It is not easy changing your lifestyle. Here are some tips to assist you before and after weight loss surgery.

Tips to Increase Your Protein:

One of the obstacles after bariatric surgery is consuming enough protein in your diet.  Check with your Nutritionist to determine your protein goal. Typically, I recommend a goal of 60-80 grams of protein per day.    Protein goals may vary based upon height, weight, and activity level. Try these tips below:

• Consume a high protein, low calorie shake for breakfast or lunch.  Make sure it is less than 200 calories and low in sugar!
• Most popular and best tasting protein supplements reported by my patients are Unjury, Nectar, Atkins, Premier Nutrition, and Bariatric Advantage.


• Bariatric Advantange High Protein Meal Replacement contains 27g protein in 2 scoops mixed with 8 oz. of water or milk.  Available at www.bariatricestore.org.  Nectar is also be found on this website.
• Try the new Ketogenix line from Bariatric Advantage. The high protein vegetable soup is delicious and contains 20 grams of protein.
• Unjury is a protein powder that comes in a wide variety of flavors.  Try adding unflavored or flavored powder to crystal light.  They also have a chicken broth that contains 20g of protein.  Products are available at www.unjury.com.
• Add protein powder to soups, shakes, & puddings.
• Drink protein water between meals, such as Isopure, Stacker2, or Designer Whey Protein Blitz (found at GNC or vitamin shoppe).
• Add low-fat cheese to vegetables, meats, eggs and soups.
• Add 1-2 protein snacks per day, such as lowfat cheese, nonfat greek yogurt, boiled egg, nuts, or turkey and cheese roll-up.
• Start food journaling to track your protein intake. My Bari Good Life book contains plenty of food and exercise journals.

Prevent hair loss after surgery:

A common fear of patients is losing hair after weight loss surgery. Hair loss may be a result of inadequate protein, vitamin, and mineral intake.  It may also be due to the body’s stress response and hormonal changes that occur from surgery and rapid weight loss.  To prevent hair loss, consume 60-80 grams of protein per day and take the recommended vitamin and mineral supplements!  Taking extra biotin and zinc may help if your multivitamin does not contain enough of these vitamins and minerals.

Vitamin and Mineral Supplements:

There are thousands of vitamin brands on the market today but most are not adequate for bariatric surgery patients.  You must choose wisely to maximize your intake and absorption of vitamins and minerals!   Vitamin deficiencies can lead to serious problems. 

After gastric bypass surgery, you do not have as much digestive acids and enzymes to help break up food and vitamin pills so I strongly recommend chewable or liquid vitamins.  Avoid tablets or time-release vitamins.  These two brands below, in my professional opinion, are ranked the best:

Nutrametrix Isotonic Liquid Vitamins & Antioxidant Supplements-  Isotonic-capable nutritional supplements are absorbed quicker than most vitamin products since they are in a  readily absorbed form not requiring the body to break it down.  These products do not contain dyes, sugar alcohols, fillers, or artificial sweetners. You must take the correct dosage:  For gastric bypass patients take 1 multivitamin cap + 2 calcium caps in 6oz of water in the am, and repeat in pm.   For lap band patients and sleeve patients, take 1 cap multivitamin + 2 caps calcium in 8 oz of water once per day.   The vitamin cocktail tastes like orange tang.  For a berry flavor, add the orac antioxidant.  Orac is an antioxidant supplement containing berries (pomengranate, cranberry etc.) Products may be purchased at www.myvitamins.nutrametrix.com.

Available Products:


• Isotonic Multivitamin-Type "multivitamin" in the product search box at the top of the page. It tastes like orange/mango tang.
• Calcium Complete-Click under bone and joint health or type calcium complete in search box.
• Isotonic Liquid Vitamin D 5,000 IU for patients requiring extra vitamin D.
• ORAC (oxygen radical absorption capacity) is a potent antioxidant formula that prevents oxygen and nitrogen free radical damage to your cells. It helps with cancer prevention, anti-aging, urinary tract infections, kidney stones, supports a healthy immune system etc..This product contains pomegranate, blueberries, elderberries, cranberries, raspberries, potassium etc..Tastes like berries.
• OPC-3 is one of their most popular products.  It’s an anti-inflammatory supplement that helps to increase blood and oxygen circulation.  OPC3 helps to decrease inflammation with any inflammatory diseases like allergies, ulcerative colitis and arthritis.  OPC3 promotes cardiovascular health.  It contains red wine extract, grape seed extract, bioflavonoids, pycnogenol (pine bark extract). 
• Ultimate Aloe Juice for reflux, contains no sugar
• Nutraclean Probiotics is located under digestive health.  This product contains 10 billion CFUs from 10 probiotic strains, specifically targeting numerous areas of digestive and immune health.  Probiotics are recommended to help with IBS, Crohn's, Colitis, and other bowel diseases.
• Transitions Lifestyle Program-protein shakes and meals for weight management.

Bariatric Advantage Chewable Vitamins and Protein Supplements- Vitamins and protein supplements developed for bariatric surgery patients.  Available at www.bariatricestore.org in a variety of flavors.


