Dietary Guidelines After Bariatric Surgery

Introduction

Obesity is a major public health problem that is common worldwide. In 2014, 13 percent of the world's adult population (>600 million people) was classified as obese. Bariatric surgery is currently the most effective treatment modality for morbid obesity as compared to non-surgical intervention. The main advantages of this procedure include prolonged weight loss, improved obesity-related comorbidities, and improved quality of life. Patients must be willing to make significant lifestyle changes to ensure long-term postoperative success. Nutritional care following bariatric surgery is a critical issue. Dietitians are essential members of the multidisciplinary team before and after bariatric surgery. Previous research has shown that regular nutritional follow-up contributes to weight loss after surgery and prevents weight regain. This article's goal is to review the current scientific literature and present a protocol for nutrition care in bariatric patients in order to improve the quality of care, establish uniform guidelines, and ensure safe practice.

What Is Bariatric Surgery?

Bariatric surgery refers to weight loss surgery, a medical procedure that is performed on people who are severely overweight or obese. This type of surgery is designed to help individuals lose weight and improve their overall health. Bariatric surgery works by reducing the size of the stomach and limiting the amount of food consumed at one time. This leads to a reduction in the number of calories that are consumed, resulting in weight loss.

The eligibility criteria for bariatric surgery are:

• The patient's BMI (body mass index) should be less than or equal to 40.

• The patients should be without coexisting medical problems.

• The patients have obesity-related health conditions such as diabetes, high blood pressure, or sleep apnea.

What Are the Types of Bariatric Surgery?

The following are the types of bariatric surgery:

• Gastric Bypass Surgery: This procedure involves dividing the stomach into a small upper and larger lower pouch. The small intestine is then rearranged to connect to both pouches. This leads to a reduction in the amount of food consumed and reduces the absorption of calories from food.

• Sleeve Gastrectomy: Large portions of the stomach are removed during this treatment, leaving behind a small tube-shaped pouch. This reduces the size of the stomach and limits the amount of food that can be consumed.

• Adjustable Gastric Banding: This procedure involves placing an inflatable band around the upper portion of the stomach, creating a small pouch above the band. The band can be adjusted to control the size of the pouch, limiting the amount of food that can be consumed.

What Are Dietary Guidelines After Bariatric Surgery?

Weight loss surgery, also referred to as bariatric surgery, is a medical procedure that helps individuals who are severely overweight or obese to lose weight. This type of surgery involves reducing the size of the stomach, which decreases the amount of food an individual can consume. While bariatric surgery can be an effective way to lose weight, following a healthy and balanced diet is important to ensure successful weight loss and maintain good health. After bariatric surgery, the dietary guidelines are crucial for the success of the surgery. These guidelines will help you achieve and maintain your weight loss goals while ensuring you get all the necessary nutrients to maintain good health.

Here are some of the dietary guidelines after bariatric surgery:

• Start with Clear Liquids: After the surgery, patient will need to start with clear liquids such as water, broth, and sugar-free gelatin. This will help the stomach adjust to the new size and allow them to slowly transition to solid foods.

• Gradually Introduce Solid Foods: Once patient have successfully tolerated clear liquids, one can start introducing pureed and soft foods such as scrambled eggs, cottage cheese, and pureed vegetables. It is important to eat slowly and chew the food thoroughly to prevent any discomfort or complications.

• Focus on Protein: Protein is an essential nutrient after bariatric surgery as it helps build and repair tissues in the body. The diet should consist of lean sources of protein, such as chicken, fish, and tofu.

• Avoid Sugary and Fatty Foods: Foods high in sugar and fat can cause discomfort and may slow down weight loss. Avoid sugary beverages, candy, and desserts, and limit the intake of fatty foods, such as fried foods, cheese, and butter.

• Stay Hydrated: Water consumption is crucial for good health, especially after bariatric surgery. Aim for at least eight cups of water a day to prevent dehydration.

• Take Vitamin and Mineral Supplements: After bariatric surgery, the body may have difficulty absorbing certain vitamins and minerals, such as iron and vitamin B12. Patients may need to take supplements to ensure they are getting all the necessary nutrients.

• Avoid Drinking During Meals: Drinking fluids during meals can cause discomfort and prevent them from eating enough food to meet the nutritional needs. It is best to avoid drinking fluids 30 minutes before and after meals.

How to Prevent Nutritional Deficiencies After Bariatric Surgery?

The following supplements can be taken to prevent nutritional deficiencies after bariatric surgery:

• Multivitamin-Mineral - The multivitamin intake can prevent nutritional deficiencies, which are very common after bariatric surgery. The dose for multivitamins is two tablets of multivitamin-mineral supplements/day containing iron, folic acid, zinc, copper, selenium, and thiamin.

• Calcium Citrate - The suggested dose for calcium citrate is 600 mg Ca supplement/day.

• Vitamin D - Vitamin D is recommended in the dose of 3000 IU/d [as Ergocalciferol (vitamin D2) or Cholecalciferol (vitamin D3)].

• Iron - Iron in the dose of 45–60 mg elemental Fe/day should be taken to prevent nutritional deficiencies in the form of multivitamins and supplements.

• Vitamin B-12 - The dose for vitamin B-12 is 250–350 μg/day or 1000 μg/week sublingual, 1000 μg/month or 3000 μg every six months.

• Thiamin - Thiamin should be included in the routine multivitamin supplement.

• Folic Acid - The amount of folic acid is 400 μg/day, which should be included in the routine multivitamin. Pregnant women or those planning to conceive should take 800–1000 μg folic acid/day.

Conclusion

Following dietary guidelines after bariatric surgery are crucial for successful weight loss and good health. By focusing on lean protein sources, avoiding sugary and fatty foods, staying hydrated, and taking vitamin and mineral supplements, the patient can achieve weight loss goals and maintain good health. Never alter the diet or lifestyle without first consulting a healthcare physician.