4 Facts About Gastric Sleeve and Weight Loss

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The gastric sleeve, also known as the vertical sleeve gastrectomy (VSG), is one of the most popular weight loss procedures in New Jersey, and the most performed weight loss surgery here at New Jersey Bariatric Center. 

We get a lot of questions about gastric sleeve surgery from how it helps you lose weight to the health benefits for the procedure. If you’re considering a bariatric surgery procedure, here’s 4 things to know about gastric sleeve: 

1. Gastric Sleeve Helps You Lose Weight in 2 Ways

First, gastric sleeve surgery jumpstarts weight loss by removing a portion of the stomach and narrowing the remaining part of the stomach into a thin “sleeve-like” tube. The reduced stomach size holds less food so you feel full faster, while still allowing for the digestion of key nutrients. The second way is that the gastric sleeve procedure reduces the secretion of ghrelins in your stomach. Ghrelins are hormones responsible for making you feel hungry. Patients on average can lose about 40-70% of their excess body weight after a gastric sleeve procedure. 

2. The Health Benefits Go Beyond the Numbers on the Scale

Not only does the gastric sleeve help you to lose weight, but it can also offer other health benefits and improvements for obesity-related conditions. In a study by the American Society for Metabolic and Bariatric Surgery (ASMBS), after gastric sleeve surgery: 

As with any surgery there are side effects and risks to weight loss procedures. To learn more, visit our Side Effects & Risks page.

3. Gastric Sleeve Surgery is performed Laparoscopically or Robotically-Assisted

During gastric sleeve surgery our surgeons make small incisions in the abdominal wall to remove 75-80% of the stomach. This reduces the capacity of the stomach to 3-4 ounces, resulting in patients feeling full, faster on a smaller portion of food. At New Jersey Bariatric Center the surgery is performed either laparoscopically or is robotically-assisted, and usually lasts approximately 1-2 hours.

4. Hospital Stays are Generally 1 Day 

Both methods - laparoscopic or robotic-assisted - of surgery involve smaller incisions through the stomach, which often leads to, for many patients, less pain and a short, 1 day hospital stay, in general. To learn more about recovery at home, post-surgery nutrition as well as returning to work and regular activity, click here.

For more questions about gastric sleeve or to schedule an appointment give us a call at 908-481-1270. To register for one of our free webinars, click here

*Metabolic and bariatric surgery. (2018, October). In the American Society for Metabolic and Bariatric Surgery. Retrieved November 10, 2020, from https://asmbs.org/resources/metabolic-and-bariatric-surgery

Healthy Habits for the Back to School Season Part 2: Healthy Quick Stop Options

At New Jersey Bariatric Center, we understand how hectic weeknights can be between the evening commute, after school activities, and having a healthy dinner. When you’re running low on time and need a quick meal for the whole family, stopping at a fast casual restaurant can be the most convenient option. Here are some healthier quick stop options to choose from:

