Category Archives: Front Page

Holiday Gifts for the Bariatric Patient

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Overcoming and Preventing the Weight Loss Plateau

Have you had bariatric surgery?  Has your weight loss slowed or stopped?  Are you no longer seeing results, and don’t understand why? Well… you most likely need to learn how to stop weight-loss plateau. Weight loss, after bariatric surgery, is very significant early on; this typically occurs because the body is adapting to the lower calorie diet and is burning alternative energy sources. The body will first burn glycogen that is stored in the muscles and the liver (which causes a loss of water weight which is a significant amount of your overall weight loss), and the body then turns to fat and lean muscle mass. As your body burns muscle, your metabolism slows and this is typically what causes you to hit a plateau.  Before weight loss surgery, you still had quite a bit of muscle which is why it was so easy to lose weight shortly after your bariatric surgery. A person with lots of muscle mass will have a high metabolism, which means they will burn more calories throughout the day, even when just lying in bed, than a person with less muscle mass. As a lighter person, you no longer have as much muscle mass as you previously may have, so you may no longer be at a deficit with calories because of your lower metabolism.

GETTING PAST THE PLATEAU

After bariatric surgery, If you are off track of your weight loss goals or exercise regime.  Do not worry, hope is not lost. Learning how to stop the weight loss plateau after an obesity surgery can be very challenging, but you can do it. Firstly, you must stay on track with your diet and exercise. Remember back to when you lost weight at the quickest rate and determine when you fell off track. If you have not been exercising like you should, it is very important to start an exercise program. This will increase your caloric deficit, help build or maintain lean muscle mass, and boost your metabolism.  After bariatric surgery, if you have been exercising regularly but are no longer seeing results it is most likely because you’ve been doing the same routine over a period of time or you have not kept yourself challenged by increasing the intensity of your exercise. Your body has adapted to the exercise and has become more efficient at that exercise. This means that your body is no longer burning as many calories during this exercise as when you first began.

It is very important to frequently change your exercise routine to keep yourself challenged.  By doing this, your gastric bypass or lap band surgery can be more effective.  A good way to determine if you are exercising, at the correct intensity, is to track your heart rate. You should be exercising at 60-85% of your predicted max heart rate (220-your age). As you get in better shape, you will notice that it will be more challenging to increase your heart rate.   So step up the intensity! You should try exercises that keep you out of your comfort zone, such as, circuit training (exercising a different muscle group with each exercise, and doing each exercise in a row with little or no rest in between), high intensity interval training (low-moderate intensity exercise with bursts of high intensity spread throughout, such as, jogging with sprint intervals), fast paced exercise classes (Zumba, Kickboxing, Body Blaster, etc.…), super sets (Performing 2 exercises back to back with no rest in between for a certain number of sets before moving to the next superset or exercises), and giant sets (three exercises performed consecutively for a specific muscle group). It is also important to keep rest periods short, change up the amount of weight you lift, the number of sets, the number of reps, and the order of the exercises.

If you need guidance contact our office and set up an appointment with either our doctors, nurse practitioner, nutritionist or exercise physiologist for questions regarding your specific conditions.

STOP WEIGHT LOSS PLATEAU

It is very common for people to hit a plateau at some point after their gastric bypass, lap band or gastric sleeve weight loss surgery but how exactly do we prevent hitting these plateaus? It is absolutely vital to start and stay consistent with an exercise program after your obesity surgery. Exercising regularly will allow you to maintain your lean muscle mass, bone density, and boost your metabolism. You must also change your exercise routine about every 4-6 weeks to help keep yourself challenged and interested in exercise, as previously stated. Doing resistance training exercises such as free weights, machine weights or resistance bands are most beneficial to maintaining lean muscle mass.  If you maintain your muscle mass, you will have a higher metabolism, and in turn you will be able to lose weight at a quicker rate and most likely reach your weight-loss goals without any plateaus.  Of course exercise alone will not provide all of the results you may want. You must consume your recommended amount of protein each day, drinking at least 64 fl oz. of water and staying consistent with the recommended diet. Weight loss surgery is a difficult process and only begins with the surgery, but if you make these changes a part of your daily routine and stay consistent, nothing will stop you from reaching your weight-loss goals.

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Finding a Fitness Routine After Bariatric Surgery

Exercise after weight loss surgery helps boost weight loss results, reduce sagging skin, and improve overall health. If you enjoyed exercise before surgery, it probably wasn’t hard to jump back onto the fitness wagon after your recovery. For those who never exercised before surgery (especially if you didn’t particularly like it), finding your fitness groove may seem difficult. Instead of taking up an exercise routine that you don’t enjoy make it a goal to find an activity that makes it fun to get your daily 30 minutes of exercise.

