10 Things I’ve Learned as a WLS Post Op and Dietetic Intern

July 28, 2015

I first started my journey into the WLS life as a student, so it feels right to be a student once more, furthering my education as a post-op. I know that this is not every post-op’s passion, so I am bridging the gap between what I have learned as a WLS post-op, and what I've learned studying nutrition and dietetics.

10 Things I've Learned as a WLS Post Op and Dietetic Intern

Protein is what it’s all about! We hear about it all the time but it is true. Not only does it increase your resting metabolism by 20-30% due to the thermic effect of food (compared to 5-10% for carbs and 0-5% for fat), but in addition, it helps prevent loss of lean muscle mass, protects against hair loss and weakened nails, and provides more satiety for longer. So that minimum of 60 grams of protein per day? Yeah, that’s a big deal.
Support is all around you. Your bariatric team is there to support you. You are never alone on your journey. If you have a question, ask your surgeon, dietitian, or other office staff. If they don’t know the answer, perhaps they can help you find it. And if you have a question, chances are that another post-op has asked that same question, or may even be too shy to ask. More importantly, your team is there to provide guidance every step of the way. From when to transition from liquids to puréed food, to how to push through a plateau, they are there to encourage you in your journey, never to judge you. And the support doesn’t necessarily end with your bariatric team. Look to friends, family, other post ops and ObesityHelp. Post on the General Discussion message board or your surgical procedure message board. You have support, be willing to reach out for it.
It is up to you. No one can do the work for you. If you aren’t willing to make the changes, then nothing will ever change. I can’t really say much more than that.
Don’t fall for the marketing gimmicks. I saw a product being marketed as having the “perfect 10” omega fatty acids because it had both omega-3’s and omega-7’s. However, omega-7 fatty acids are not essential; this means that our bodies can produce them on their own, and we don’t need to consume them in our diet. So before you purchase the latest and greatest supplement, protein powder or other food items, ask your dietitian, your doctor or even your post-op friends. Maybe they’ve used the product and found success, or maybe (like biotin supplements), much of the hype is linked to the placebo effect.
The next fad diet is just that… A fad. Without naming names, most fad diets show great success in the short term, but in the long term, lead to some form of deficiency, or upon ending the diet, lead to complete regain of the weight lost while on the diet. Unless you have a medical condition (such as Celiac’s disease), your body needs a variety of carbohydrates, proteins, and fats. The best sources of vitamins, minerals, and calories are from their natural sources. Does this mean you have to eat a raw-only diet? Absolutely not. But taking your supplements is not a substitute for healthy foods. This is why they are called “supplements,” not substitutes. Unsure of what to eat to meet your post-op goals and maintain maximum nutritional value? Ask your dietitian for recommendations that fit your goals.
One size does not fit all. Don’t get hung up comparing yourself to others. What works for one post op may not work for another. Suzy Somebody has normal lab values for her vitamins, but hasn’t taken her supplements in six months; so you think you should be able to stop taking those darn pills every day, right? Well, consider, perhaps, that Suzy eats her fruits and vegetables every day and has a different surgery type than you. She may not be at as high of a risk as you are for malabsorption. Pay attention to your goals, focus on what you need to be successful, and find what fits best for you.
Vitamins are required. Vitamin deficiencies are a big deal. The average Joe Schmoe could probably go his entire life and get enough vitamins just from his food intake. However, as post-ops, 1) we don’t consume as much food as the average person, so it’s difficult to get in all of the vitamins that we need just by reduced food intake, and 2) what vitamins we do consume from food are often not fully absorbed due to the malabsorptive properties of bariatric surgery. Gastric bypass and duodenal switch patients are at the highest risk. However, gastric sleeve and gastric band patients both have reduced food intake. In addition, gastric sleeve patients have lost portions of the stomach that produce certain factors required for absorption of some vitamins, such as B12. So take your vitamins.
Exercise, exercise, exercise. While you can’t out-exercise a bad diet, relying on a good diet alone will limit your weight loss. Getting in your exercise can help reduce the loss of lean muscle mass, and also help to prevent bone loss. In the early periods post-surgery, your body is pulling energy from any source it can get (hair, nails, bones, muscles and fat), since your caloric intake is so low. By adding in resistance exercise, you are forcing your body to build up those muscles, which in turn help burn more calories and lead to more fat loss. What is your excuse not to exercise? If you have limited time, set your alarm a few minutes earlier and complete a 7-minute workout. Need accountability? Grab a friend or neighbor to go on walks whenever is most convenient for you, but try to set a schedule to stay regular. Don’t like to exercise outside? Pull up a fun YouTube video and get sweating. Can’t bend/twist/move that way? Then move in any way that you can. Walk, squat, lunge, swim, run, jump, play… Just move!
Don't believe everything you hear about weight loss surgery. The media isn’t always right about weight loss surgery. I don’t think a single week goes by without weight loss surgery being mentioned by the media. Frequently a celebrity will claim she lost weight “without a gimmicky diet, crazy exercise routine or weight-loss surgery.” However, “they” are not you, me or anyone else. What they say has no direct effect on your personal journey. So regardless of what you see in the media, or what conversation you overhear in the line at the grocery store, or even what some may say directly to you about your choice to have WLS, keep your head up high. Focus on the positive changes you have made in your life to get you to where you are today because this is your life and no one else’s.
There is no cure to obesity. Regain is real. But one thing I learned is that a lapse doesn’t necessarily mean a relapse. One poor choice at a meal doesn’t mean that I have to toss the whole day away. If you notice yourself making poor choices more frequently, take a look at why. If you catch the scale going up, if you feel like you let it get too far, know that it is never too late to get back on track. Don’t start the self-sabotaging cycle of guilt, repent, repeat. Choose to take care of yourself because you are worth it!

Share in the Comments below any things you've learned from having weight loss surgery, so we can learn and support each other.

Photo credits: Sangudo cc

ABOUT THE AUTHOR

Bec McDorman, MS, RDN discovered her passion for health and wellness after undergoing Roux-en-Y Gastric Bypass surgery in 2010 to lose more than 100lbs. Bec has received her masters from Cal Poly Pomona and completed her dietetic internship at Johns Hopkins Bayview Medical Center. She has reached her goal of being a registered dietitian so she can help pre- and post-op bariatric patients with their journey.

Read more articles by Bec!