  1. Dunkin/Starbucks – Try the Dunkin Turkey Bacon Wake-up Wrap (180 calories, 10g fat, 13g carb, 1g fiber, 8g protein) or Starbucks Egg White and Roasted Red Pepper Egg Bites (170 calories, 8 g fat, 11 g carb, 12 g protein). An Egg and Cheddar protein box from Starbucks can also be a good choice if you ditch the included bread or crackers (About 390 calories, 22g fat, 21g carbs, 23g protein). This helps to keep the focus on protein and fiber, rather than simple carbohydrates. 
  2. Chick-Fil-A – This chain offers several protein options like a grilled chicken sandwich. We recommend that you lose the bun. Without the bun the nutrition content is about 230 calories,12g fat, 5g carb, 28g protein and with the bun about 600 calories, 35g fat, 35g carbs, 30g protein. Side salads and fresh fruit are also available, making this a good place to stop. Just remember that salad dressing adds additional calories so stick with 1 serving or less of dipping sauce or dressing to keep empty calories in check.
  3. Wendy’s – A quick stop at Wendy’s can refuel you and your crew with a classic cup of chili (small cup: 240 calories, 11g fat, 18g carbs, 16g protein) and a side of fresh apples (35 calories, 0g fat, 7g carbs, 0g protein). Other good choices include salads (about 400 calories, 22g fat, 10g carbs, 40g protein) or a no-bun sandwich made with grilled chicken (without bun: about 230 calories, 12g fat, 5g carb, 28g protein). Avoid high-carb salad toppings like croutons or chips and anything labeled “crispy” as the chicken is most likely fried. 
  4. Chipotle – This is a great option for when you need a filling and fully customizable meal on-the-go. Choose from one of their protein and veggie packed Lifestyle Bowls like the Whole30, Paleo or Keto options which are low in carbs (about 500 calories, 33g fat, 15-20g carbs, 30-40g protein). You can also make your own bowl with a base of greens and fajita veggies instead of rice. Top with your choice of protein, salsa, veggies, beans and guacamole. Go easy on cheese, sour cream and tortillas. 
  5. Wawa – It seems that Wawa stores are popping up all over the place and they can provide some decent choices if you’re in a hurry and you know what to look for. Try one of their made-to-order breakfast bowls with eggs and turkey sausage. Or build your own salad with lots of fresh veggies and protein options to choose from like roasted chicken, turkey bacon, tuna, boiled eggs and turkey breast (about 350-450 calories, 10-30g fat, 15-30g carbs, 30-45g protein). There are also some protein and veggie based soups and side dishes like chili, tomato basil soup and a side of meatballs with marinara sauce (small dish: 240 calories, 19g fat, 10g carbs, 6g protein). Healthier kids meal options plus grab-and-go choices like yogurt or a small bag of nuts make this a great place to keep on your shortlist if a game runs late and you have to grab something fast. 

RELATED: Bariatric Friendly Fast Food Options

For more information on healthy options at your favorite fast food restaurants and staying on track, make an appointment to see your dietitian at 908-481-1270.

Why It’s Important to Have a Support System for Weight Loss Surgery

Having a support system for weight loss surgery can help you stay on track, keep you motivated and celebrate milestones with you along the way. At New Jersey Bariatric Center we encourage our patients to establish a circle of support early in the process because the months and weeks prior to your surgery are a very exciting and important time when you begin lifestyle changes. Having the support early on can set you up for long term success beyond surgery.

Identify Your Support Circle

Think about the people around you who are supportive. Maybe it’s an immediate relative or friend. Or maybe it’s a neighbor who’s caring and always willing to help. It could even be a coworker, or people that you meet through social media support groups. Start by letting them know that you’ve made a decision to live a healthier life and ask for their help as you begin to prepare for your journey.

How Your Support System Can Help

Support can mean cheering you on as you lose weight, helping you stick to your new eating plan. Or, it could even joining you in your new healthier lifestyle changes. For instance, if you think it’s going to be difficult to break the habit of drinking soda after surgery, the earlier you start to cut back and eventually eliminate soda, the easier it will be. And having an accountability partner who understands the support you need and even suggests healthier options can help. The same can be said for healthy meal plans. The people you spend time with can even benefit by following along with you and learning how to prepare foods the same way. 

Invite Them to Your Appointments 

A great way to include your support system is to bring them with you to your appointments. This way they can learn about the process and feel closer to you on your weight loss journey. Your surgeon, physician assistant and registered dietitian will explain the surgical procedure and the dietary and lifestyle changes. They will also answer any questions about how your circle of support can contribute to your success. 

Find Support at NJBC

At New Jersey Bariatric Center, every patient is paired with a patient navigator who helps them every step of the way. Our navigators help with everything from verifying insurance, going over criteria and scheduling appointments. Our doctors, physician assistants, dietitians and entire medical staff are available to answer any questions about the process. After weight loss surgery, we offer more ways to help you achieve long term success. Our Tuesday Talks support group meetings and our private Facebook community connect you with others who are on the same journey. You can share experiences and get ideas to help stay motivated. For meal planning and healthy recipes, our team of registered dietitians provide tips every month on our blog. 

