Dietician Letter

Your diet history ? what your dietician needs to cover

This may be the hardest part of the process. It almost feels like admitting to failure time after time. You should try not to feel this way. There are no published studies that prove that dieting ever works.

It is nice but not absolutely necessary that the dietitian lists any medications you are on that MAY cause weight gain, such as Wellbutrin (Bupropion), and others.

Dear Nutritionist,

I have printed the following important guidelines for the consult I am seeking with you as part of a screening process for gastric bypass surgery. Your consult is important in order for me to obtain insurance preapproval for the surgery. It is also important for use in my bariatric surgeon's evaluation.

Gastric Bypass is a major surgical operation performed by either laparotomy or laparoscopic technique, in which the capacity of the stomach is severely restricted and the foodstream is diverted into the promimal small intestine. Patients experience an early sensation of fullness followed by a sense of satiety. The operation serves as apowerful support for alteration in eating behavior and requires compliance with a simple program of maintenance to achieve optimum and sustained weight loss.

Surgical treatment is associated with a mortality risk of less than 0.5%, and morbidity of less than 10%. Typically, weight loss is dramatic and sustained and is associated with resolution of over 90% of comorbid conditions.

Please cover and include in your report your evaluation of me as suggested by the bariatric and insurance experts at ObesityHelp.com, which follows this letter. Thank you.

Sincerely,

(your name here)


Diagnosis

Clinically severe obesity (ICD9 code 278.01)

Medications

It is nice but not absolutely necessary that the dietitian lists any medications you are on that MAY cause weight gain, such as Wellbutrin (Bupropion), and others.

Diet History

This should include your recognition of the need for changes in your diet and any positive moves you have made in that direction. Include any diet plans you have embarked upon. List approximate start and finish dates, how much weight you lost and how much weight you regained after stopping the medication/plan.

    1. Start with diet plans or diet medications your PCP has prescribed for you, such as Redux, Phen-fen, Meridia etc.
    2. Next, list any formal diet plans you have tried. For instance, Weight Watchers, NutraSystem, HerbaLife, etc.
    3. List any diets you have attempted on your own. You can include calorie/fat restriction diets, cabbage soup diet, Richard Simmons tapes, etc.
    4. Always end this list with ?and many of the over-the-counter diets and diet medications.? Include your age, height, weight and BMI with your diet history.

Assessment

Included should be a statement that you do not have an eating disorder. Also included should be your understanding:

    • Of the foods that cause osmotic diarrhea.
    • That the volume of food you can eat will be severely limited.
    • That you can no longer have carbonated beverages, eat sweets or fats.
    • That you will need to drink at least 6?8 cups of fluids throughout the day in small portions.
    • That fluids will be taken in between meals and not with meals.
    • The importance of your protein intake.

The Plan

Included should be the dietitian's conclusion regarding your understanding of the postoperative diet plan.

The dietitian should conclude with a plan for follow-up after your surgery and then as needed if you feel like you are getting off track or are worried if you are eating the right foods in the right amounts. The dietitian should recommend that having the surgery would be beneficial and any feelings she may have regarding your postoperative compliance abilities.

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