Habits for Success
Postoperative success boils down to four main issues. When you meet with your surgeon and dietitian postoperative many questions will be discussed. The pathway to success however comes down to four topics in question format.
The first is how your nutrition is progressing. The main idea is to obtain how your reaching the daily nutrition goals set forth preoperatively. We are looking to ensure that you are achieving the protein and calorie goals, or as close to them as possible, daily. We understand in the first few weeks after surgery this may be difficult. However as healing and time progress we know achieving these goals will become easier. Reaching your daily goals we also know nutritionally you are maintaining healthy weight and losing “bad” weight correctly. Achieving only 50% of daily protein we start to become concerned for “good weight loss which overall means muscle mass losses. Reaching these goals will reduce this concern.
Secondly, adding exercise to you routines also ensure added proper weight loss and maintenance of muscle mass.
Thirdly, hydration is a key component to running all the systems of our body. Improper hydration (less than 64 ounces fluid daily) can lead to various issues ranging from constipation and decreased weight loss potential. Stay hydrated!
Lastly, we always want to ensure our patients take their daily vitamins as discussed. Especially based on the surgery you underwent such as the gastric bypass in which various deficiencies can arise over time such as calcium, iron and vitamin B12.
We as the bariatric team understand success can be accomplished by remaining on this pathway 95% of the time. Detrimental situations arise usually when one or more of these four ideals are lost. The most common and most detrimental will always be nutrition. I like to call it the 2 “Q’s,” quality and quantity. As it sounds, when the quality of your nutrition declines and old habits come forward with increased fats and carbohydrates this can lead to weight gain potential.
Quantity is also a large factor in that over your first 12 months from surgery your volume that your stomach (whether sleeve or bypass) changes based on time. The overall end goal for lifetime is tolerating about 1-1.5 cups per meal depending on food character (i.e. dense meat vs vegetables). If volumes go well beyond then added calories into the system will be assimilated and weight gain potential can occur. More concerning is that the volume of food required for “fullness” will continue to increase adding to the weight gain potential.
Long term success can be continued and past patients have always told me several mantras to which they live by… “chew chew chew, sip sip sip, eat protein first, separate solids and liquids, and continue to measure or weigh your food” to always keep you accountable.