With a strong support system around you, you will be better positioned to achieve your happiest and healthiest weight. For more questions or to make an appointment, call our office at 908-481-1270. 

Loose Abdominal Skin After Bariatric Surgery

After losing a significant amount of weight with bariatric surgery, some patients may have loose skin – specifically around the lower part of the belly. This is not uncommon. Loose or sagging skin around the abdomen can occur when you lose weight and the skin does not have the elasticity it needs to shrink back to your new shape. 

Before gastric sleeve or bypass, I often tell patients that predicting who may or may not develop excess abdominal skin after weight loss is difficult. Factors that contribute to this condition are age, underlying medical issues, tissue disorders, and losing a significant amount of weight. 

While strength-based training exercises can help tone muscles in some cases, no amount of exercise will get rid of sagging or excessive hanging skin caused by significant weight loss. To treat this condition, the surgeons at New Jersey Bariatric Center can perform a panniculectomy, a surgical procedure to remove excess or sagging skin.

How a Panniculectomy works

During a panniculectomy the excess skin, or pannus is removed from your lower belly. Once the excess skin is trimmed, the remaining skin is pulled together and sutured, and the belly button is typically re-positioned in a similar location on the abdomen. The procedure takes between 2-3 hours and usually involves a 1-2 night stay in the hospital.  

Is it the same as a Tummy Tuck?

You may be thinking that a panniculectomy sounds similar to a tummy tuck but there are some key differences. Both procedures rid the excess skin that hangs down over the pelvic region and thighs. Except a tummy tuck is for aesthetic purposes while a panniculectomy is often considered a medical necessity. For example, if the excess skin is causing a recurrent rash, fungal infections, and it limits your mobility. Another difference is that a tummy tuck removes the excess skin and tightens the abdominal muscles under the skin in most cases. A panniculectomy removes just the excess skin, and treats medical issues. 

Is a Panniculectomy right for me?

This procedure may be a good option for you if excess abdominal skin is affecting your day- to-day activities and your overall well being. If the skin is causing pain, discomfort or infections, and it has been 18-24 months since your weight loss surgery, make an appointment with your surgeon to discuss how a panniculectomy can help.

For more questions, call us at 908-481-1270.

Marijuana, Smoking and Weight Loss Surgery

Now that the state of New Jersey legalized the use of recreational marijuana for adults, several patients have asked how using marijuana can affect their weight loss surgery journey.

To start, the use of marijuana should be discussed with your surgeon. Smoking, whether it’s cigarettes or marijuana, is a health risk that can lead to lung and heart complications both during and after bariatric surgery as well as long-term health consequences. Marijuana itself can alter clotting factors in our blood, making our bodies more prone to developing clots which can lead to heart attacks and strokes. Your surgeon will discuss these risks and how to safely prepare for surgery.

Marijuana Use when Planning for Weight Loss Surgery

Marijuana use has been studied extensively, and when it is smoked or eaten as edibles, chemicals called cannabinoids are released into the body and can cause increased heart rate, high blood pressure and heart rhythm abnormalities. Transitioning from smoking marijuana to oral formulations, such as edibles or extracts, may lessen the risk of airway compromise and decrease the chances of systemic issues during and after surgery, but must  be discussed with your doctor prior to surgery.

Marijuana Use after Weight Loss Surgery

There is not enough research available to have a definitive answer to how marijuana use will affect you after your weight loss surgery whether it’s gastric sleeve, bypass or band. In a small, study at a an academic center participants were followed up to 2 years after their gastric sleeve or gastric bypass procedures and the excess weight lost after surgery measured by BMI did not differ significantly between marijuana users and non-users. Even with the findings in this small study, it’s still important to understand that marijuana use is a health risk. 

