Question:
Having problems with a preop diet to satisfy Nutritionist
I met with the Nutritionist as part of my preparation for surgery and was told i needed to keep a diary of meals and lose 20 olbs before she will approve me for surgery,i am having a really hard time, not so much that i eat too much but with my busy schedule its hard to eat healthy balanced meals. Does any one have any suggestions??? — David A. (posted on May 24, 2004)
May 24, 2004
A LIQUID DIET AND YOU WILL LOSE
— donald H.
May 24, 2004
It concerns me that if you're having trouble now with healthy eating
because of a busy schedule, you'll have trouble after surgery too and you
will have to eat healthily after surgery or you will regain weight. I'd say
sit down and figure out what your post-op plan is going to look like and do
as much of it now as you can. Cut out all refined carbs, eat only protein,
veggies, and complex carbs. Drink LOTS of water, get a protein supplement
that you like and use it to help stave off hunger. Either the South Beach
diet or the insulin resistance diet is a great way to lose the weight and
start getting you prepared for the post-op life. If you have to eat out a
lot, be sure to always choose the lo-carb options,if you have a burger,
order it without bread or throw the bread away, cut out white rice,
potatoes, and pasta. If you do all those things, you won't have to limit
your portions and you should still lose weight. Good luck to you and hope
some of the suggestions help.
— scbabe
May 24, 2004
I have to agree with SC BABE. If you can't eat healthy now as a pre op
it's going to be really difficult as a post op. This is one area where it
is up to you, the patient, to bite the bullet so to speak and do whatever
it takes. Speaking from my own experience - I thought I didn't have time
to eat healthy either and I discovered that it only takes a little extra
time and creativity to eat healthy both at home and one the road. You can
do it -- you just have to put your mind to it. You owe it to yourself to
get healthy prior to surgery. Best wishes in your journey!
— ronascott
May 24, 2004
I don't mean to sound mean, but you have to ask yourself, if you
"don't have time for a healthy eating" why are you having the
surgery? You are only kiddig yourself, if you think that you be better off
after the surgery. You need to think long and hard if this surgery is for
you. Will ou lose the weight after surgery, yes, more than likely. BUT if
you can't adapt a healthy lifestyle, you can very easily gain it all back
and THAT would be terrible for you! Timeto do some serious sole searching,
it doesn't sound liek you are truly ready to make the commitment yet. Go
to a support group a few times and listen to people who have had the
surgery, listen to what they have to say, son't make any rash decisions.
Good luck to you!
Sherry S
— sac287
May 24, 2004
David- You have received some of the worst advice I have ever read on this
board (which says alot because I have offered more than my own share of
bone-headed ill-conceived pearls). If you could adopt to a healthy,
measured, moderate and healthy lifestyle, why would you be having surgery?
Like the rest of us who are honest with what got us into trouble, you
appreciate how the daily challenges in your life undermine your good
intentions. I have been highly successful--- starting at over 500 pounds
on Oct. 9, 2002 and getting down to 250 pounds by September 1st. And since
then, I've lost about 35-40 more pounds, all the while avoiding plateaus.
Could I have done that before surgery--- no. Could I have achieved these
results simply because some dietician told me I had to--- no freakin' way.
You see, I needed to get a head-start on my hunger to develop a healthy
eating lifestyle. And, I needed the impediments that a small pouch and
that dumping when eating sugars would provide. As someone who was addicted
to food, I needed the surgery to help me combat my addiction. It worked for
me and it will work for you too. And, if you feel that the dietician is
just putting an obstacle in your way that is unreasonable, don't hesitate
to talk to your surgeon. Good luck. Your peer in CT.
— SteveColarossi
May 24, 2004
For me I didn't even have to go through all that. I did have to see a
dietition, but it was just discusing food issues and I enjoyed the meeting,
I only had to see him once. I didn't have to lose any wt before my wls
either. Basicly all I did was make a appointment with my surgeon, then get
my tests, then wait for approval and then get my wls. all within 2 months.
No problem, I didn't have to go through classes, blah blah blah. I
understood what was ahead and was 110% ready to have the op. and I have
never regreted it. I have loss 208 lbs, my wt today is 192 lbs and have 50
more to lose. plus I'm waiting for approval for PS. I don't know why some
docs make you go through hell to get Wls, and then some don't. I guess some
folks are not ready and will have a hard time getting through. but that's
what the phycho test is for. I didn't even have to have this or the sleep
test. lucky me. it wasn't a required test with my insurance. Hang in there
and Best wishes to you.
— B4real
May 24, 2004
I take exception (as is my right on a public forum) to the post about
"bone headed advice." Most surgeons and nutritionists that I
have either seen or read about use the pre-op phase to see if you can be
compliant to their instructions. They don't necessarily expect you to lose
the entire amount of weight they specify for you, they just want to be sure
that you are committed enough to at least attempt to follow instructions.
It is true that some don't require anything and I have to wonder if some of
those patients are the ones we see on this board who are astonished when
they eat anything and everything and start gaining the weight back! I
followed my surgeon's and dietician's instructions to the letter pre-op and
was able to do it because I knew that in just a few weeks, I would have a
VERY powerful tool to help me continue to eat a healthy diet. I
"practiced" everything that I would have to do post-op because I
absolutely did not want to put myself thru a major, risky surgery and then
find that I could not follow the post-op regimin. To me, that is
"bone-headed" behavior. As a result, I lost 40 pounds before I
had the surgery. That was 40 pounds that I didn't have to worry about
losing after surgery and my surgery risk was lower with every pound I lost.
