HELP! Need some diet suggestions!!
In our program we are required to loose 10% of our body wt before surgery....
Loosing weight pre-op is required by many surgeons & for many reasons... and I am so happy I did!
1.. to show motivation,
2.. ability to adhere to a plan (as we will need to for life!), if you can't be mindful and able to follow restrictions pre-op how will you do it post-op?
3.. to increase your health even a modest 5-10% wt. loss is very helpful, the National Institute of health has even researched this...(hence why weigh****chers is so focused on the 10% wt loss)
4.. decreases surgical complications (by exercise and decrease wt your heart and lungs are in better shape for surgery, anesthesia and healing!)...
5.. Also psychologically it is tough going from a super-sized big Mac meal to clear liquids for 2 weeks post-op!
6.. ***MAIN ONE FOR PROTEIN SPARING or MEDIFAST DIETING***It helps shrink the liver and this eases their surgical procedure and decreases chance of nicking it....
7.. exercising before helps you continue after!
8..The more you lose pre-op the less you will have to lose post-op and the closer to an ideal body-wt you will attain!
I lost the weight by doing the food pyramid. That's it, I was eating so bad (fast food daily, large portions, consuming every high-fat/sugar thing imaginable and NOT exercising that just cutting down and walking 2 miles a day helped!
For ME, it was "no one" was going to stop me from having this operation, it was my decision and all that was asked of me was to loose 30 lbs, I figured this is a small price for such a wonderful gift I would be given and the opportunity to have a healthier happier longer life....! I was so motivated/psyched; I dropped 30 pounds in 30 days and went on to drop 15 more before surgery! (Although this took me 2 months, as it got harder and I had a few last meals, we all do but you can't let this ruin your opportunity!) I believe it is what allowed me to get to a normal BMI as well! And it is not unheard of for surgeons to postpone or cancel surgeries if one gains weight!!!
Exercise was another key; I faithfully walked 2 miles everyday..it helped that my mom went with me a lot! (a buddy is so helpful!) I followed the food pyramid given to me by clinical nutritionist Dr. Boham...I also wrote everything down (Many find www.fitday.com helpful for this) that went in my MOUTH!!! Or you can get food pyramid/bullseye version at: http://www.xenical.com/hcp/1400_Am_Beye.pdf
I also had to remind myself how BAD I wanted this! Everyday it was/had to be more important to me to change my bad habits and lose weight to have this surgery than to continue to slowly kill myself with food/keep myself from the only hope I had!. I also told everyone about my plans and they helped support me, my friends/family and coworkers! I really can't give you any more guidance than this, it really had to come from within, it was a mindset with me, and I wanted this BAD real bad and I knew it was my last resort/chance! I felt invigorated and motivated by the end results...the long-term had to outweigh the short-term gratification of eating bad choices or overeating! It was a learning opportunity for me to change my habits and practice chewing well, not drinking with meals and eating smaller portions, giving up sugar/caffeine/carbonation/alcohol (if any of those are your issues, carbonation/caffeine/alcohol weren't issues for me)!
So a few weeks/months of healthy habits to lose pre-op wt is not a lot if you frame it right! IT IS NOT FOREVER and it is about starting this journey!
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
glad you are looking preop at the possible challenges and barriers to your longterm health and wellness and success.
A routine will help, vs mindless grazing after surgery due to not having one....
You will be eating less food esp for 6 mo or so cost doesnt have to be the issue we think it may.
The cost of not eating health can far outweign the cost of in the longrun with medical issues, loss of work etc...
I dont recommend slimfast but instead have you ever doen a low carb high protein plan like soutbeach? This is how we should eat postop..
Noodles, pasta, rice may not be ever tolerated after surgery, I havent touched em and hey used to live on it and am fine and thinner for it! Bread well I can eat it and it is my nemesis and 20# regain cause at 6 1/2 yrs postop!
Exercise is key also to longterm success start now practice as a dress rehearsal. I fee we can lose wt preop and if we dont it may truly be a signal we are not quite ready for surgery..I have seen folks nee to lose 100# first due to issues, I have seen them do it and excel, I have seen foks take 2 yrs to lose 30# but they although frustrated never gave up and stated they were more prepared after the wait than 2 yr prior....
THerapy is also a great tool, the emotional stuff doesnt go away! It can and usually compounds as we cant eat to soothe out rmotions and as we lose wt...
I tell folks if you can not afford to be healty after surgery please do not have it trading morbid obesity for malnutrition both are deadly
WLS is expensive the medical copays, the gas to go to mds apt for life, the special vits and protein and of course better foods.....
Think fresh fruits and veggies, lean protein (chicken is ok) fish etc. Stay clear from bread, rice, potatoes and pasta..Wt drops off me when I do that esp when I drink lots of water 16 cups a day and exercise at least an hour aday!
