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When it comes to losing weight, changes to your food and exercise routines are generally the first line of defense. But for some people with obesity—a BMI (body mass index) of 40 or higher—weight-loss surgery, also called bariatric surgery, can be a life-saver.
BMI is a way of estimating a person’s body fat based on their height and weight. However, it is an imperfect measure of fat as well as overall health.
Most insurance companies will also cover bariatric surgery for patients with a lower BMI (35 and greater) if they have medical conditions related to obesity, including high blood pressure, type 2 diabetes and sleep apnea.
Weill Cornell Medicine offers a variety of weight-loss surgical procedures, depending on a patient’s needs, including:
Most patients undergoing bariatric surgery spend just one night in the hospital.
Soon, patients typically experience major health improvements such as:
“After surgery, however, you’ll need to make dietary changes,” says Liz Goldenberg, a clinical dietitian and staff associate with the GI Metabolic and Bariatric Surgery Program at Weill Cornell Medicine. “You’ll start with liquids and progress gradually to blended foods and soft solids over the course of 3 to 6 weeks.”
As a registered dietitian working exclusively with patients undergoing metabolic and weight loss surgery, Liz has a strong interest in the nutritional consequences of these procedures. Continue reading to learn more about the dietary adjustments patients are encouraged to make in the aftermath of bariatric surgery, both short- and long-term.
“We recommend that patients practice eating more slowly, chewing thoroughly, prioritizing protein intake and decreasing liquid sources of calories such as juice and soda,” she says. “These strategies will help you meet your nutritional needs, promote a feeling of satiety and maximize your chances of long-term success.”
Over time, she says, most patients will be able to tolerate a wide variety of foods, and they won’t need to avoid specific foods forever. “We encourage our patients to enjoy their favorite treats—desserts or fried foods, for example—in small amounts on special occasions. At the same time, we teach them that indulging in these on a regular basis could thwart their success.”
The most difficult food to tolerate after surgery, she adds, is actually red meat.
Before surgery, each patient meets with a dietitian, either in person or on video, to learn about the habits and behaviors they’ll need to start practicing after their procedure. They’ll be given a host of written materials, along with online resources that will provide guidance throughout their weight-loss journey.
The surgery affects gastrointestinal hormones involved in hunger and satiety. This often leads to nutritional challenges that are usually temporary but may be startling for some patients, she says, including:
“Patients are required to take vitamin and mineral supplements every day for the rest of their lives,” she says. “Not taking these supplements, and not following up with the required bloodwork, can put them at risk for developing iron deficiency anemia or neurological disorders, among other serious health problems.”
The best advice Liz can offer is to follow up closely with your health-care team. “Your nurse practitioner, physician assistant, dietitian, behavioral health provider and surgeon all play an important role in your long-term care. The people who struggle most are usually the ones who aren’t following up with us regularly. Attending support group meetings is another powerful tool to help patients over the long term. We offer twice monthly virtual meetings at no charge.”
Learn more about Weill Cornell Medicine’s GI Metabolic and Bariatric Surgery Program or make an appointment by calling (646) 962-8462 or visiting our website.