I know that we all have to find our own individual paths to success but I
still believe, if a person is too busy to make good, healthy food
selections pre-op, what will have changed after surgery? Nothing because,
based on observation and experience, most post-ops have gotten a LOT busier
after surgery because we have way more energy.
Good luck to you in whatever path you choose. Just remember that this
commitment is for life and it is worth taking the time to figure out early
how to incorporate healthy food choices into your busy life.
— scbabe
May 24, 2004
I just wanted to say that before I had surgery I met with the psychiatrist
who said I had an "emotional attatchment to carbohydrates"!!!
What I really had was insulin resistance which made my body crave
carbohydrates and the more I ate of them the more I wanted. I would fail at
every attempt to go off of them before surgery, and the psychiatrist was
not going to give me an approval. Well luckily I got to have surgery
anyway, and I have not had the slightest problem!!! It was the tool my
body needed in order for me to eat healthier!! Now that my body is not
craving sugar and carbohydrates, and since I dump when I eat them anyway, I
am able to be on a very successful "low-carbohydrate" life style,
not diet!!!! So maybe you will do ok after surgery, I know everyone is
different, but like a previous poster said, if we could physically do it
now, why have surgery? I sure wouldn't have!!
— GAYLE CARMACK-LYONS
May 24, 2004
I'm in agreement again with SC BABE and would like to respond to this
comment made by a previous poster: "If you could adopt to a healthy,
measured, moderate and healthy lifestyle, why would you be having
surgery?" David's nutritionist has advised him to lose only 20 pounds
prior to surgery. The nutritionist has not asked him to adopt a healthy,
measured, moderate lifestyle forever and forget about having surgery. She
has asked him to adopt this lifestyle temporarily until he has the tool in
place to enable him to adopt it permanently. Let's be honest with
ourselves. As morbidly obese people we can lose weight like champs without
surgery. We just can't keep it off. Asking a patient to improve eating
patterns and lose some weight prior to surgery is a great indicator of the
patient's post operative compliance as well as a means to get healthier
BEFORE surgery. I don't think anyone has given bone-headed advice. Now,
if the nutritionist said "Eat healthy, lose weight and forget about
having surgery" THAT would be bone-headed. Just my opinion. Best
wishes to all.
— ronascott
May 25, 2004
I agree with SC Babe and Rona, but in response to Rona's last post: To be
honest, I've begun to wonder if *every* M.O. person has a history of losing
weight and then regaining it. Sometimes I get the impression -- not
necessarily from this post -- that there are some post-ops who never truly
did stick on a diet or eating plan for any meaningful length of time.
Otherwise, I don't think I'd be seeing such panic at plateaus, the concept
of exercise as an aid to getting to goal, lack of understanding of why
eating junky foods is a problem, etc. I just wonder
sometimes.<P>With respect to Dave's post, *ding* *ding* *ding* I see
a Big Warning Sign. I understand the busy schedule thing. Pre-op, I piled
on most of my weight by eating very heavy meals in the evenings because I
was too busy at work to eat normally (if much at all). Since WLS I've
learned that the whole idea of staying fueled evenly throughout the day,
with steady, small meals, is critical. I've learned a lot of shortcuts to
get me through busy periods, but breaking the habit of eating crappy foods,
late at night, and skipping meals, is something we all have to deal with
and stick with even as post-ops. I'm not a fan of the required pre-op diet
(ho-HUM, been there before, haven't we? ... or have we in some cases, I
dunno. I had.). Anyhoo -- to me, this is a no-brainer, easy requirement
that should be doable because for once -- with WLS on the horizon -- you
can actually entertain the thought that you'll KEEP this "diet"
weight off once and for all once you have your WLS. The problem, however,
is that this first 20 pounds may be ALL you keep off if you return to your
old ways down the road, which is what the other posters are rightly
flagging as a Big Problem Here (JMHO!).
— Suzy C.
May 26, 2004
David - I will try to answer your question for suggestions, since I don't
think anyone has yet :) My family sees a nutritionist because my husband
has severe food allergies, I am RNY post op, one son is overweight and our
other son is skinny. Trying to eat like a family was very hard for us to
coordinate. We go to the nutritionist for advice on working in these
dietary restrictions and our busy lifestyle. Could the nutritionist work
with you on coming up with a program for you to follow in accordance with
your lifestyle and food preferences? Use your nutritionist as an advocate
to your weight loss efforts and for the opportunity to learn about healthy
nutrition that you will use for the rest of your life and not an obstacle
to getting the surgery. I wish I had this guidance pre-op. I didn't even
know what a carb was then. By the way, I was not required to lose any
weight preop and I have lost 130 post op. I'm very happy and I do not
struggle with regain so far (20 months post). Good luck to you!
— Yolanda J.
May 26, 2004
You can do this--even with a busy schedule, but it takes determination and
planning on your part--stay away from fast food during this time. I lost
41 lbs. prior to surgery while I was waiting and kept a food diary,
conforming to 1600 calories a day. A typical day for me would be fruit for
breakfast, veggies/dip and soup for lunch, and a salad and some kind of
entree for dinner. No in between eatings. That worked fine for me, but
you have to find something that works for you.
— Cathy S.
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