If you are planning to have weight loss surgery or have had weight loss surgery and have more questions regarding marijuana use related to your weight loss journey, give us a call at 908-481-1270.

Sources

  1. Haskins IN, Amdur R, Vaziri K. The effect of smoking on bariatric surgical outcomes. Surgical Endoscopy.  2014;28(11):3074-3080. doi:10.1007/s00464-014-3581
  2. Haskins IN, Nowacki AS, Khorgami Z, et al. Should recent smoking be a contraindication for sleeve gastrectomy? Surgery for Obesity and Related Diseases. 2017;13(7):1130-1135. Doi: 10.1016/j.soard.2017.02.028
  3. Shockcor N, Adnan SM, Siegel A, Wise E, Zafar SN, Kligman M. Marijuana use does not affect the outcomes of bariatric surgery. Surg Endosc. 2021 Mar;35(3):1264-1268. doi: 10.1007/s00464-020-07497-5. Epub 2020 Mar 12. PMID: 32166550.

Maintaining Weight Loss After Bariatric Surgery

The moment you started the process for bariatric surgery was the moment you made a commitment not only to yourself but to a healthier lifestyle.  Now that you’ve reached your goal weight, the objective is to maintain that commitment.  To maintain weight loss and the goals you set for yourself means staying committed to the healthy lifestyle choices you make every day. Whether it’s healthier dietary decisions, incorporating physical activity into your schedule daily or getting adequate hours of sleep, your challenge is to keep it up. Here are some tips to keep you on track while  maintaining your goal weight.

Stay Within Your Calorie Range 

It can be tempting to want to eat fewer calories to maintain the weight loss, however, eating too little can be incredibly detrimental to your weight loss journey. Without proper nutrition, it’ll be even more difficult to sustain weight loss. Make sure that you’re reaching your protein goal daily and staying within your calorie range. 

You can self monitor your daily calories by using an app (e.g. MyFitnessPal, LoseIt, Baritastic, Carb Manager) to track your food intake or by jotting down your meals/snacks on a daily basis on a sheet of paper or journal. Try planning out your meals the night before. That way, you’re more likely to stick with your plan.

Remember to eat slowly and chew your food thoroughly. Doing so, helps you become more mindful of your food intake and able to feel full and enjoy your meal. A good rule of thumb we like to tell our patients is to make each meal focused around protein and fiber-rich veggies. In terms of drinks, liquid calories count also. Water and sugar-free, decaffeinated beverages are healthy options.

Don’t let yourself get too hungry either. Waiting until you’re ravenous can lead to grabbing unhealthy choices and overeating

Stay Active

Physical activity has an impact on weight loss and long-term weight maintenance. It prevents muscle depletion during weight reduction, helps maintain bone mass, increases the metabolism rate, and is related to increasing your overall mental and physical health. It’s recommended to exercise for at least 20 minutes daily. I like to tell my patients that 2-3 days of strength training is good and the other days can be long walks, bike rides, yoga and more.

Take Your Vitamins 

Maintaining your vitamin/mineral supplement intake post surgery is very important even after you’ve reached your goal weight. Routine vitamin and mineral status screening is also important so make sure you’re getting yearly blood work.

Recognize Physical vs. Emotional Hunger

Pay attention to physical and emotional hunger cues. Physical hunger comes on gradually and doesn’t trigger an emotional response. On the other hand, emotional hunger comes on suddenly and can trigger feelings of guilt and shame which can lead to poor food choices. It’s important to know the difference and plan for those moments by incorporating non-food related responses to your triggers like going for a walk, taking a few moments to yourself to read or take a bath. Trusting your hunger, eating mindfully and stopping when you are comfortably full are key elements of successful weight maintenance.