You can do it if you be;ieve and well you wont do it if you beieve you cant!
Mindset!
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
I received an email the other day from a reader *****cently had been taken to surgery only to have the surgeon abort the case before completion of her gastric bypass. She expressed her concern, anger and disappointment and could not understand why the surgeon would abort the case. After a lengthy discussion the reason was quite clear, her liver was so large and diseased that it required the surgeon to make a medical decision, continue the case with possibility of losing the patient or quit. The decision was to abort and allow the patient to recover followed by having a liver specialist become involved in her care.
The patient also revealed to me that when she had last been examined in the surgeon's office four weeks prior to her surgery she was told that she must lose more weight to soften her belly. Instead of following the advice, over the next four weeks she gained an additional 20 lbs. She had eaten every meal after she left the surgeon's office as if it would be her "Last Supper". Had the surgeon lost this patient her meals would have been just that, they would have been the last she would ever eat again. I asked her, "How serious were you about having weight loss surgery?" She never emailed me with a reply. I assumed she was now angry with me.
This was not the first nor will it be the last time a patient would go on an eating frenzy prior to surgery. Sometimes I do not believe we make the point very clear that it is important to lose weight prior to surgery to lessen the weight around the heart and lungs. During any procedure with anesthesia the heart and lungs and kidneys have to work harder during the recovery process. To add more weight around these organs virtually adds insult to an already injured body. Our practice has now established the 'one pound and you're out' rule. It is a rule we make very clear to the patient. The last time the patient is weighed in our office that weight is sent ahead to the surgery department. If the patient weighs one pound more the morning of surgery the procedure can and likely will be postponed. If they gain weight we question how serious is this individual about having weight loss surgery? Will they be compliant after surgery with all of the lifestyle changes they must go through? This is serious life threatening surgery and I commend any surgeon for knowing when to say 'no'. No you cannot go to surgery until you go though medical clearance. No, you cannot have surgery until you attend support group meetings to help educate you for what lies ahead. And no I will not continue with this surgery because you may die.
The lady whose surgery was aborted could only blame the surgeon. I guess that is easy enough for any patient to do if something goes wrong. Actually, come to think about it, if anything goes wrong in our lives it is always easier to blame someone else as opposed to taking responsibility for our own actions. I had to tell her that I would congratulate the surgeon for saving and not taking my life. It was definitely not what the surgeon wanted to do. Surgeons want to operate, they want to save lives or in the case of bariatric surgeons they want to help a life begin.
Sometimes surgeons quit doing surgery altogether. They are tired. Tired of fighting with insurance companies and all of the criteria demands. They are tired of the malpractice crisis that is hovering over the medical profession creating exorbitant malpractice insurance rates. In the January 2005 issue of Beyond Change, Dr. David Greenbaum discussed this very critical problem. He states, "You don't have to commit malpractice to be sued. All you have to do is have a complication. That, along with an unhappy patient and a trial attorney who sees the possibility of a large payout - and viola- a suit begins. Never mind that bariatric patients can develop some of the most challenging problems to care for. Never mind that you spend hours discussing the various risks and potential problems with each and every patient. Never mind that despite giving verbal and written instruction in great detail, some do not follow them. Never mind that your overall results are excellent. All that matters is that one patient had a less than wonderful result and you may find yourself in the middle of a lawsuit. Then, even if you win the lawsuit, your malpractice premiums go up because you had to have the insurance company pay a lot of money to defend you. So, you lose even if you win." Some of these surgeons are paying in excess of $200,000 a year, a sum that is unimaginable for most people to comprehend. It would make surgeons want to quit and many have done just that.
There is nothing more rewarding in our business than to see patients do well. For the few complications that arise, it only takes the success of so many others to reinforce why we stay in business doing what we do. None of us want to quit doing what we do because of the sense of satisfaction we receive from our work but each of us may have to realize our limits one day. If the pressures of the business, financial as well as emotional become so overwhelming, then we may cease being effective to those we treat. If that day comes then we have no other choice then to quit.
For the individuals who have suffered with the disease of morbid obesity for so many years their decision to have surgery is based to a large extent on their diminished quality of life. If they do not lose weight and improve their health they will die or worse yet their quality of life will continue to decline. They have surgery because they refuse to quit. They refuse to give up on life. What they must understand is that surgery is not the easy way out, it requires a lot of work, emotional and physical and that work begins the first time an appointment is made with the surgeon. The woman who was disappointed about not having her surgery may still have surgery one day once she receives clearance from the specialist and after she works to lose the weight her surgeon had originally suggested for her to do. Perhaps she will then become one of the most successful patients the surgeon ever had.
