Nutrition With Bariatric Surgery
Sleeve Gastrectomy  Gastric Bypass  Gastric Banding Duodenal Switch
NUTRITION CLASS 1 : INTRODUCTION
“HOW YOU WILL USE YOUR NEW TOOL
SUCCESSFULLY”
SAGE BARIATRIC INSTITUTE
What We’ll Cover Today
 Nutrition and behavior guidelines for successful
weight loss with bariatric surgery
 Protein Shakes/Meal Replacements
 Bariatric Surgery Readiness Diet
 Healthy Food Guide
Guidelines for Successful Weight Loss with
Bariatric Surgery
 Bariatric Surgery is a highly effective tool for weight loss
but there are important principles to use your tool
optimally.
 Your “weapons” against obesity (or WEPNSS) are your
rules to live by.
 We know they work! Learn them. Live by them.
 Begin practicing these guidelines NOW to ease your
transition into surgery.
WEPNSS
 W- water
 E- exercise
 P- protein
 N- no snacking or grazing/Purposeful FASTING
 S- supplements (vitamins and minerals)
 S- support
(WEPNSS) Water Water Water
 Hydration is the solid foundation for your weight
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management program.
Drink consistently throughout the day.
Goal of at least 64 ounces (8cups/4 bottles) of zero or <10
calorie, sugar-free, non-caffeinated, non-carbonated fluids
Avoid caffeine for 3 months after surgery. Decaf is OK.
Avoid alcohol for 1 year following surgery.
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Delays healing
Slows/halts weight loss
1 drink=4 drinks
 Avoid carbonation.
 Avoid any empty calories particularly from beverages
(juice, milk, soda, sweet tea, coffee drinks, smoothies,
alcohol)
Spacing Water and Meals
 Separate fluid from your meals. Stop drinking at the first
bite. Wait 1 hour after meals to resume drinking.
 Focus on optimizing nutrition in the early phases after
surgery.
 Water during meals can flush your food through your
stomach faster. Allows you to eat more or get hungry again
sooner.
 Eat slowly, small bites, chew food well
Water Water Water
Meal ………………
Water Water Water
(WEPNSS) Exercise
 Helps to burn more calories day to day
 Helps to preserve lean body mass
 Use those muscles to keep them
 Increase purposeful movement
 Find activities that you enjoy
Exercise
 Cardiovascular + Resistance (weights/bands)
 Upper body & lower body
 Goal = minimum of 30 minutes
cardio 5x/wk and 15 minutes
strength/resistance 3x/wk
 Develop the habit of movement prior to your surgery.
 Even start with 10 minutes at a time
 Sit and Be Fit
 Utilize physical therapy to come up with a safe and realistic goals
(WEPNSS) Protein
 Goal of 60 grams per day for women and 80 grams
per day in men
 Early benefits of protein
 Helps protect against loss of lean body mass (muscle)
 Main building blocks of our bodies/promotes healing
 Late benefits of protein
 Protein gives a feeling of satiety (satisfied)
 Fewer calories per gram than fat and more satiety than
carbohydrates
Protein
 Refer to your Healthy Food Guide
 50-70% of meals should be lean proteins

Choose protein foods first
 30-50% should be non-starchy vegetables (anything
other than corn, peas, or potatoes)
 Less than 15% of your meal should be from healthy
carbohydrates such as beans, fruit, low fat dairy, or
starchy vegetables. Keep to 1/3 cup or less no more than
twice per day.
 Avoids sweets and processed, refined carbohydrates as
they will interfere with your weight loss…juice, soda,
sweet tea, candy, cookies, breads, tortillas, rice, pasta,
crackers, oatmeal.
