I have just had surgery, what do I do from here with my diet?

For a detailed explanation, please refer to the videos explanations on the gastric bypass presentation page, to view click here, and there is a handout explaining the dietary changes under the Handouts and recipe page, please click here to view.

Is there something wrong with my bypass, I can drink and eat quite easily?

This is a great question and a common concern.  The basis of the the Roux en Y bypass is not to restrict. The structure of the surgery allows a natural flow through of liquids and food.  The diagram below illustrates this.  Also please refer to the videos to explain this further on the Roux en Y bypass, click here to view.

For individuals moving from a gastric band to a roux en Y bypass, would notice a significant difference in the ability to eat with more ease and this can take some time adjust to.  With the hunger now under control, portion control is now up to the individual to manage, but this becomes easier because of the reduction in hunger.   For a detailed explanation of the portion control, please refer to the videos on the Roux en Y bypass, click here to view.

I have just had surgery and I am struggling to hydrate, what should I do?

This situation is not too common post the Roux en Y Bypass. However when it does occur, it is most likely due to extra swelling your body has responded to the surgery.  To help reduce this faster, sucking on ice cubes and drinking ice cold temperature drinks will help also.  If there are any additional concerns, it is important to contact the medical clinic for reassurance.

Is there any food or drink that I should not consume?

Yes there are.  Due to a segment of the small intestine being bypassed, there is less intestine available to absorb the fats and sugars in food.  For this reason a number of fluids and foods need to be avoided to avoid dumping syndrome, these include:

  • Sugar drinks such as regular soft drink, fruit juices, fruit smoothies, sweet alcohol, ice poles, sorbet ice cream
  • Fatty food such as any fried food, fats on meats (red meat, pork, bacon), cakes, chocolate, biscuits, ice cream

Dumping syndrome can occur at two stages early(10-30mins post a meal)  or late( 1-3hrs post a meal) .  The symptoms include the following:

Early signs include:
  • Abdominal cramps
  • Diarrhoea minutes after eating
  • Nausea
  • Vomiting
  • Flushing
  • Dizziness
  • Rapid heart rate

 

Late symptoms include:
  • Sweating
  • Hunger
  • Low blood sugar
  • Fatigue
  • Dizziness
  • Weakness
  • Rapid heart rate

Dumping syndrome is fixed by changing the diet.  You should notice an improvement quite quickly within a few days.  If symptoms continue it is best to discuss your diet with a dietitian to review further.

Am I at risk of dumping syndrome?

Due to a segment of the small intestine being bypassed, there is less intestine available to absorb the fats and sugars in food.  For this reason a number of fluids and foods need to be avoided to avoid dumping syndrome, these include:

  • Sugar drinks such as regular soft drink, fruit juices, fruit smoothies, sweet alcohol, ice poles, sorbet ice cream
  • Fatty food such as any fried food, fats on meats (red meat, pork, bacon), cakes, chocolate, biscuits, ice cream

Dumping syndrome can occur at two stages early(10-30mins post a meal)  or late( 1-3hrs post a meal) .  The symptoms include the following:

Early signs include:
  • Abdominal cramps
  • Diarrhoea minutes after eating
  • Nausea
  • Vomiting
  • Flushing
  • Dizziness
  • Rapid heart rate

 

Late symptoms include:
  • Sweating
  • Hunger
  • Low blood sugar
  • Fatigue
  • Dizziness
  • Weakness
  • Rapid heart rate

Dumping syndrome is fixed by changing the diet.  You should notice an improvement quite quickly within a few days.  If symptoms continue it is best to discuss your diet with a dietitian to review further.

Will I be at risk of experiencing dumping syndrome for life?

No. The body is very efficient to with the desire to survive. Typically around 18months post surgery, the body absorb fatty and sugary food more efficiently and dumping syndrome typically ceases.  So this would be a perfect time frame to really work on habits to reduce cravings for these foods.  To manage non-hungry eating, please refer to the video, on the non hungry eating page, click here to view.

Which is the best multi vitamin that I should take?

In Australia there are two key brands:

  1. FitForMe.com.au,
  2. BNmulti.com

 

The key differences are:

  • Fit for me is a once day tablet
  • BNmulti is twice a day
  • Both companies  have chewable and capsule options
  • Fit For Me has removed the iron from the chewable and coated it to be absorbed lower in the intestine to reduce the chances of nausea.

