Why it is Important to Have Nutritional Support After WLSSeptember 20, 2023
Could a person technically have weight loss surgery with a surgical practice that does not provide a Registered Dietitian as a resource for support, guidance, and aftercare? Yes, this is entirely possible and there are many programs in the world that provide minimal to no nutritional support to the pre and post bariatric surgery patient. And most often, these patients will still recover from surgery safely and go on to lose a good percentage of their body weight. Would that mean that the Dietitian’s role in working with the pre and post-op bariatric surgery patient isn’t extremely important? Of course not, it is important to have nutritional support after WLS and I’ll explain why.
Although the rates are very low, there are still potential nutritional issues that can arise after having bariatric surgery. Dehydration can set in quickly right after surgery unless fluids are monitored, and a proper expectation of fluid intake is established. Multiple studies point towards the importance of proper protein intake in the first few weeks after surgery to promote healing and prevent muscle loss. Vitamin deficiencies can set in quickly if the patient is unsure of when to take vitamins/minerals, how much to take, and which ones should be a priority.
Even something as simple as knowing that most gummy multivitamins lack the B vitamin Thiamin should be explained to the patient when counseling is done on post-op bariatric vitamins/minerals.
There is no "one size fits all" recommendation when it comes to post-op nutrition. Although you may see a surgical practice recommend that all post-op patients should get between 60-80 grams of protein each day, this is merely a generic recommendation. In reality, we are all built differently, and many factors can affect a person’s daily needs for not only protein, but other macronutrients (carbs and fats) and supplements. A qualified dietitian/nutritionist would work much closer with you as an individual and tailor their recommendations for only you and not just offer generic advice that is the same for every patient.
Nutritional Support After WLS
Continuing to work with a Dietitian or Nutritionist after surgery can be useful in helping to identify trends or habits that are coming back and working to correct them and get the patient back on track. Things like increased alcohol or liquid calorie consumption, grazing, increased portions/hunger, etc. For most, weight loss surgery is a first-time experience (revisions notwithstanding) and the patient will have many unexpected issues that will arise. This means lots of new questions will come up for months and even years after they have their surgery that a qualified nutritionist can help answer.
In addition, an experienced dietitian can be there if/when an extended weight loss plateau begins. Or the dreaded weight regain happens after a few years. The dietitian can help determine the cause and work with the patient to get them back on the path to losing weight (Fat loss) while retaining valuable muscle mass. On the positive side, what if the patient is now at goal size and wants to begin training for a marathon or starts spending more hours per week devoted to intense exercise? This becomes a brand-new conversation in terms of making sure proper nutrition is achieved to maximize results.
Dedicated To a Lifelong Change
When a person decides to have weight loss surgery, they are dedicating themselves to a lifelong change, not just a few months. With this decision comes the responsibility of the person to ensure that they have all of the necessary tools lined up to help them to be successful and remain successful. Their surgeon should be chosen carefully, family and friends should understand their supporting role and the qualified nutritionist/dietitian should be considered just as important in this process.
ABOUT THE AUTHORMichael Murphy, RD, is a registered dietitian with over 18 years of experience working with weight loss surgery patients. He is the lead dietitian and nutrition adviser for AZ Weight Loss Clinic. His mission is to re-shape the nutritional habits and behaviors of his weight loss surgery patients to ensure permanent success after weight loss surgery.