Maintenance Diet...post again

Some of you may need to read this again. It's a reprint of a paper my surgeon gives us. Print it out and put it on your fridge... paula MAINTENANCE DIET FOR WLS PATIENTS 6 MONTHS OUT-PLUS As I'm sure you have noticed, your pouch and appetite have grown. This is a natural and normal process of pouch stretching that occurs over a two-year period following your surgery. While Lap Band and Gastric Bypass pouches dilate at different rates, the ways in which you can maximize your sense of fullness to compensate for this stretch are the same. Once you have reached the 6-month postoperative period, you need to start practicing the techniques listed below. Start gradually if you are still in the period of rapid weight loss. If you are still struggling to reach your protein goals, then simply review these techniques so that you may understand what is in your future. There are 6 techniques you must practice in order to maximize your sense of fullness, limit your appetite, reduce the need for between meal snacks, and improve your weight loss success and maintenance. 1.FLUID LOAD: Drink fast and hard fifteen minutes before your meal using a calorie free beverage. DO NOT SIP! Drink as much as you can as fast as you can. Your goal here is to temporarily stretch your pouch and put it into spasm. Drinking in this fashion will give you a full/uncomfortable sensation. When you eat 15 minutes later, you will find you fill up more quickly and possibly your appetite for this meal will also be diminished. This is the single most powerful tool for reducing portion sizes. USE THIS MANEUVER TO AVOID BETWEEN MEAL SNACKS!!!! Make sure you always have a water bottle on hand so you can drink when the need arises. 2.DO NOT HAVE ANY LIQUIDS WITH YOUR MEALS OR FOR 2 HOURS THEREAFTER: This allows your undigested food to slowly empty from your pouch. If you find your thirst at meals and after to be uncomfortable, make sure you have fluid loaded adequately. If you have, then the next step is to try and go "cold turkey" for 2 weeks without drinking at mealtimes. This will allow your brain's "thirst center" to reset. After the 2-week period has elapsed, you will find your thirst after meals to be diminished. 3.FORK AND KNIFE FOODS ONLY: Your procedure only limits the passage of solids. Therefore liquid calories are not delayed and will not make you feel adequately full. This mean NO SOUP< YOGURT< PUDDING< AND ESPECIALLY NO PROTEIN SHAKES!!! Eat every meal seated at the table with a fork and knife. 4.THREE 15 MINUTE MEALS A DAY: Your goal is 3 meals a day. You should spend no longer than 15 minutes eating. Use as small a plate as possible (tea saucer). It seems like a ridiculously small meal but given your very slow metabolism, it is all you need. 5.BALANCE YOUR DIET: You do not need to be on a high protein diet. In face, over years, high protein intake will lead to less success than a balanced diet. All you need is approximately 50 gms of protein a day - a deck-of-card-sized piece of meat is about 3 oz. The remainder of your diet should include fiber, fats and complex carbs. Make sure to have some starch in your diet. A common problem seen 1-3 years after surgery is "hypoglycemia" -feeling of tremulousness and nausea and hunger occurring between meals. This ia a sign that you have inadequate carbohydrate reserves in your system. By keeping at least 30% of your diet as complex carbs (like grains, potato, etc.) you will prevent this sensation and the need for between meal snacks. The end result is you'll eat less. 6.DON'T DIET: Don't think that going on a strict "diet" will speed your weight loss. Short term periods on Atkins, Stage III shakes, or other severely restricted diets will only cause yo-yoing. Practice a balanced diet. If you want further weight loss then work on the techniques discussed here. If you need further help then please see Dr Aranow or the program dietician!!! **Transcribed from a hand out given by the office of bariatric surgeon: Dr. Jonathan Aranow, at Shoreline Surgical Associates, Middletown, CT...860-347-9167

THAT'S the post I remember, thanks for reposting Paula Well I did my firs****er load today, and OMG! What an uncomfortable feeling it was chug-a-lugging all tha****er, but it certainly worked! I had a much smaller lunch.

Thanks Paula! I needed that! My surgeon has never said anything abou****er loading, so I found that interesting and it certainly makes sense. Im gonna start doing that. Ive really been wanting to snack between meals lately, hope that helps. And the fork and knife rule, I never heard that either, but it makes sense too, although I do eat a lot of beans and vegetable soup. Thats the only way I can get my vegetables in,,I cant tolerate many by themselves. Wierd I know. I can do green beans and corn, but not carrots or broccoli or cauliflower. And I cant stand V8 juice, cant tolerate salads either. I must have a sensitive grouchy pouch! Anyway, thatnks for the post, Im gonna print it out !

Thanks Paula, I will print this out and keep it. I seem to have a funny thing happening to me, Paula, but i don't think it's permanent. But since my knee surgery I have lost about 9 pounds and am down to 151, which is really a little too thin for me. I am 5'7" so if I were a few years younger it wouldn't matter, but at my age I think I am looking too frail and weak. Like I said, I think it's temporary and only a result of surgery. Isn't that weird - who would have thought I would ever say I'm getting too thin!!! love donna