Jamie Carpenter, MS, RD, LDN, Bariatric Dietitian
Staying adequately hydrated post bariatric surgery can seem daunting since the stomach’s capacity is significantly reduced. The current recommendation is that patients consume 48-64 ounces (six to eight 8 ounce glasses) of low calorie fluids per day with the emphasis on water. It is recommended that patients SIP fluids throughout the day and NOT gulp or chug.
It is also recommended that patients wait a minimum of 15- 30 minutes before and after they eat before drinking fluids. It is especially important to wait closer to 30 minutes after they eat to prevent faster gastric emptying which can lead to dumping syndrome, nausea and vomiting. If a fluid and food are consumed too close together, then that food and fluid have to compete for space in that smaller pouch. If they drink too soon after eating, food can be pushed through the stomach faster and empty out of the stomach sooner and actually cause one to feel hungrier sooner as well. Another bonus to staying hydrated is that it helps decrease constipation and even decreases the risk of urinary tract infections.
Here are some tips to help our patients prevent taking a vacation from hydration!
- Invest in a nice water bottle (one without a straw so that extra air isn’t swallowed and avoid one with too large an opening to prevent gulping). Take it with you everywhere you go (i.e.: car, purse, work) to allow for more opportunities throughout the day to sip to the 48-64 ounce goal range.
- If tap water isn’t an option, keep a pitcher of filtered water or bottled water in the refrigerator. You can even add lemon or sliced cucumbers to add flavor!
- Choose non-carbonated, caffeine-free, low sugar, non-alcoholic beverages.
- Monitor your urine. If your urine is too dark/concentrated or you aren’t urinating at least every 4 hours after surgery, then you are not drinking enough fluids and are possibly dehydrated.
- Sip on an 8-10 ounce glass of water first thing in the morning to kick start your hydration for the day!
Anna Bryant, MS, RD, LDN, Bariatric Dietitian
Many patients will experience some degree of post-surgical hair loss. Most commonly this occurs between four and six months after having had bariatric surgery. The hair loss can often be caused by the rapid loss and stress the body will go through after surgery. This hair loss is called Telogen Effluvium and should continue no longer than six months post-op. The hair will grow back!
If your hair loss starts later than six months post-op it could be caused by a nutritional deficiency in biotin, phosphorus, potassium, vitamin B6, zinc, or most commonly protein. It is very important to come to follow-up appointments and have blood work checked regularly to ensure you are providing proper nutrition for your body.
Ways to prevent or stop hair loss post-op include:
- Meet daily goal of 60 to 80 grams of protein each day.
- Take all vitamins and minerals as recommended
- Eat a variety of nutrient dense foods
Don’t forget you can always reach out to one of the Registered Dietitans in the office for help!
Anna Bryant, MS, RD, LDN Program Dietitian
For most of us eating out is something we do on a regular basis but for many post bariatric surgery patients it can be frightening. Don’t be scared, be prepared! I always encourage patients to view restaurant menus ahead of time if available. Most can be found on the internet. When you view the menu ahead of time and make your decision prior to going to the restaurant you are much more likely to stick to your healthy choice.
Most restaurants are happy to help accommodate any specific food requests you may have. Don’t be scared to ask how your food is prepared or what condiments may come with it. In the event that a restaurant is not accommodating to your special food requests just make a mental note to avoid that specific place next time you’re going out. Remember, you can always pack your own meal and take it with you.
Make sure you are aware of your portion sizes. Splitting the meal and bill with a friend is always a good option. A pre-meal doggy bad is also a great idea. When your food arrives at your table go ahead and box up the portion you will not be eating that way you’re not tempted to continue to nibble as you socialize. The last thing you want to do is overeat and get sick while you’re out!
Eating out for convenience or as a social event can still be fun post-op. Just remember to keep the above information in mind. Don’t be scared, be prepared!
Amir Caldera – Mendoza, Surgical Weight Loss Patient
I am 33 years old and I am 1 year and 3 months post Bariatric Surgery. I decided to do the surgery because I gained weight after my pregnancy. The excess weight left me feeling sad, frustrated, tired and depressed. People called me names like “big whale” and “three hundred.”
