|INOVA Bariatrics' most popular surgeries are bypass and sleeve,|
only one LapBand surgery has been performed in the last year.
Here are three of my biggest “shockers” from my 2-week rotation
ONE: Smaller than small portions sizes
It’s hard to imagine, but a starting meal fits into a 2oz plastic cup. Even as a dietetic student, I asked myself what does a 2oz plastic cup even look like? Here at the center, we give condiment containers as a guide. So the little cups you put ketchup in - That’s a meal for a bariatric patient the first 3 months following their surgery. No wonder the weight drops so fast (that is if you’re following the rules!). Portion sizes grow over a year period, but in small amounts and peak at 1 cup per meal for the rest of a patient’s life.
|Condiment containers are provided to patients as measuring tools|
for meal size.
TWO: No bread, rice, or pasta
This is something I have never recommended for other patients in the past, but eventually made sense to me in the bariatric setting. If you put bread into a cup of water, it absorbs and swells. When a patient’s stomach is reduced to the size of a thumb, a few bites of bread can swell and fill the entirety of the stomach. For many patients, they learn the hard way – they eat the bread they have been craving, and then experience abdominal pain, nausea, or sometimes vomiting. A portion of bariatric patients can tolerate these foods after a year, but still may cause discomfort. All those healthy and vital B vitamins patients are missing out by skipping the grain products are made up through daily supplementation.
THREE: Calories… not really that important
Dietitians are trained to focus primarily on the nutrient content of food when making recommendations, and to not always get caught up in calories. However, our profession revolves around calculating energy expenditure, and knowing that eating less than that estimated number equals weight loss. After bariatric surgery, the stomach acts as a physical calorie counter. And by that, I mean it would be hard for a patient to eat enough calories to exceed their energy expenditure without feeling nauseatingly full. A stomach after bariatric surgery keeps portion sizes small enough that calories aren’t the major problem. That is why most of diet counseling focuses on what kinds of nutrient dense foods are patients putting into those small meals that help them receive optimal nutrition.
|During my rotation I was able to teach the class|
"Eating out after weight-loss surgery" to help
patients learn healthy tips to eat outside their home.