Jacquelyn K. Smiertka, RN
has been a bariatric surgical clinical coordinator for over eighteen years. She is a member of the ASBS Standards Committee and a member of IFSO and has presented at both national and international conferences on obesity.
http://www.beyondchange-obesity.com/editorsNotes/whenTheSurgeonQuits.html
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
South Beach Diet Philosophy |
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Learn about the delicious, foolproof plan for fast and healthy weight loss...for life! |
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Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
South Beach Diet Basics
Lose weight, banish cravings, shrink your belly--without ever feeling hungry.
by Arthur Agatston, M.D.
http://www.prevention.com/cda/feature2002/0,2479,s1-5345,00.html
In the mid-1990s, I became disillusioned with low-fat, high-carbohydrate diets. They didn't work for many of my patients, especially over the long haul. Being a cardiologist, my concern was not for my patients' appearance, of course: I wanted to find a diet that would help prevent or reverse heart disease.
I never found such a diet. Instead, I developed it myself.
The South Beach Diet is not low-carb. Nor is it low-fat. Instead, it teaches you to rely on the right carbs and the right fats--the good ones--so you lose weight, lower your cholesterol, reduce your risk of heart disease and diabetes, and get rid of cravings without feeling hungry.
In one 12-week study of 40 overweight people, those who followed the South Beach Diet lost an average of 13.6 lb, almost double the 7.5 lb lost by those on the strict "Step II" American Heart Association (AHA) diet. And the South Beach group showed greater decreases in waist-to-hip ratio (belly fat) and triglycerides, and their good to bad cholesterol ratio improved more. Plus, only one person dropped out compared with five in the AHA group.
By choosing the right carbs and the right fats, you simply won't be hungry all the time, and portion sizes will take care of themselves.
Caution: If you have kidney problems, talk to your doctor before starting this diet. If you have diabetes, get tested to make sure that your kidneys are not impaired before starting this diet.
Good Carbs versus Bad Carbs
Much of our excess weight comes from the carbohydrates we eat, especially the highly processed ones found in baked goods, breads, snacks, soft drinks, and other convenient favorites. Modern industrial processing removes the fiber from these foods, and once that's gone, their very nature--and how we metabolize them--changes significantly, and for the worse.
One side effect of excess weight, we now know, is an impairment of insulin's ability to do its job of processing fuel (fats and sugars) properly. This condition is called insulin resistance. As a result, the body stores more fat than it should, especially in the midsection.
Decrease consumption of those bad carbs, studies showed, and the insulin resistance starts clearing up. Weight decreases, and you begin metabolizing carbs properly. Even the craving for carbs disappears once you cut down on them. Finally, cutting out processed carbs lowers triglycerides and cholesterol.
The Right Fat
To make up for the overall cut in carbs, my diet permits ample fats and animal proteins. The low-fat regimen's severe restrictions on meat were unnecessary. The latest studies had shown that lean meat did not have a harmful effect on blood chemistry. Even egg yolks are good for you, which is contrary to what we once believed. Chicken, turkey, and fish are recommended, along with nuts and low-fat cheeses and yogurt.
As a rule, low-fat prepared foods can be a bad idea; the fats are replaced with carbs, which are also fattening. But dairy products such as cheese, milk, and yogurt that are low-fat are exceptions to this rule; they are nutritious and not fattening.
I also allowed plenty of healthy monounsaturated fats such as olive and canola oils. These are the good fats. In addition to actually reducing the risk of heart attack and stroke, they taste good and make food palatable. They're filling too.
Phase 1: Two Weeks of Restraint
This is the strictest part of the diet and is meant to last for 2 weeks only. But you could lose up to 13 lb depending on your starting weight. It allows ample portions of protein, good fats, and the lowest-glycemic index carbs needed for satisfaction and blood sugar control. By the time this phase ends, your cravings for sweets, baked goods, and starches will also have vanished.
Each day includes six different occasions to eat, so you should never feel hungry. If you do, maybe you're being too stingy with your portions. Meals should be of normal size, enough to satisfy you, but no more than that. No need to measure most things.