RELATED: Physical vs. Emotional Hunger

Keep up with Your Follow Up Appointments

Following up with your surgeon and registered dietitian after bariatric surgery is not only crucial to assess outcomes, weight loss and resolution of comorbidities, but also is necessary for patients to receive continual support regarding diet and lifestyle modification. At New Jersey Bariatric Center, our post operative program will help you along the way.  From individualized meal planning, exercise routines , and custom appointments, our team is here to help you maintain your goal weight. 

Find Support

Support is an important part of your success and can help you stay motivated. New Jersey Bariatric Center offers monthly Tuesday Talks group meetings and access to a private Facebook community to share stories and find support.  If you have any questions or would like to make an appointment call us at 908-481-1270.

Why You Shouldn’t Feel Embarrassed About Revision Surgery

If you’ve experienced weight regain in the years after your bariatric surgery, feelings of shame and embarrassment often come with the weight. 

If you’re feeling these emotions right now, I encourage you to remember that obesity is a disease that weight loss surgery doesn’t cure. And, know that you are not alone and it’s OK to want a second chance to jumpstart your weight loss with revision surgery. Whether you regained weight due to the pandemic, like many of us did, or you’ve faced life changing experiences that contributed to weight regain, you shouldn’t feel embarrassed. Everyone deserves a second chance.

At New Jersey Bariatric Center, we understand how hard it is to lose weight and keep it off. And, we provide a supportive environment with resources to help our patients process their feelings around their weight and make the decision that’s right for them. Once you’ve decided, here are tips to address it with family and friends. 

Telling loved ones

Telling loved ones can also cause feelings of shame. Especially if they were not supportive of your first procedure or if they do not understand how weight loss surgery works. Preparation and understanding are key.

Do your research

To help you navigate the conversation, do your research beforehand and know what your surgical options are. You can then help them understand how revision surgery works and that it’s a tool to help jumpstart your weight loss and give you a second chance at achieving a healthier life. 

Give them time

Understand that your loved ones want the best for you and their concerns are valid. Be sure to give them time to articulate their concerns and answer questions based on your research but stay firm in your decision. 

Ask for their support

As you may remember from your first weight loss surgery procedure, support is essential especially during recovery. After you explained your decision and heard their point of view, ask for their support to help you get through your weight loss journey.

RELATED: Revision Surgery: Gastric sleeve and gastric bypass

For questions about revision surgery, give us a call at 908-481-1270 to schedule a consultation with a board-certified, fellowship-trained surgeon who would be happy to meet with you and your loved ones.

Should I follow a plant-based diet after bariatric surgery?

Patients often ask if plant-based diets are a safe and healthy option after bariatric surgery. This can be a challenging question as there isn’t a one size fits all answer. Plant-based diets often eliminate all or some animal products and may increase the consumption of carbohydrates and decrease protein intake. After bariatric surgery, protein is essential to maintain lean body mass and for optimal health and weight loss. So should you or can you follow a plant based diet after weight loss surgery? Our answer is yes, as long as you’re getting the required nutrients. Here are some things we want you to consider:

Protein

Reaching your protein goals after gastric sleeve, bypass or revision surgery requires a significant amount of planning and preparation with a plant-based diet. Following a vegetarian/ vegan diet will be more difficult  in reaching  protein goals than a flexitarian diet. For patients interested in cutting back on meat and increasing their plant-based intake, a flexitarian diet along with a few animal products will offer variety and help you reach your weight goals in a safer way.

Fiber and digestion 

People who consume a plant based diet tend to eat more vegetables and are generally getting more fiber.  While fiber is important for healthy digestion and feeling fuller longer, for patients who have had gastric bypass, fiber can be more difficult to digest and lead to bloating and discomfort. 

Iron

Iron is a nutrient that also becomes difficult to get if you are on a vegan or vegetarian diet. Although iron can be supplemented, taking iron supplements may cause constipation in some people.  

Now that you’ve considered the implication of protein, fiber and iron, let’s take a look at some more information on the various plant-based diets below. 