To ensure you achieve your maximum nutrition, the convenience and taste of fit for me, would be ideal for you.  Both supplements can only be purchased online using the links above

How long do I need to take multi vitamins for?

For life. It is absolutely crucial to avoid malnutrition.  Blood tests will confirm if any additional supplementation is required.  Do not wait to commence the supplements once you feel fatigued, you will likely be experiencing some malnutrition.  prevention is better and easier than management.

Do I need protein powder to meet my protein needs?

Short term, yes you may, until it is easier to slightly more volumes.  Long term, with a well balanced diet, protein powders are not required.  This is all based on the natural flow of food which allows you to consume a balanced diet.

I have become constipated, what should I do?

The best thing to do is to get on top of the situation as soon as possible.  Commence a laxative to support your bowels opening up.  When the laxatives are commenced, when your bowels open, do not immediately stop these. It is recommended to slowly wean off them, to allow time for your body to adjust to a lower food intake hence a reduce output.

To support an increase in fibre, you may consider the addition of Benefibre.  

Is it ok to graze?

Immediately after surgery up to the point you are on a full diet, eating normal solid food, yes it is ok to graze.  The reason, this allows time for the swelling to reduce to allow you to eat sufficient amounts of food to be satisfied.

Long term, grazing on food between meal times from habit, boredom emotional reasons will slow down the weight loss and on some occasions, cause weight regain.

My weight loss is slow, what can I do to lose weight faster?

Everyone will lose weight at a different rate. A starting weight above 130kg will always experience a greater weight loss initially, compared to a starting weight of 100kg.  so please keep this in mind.  It is also best to not compare yourself to others, as this can create frustration and possibly derail you.  Always look at the ultimate goal, of losing your excess weight and keeping it off.  For some this does occur at a slower pace.  So what should you expect:

  • Your weight loss journey will always start from the pre surgical VLCD.  On average, you are looking at  3 to 4 kilograms weight loss per month.  Some months will be slower than others.  This is normal.  So reflect on this at the 2, up to 8 month mark as a guide.  If you weight loss stalls for two weeks, it is ok, always look at the average.
  • As you get closer to your ideal weight, your loss will always slow down.
  • At the 3 week mark post surgery, weight loss can stop. This is ok.  It will pick up again.
  • On the scales your weight will always oscillate 1/2 to 1 kilogram up and down.  This is normal.  So if you see your weight increase by 200gms, this is not weight gain.  In fact quite normal.
  • If you are a few months after surgery, and you would like to increase your weight loss, you may consider 16/8 intermittent fasting.  A food diary recording exactly what you have eaten as the day progresses will highlight if anything needs improving.
  • If you can become more physically active and incorporate some light weight as medically able would be ideal
How many calories should I am for to lose weight and keep my weight off?

1000 to 1200 calories would be a guide.  Under the Roux en Y Bypass Presentation, there is a video explaining this in detail.  Please click here to view.

Do I need to eat a high protein diet to lose weight?

No. A high protein diet is not essential.  If carbohydrate rich foods are avoided,  then your diet will only consist of animal protein such as meat, chicken, fish, egg, tofu (vegetables) with carb free vegetables.  If this suits you, then please feel free to limit your food choices and follow this plan.  This would result in a high protein diet.

However if you enjoy variety and would like to add a small amount of carbohydrate, this will be absolutely fine.  The key is to chew not drink your carbohydrates.

For example eating one whole piece of , would really limit the calories.  If you drank 1/2 cup orange juice, that could provide the calories of 2-3 pieces of fruit.

Details of managing calories and carbohydrate rich foods plus the fatty and sugary food are detailed in the video under the Roux en Y Bypass Presentation, click here to view.

The multi vitamins make me feel nauseated, what can I do?

If you have just hard surgery and the supplements are causing nausea, please consider any of the suggestions below:

  • use the fit for me chewable, as it separates the iron into a very small white tablet that you swallow.  It is coated in a manner to help the iron be absorbed lower in the intestine to support, to lower the chance of nausea.
  • Break the fit for me into 2 sitting to lower the concentration
  • Ensure the multi vitamin is consumed with liquid or food, it will help reduce the impact of nausea
  • Consider swapping the chewable multi vitamin to the capsule.
  • Commence the capsule once off liquids

If you are weeks after surgery, swap from the chewable to the capsule version.  If the supplements specific for weight loss surgery still create nausea, it is best to discuss your needs with your dietitian / medical team.