Considering Weight Loss Surgery?

If you’re living with diabetes and considering weight loss surgery, there are some important tips and tricks you need to keep in mind to ensure you remain healthy after the surgery.

By Janice Baker, MBA, RD, CDE, CNSC, BC-ADM

Weight loss surgery is an option some may consider in the realm of therapies to manage diabetes. This surgery may significantly decrease the number of medications needed to control blood sugar, as well as blood cholesterol and blood pressure.

There are many aspects to consider, so being educated about the risks, benefits, commitments, and changes that go along with this decision is extremely important. If you’re considering weight loss surgery, attend educational seminars and speak with not only your physician and surgeon but also a registered dietitian/certified diabetes educator about how the surgery may impact your overall health and nutrition status.

Nutrition changes are important, and the following are some important considerations that are often discussed to maintain nutritional health and reduce the risk of both short-term and long-term complications:

• Start meals with protein first: It is important to start with high-quality protein so that you feel full longer. This helps prevent the loss of muscle. Protein drinks are essential postoperatively. Protein powders made from whey protein isolate are recommended. High-quality proteins include lean meat, chicken, fish, eggs, cottage cheese, and yogurt.
• After surgery, do not drink with meal: You will only be able to tolerate a small volume of food at a time, so waiting 30 minutes after a meal postoperatively will be important.
• Drink plenty of water between meals (48-64 ounces/day): Water will help you stay hydrated and helps prevent constipation
• Don’t drink your calories in soda and alcohol: This will add unwanted calories, which can slow or defeat your weight loss goals. Alcohol can be very irritating to your gastrointestinal tract, and also much more potent after surgery, as well as interfere with nutrient intake and absorption.
• Limit or avoid simple sugar and carbohydrates: White bread may ball and stick in your small stomach pouch. Empty calories such as ice cream and candy can slow your weight loss and possibly cause unpleasant side effects
• Eat slowly and chew your food very well: If you eat too fast you may miss your signal that lets you know you are full, which can lead to eating too much with the potential for vomiting. Chewing your food thoroughly can prevent large pieces of food from becoming stuck. Practice chewing very thoroughly well before. This is a very important lifelong habit.
• Limit fatty red meat: High-fat cuts of red meat have more calories and fat which can slow your weight loss goals. Red meat does have important nutrients such as iron and protein, so use small amounts and chew very thoroughly.
• Avoid skipping meals: Skipping meals interferes with important nutrition intake and increases the loss of muscle tissue important for strength and overall health.
• Take ALL prescribed vitamin/mineral supplements daily, every day and do not discontinue unless advised by a physician: Long-term and permanent health damage can occur because of nutrition deficiencies. Be sure to inform and remind your primary care physicians and specialists if you have weight loss surgery so they are aware of possible medication and other related health issues, and order routine labs and screenings important after weight loss surgery.
• Continue blood sugar monitoring: Diabetes may change significantly after weight loss surgery, however, everyone is different and much depends on how long one has had diabetes, why they have diabetes and what type of surgery has been performed as well as medications that have been used for blood sugar management. Elevated blood sugar can occur after surgery for many reasons, so discuss blood sugar monitoring details with your physician and diabetes educator.