Vegan Diets

Vegan diets must be very carefully planned to avoid nutrient deficiencies such as iron, calcium, vitamin B12, and zinc. Carbohydrate intake may also be higher when following a vegan diet and this should also be carefully monitored following bariatric surgery. Since a vegan diet completely eliminates all animal products including honey, wine or beer that use animal products as clarifying agents, products tested on animals or items made from fur or leather; the main sources of protein in the vegan diet are seeds, nuts, beans, peas, lentils and legumes. Tofu, seitan, soymilk, beans and peas are some common vegan protein substitutes. 

RELATED: Plant Based Burgers

Vegetarian Diets

Patients considering a vegetarian diet want to exclude all flesh foods (such as meat, poultry, wild game and seafood). To reduce meat intake while ensuring an adequate daily protein intake, a well-planned vegetarian diet can include some animal proteins - possibly dairy, eggs or seafood (pescatarian) along with vegetables, fruits, whole grains, legumes (beans, lentils, peas), nuts and seeds.

Flexitarian Diets

Some patients opt for a flexitarian diet as it’s essentially what it sounds like -- a flexible diet. You might eat meat occasionally, but for the most part it’s not typically included daily in your diet. This can help take the pressure off sticking to the diet/lifestyle labeled as vegan or vegetarian. 

Whether you’re considering a vegan, vegetarian, flexitarian or any other plant-based diet, it’s important to choose one that allows for a healthy amount of protein and to know what each diet entails to determine what’s right for you.

If you have questions about the plant-based diet you’re on or are considering one, make an appointment to meet with your dietitian to ensure you are getting adequate protein pre and postoperatively.

How to Reset After Holiday Eating

If you’ve overindulged this holiday season and are looking for a fresh start this New Year, you’re not alone. With lots of holiday gatherings, it’s hard not to veer off track a little bit. Rather than searching for a quick fix, cleanse or product, let’s look at some steps to take if you’re trying to get your health back on track or resetting after the holidays.

  1. Resist the urge for a quick fix.

    Cleanses, fad diets and juice fasts are everywhere in the new year but we all know they don’t work in the long run. Set an intention to make better choices starting now and don’t beat yourself up for what can’t be changed.

  2. Make a plan.

    This is so important, and you’ll want to give some serious thought to your next steps in order to be successful in the days and weeks ahead. Grab a blank calendar page or open your Notes app and write/type a list of specific ways to help you meet your goal. It could be resuming a protein focused pre-op diet, exercising 3 times this week or drinking 8 glasses of water. Use the SMART method of setting goals to help set yourself up for success.

  3. Tackle your temptations first. Then restock with healthy choices.

    First, get rid of any lingering temptations that don’t fit with your priorities. Give away or toss leftovers, soda or that half-full bag of chips so they don’t come calling later on. Then stock up on healthy choices and even do some meal prepping if time permits. Chop up fresh veggies, prepare a salad and cook a big batch of soup or crock pot chicken. Grab some cheese sticks, yogurts and hummus for easy snacks and you’re well on your way to a healthier you. 

  4. Weigh yourself as needed.

    While frequent weigh-ins might seem like a good way to track your progress, it’s best to aim for once or twice a week at most and focus on other cues in between. You might notice you have more energy, your pants fit better and your digestion is less sluggish. These are all great ways to check in with yourself to gauge if your efforts are yielding the results you’re looking for. 

  5. Get moving.

    If you’ve been off the exercise wagon for a week or more, it’s best to start back slowly and always check with your doctor if you have any pre-existing health conditions that limit your activity. Choose something enjoyable - maybe a walk, a favorite class online or at the gym or yoga studio to work on flexibility. Whatever you choose, take it easy and listen to your body. Schedule time each day or week for exercise to get back into a regular routine.

  6. Celebrate small wins

    A decision to have bariatric surgery requires committing to a new way of approaching food and health, but there will be bumps along the way. When you meet one of your goals whether it’s drinking 8 glasses of water or exercising, celebrate those small wins and let it motivate you to achieve the next goal on your list.

