By Mariam Lakdawala- Registered Dietician and Bariatric Nutritionist
It is rightly said, “Today’s preparation determines tomorrow’s achievement”.
As a patient it is expected of you to understand the lifestyle and behavioural changes required to be made post Bariatric surgery. Prior awareness about what to expect will help you to prepare and commit to follow healthy dietary and exercise practices after the surgery.
Anthropometry measurements, medical history and diet history obtained in the 1st consultation, gives us an idea about the patient’s eligibility for bariatric surgery, lifestyle and eating behaviour. The bariatric surgeon will recommend the procedure/ surgery that will be best suited as per the details obtained in the consultation and explain its pro’s and con’s.
Pre bariatric surgery protocol followed at our unit is as under:
A minimum of two pre-surgery consultations with the bariatric team where all the pros and cons are explained and the doctor and patient take a joint decision about the type of bariatric operation.
This is followed by investigations and fitness consultations for surgery by the physician/endocrinologist and anaesthesia team.
If there are any nutritional deficiencies, supplementation for those are started pre-surgery.
A pre-operative high protein diet is advised for a minimum of 7-10 days before the surgery. It is a low calorie, low fat, low carbohydrate, moderate protein liquid diet. It is crucial as it not only helps the patient to prepare for the liquid diet which is to be followed post-surgery but also helps to shrinks the liver. This makes surgery technically easier for the surgeon and safer for the patient.
In case of patients suffering from liver and kidney disease specialist consultations are done and appropriate diet is started.
To work on de-addiction in case of drug/ alcohol/ food addictions. The 1st consultation helps us to gauge if the patient suffers from any kind of substance abuse disorder or food addictions. In case of any addiction we counsel the patient about its ill effects post-surgery and ask them to take out time and work on de-addiction in conjunction with a counsellor. Only when the patient shows commitment towards getting rid of the addiction we consider going ahead with the surgery.
To understand about various behavioural and lifestyle changes to be made after bariatric surgery. Right from the 1st consultation we tell the patients that obesity is a disease and counsel them about the nature of this chronic disease. It is very important to make them aware that Bariatric Surgery is not a 100% full proof method of weight loss and that it has to be accompanied with lifestyle modification in order to obtain a good weight loss outcome in the long term.
To be aware about the Immediate dietary changes to be made and supplementation required post-surgery.
Very often we come across patients who are volume eaters, emotional eaters, fast eaters, sweet eaters, etc. Thus, it is imperative to inform them that after surgery they will have to eat more mindfully. Their diet will transition from clear liquids to full liquids to soft diet and only after 1 month, they will be able to eat a full diet, that too the quantity will be less. Depending on the type of bariatric surgery decided they are counselled about the importance and duration of nutritional supplementation.
Counselling the patient thoroughly before surgery will help to decrease the risk of surgery and fasten the post-operative recovery.
About Dr. Aparna Govil Bhasker
Dr. Aparna Govil Bhasker is an accomplished Bariatric Surgeon and Laparoscopic Surgeon. She is very renowned and is extremely passionate about her field of specialization.
Dr. Aparna Govil Bhasker is an accomplished Bariatric Surgeon and Laparoscopic GI Surgeon. Extremely passionate about her field of specialization. She completed her MBBS and MS in General Surgery in 2006, from Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sewagram. Set up in 1967 by none other than the first health minister of India, Ms. Sushila Nayar, MGIMS is deeply rooted in Gandhian ethics. Read more