I tried dieting, exercise and I hired a personal trainer but nothing worked for me. I would always lose a few pounds that would come right back. Eventually I had enough and I decided to go to a Saint Francis Center for Surgical Weight Loss seminar. That night was the first day of my new life!
Two weeks before my surgery I weighed 210 pounds. I followed the directions from Dr. Virginia Weaver and proceeded with my liver shrink diet. The day of the surgery I weighed 199 pounds. After the surgery I continued to lose a lot of weight.
Today, I weigh 120 pounds and I feel great! I wear clothes that look good on me and make me feel good. I eat healthier, I quit smoking, I have more energy and my depression is gone. I want to thank Dr. Weaver and her staff for all their help and support!
I am a happy girl again thanks to the best decision I’ve ever made!
Amir Caldera – Mendoza
Weight Loss is one of the top “New Year’s Resolution” made in America each year but if you are post op from Weight Loss Surgery you have already been working hard towards your goals. Here are three things to do to stay on track but keep it simple.
- Choose one healthy habit to work on at a time, not five. Part of staying motivated means setting goals for yourself that you can actually achieve. It is overwhelming to take on too much at one time and too easy to get discouraged when you inevitably are not able to do everything perfectly. Hold yourself accountable with some small changes or one specific goal. I always recommend focusing on adding something healthy and “good” for you rather than banning anything. Once you have mastered a new change and it has become habit, move on to something else you would like to work on. Always give yourself grace for slip ups.
- Keep a Journal. This cannot be overstated. It does not necessarily have to be a food or exercise journal but that is certainly a good idea! Make your journal fun and something that inspires and motivates you. Speak kindly to yourself in your words and keep up with “Aha” moments and encouraging things that people say to you as well as goals you have, feelings about how your life is changing, and something you feel positive about or are grateful for each day.
- Celebrate small and large victories. Rewarding yourself can be a fun way to keep up your motivation. You know those things you would love to have but never buy yourself? At the end of a good week, treat yourself with experiences and non-food treats. In little ways and big ways make sure you pat yourself on the back for all the good you are doing and forget focusing on the “bad.”
After making this life-changing decision, you owe it to yourself to do everything you can to stay positive and motivated. All of the hard work you have been doing and good decisions you have been making will pay off and you will have the healthier lifestyle you have longed for that will improve the quality of your life for many “New Year’s” to come. Happy 2017! Make it a great one!
Losing the weight after having bariatric surgery is fun and exciting but that doesn’t mean it’s always consistent. Many patients will experience weight stalls or plateaus. This can be part of normal weight loss, unfortunately. For most patients it is frustrating and can be discouraging. Don’t be discouraged! Check yourself!
When weight stalls or plateaus happen, I always encourage patients to food journal. It can be very eye-opening. It forces you to really evaluate the foods you’re eating or not eating. Are you getting enough protein? Are you eating often enough? Are you snacking too often? Are old habits creeping back in?
The next thing I ask patients to look at is activity level. Are you setting aside time for structured activity? Is your body used to the activity you are doing? Sometimes starting a new exercise plan or just increasing the intensity of your current plan can make a big difference. If you are hitting the gym and feel like you’re building muscle then you may need to pay more attention to your measurements than the scale. Muscle is denser than fat so you may notice a difference in your measurements even if the number on the scale isn’t moving.
The next time you encounter a weight stall or plateau simply ask yourself these questions. Remember, the team at Saint Francis Center for Surgical Weight Loss is always here to help!
Allison is at the 6 month mark in her post weight loss surgery journey. Since her surgery, she’s lost 72 pounds and her high blood pressure, high cholesterol and sleep apnea have been solved. Exercise, supplements and her healthy diet have helped her lose 60% of her excess body weight.
Check out our latest addition of Allison’s Adventure to hear about her new exercise routine and what it was like for her to go on a cruise now that she’s lost all the weight.
Jamie Carpenter, MS, RD, LDN
I have been asked multiple times why I decided to work with bariatric patients. Patients often assume that I have never struggled with a weight problem. The truth is that I have personally struggled with my weight in the past (during my college years) and I have a VERY strong genetic background to make me more susceptible to being overweight. Because of that, I decided many years ago to absorb my studies in nutrition for both undergraduate and graduate school and become a Registered Dietitian with the goal of working with patient wellness and/or weight loss. I am personally dedicated to lifestyle choices with healthy and mindful eating, regular physical activity, stress management and I believe that a healthy lifestyle is the key to weight maintenance.
