The past few months have been unprecedented. The new norm is still unusual and as such I’ve been having some emotional conversations with my bariatric patients. Some of my patients have been unfortunate in that their bariatric surgeries have been cancelled (those booked in April onwards) whilst others have reported to be snacking more due to spending more time at home.
In this article I wanted to share with you the advice that I’ve been giving to patients who are both before and after surgery, in the hope that they will feel more positive and be kinder to themselves – now may not be the ideal time for losing substantial amounts of weight, but it is the time to establish a new healthier way of life, and to focus on either weight maintenance or a slight reductions in weight.
I’ve been directing a lot of my patients to the NHS One You website which has some fantastic resources for managing both stress and anxiety, as well as issues with sleep (as adults we need around 7-8 hours a night). The information on this website applies to patients who are both pre and post weight loss surgery, as well as friends and family who aren’t weight loss patients too.
Carol Bowen Ball has written a fantastic book called The Bariatric Bible, which I recommend to every single one of my patients. The book is ideal as it contains 50% advice and 50% recipes which are divided up and colour coded into liquids & purees, soft and then normal textures to guide you through the first few months of surgery and then beyond. Regarding further research into surgery, the Ramsay also has some brilliant information on what each of the surgeries
Try to structure your day i.e. have set times for meals, snacks, a walk/workout, face-time with loved ones and work! A structure helps to reinforce positive habits which in time will be carried out with minimal thought and effort. And if you find yourself with more ‘down time’ than usual, make yourself a to-do list, I often recommend that people divide tasks up into: MUST (important tasks with an imminent deadline), SHOULD (important tasks with a longer deadline), COULD (unimportant tasks that need to be done in time) and WANT (desirable tasks e.g. having a bubble bath).
You are unlikely to be seeing your health care professionals during this time which is why I encourage you to invest in a set of digital scales. Weigh yourself on a hard and flat surface on a weekly basis and write it down either in a diary or in an app such as MyFitnessPal. Remain accountable and don’t let a weight gain of a couple of pounds turn into a couple of stone.
As well as writing down weekly weights, you may also find it useful to write down what you are eating. Have a go at doing this for a week and then be your own diet-detective; go back through as ask yourself ‘why’ were you eating foods such as biscuits; was it because you missed a meal or because they are kept in easy reach next to the kettle? Plan to prevent the same slip up from happening again the following week.
Eat your 5 portions of fruits, salad and vegetables a day! Canned and frozen count too (they actually contain more nutrients such as vitamin C than their fresh varieties). If you can, try to buy fruit canned in juice as opposed to syrup. Three of the nutrients that help to support your immune system during this time include Vitamin A, which is found in sweet potato and spinach, Vitamin C, which is abundant in berries, tomatoes and peppers, as well as Zinc which is found in meat, shellfish, dairy and bread.
Drinking an adequate amount of fluid is essential in order for you to feel and function at your best. Water, squash, tea, coffee and milk count towards our fluid needs but try to make sure that they are sugar free (use sweetener if needed!) and kept to 30 minutes either side of a meal or snack.
Make your snacks not only interesting but nutritious too. Think protein and produce when it comes to snacks e.g. cheese and apple, yoghurt and berries, nuts and dried fruit or even hummus and carrots!
This is essential. Being out in the open (in nature ideally) does wonders for our mental health and also helps with our vitamin D levels – and don’t forget that you still need your vitamin D and calcium supplements, as well as your multivitamin, iron tablet and vitamin B12 injections too*.
A little bit of what you fancy does you good! Now is certainly not the time for restriction (you crave more what you ban from your diet!). The key is balance, think 80/20 – as long as you are eating and drinking well 80% of the time, you can afford to indulge for 20% of the time.
I really hope these tips help you to get back on track – you can do it!
*Please note that if you are unable to receive your vitamin B12 injection during this time you can buy oral vitamin B12 as an interim – please click here for more information.
By Nichola Ludlam-Raine, Specialist Dietitian at Ramsay Health Care