Tips to Increase Fiber:

Some patients complain of constipation after surgery.  It is challenging to get enough fiber in your diet when your food intake is very limited.   Emphasis is on protein after surgery but it is important to incorporate fruits, vegetables and whole grains into your meal plan.  Try these tips below:

• Increase fruit and vegetable intake to at least 3-4 one ounce servings per day.
• Consume a salad for lunch or dinner.
• Start your day with a high fiber cereal in the morning, such as kashi, total, bran cereals, or oatmeal.  If you drink a protein shake for breakfast, add benefiber.
• Beans and peas contain a good source of fiber.
• Dilute prune juice.
• Add an apple slice as a snack.
• Add flaxseed, oatbran or a high fiber cereal to yogurt
• Try a probiotic yogurt, such as activia light or a low sugar probiotic drink
• Make sure to drink plenty of water and don’t forget to exercise!

Hydration:

Another big obstacle after weight loss surgery is consuming enough liquids since you cannot eat and drink at the same time. Sip on water or a low calorie sports drink between meals.  Carry a small water bottle with you at all times!  Dehydration after surgery can lead to nausea and an increased risk of developing blood clots and kidney stones. 

Typical Diet after Bariatric Surgery:

Most surgery programs recommend a liquid diet to start then gradually advancing to solid food.  This allows your new stomach to heal and prevents you from vomiting or getting sick.  Follow the diet recommendations of your program.  Each program may differ a little depending on your surgeon.  Here is an example of a post-surgery bariatric diet:

• Clear Liquid- Broths, flavored waters, protein waters, low calorie sports drinks,    
  
• unjury high protein chicken broth, vegetable broth,
  
• Full Liquid-Protein shakes, soups, high protein bariatric advantage vegetable 
  
• soup at www.bariatricestore.org, yogurt, oatmeal, greek yogurt, cottage cheese
  
• Pureed-blended meats, veggies and fruit, tuna salad, chicken salad, egg salad, 
  
• lowfat cheese, soft fish, baby food
  
• Soft-fish, eggs, softly cooked vegetables, protein shakes, lowfat cheese, tuna or chicken salad
  
• Regular solid food.

Get Back on Track:

Busy work schedules, hectic lifestyles, and convenience are all a part of today’s society. It’s challenging finding the time and sometimes energy to take care of our health and emotional well-being. Perhaps the most challenging part of weight loss surgery is changing your lifestyle and dietary behaviors permanently, especially if you grew up a certain way or are used to eating certain foods.   My Bari Good Life contains food journals, exercise journals, goal setting checklists and weight charts to help you get back on track.  Start food journaling and make an appointment with your Nutritionist for appropriate recommendations!

Tips for Pre-Operative Patients:

• Start changing your lifestyle and dietary habits now!  This will help ease the transition from pre- to post-surgery.  I find patients who change their dietary habits before surgery do much better than patients who do not.  My Bari Good Life includes charts and food journals to help you focus on changing your diet before surgery. 
• Lifestyle changes don’t happen over night.  Set 1-2 goals to start.  Your Nutritionist will help you set goals. Here are some examples of dietary changes to start working on:

  1) Wean off sodas and drink more water!  Add a lemon slice to flavor your water.

  2) Avoid regular fruit juices.  Instead consume a piece of fresh fruit!

  3) Choose diet or light drinks with less sugar (ex. Crystal light, flavored waters, minute maid light lemonade, diet teas). 

  4) Eliminate sugary foods, such as cakes, cookies, candy
  

  5) Limit starches with your meal (breads, pastas, potatoes)
  

  6) Eat three meals per day.  Do not skip!  Not only will skipping meals slow down your metabolism but you’re likely to eat more at night to make up for the missing calories during the day!  Calories at night=weight gain.
  

   7) Be aware of any emotional or binge eating episodes.  The surgery is an excellent tool for weight loss but it does not cure the emotional need for food.  Consider counseling to help cope with the loss of food.  My Bari Good Life contains emotional eating journals and worksheets to help you stop these behaviors!

• To help you lose weight prior to surgery, include 1-2 low calorie meal replacements.  For example, incorporate a protein shake for breakfast and a low calorie frozen entrée for lunch.   Try transition entrees from www.myvitamins.nutrametrix.com.  Click on weight management. These meals are high in protein, high in fiber and low in calories.   Other good options are South Beach, Medifast, Bariatric Advantage shakes or soup, Lean Cuisine, or Weight Watcher meals.  These meals will help you reduce calories and portions. If you have a history of high-blood pressure, or retain fluid, then you may want to steer away from frozen meals, since they tend to be high in sodium. Fresh food is best but portion control is the key.
• Make a list of pre-operative tests to complete.  My Bari Good Life contains a pre-operative workbook section to track pre-operatives tests.
• Follow the recommendations of your program!  It won’t be easy.  Your weight management team will coach you on dietary changes and pre-operative tests to complete in preparation for surgery!