  7. Be in it for the long haul

    Don’t let a bad day or week undo all the progress you’ve made during your weight loss journey. Every step you take puts you a little closer to becoming a healthier you.  For even more inspiration, check out these daily steps to get healthier each day.

  8. Meal plan

    In general, we like to tell our patients to stick to 3 meals and a healthy snack with a focus on protein a day. Below is a sample menu for an idea of what your meals can look like.  

Remember, you can always substitute a protein shake for one of your meals or snacks.

If you need help resetting after the holidays or getting back on track, make an appointment to see a NJBC RD at 908-481-1270.

Gaining Healthy Pregnancy Weight After Bariatric Surgery

.Bariatric surgery -  gastric bypass and gastric sleeve - offer numerous health benefits for women living with obesity. Achieving better fertility and delivering a healthy baby is one such outcome. Many expectant mothers who have also had a bariatric procedure may feel excited and uncertain about their experience, particularly about weight gain and how to achieve a healthy pregnancy after bariatric surgery. 

While some degree of weight gain is necessary to grow a healthy baby, doing so the right way is important to also maintain the health of the mother. Just as New Jersey Bariatric Center dietitians are here to help following surgery, we can provide guidance on the best way to gain weight for a healthy pregnancy. 

According to The American College of Obstetricians and Gynecologists (ACOG), the right amount of weight gain during pregnancy benefits the health of a growing fetus and reduces the chances of a low weight at birth. However, gaining too much weight may increase challenges at birth. These challenges can include complicated deliveries and obesity later on in the child’s life. Increased maternal weight gain is also associated with a higher BMI for the mother in the months and years following birth. For these reasons, gaining the appropriate amount of weight in the healthiest way possible should be the goal for post-bariatric mothers and their healthcare team. 

How to Gain the Healthiest Amount of Weight

The healthiest approach to weight gain during pregnancy is to follow a nutrient dense diet made up of high quality protein, healthy fats and minimally processed fruits and veggies. When adding calories, the best way to start is having one extra healthy snack per day that consists of 50-250 calories. This snack is ideally from protein whenever possible. Healthy snack options include a cheese stick and a few apple slices, turkey breast rolled around a slice of avocado or raw veggies dipped in hummus. A cup of Greek yogurt, protein shake or ¼ cup of nuts make great on-the-go options. Be sure to talk with your dietitian about meal structure and timing, especially as the baby grows bigger. Heartburn and feeling full very quickly are common in the second half of pregnancy. This may be particularly challenging for bariatric mothers. Temporarily increasing the frequency of mini-meals and not laying down right after eating are some ways to help ease any discomfort. 

Depending on the specific weight goal, adding additional calories may not be necessary until the second or even third trimester, however consulting with your doctor will help you determine the right time to start.

RELATED: Tackling Postpartum Weight Loss

Overall, the  ACOG recommendations for weight gain in women pregnant with one baby:

Just as no two post-op experiences are the same, each pregnancy is unique and special in its own way. The experienced bariatric registered dietitians at New Jersey Bariatric Center are always here to help guide you through this amazing time. We can customize a nutrition plan for all stages of your pregnancy. We're here help you reach your health goals after giving birth. Please call and make an appointment today!

How Long Do I Need to Take Vitamins After Bariatric Surgery?

After bariatric surgery, vitamins fill in any nutritional gaps that might arise from the change in eating habits or from the procedure itself. As a bariatric dietitian, two of the most common questions I get asked from pre-operative patients is how long they will have to take vitamins and which ones they should take.

How Long to Take Vitamins

What I tell patients is that having weight loss surgery, whether it’s gastric sleeve or gastric bypass, means there will always be a need for some type of nutrient supplementation. This is because a portion of your stomach, where vitamins and minerals are absorbed, is removed during the surgery causing your body’s needs to be greater. Taking a high quality multivitamin/mineral supplement and calcium will be important following surgery

At New Jersey Bariatric Center, we have postoperative patients do blood work at their 3 month visit after surgery. This is to check for healthy vitamin and mineral levels. In some cases, results may indicate that the blood levels of a supplemented nutrient are within the normal range and the supplement can be discontinued. 

