Success Habits of Weight Loss Surgery Patients: How medical providers can help their patients be a success story

Transcription

1 Success Habits of Weight Loss Surgery Patients: How medical providers can help their patients be a success story Megan Keesee, RD LDN Registered Dietitian Duke Center for Metabolic and Weight Loss Surgery Duke Raleigh Weight Loss Surgery

2 What is success? ASMBS defines successful weight loss as 50% of excess body weight Excess body weight = pre-operative weight ideal body weight (BMI =25)

3 Why do we need help? One study by Stanford University School of Medicine showed 49% of bariatric surgery patients are lost to follow up Lost to follow-up: missed 12 month post-op appointment and never returned to clinic afterwards Another study showed typical follow-up rates for GBP patients are in the range of 60% to 80% Patients who attend all scheduled follow-up appointments experience greater long-term weight loss than those who do not

4 What are the Success Habits? Healthy Eating (following bariatric nutrition guidelines) Exercise Self-Care Accountability

5 Healthy Eating Behaviors Eat every 3-4 hours Focus on protein, fiber, and heart healthy fats Protein first to ensure fullness and maintain lead body mass Hydration 64+ ounces per day Avoid sugar-sweetened beverages Limit high fat and high sugar foods

6 Healthy Eating Behaviors Continued Eat slowly and chew well Separate fluids from food Plan ahead Meals, snacks and supplements Keep a food journal

7 Exercise Research shows Consistent exercise leads to a 4.2% lower BMI Moderate intensity exercise leads to a 5.7% greater excess weight loss People who become active after surgery lose more weight than inactive patients, suffered from less depression and anxiety, and had higher scores in general health "active" defined as at least 200 minutes per week of walking or other moderate or vigorous exercise

8 Exercise Continued 3 components: Cardio or Aerobic Exercise Walking, running, swimming, biking, dancing, rowing, boxing, aerobics class Recommendation: 150 minutes moderate intensity and 75 minutes vigorous intensity Strength Training Exercise Body weight, dumbbells, machines at a gym, resistance bands Recommendation: at least 2 times per week Stretching Stretching, yoga, Pilates

9 Self Care Realistic expectations Let go of perfection Positive self-talk Avoid the all-or-nothing mind-set Handle emotions with out food Exercise Breathing exercises Reach out for support Measure small successes and non-scale victories Exercise longer? Clothes fit better? Able to do more?

10 Accountability Goal Setting Behavior focused SMART goals (Specific, Measurable, Attainable, Realistic, Timely) Attend scheduled follow-ups 2-3 weeks, 3 months, 6 months, 1 year, and annual visits Seek Support Support groups Friends/family Therapist Personal Trainer Nutrition Counseling

11 How Can You Help? Ask and engage in conversation Express empathy Non-weight bias Give positive reinforcement and recommendations Encourage The success habits and goal setting Utilize resources Technology Support groups Blogs/Recipe sites Local gyms and wellness centers Follow up with the bariatric team

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13 References Azagury, Dan, et al. Loss to Follow-up after Bariatric Surgery: Are Lost Patients Doing Better or Worse? Surgery for Obesity and Related Diseases, vol. 12, no. 7, 2016, doi: /j.soard Benefits of Bariatric Surgery. American Society for Metabolic and Bariatric Surgery, asmbs.org/patients/benefits-of-bariatricsurgery. Cummings, S., Isom, Kellene A. Pocket Guide to Bariatric Surgery, 2nd Edition. Academy of Nutrition and Dietetics; Fielding, G. A., & Ren, C. J. (2005). Laparoscopic adjustable gastric band. Surgical Clinics of North America, 85, doi: /j.suc Gould, Jon C., et al. Impact of Routine and Long-Term Follow-up on Weight Loss after Laparoscopic Gastric Bypass. Surgery for Obesity and Related Diseases, vol. 3, no. 6, 2007, pp , doi: /j.soard Johnell, Patrice. Characteristics of Bariatric Surgery Patients. Florida State University Libraries, 2009, diginole.lib.fsu.edu/islandora/object/fsu:181803/datastream/pdf/view. Ramnarace, Cynthia. Exercise Before and After Weight-Loss Surgery. EverydayHealth.com, 20 Nov. 2008,

14 Thank you!