On Thanksgiving Day in 2003, I received the dreaded call from my brother with the words I will never forget, “Jamie, dad has passed.” My heart sunk and I couldn’t speak. My dad had unexpectedly passed away from a massive heart attack. My worst fear had come true. He had walked me down the aisle to give me away in marriage and three months later, he passed away. To this day, I will never forget his shortness of breath when walking me down the aisle. Not only was he short of breath, but his knees were in so much pain from all of his weight. I remember feeling his body weight practically leaning on me. He danced and even sang to me during our father-daughter dance. I’ll cherish that dance forever but I still remember how tired he was afterwards. I look back at wedding pictures and video and although my dad was so very happy, he was so very tired and sick.
My dad had always been medically obese for as long as I can remember. During childhood, I witnessed him overindulge in foods and live a sedentary lifestyle. My dad just loved food! He was overweight, had a high stress job and smoked. His first heart attack happened when I was in 2nd grade. After he was diagnosed with hypertension and congestive heart failure I witnessed him go on diet after diet. He would lose weight and then rapidly regain it and then some. He participated in the typical yo-yo dieting that so many of my patients have participated in over the course of years.
Our family was relocated to Memphis, TN in 2008 for my husband’s job. I found a job opportunity for a part-time bariatric dietitian at Saint Francis Hospital Center for Surgical Weight Loss. I applied and was hired. Less than a year later, I eagerly accepted the opportunity to work full-time. Over these past 8 years, I am amazed at how much our practice has grown and how many lives our multidisciplinary team has helped transform in so many awesome ways.
I shared with Dr. Virginia Weaver early on that I wish my dad could have had the opportunity to have had bariatric surgery. Bariatric surgery was not a popular option for weight loss 15-20 years ago. I feel sure that had he been given the opportunity to have bariatric surgery before his diagnosis of Congestive Heart Failure he would have been around a little longer on earth to enjoy life and meet and play with all his grandchildren!
This time of year, I always feel a little sad because Thanksgiving Day is when he passed away. My work reminds me of my dad daily and even though he didn’t have the opportunity to have bariatric surgery to expand his life and improve his quality of life, it always makes me happy to see all the patients that are gifted with this opportunity! I love hearing patients share their personal weight loss journeys with me. I love hearing how their health conditions have significantly improved or been resolved. I love hearing when patients are playing with their children and grandchildren when they weren’t able to prior to surgery. I love hearing all their non-scale victories like crossing their legs, riding in airplanes without seatbelt extenders, riding amusement park rides, wearing high heels, and walking without feeling shortness of breath. I do what I love and love what I do! I enjoy being a part of their journey!
In the spirit of Thanksgiving, I am so very thankful that I was led to work in a field of nutrition that I am so passionate about. I am even more thankful for the opportunity to work with two miracle worker bariatric surgeons, Dr. Virginia Weaver and Dr. Robert Wegner, as well as an amazing multidisciplinary team and most importantly– our inspirational and hardworking patients who have chosen to make healthy lifestyle changes!
Anna Bryant, MS, RD, LDN Program Dietitian
For many of us the holidays are a tricky time. It can be very challenging to lose weight or maintain weight during the holiday season. Here are some helpful tips to keep you on track!
- Volunteer to bring a dish to the gathering. If you prepare a healthy option to take to the get together you are at least assured one good option. You may actually encourage others by providing a healthier option as well.
- Eat before you go. If you are able to eat before you go to an event then you won’t arrive hungry and you may find it easier to avoid some of the temptations.
- Stay on track with your physical activity. Stay active and encourage those around you to join you! The best way to offset a holiday treat is to get up and burn it off. Those who remain more active during the holidays tend to make better food choices as well.
- Only make one trip to the food table and don’t socialize around the food. If at all possible stay away from the food table after you’ve finished your meal. If it is impossible to get away from the table then simply move the food out of arm’s reach to help alleviate the temptation to mindlessly “pick” at the food.
The holidays are an exciting time we should all enjoy but that doesn’t mean you have to set yourself back in your weight loss/maintenance journey. Practice the tips listed above to stay on track this year and every year!