Bariatric Nutrition Lecture Notes

Speaker Introduction

• Name: Stephanie Wagner
• Role: Bariatric dietitian
• Experience: 8.5 years in bariatric nutrition
• Credentials: Registered dietitian, Master's in Food and Nutrition
• Career: Worked with three weight loss clinics and seven surgeons
• Publication: Published cookbook author for bariatric recipes
• Website: foodcoach.me

Importance of Bariatric Nutrition

• Field Dynamics: Bariatric surgery field is rapidly changing
• Accrediting Body: ASMBS (American Society of Metabolic and Bariatric Surgery)
  • Provides best practices guidelines for surgery and nutritional guidelines
  • Allows for variance in dietary and lifestyle recommendations

Bariatric Surgery Overview

Types of Surgeries

1. Gastric Sleeve

   • Most popular weight loss surgery
   • Laparoscopic procedure removes 80% of the stomach
   • Maintains the digestive system without rerouting
   • Reduces hunger hormone ghrelin by 70%
   • Successful weight loss, particularly in the first year

2. Gastric Bypass

   • Alters anatomy, bypasses part of the stomach and duodenum
   • Restrictive and causes malabsorption
   • Effective for significant weight loss
   • Can deter high sugar/fat intake due to dumping syndrome

3. Gastric Banding (Lap Band)

   • Less favored, becoming outdated
   • Adjustable band that restricts stomach size
   • Less effective due to ability to "cheat" the system

4. Duodenal Switch

   • Newest surgery, combines elements of sleeve and bypass
   • Involves significant rerouting and malabsorption
   • Requires extensive vitamin supplementation

Candidate Requirements

• BMI: Over 40, or over 35 with comorbidities like diabetes, hypertension
• Pre-surgery Requirements: 3-6 months supervised weight loss program
• Insurance Requirements: May vary based on provider and policy

Post-Op Considerations

Dietary Recommendations

• Focus on Protein: Essential for fullness, muscle maintenance
• Non-starchy Vegetables: Avoid high-starch veggies (corn, potatoes)
• Fruit Consumption: Moderation due to natural sugars
• Healthy Fats: Included but monitored for calorie content

Eating Behaviors

• Small Bites and Slow Eating: Crucial for digestion comfort
• Fluid Management: No drinking during and shortly after meals

Potential Post-Surgery Issues

• Dumping Syndrome: Rapid digestion causes discomfort
  • Associated with high sugar/fat intake
• Hydration Challenges: Must avoid dehydration

Vitamin and Supplementation Needs

• Multivitamins: Twice a day
• Calcium Citrate: 1200-1500 mg/day
• Iron: 45-60 mg/day
• Vitamin B12: Essential due to reduced absorption
• Vitamin D: 3000 IU daily
• Probiotics: Recommended for GI health

Conclusion

• The field is continually evolving, so staying updated with the latest guidelines is crucial.
• Collaborate effectively with bariatric clinics and surgeons for holistic patient care.
• For questions, contact Steph at foodcoach.me

Note: The information provided is based on 2018 data and guidelines. Regular updates and direct communication with health professionals are recommended for the most current practices.