Preparing for Surgery

Transcription

1 Preparing for Surgery Specialist Bariatric Surgery Dietitians Gail Pinnock Laura Carstairs Cleverly Fong Bariatric Nurse Specialist: Tamara Ramkalawan Cecilia Jones

2 1. 5 Golden Rules Objectives 2. Expected weight loss 3. Physical activities 4. Food labelling and nutrition 5. Eating behaviour 6. Monitoring your own weight before surgery

3 1. What would you like to get out of today s session? 2. What will surgery change about your eating habits?

4 What will surgery change about my eating habits? Surgery can Make you feel fuller quicker Make your portion size smaller Surgery will not Stop head hunger or cravings Make you eat healthily Reduce hunger for most people

5 5 Golden Rules! Small portions Small tea plate or side plate Stop as soon as you feel full Eat slowly 30 minutes Chew food well Don t eat and drink at the same time

6 Unfriendly foods Some foods may not be tolerated after surgery Roast meats Bread Stringy vegetables Fizzy drinks Alcohol Sugary foods and drinks Fat and fatty foods

7 Vitamin & Mineral Supplement First 4 weeks: Dalivit 14 drops/ day After 4 weeks Sanatogen A-Z Complete/ Centrum Advance once a day

8 How much weight can I expect to lose? Most rapid weight loss in the first year After 2 years: weight maintenance / slight weight regain

9 Excess weight loss Gastric band 50% Sleeve gastrectomy 50-60% Gastric bypass 60-70% Duodenal Switch 70%

10 Excess Body Weight Have a look at 1.What is your weight today (in kg)? 2.What is your weight at a healthy BMI of 25 (in kg)? (Height in m) 2 x 25 Excess Body Weight (kg) = Weight today Weight at BMI 25

11 Example of excess weight My weight My weight at a healthy BMI of 25 kg/m 2 Excess Body Weight (Weight in kg) 127 kg (20 stones) 69 kg (10 stone 12lbs) = 58kg (9 stone 2lbs) In 2 years time At 50% Excess Weight Loss (Excess Body Weight / 2) At 70% Excess Weight Loss (Excess Body Weight x 70/ 100) (My Weight minus 50-70% Excess body weight) I will bring down a total of 29 kg (4 stone 7lbs) 40.6 kg (6 stone 5lbs) In 2 years time I should be at: kg (13 stone 8 15 stone 3)

12 My weight My weight at a healthy BMI of 25 kg/m 2 Excess Body Weight (Weight in kg) In 2 years time At 50% Excess Weight Loss (Excess Body Weight / 2) At 70% Excess Weight Loss (Excess Body Weight x 70/ 100) (Weight at surgery minus 50-70% Excess body weight) I will bring down a total of In 2 years time I should be at:

13 Importance of being active

14 Physical Activity Build up 30 minutes of moderate intensity physical activities or exercise, 5 of the 7 days of the week. E.g. 10 minutes + 10 minutes + 10 minutes. You will need to accumulate 60 minutes, 5 of the 7 days of the week for effective weight loss. Moderate means Heart beats faster, feeling warmer, slightly breathless though you can continue a conversation E.g. heavy housework, brisk walking, light gardening, taking the stairs, washing your car

15 Physical Activity Start off slowly, gradually increase what you are doing to avoid causing injuries. Make small changes Take the batteries out of the remote, use the stairs not the lifts, park far away, change your position every 10 minutes.

16 Physical Activity It is normal to sometimes experience some general muscle aches after physical activity. Pick activities you enjoy so you will look forward to doing them. Get family and friends involved to make it fun and sociable. Check with your GP to see if they can send you to an Exercise Referral Scheme.

17 Food Labelling Per 100g Of which Sugars Fat (Saturated fat) Sodium (Salt equivalent) High (Just occasionally) Medium (Fine most of the time) Low (A healthier choice) 15g g 5g 20g (5g) 0.6g (1.5g) g (1.6-5g) g ( g) 3g (1.5g) 0.1g (0.3g) Always look at per 100g!

18 Portions after surgery Protein Vegetables/ salad Carbohydrates

19 Protein Why is protein important after surgery? Building blocks of the body Needed for growth and repair Body cannot do with out it What foods is protein found in? Red meat, chicken, fish, eggs, beans and pulses, dairy foods (e.g. milk, yoghurts, cheese), tofu and quorn

20 Calcium Why is calcium important after surgery? Not as well absorbed Needed to keep bones healthy and strong What foods is calcium found in? Dairy foods: milk, yoghurt, cheese- main sources Non-dairy: tofu, kale, okra, calcium fortified soya products

21 Iron Why is iron important after surgery? Needed to help red blood cells carry oxygen around the body Low iron levels can cause anaemia Not as well absorbed after a gastric bypass Absorption increased by vitamin C What foods contain iron? Red meat, offal (e.g. liver, kidney) Sardines, pilchards, anchovies Fortified breakfast cereals, beans, leafy green vegetables

22 What will be different after surgery? Foods that you love, might not love you anymore Losing a friend Changing your relationship with food Life long multivitamins & minerals supplementation

23 From our past experience, people who do well tend to do these Eat regularly to pre-empt hunger Plan ahead, only eat what you planned to eat, but not eating in response to emotions/ situations Activity/exercise

24 Managing hunger: Ask yourself! 1. When did I last eat? 2. Was it less than 3-4 hours ago? 3. Am I physically hungry or is my head hungry? 4. Have I had a hot drink yet? 5. What else can I do before I eat? 6. What else is healthy that I can eat before I have a snack?

25 What happens if I slip-up? The extra that you eat is unlikely to affect your weight dramatically Missing meals or snacks may lead to further uncontrolled eating.

26 Plot you own weight graph! Flexible weight control Normal to have small fluctuations Only weight yourself weekly! Overall decreasing trend is more important!

27 When preparing for your surgery, Weight loss is not everything Managing your relationship with food is as important as watching your weight

28 Funding queries Diane Bushell will contact you directly regarding funding issues and surgery date

29 Any Questions?