Bariatric surgery – gastric bypass, Lap Band and REALIZE Band procedures - is recognized by the National Institute of Health as a safe and effective way for morbidly obese patients to lose weight. But surgery is only a tool, it’s still up to the patients to adhere to healthy diet and exercise program. With the food the center of many family activities, the New Jersey Bariatric Center finds that patients with strong family support and encouragement can increase weight loss success. Family support keeps patients on track as well as losing and maintaining their weight throughout their life.
“From the simplest everyday family dinner to the large family holiday celebrations, food and family are closely linked,” says Dr. Ajay Goyal, surgeon, New Jersey Bariatric Center. “While the ultimate success of weight loss surgery lies with the patients and their adherence to a healthy diet and exercise program, with family present during the majority of times when patients interact with food, their support and encouragement plays a significant role in a patient’s weight loss success.”
New Jersey Bariatric Center patient Dawn Rodriguez credits her husband and daughter’s support to her weight loss success. Rodriguez says while it wasn’t always easy on her family, “we had a lot of issues come up, even just sitting down to eat as a family became an issue because of what and how I had to eat compared with what and how they ate,” no matter what the issues were or how difficult it was at any given moment, her family never failed to support and be happy for her. “Even though losing weight is my accomplishment, if it wasn’t for them, I don’t think I would have gotten as far as I have or had the success that I’ve achieved.”
Five Tips for Family Members
Dr. Goyal offers five tips to friends and family members so they can help bariatric surgery patients achieve their goal weight loss after gastric bypass, Lap Band and REALIZE Band surgery.
1. Learn About the Surgical Procedure: Just as patients research and learn about what changes their bodies will undergo, it’s important for family members to do the same. Understanding the journey your family member is about to take will help you guide, coach and offer support throughout the process.
2. Respect Patients New Eating Habits: Your family member’s eating habits are going to change drastically immediately after weight loss surgery. Be respectful of their weight loss goal, don’t bring “treats” to the hospital after surgery, don’t encourage them to finish their plate when their full and try to refrain from tempting them with food - “a little bite won’t hurt you” - or inadvertently sabotaging their efforts, i.e. giving them a box of chocolates as a gift.
3. Don’t Blame the Patient: Over and over again patients remark that many of the toughest times during weight loss is when the family sits together at the dinner table. In many cases, the person who’s in charge of feeding the family is the patient, and the family overall sees a difference in the type of food now served that can be frustrating for family members. Fried chicken becomes grilled chicken, an ice cream treat is not a fruit treat. These little changes can cause bickering, squabbling and even heated debates at the dinner table. Try to stay away from responses such as “You chose this not me” or ‘Don’t punish me for your decisions,” stay calm, count to 10 before you respond, and find a solution that works for both parties.
4. Prepare for the Dynamics of the Relationship to Change: Was this your friend who you always went out for ice cream sundaes with when times got tough? Was your family member always a little shy due to her/his weight causing them to shrink from attention? As the weight comes off, prepare for the dynamics of the relationship to change. Instead of bonding over food or taking your joint frustrations out with food, find a new activity to enjoy together that doesn’t involve food – join a gym, take a class or start a book club. And understand your family member is still the person you’ve always known and loved, they’re not changing on you – you’re seeing a new confident side of them that’s always been there but that they were uncomfortable expressing when they were carrying the extra weight.
5. Compliment Success, Offer Encouragement During Setbacks: And finally, don’t forget to compliment your family member on the successes they’ve achieved, and offer encouragement during the more challenging times.
Friday, May 16, 2008
Gastric Bypass, Lap Band or REALIZE Band – A Nutritionist’s Perspective
Frequently when I meet with patients contemplating weight loss surgery at the New Jersey Bariatric Center they’re still debating which surgery – gastric bypass, Lap Band or REALIZE Band – is right for them. Often, they ask for my opinion from a nutritional standpoint, regarding which one they should pick, or which one is “better.” These are decisions that can only be made by patients, together with their doctor, based on their weight, lifestyle, and medical history. However, what I can do is explain the nutritional differences between the surgeries to arm patients with the nutritional side of what life will be like post- gastric bypass, Lap Band or REALIZE Band surgery to factor into their decision.
One of the first considerations to look at nutritionally regarding weight loss surgery is vitamin and protein maintenance. While all three procedures require a multi-vitamin, a calcium supplement and a diet high in protein, Lap Band and REALIZE Band surgery requires less vitamin and protein maintenance than the gastric bypass. When bypassing the stomach and initial section of the small intestine as one does in gastric bypass surgery, you also bypass the area where B12, a key nutrient, is prepped [it binds with a stomach enzyme] to be absorbed in the small intestine. It’s therefore very important that gastric bypass patients take a daily supplement of B12, which is placed under the tongue so it can be absorbed directly into the bloodstream.