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Foods to Enjoy |
Foods to Avoid |
Beef: Lean cuts such as sirloin (including ground), tenderloin. Poultry (skinless): Cornish hen, turkey bacon, turkey breast, chicken breast. Seafood: All types of fish and shellfish. Pork: Boiled ham, Canadian bacon, tenderloin. Veal: Chop, cutlet, top round. Lunchmeat: Fat-free or low-fat. Cheese (fat-free or low-fat): American, Cheddar, cottage cheese, cream cheese substitute (dairy-free), feta. Nuts: Peanut butter, peanuts, pecans, pistachios. Eggs: Whole eggs are not limited unless otherwise directed by your doctor. Use egg whites and egg substitute as desired. Tofu: Use soft, low-fat, or light varieties. Vegetables and legumes: Artichokes, asparagus, beans and legumes, broccoli, cauliflower, celery, cucumbers, eggplant, lettuce, mushrooms, spinach, tomatoes, zucchini. Fats: Canola and olive oils. Spices and seasonings: All seasonings that contain no added sugar, broth, butter sprays, pepper. Sweets (limit to 75 calories per day): Chocolate powder (no added sugar), cocoa powder (baking type), hard candy, sugar substitute (all sugar-free unless otherwise specified). |
Beef: Brisket, liver, rib steaks, other fatty cuts. Poultry: Chicken wings, thighs, and legs, turkey wings, duck, goose, poultry products (processed). Pork: Honey-baked ham. Veal: Breast. Cheese: Brie, Edam, all full-fat. Vegetables and legumes: Barley, beets, black-eyed peas, carrots, corn, pinto beans, sweet potatoes, white potatoes, yams. Fruit: Avoid all fruits and fruit juices during Phase 1. Starches: Avoid all starchy food during Phase 1, including all types of bread, cereal, matzo, oatmeal, rice, pasta, pastry, potatoes, and baked goods. Dairy: Avoid all dairy foods during Phase 1, including ice cream, milk, soy milk, yogurt. Miscellaneous: Alcohol of any kind, including beer and wine. |
Phase 2: More Liberal Meal Plans
Here's where you gradually reintroduce certain healthy carbs into your diet: fruit, sweet potatoes, whole grain bread, whole grain rice, whole wheat pasta. Start with one piece of fruit a day for lunch or dinner, and continue with some cereal or a piece of bread. Weight loss will slow a little. (A healthy average rate of weight loss is 1 to 2 lb a week over time.) Stay on this phase until you hit your target weight. If you regain some weight, switch back to Phase 1 until you lose it.
A key to success is the glycemic index (GI) that ranks carbohydrate foods by their effect on your blood sugar levels. Focus on adding low-GI foods (apples, berries, grapefruit, high-fiber cereal, whole grain breads) to your diet instead of those with a high GI (cakes, cookies, crackers, pasta, white bread).
The goal is to eat more carbs again while continuing to lose weight. If you add an apple and a slice of bread a day, and you're still dropping pounds, that's great. If you try an apple, two slices of bread, and a banana daily and notice that your weight loss has stalled, you've gone too far. Cut back, or try some different carbs.
You'll go on that cautious way as long as you're in Phase 2, eating the most beneficial carbs and paying attention to how they affect you. You should also be aware of foods that increase cravings. No two people will experience this phase the same way. Some dieters can have pasta once a week with no detrimental effects. Others have to avoid pasta but can eat sweet potatoes. You'll have to figure this dynamic out for yourself.
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Foods You Can Eat Again |
Foods to Avoid or Eat Rarely |
Fruit: Apples, blueberries, cantaloupe, grapefruit, grapes, mangoes, oranges, peaches. Dairy: Milk (light soy, fat-free, or 1%), yogurt. Starches (use sparingly): Bagels (small whole grain), bran muffins, bread (multigrain, bran, whole wheat), cereal (high-fiber, oatmeal [not instant]), pasta (whole wheat), pita, rice (brown, wild). Vegetables and legumes: Barley, black-eyed peas, pinto beans, sweet potatoes, yams. Miscellaneous: Chocolate (bittersweet or semisweet, sparingly), pudding (fat-free). |
Starches: Bagels (refined wheat), bread (refined wheat, white), cookies, cornflakes, dinner rolls, matzo, pasta (white), potatoes (white baked, instant), rice cakes, rice (white). Vegetables: Beets, carrots, corn, white potatoes. Fruit: Bananas, canned fruit, fruit juice, pineapple, raisins, watermelon. Miscellaneous: Honey, ice cream, jam. |
Phase 3: The Rest of Your Life
This is the maintenance phase: how you'll eat for the rest of your life. It's the most liberal stage. You can continue to eat snacks if you need them, but most people find that they are satisfied without them.
There will always be times when you overindulge a little even after years on the diet. Those are the times when you'll switch back to Phase 1 for a week or two. You'll get back to where you were, and then you'll return to Phase 3.
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Don't Forget (All Phases)
1. Drink at least eight glasses of water or decaf beverages (club soda, unsweetened flavored seltzers, decaf tea or coffee [no sugar], decaf sugar-free sodas) per day.
2. Limit caffeine-containing beverages to 1 cup per day.
3. Take a daily multivitamin and mineral supplement.
4. Take a daily calcium supplement (500 mg for men of all ages and women under 50, 1,000 mg for women over 50).
Jamie Ellis RN MS NPP
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163(lowest)/185(current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"