After the first year, annual blood work and a yearly visit with your surgeon is the best way to assess long-term nutritional status. Meeting regularly with your bariatric dietitian is another way to ensure all your nutrient needs are being met. 

RELATED: Keep Your Weight Loss on Track with NJBC RDs

Type of Vitamins

At New Jersey Bariatric Center, vitamin and mineral recommendations are based on the most recent data from the American Society for Metabolic and Bariatric Surgery (ASMBS). The type of vitamin and mineral supplements can vary depending on the type of weight loss procedure as well as any nutrient gaps you may already have. 

After weight loss surgery, when you’re able to follow a regular post-op diet, you might feel that  taking vitamins is unnecessary, however since symptoms of low vitamin and mineral levels can be hard to identify in the early stages, it is best to maintain adequate levels with a nutritious diet and the right supplements. 

The types of supplements can include calcium, iron, thiamin, folic acid, vitamin B12, vitamin D, vitamin A, vitamin E, vitamin K, copper and zinc. Depending on the results of your bloodwork  you’ll know exactly which supplements you need after meeting with your registered dietitian. 

If you have questions or concerns about vitamins after bariatric surgery, give us a call at 908-481-1270. 

How to Handle Questions about Weight Loss After Bariatric Surgery

When you first start seeing family and friends after weight loss surgery, they may be surprised by the new you. If you’re comfortable talking about your weight loss, a surprised reaction may be welcomed and sharing your experience with bariatric surgery comes with ease. If you’re not comfortable, the questions and attention may put you in an unwanted spotlight. 

It’s important to remember that your weight loss journey is your journey, and your journey only. You made this decision for you.  If you want to share your decision with those around you, that’s great; but if you don’t want to share, that’s okay too.  Each journey is personal.

The reality is that once you start losing a significant amount of weight, people will notice and some will comment. In our experience, the best way to handle questions and comments is to decide ahead of time how much, if any, you are comfortable sharing and prepare your responses.

Here are some ways to respond to the typical questions and comments you may get.

The ‘How did you lose so much weight?!’ questions

When you don’t want to go into details, a simple response of “I have been working hard and I appreciate you noticing” often works best. You can even share that you are on a healthy path, you have increased your lean proteins and vegetable intake and you are feeling great. Quickly changing the subject to a new topic may prevent further questioning. 

The ‘I can’t believe new eating habits made you lose so much weight!’ comments

Everyone has an extra curious aunt or a friend who just won’t let it go. They may continue to comment on and question your weight loss and what you have done to get the results. If you do not want to share your weight loss journey, a firm line in the sand needs to be drawn.  Once you've shared what you feel comfortable with, a “ thanks for your support, but I am done speaking about my weight right now” can work. For those who don’t take the hint, politely excuse yourself to escape more questioning.

The ‘You had weight loss surgery, isn’t that the easy way out?’ questions

Not everyone understands that obesity is a disease and the hard work it takes to achieve sustainable results after weight loss surgery, so insensitive comments are inevitable. First, decide if the comments are coming from a place of concern or meant to be intentionally hurtful. If the comments are about concern you can simply say, “thanks for your concern, I did my research and I’m comfortable and happy with my decision. I'm healthier now than I was before.” On the other hand if you feel that the comments were meant to be hurtful, you can choose to be vocal about how the comments made you feel; change the subject or remove yourself from the situation. 

RELATED: How to Maintain Weight Loss

Remember that being prepared with what you are willing to share is going to help you feel more comfortable and in control to handle social and everyday encounters. We offer support to help guide you through these sticky situations. Our Tuesday Talks Support group is a great way to share your stories and hear what other postoperative patients have done in similar situations. For more information about support group, email info@njbcenter.com