Protein supplements are also an important part of a weight loss surgery patient’s diet. It’s important for a Lap Band and REALIZE Band patients to supplement protein for the first two weeks after their surgery while they’re on a full liquid diet, and for gastric bypass patients to take a protein supplement for the rest of their life. The mal-absorptive nature of gastric bypass results in not only preventing the absorption of part of the calories one eats, but also the absorption of the proteins and nutrients one needs to survive. That’s why gastric bypass patients will need to supplement proteins and vitamins (Iron, Calcium, Vitamin B12) for the rest of their lives. To ensure you’re getting the nutrients you need to stay healthy, your doctor will perform annual blood check to see if you are adequately talking these vitamins and minerals. [Note - the side effects of not regularly taking supplemental proteins and multivitamins can take years to develop in some cases and by then it can be too late to replete the body of these essential building blocks so it’s essential you follow the supplement regimen your doctor prescribes.]
So, now it seems like the decision is simple – the Lap Band or REALIZE Band is the way to go, less vitamin and protein supplements to deal with, therefore it must be easier. It’s actually the opposite, Lap Band and REALIZE Band patients must be more vigilant about what they eat than gastric bypass patients.
Here’s why, let’s use liquids as an example- specifically liquid calories such as juices, sodas and fancy coffee drinks. For weight loss in general, it’s recommended to avoid all liquid calories. It’s even more important with weight loss surgery. Due to the mal-absorptive component of gastric bypass, liquid calories that are sweet will cause a patient to experience dumping syndrome (nausea, sweating, increased heart rate). Dumping syndrome is unpleasant, and experiencing it once often prevents patients from consuming these high calorie beverages again. This side effect, while unpleasant, helps curb a patient’s desire for unhealthy foods such as sweets. However, Lap Band or REALIZE Band patients can consume liquid calories without experiencing dumping syndrome. The absence of the mal-absorptive nature of the Lap Band or REALIZE Band doesn’t give their body the signal that these beverages are not good for them, thus making compliance with dietary restrictions more rigorous.
All surgeries – gastric bypass, Lap Band or REALIZE Band - have their pros and cons from a nutritional stand point, and choosing one is an individual decision based on your doctor’s counsel, your lifestyle and your tolerance to the different restrictive natures of both procedures. Regardless of which procedure you decide to move forward with, adopting an overall healthy lifestyle with proper nutrition and exercise is the key to success.
By Karen Kelly, RD, New Jersey Bariatric Center
One of the first considerations to look at nutritionally regarding weight loss surgery is vitamin and protein maintenance. While all three procedures require a multi-vitamin, a calcium supplement and a diet high in protein, Lap Band and REALIZE Band surgery requires less vitamin and protein maintenance than the gastric bypass. When bypassing the stomach and initial section of the small intestine as one does in gastric bypass surgery, you also bypass the area where B12, a key nutrient, is prepped [it binds with a stomach enzyme] to be absorbed in the small intestine. It’s therefore very important that gastric bypass patients take a daily supplement of B12, which is placed under the tongue so it can be absorbed directly into the bloodstream.
Protein supplements are also an important part of a weight loss surgery patient’s diet. It’s important for a Lap Band and REALIZE Band patients to supplement protein for the first two weeks after their surgery while they’re on a full liquid diet, and for gastric bypass patients to take a protein supplement for the rest of their life. The mal-absorptive nature of gastric bypass results in not only preventing the absorption of part of the calories one eats, but also the absorption of the proteins and nutrients one needs to survive. That’s why gastric bypass patients will need to supplement proteins and vitamins (Iron, Calcium, Vitamin B12) for the rest of their lives. To ensure you’re getting the nutrients you need to stay healthy, your doctor will perform annual blood check to see if you are adequately talking these vitamins and minerals. [Note - the side effects of not regularly taking supplemental proteins and multivitamins can take years to develop in some cases and by then it can be too late to replete the body of these essential building blocks so it’s essential you follow the supplement regimen your doctor prescribes.]
So, now it seems like the decision is simple – the Lap Band or REALIZE Band is the way to go, less vitamin and protein supplements to deal with, therefore it must be easier. It’s actually the opposite, Lap Band and REALIZE Band patients must be more vigilant about what they eat than gastric bypass patients.
Here’s why, let’s use liquids as an example- specifically liquid calories such as juices, sodas and fancy coffee drinks. For weight loss in general, it’s recommended to avoid all liquid calories. It’s even more important with weight loss surgery. Due to the mal-absorptive component of gastric bypass, liquid calories that are sweet will cause a patient to experience dumping syndrome (nausea, sweating, increased heart rate). Dumping syndrome is unpleasant, and experiencing it once often prevents patients from consuming these high calorie beverages again. This side effect, while unpleasant, helps curb a patient’s desire for unhealthy foods such as sweets. However, Lap Band or REALIZE Band patients can consume liquid calories without experiencing dumping syndrome. The absence of the mal-absorptive nature of the Lap Band or REALIZE Band doesn’t give their body the signal that these beverages are not good for them, thus making compliance with dietary restrictions more rigorous.
All surgeries – gastric bypass, Lap Band or REALIZE Band - have their pros and cons from a nutritional stand point, and choosing one is an individual decision based on your doctor’s counsel, your lifestyle and your tolerance to the different restrictive natures of both procedures. Regardless of which procedure you decide to move forward with, adopting an overall healthy lifestyle with proper nutrition and exercise is the key to success.
By Karen Kelly, RD, New Jersey Bariatric Center
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