For individuals who are obese, bariatric surgery can be life-saving and life-changing. According to the American Society for Metabolic and Bariatric Surgery, more than 200,000 people underwent bariatric surgery in 2008. With no end to the obesity epidemic in sight, the number of people undergoing bariatric surgery is expected to increase in the coming years. Following nutritional recommendations after surgery is of utmost importance to ensure weight loss success and health in both the short and long term.
Preoperative Assessment
Before the bariatric surgery procedure, a nutritional assessment should be performed by a dietitian or physician to evaluate for any existing problems with nutrition, to identify problems that can be corrected, and to create a nutrition plan for after the surgery. In addition to checking for other diseases like heart disease and type 2 diabetes, the doctor will take weight history, results of laboratory testing, and nutritional status into consideration. The dietician or physician will also assess the patient's readiness for change, capacity for goal setting, knowledge of nutrition, psychological health and social life.
Three Months After Surgery
In the initial postoperative period (one to two days after the surgery), no solid foods can be consumed. At this time, a liquid diet is recommended, which may consist of juice, milk, broth or cooked cereal. Adequate hydration is important. After the initial liquid diet, the diet will progress to pureed foods for approximately three to four weeks. Then, a soft food diet, such as fresh fruit, cooked vegetables and ground meat, is recommended for an additional eight weeks before regular foods can be consumed.
A patient should initially start with many small meals each day and then gradually decrease the meals until a regular diet is reached. This step-by-step process ensures proper healing of the surgical site.
Throughout this process, a physician will continue monitoring for symptoms of vitamin deficiency, as this is a significant concern in the postoperative period. Bariatric surgery alters vitamin absorption and repletion, and daily multivitamins and mineral supplements are valuable in maintaining intake for optimal body function. Protein content of meals is also very important for healing.
At each visit, the physician will reinforce what she discussed in the preoperative visit, including the previously approved nutritional plan, self-care prescription and behavioral modification.
Continuing Nutritional Recommendations
Maintaining adequate nutrition is still important after the initial postoperative period. Although regular foods can be consumed, the same principles apply as in the initial stages. Drink and eat slowly to avoid complications such as nausea or vomiting. Each meal should take 30 minutes to consume. Similarly, drinking one cup of liquid should take between 30 and 60 minutes. High-fat and high-sugar foods should be avoided to minimize problems. Continue eating protein-rich meals. Don't drink liquids while eating food, and chew food to avoid blockages. Small meals are still important, as the stomach will only hold a maximum of 1 to 1.5 cups of food at a time.
Follow-up visits with the physician will continue to touch upon nutritional goals. Hydration (ideally six to eight cups of liquid daily), texture progression, vitamin/mineral levels, and meal planning and appropriate food choices will be reviewed to ensure that weight loss is maximized.
