot keep fluids down. You are short of breath or have difficulty breathing. You notice dark or tarry (bloody) stools. You suddenly begin to bruise easily. Your incisions begin to leak pus or bleed heavily. You develop unexplainable severe leg pain

Listen to your body- Don’t eat if you aren’t hungry. Just because the clock says it is time for a meal doesn’t mean you should eat one. Learn to listen to your smaller stomach and only eat when your body wants you to.

Plan for portion control when eating out- Restaurant portions are going to be massive in comparison to your needs after surgery. Plan on taking food home or ordering a child’s portion. If you aren’t sure you can resist, divide an acceptable portion away from the meal and have the server remove the rest before temptation sets in.

Practice mindful eating-Mindful eating is based on the concept of mindfulness, which emphasizes a person’s focus on the present. Mindful eating involves eating slowly without distractions, measuring portions, eating only until you are full, eating to maintain overall health, appreciating what you are eating, and distinguishing between actual hunger and non-hunger triggers such as boredom. When eating, turn off the TV, take a hiatus on answering emails, put down your cell phone, and focus on the meal.
Prioritize protein-Protein is a very important part to both healing and weight loss after surgery, and it’s also an integral part of maintaining muscle mass and healthy hair, skin and nails. When sitting down to a meal or snack, start with protein. While fruits, vegetables and other carbohydrates are still part of a healthy diet, the priority is always protein – shoot for 60 to 80 grams per day. If you are feeling full quickly and unable to finish your meals, start with your protein to make sure you are taking in enough.

Say goodbye to caffeine-Caffeine is the most-used drug in the world, and it is a drug. Caffeine alters your mood, increases your heart rate and is a diuretic. If you drink caffeine, you will be working against your efforts to stay well-hydrated and increase your risk of a stomach ulcer.

Skip alcohol- Alcohol is full of empty calories that provide no nutritional value. It can also contribute to stomach ulcers, which you are already at risk for because of your surgery. Bariatric surgery also makes you more sensitive to alcohol than you were before, so a little goes a long way.

Stay hydrated-Dehydration is the number one reason for hospital readmission after weight-loss surgery. Sip plenty of water between meals – aim to drink 48 to 64 oz. per day – to stay hydrated. With a new, smaller stomach, it can be difficult to reach this goal at first, but it’s important. Staying hydrated is a lifelong commitment after surgery and key to ensuring your new stomach heals properly. Drink lots of water. This will help you feel more energetic, and it will prevent you from mistaking hunger for thirst. Many adults confuse the two sensations, so if you are well-hydrated, you won’t ever wonder if you are truly hungry.

Stop using straws- If you are going to drink, don’t use a straw. Straws not only allow you to drink too quickly, so you may end up with an uncomfortably full stomach, but they also allow air into the stomach that can cause serious discomfort.

Surgery won't fix your life- Remember that surgery is a way to lose weight, but it is not a miracle fix for every problem in your life. Being thin won’t make your children clean their room without being asked, it won’t fix a bad marriage and it certainly won’t make your nosy relatives behave themselves. Be realistic in your expectations of life after surgery.

Take supplements if recommended-If your surgeon recommends a supplement, take the supplement. Many bariatric surgery patients become low in dietary essentials such as iron, potassium, and calcium. If your doctor recommends an OTC drug or a prescription supplement, take one.

Watch fluid intake when eating- Don’t drink fluids immediately before, during, or after your meal. It is essential that you reserve the small amount of space you have in your stomach for high-quality, nutrient-rich food. Drinking before and during your meal will fill your stomach with fluid instead of food, and drinking immediately after your surgery can “wash” food out of your stomach, making you feel hungry sooner. Separate food and fluid by at least a half an hour.

Write it down-Keeping a food journal of what and how often you are eating can help you easily identify ways to improve your diet, or make it more clear when your healthy habits are slipping. Are you grazing? Drinking enough water? Getting enough protein? Write down what you eat or drink, the time, and how you felt before and after eating to help build and maintain good habits.
 “Don’t wait until you reach your goal to be proud of yourself. Be proud of yourself every step of the way.” (www.fitbodyhq.com)[i]




[i] Sources used:

·        “5 Steps to Avoid Falling in to Old Habits after Weight-Loss Surgery” by After Bariatric Surgery

·        “5 ways to avoid weight gain after bariatric surgery” by CarePoint Health


·        “5 Ways to Avoid Weight Gain After Bariatric Surgery” Erin Palinski-Wade


·        “Long-term Management of Patients After Weight Loss Surgery” by William S. Richardson, Amber M. Plaisance, Laura Periou, Jennifer Buquoi, and Deanna Tillery


·  “Medical Definition of Dumping syndrome” by MedicineNet

·        “Tips for Losing Weight after Weight Loss Surgery “by Jennifer Whitlock

 

 

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