Protein Shakes/Meal Replacements
Will be used as part of preop diet
 1 week prior to surgery
 Replace 2 meals with shake, 1 meal of lean protein/
non-starchy vegetables
 Use in early phases after surgery
to help meet protein needs
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Use your recommended Protein Shakes & Meal Replacement list as a guide in choosing a shake
Must meet nutritional guidelines
 Calorie Controlled
 100-200 calories
 High protein
 15-35g per shake
 Low carbohydrate
 < 15g per shake, < 4 g sugar
 Low fat
 < 5g per shake
 Start replacing 1 meal per day or several meals per week
(WEPNSS) No Snacking or Grazing
 MOST IMPORTANT GUIDELINE LONG-TERM
 Eat at least 2/day but no more than 3 times per day!
 Emotional eating: social/tired/bored/stressed
 Come up with alternatives to these situations
 Thirst vs. hunger…make sure you are hydrated
 Extra 100 calories per day=10 pounds in 1 year
 8 nuts, 1 cup sweet tea, small chocolate bar, 1 string cheese
 Snacks are habit-forming and can inhibit weight loss
No Snacking or Grazing/
PURPOSEFUL FASTING
 Fasting periods lead to fat-burning.
 Grazing lessens your body’s need to burn its fat
stores because you are frequently giving it energy
(calories).
 PURPOSEFUL FASTING
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Eat no more than 3 times per day
Space meals 3-4 hours apart
Stop eating 2-3 hours before bedtime
THIS IS ONE OF THE MOST IMPORTANT HABITS LONGTERM!
( WEPNSS)
Supplements
YOU WILL NEED VITAMINS FOR THE REST OF
YOUR LIFE, NO MATTER HOW GREAT YOU FEEL!
Why Will I Need Vitamins?
 Weight loss surgery can contribute to deficiencies because
of:
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Decreased intake of food
Decreased absorption of certain nutrients long-term
 To protect your health it is important to:
1. Be compliant with a supplement program.
2. Get your vitamin profiles checked EVERY year.
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Deficiencies are easy to correct if found early
Difficult to correct if we wait for visible signs of vitamin
deficiencies.
Which ones will I need?
 Vitamin preparations vary a lot in terms of contents,
nutrient forms, and nutrient levels.
 We recommend bariatric specific vitamins because they are
delivering the dosage of nutrients needed with your new
anatomy as well as in a way that the new anatomy can
actually absorb and utilize the nutrients.
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They are specifically designed with the needs of the bariatric surgery in
mind!
Change in gastric acid post surgery can alter the bodies ability to break
down particularly vitamins to the point the body is able to absorb the
nutrients.
 We see improved vitamin profiles in patients taking
bariatric vitamins.
Which ones will I need?
AFTER SURGERY:
 Bariatric Multivitamin with Iron/Vitamin B12/Vitamin D:
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2 chewable or 3 capsules daily if using Bariatric Advantage®
Calcium Citrate
1500 daily (in 500mg doses)
 Separate 2 hours from iron
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Optional supportive nutrients: EFA/Omegas, probiotics, amino acids
BEFORE SURGERY:
 Daily multivitamin
 Probiotic…such as Endomune
 Vitamin D if deficient
 Possible biotin if concerned with hair loss
(WEPNSS) Support
 Support Group
 Prior to surgery and after
 3rd Thursday of the Month
 Smart Phone App
 Search “Baritastic”.
 Connect with us using the code 10303
 Like us on facebook
 Follow us on Pinterest
 Website (www.sagebariatric.com)
 Recipes, nutrition and behavior tips, meal plans, etc
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Patient Support tab…Diet & Nutrition…Password: fit4life
What do I do from here?
 WEPNSS….Memorize these “weapons”, they are the
key to maximizing your success after surgery!
 Pick out the items that may be a change for you and
begin practicing them NOW.
 Complete your education checklist videos on our
website.
 Follow the Bariatric Surgery Readiness Diet
What do I do from here?
 Complete the needed items on your checklist (i.e
labs/EKG, medically supervised weight loss visits)
 Call for behavioral health consult appointment
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Required by insurance
Club for Success
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This is an integrative program to give you ongoing support. You
may start this at any time to help obtain and achieve optimal
results.
www.sagebariatric.com
210-651-0303
Heidi Jensen MS, RD, LD
[email protected]