Walking. This low-impact exercise is great for any fitness level, and is often recommended for beginner exercisers and those who have just been approved by their doctor to exercise after bariatric surgery. Make it fun by downloading a great playlist or loading your music player with an audiobook reserved only for walks.

Yoga or Pilates classes.
 Both yoga and Pilates classes are excellent for gently building flexibility and strength. Unless you’re attending specific cardio-minded classes, you may need to mix in a few walks or jogs to get a rounded fitness experience.

Join a team sport. If your idea of team sports involves watching from the stadium, maybe it’s time to get on the field or court. Being part of a team sport helps commit you to exercise because your team is counting on you to show up. Look at your local community center for intermural sport sign-ups.

H.I.I.T/H.I.R.T. High Intensity Interval Training/High Intensity Resistance Training is a mix of cardio and resistance training.  Essentially, H.I.R.T is the most effective way to burn more fat in the least amount of time.

Resistance training is anything that give resistance against your muscles. It can take on many other forms as well.  H.I.R.T exercises can be down with elastic exercise bands, cable machines, dumbbells, hand weights, and pulley systems that give great resistance.  Using your own body weight is another way to give your muscles resistance.

To receive the amazing benefits of high intensity resistance training, it not only takes far less time than other forms of exercise, but it also enhances the fat burning engines of muscles.  H.I.R.T. is the one thing that we can do that elevates our metabolism for hours after a workout.

Dance classes. Your local dance center or community center most likely offers a variety of dance classes for beginners to advanced dancers. Consider taking a class you’ve never tried before, from tap less to hip hop.

Rock climbing. Summer is coming and outdoor rock-climbing locations are opening up. If you’re a beginner, start your training in a rock climbing gym to build hand and arm strength and to learn the right climbing techniques. Rock climbing is a great way to get a cardio and weight training workout in one.

Spin classes. Do you like solo exercise but need to be pushed? Spin classes are great because you can go at your own pace or move at the speed of your instructor. Since the bikes are stationary, your pace is your business.

The key to finding a fitness routine after weight loss surgery is to find an activity you enjoy. If gyms aren’t for you, look into outdoor exercises or team sports that you can join. Try scheduling exercise appointments so that you don’t fill your day with other events. If you are just beginning exercise, please speak with your doctor to ensure you’re ok to begin a fitness routine after bariatric surgery.

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Micronutrients and You: Calcium and Bariatric Surgery Patients

After bariatric surgery, patients experience permanent changes to their digestive system in the way that nutrients are absorbed and processed. It’s important for both patients and their physicians to understand the role of ongoing nutritional support so they can maintain good health. This series of articles will focus on the importance of micronutrients for bariatric surgery patients. Specifically, the special needs they now have based on the surgical changes to their digestive systems, as well as the evidence-based products offered by Bariatric Advantage to support bariatric surgery patients in maintaining good nutrition and good health.

Calcium and Bariatric Surgery Patients

Calcium is the most abundant mineral in the human body. Ninety-nine percent of whole-body calcium is incorporated into the structure of bones and teeth. Calcium also plays a vital role in the body’s clotting capabilities. Lack of adequate calcium can contribute to poor bone health and other long term challenges.

When people do not get enough calcium, the body takes calcium from their bones. Over time, this “borrowing” of calcium can cause decrease bone health. Studies indicate that individuals who undergo bariatric surgery may be at risk for long-term challenges with bone health due to nutritional and other causes[1].

Getting Enough Calcium

Eating a calcium-rich diet is important. Calcium containing foods include dairy products, calcium-fortified products like soy and rice drinks, and leafy greens. In addition, experts recommend that individuals who have had bariatric surgery take calcium supplements to get enough of this important mineral. The recommended daily dose of calcium for bariatric patients is 1,200-2,000 mg a day, according to the guidelines published by the American Society for Metabolic & Bariatric Surgery, The Obesity Society, and The American Association of Clinical Endocrinologists.

Due to the changes that have been made to their digestive systems, bariatric surgery patients are at particular risk for challenges with specific absorption, including calcium and vitamin D. Bariatric surgeries may also increase bone turnover and loss of bone mass in patients, part of which is due to massive weight loss alone (which always results in the loss of some lean mass – including bone). Therefore, it is critical that bariatric patients regularly get adequate calcium to reduce the risk of deficiencies, bone loss, and to long-term health.

However, many types of commercially available calcium supplements may not be optimized for bariatric patients. Biologically, calcium from foods and some types of dietary supplements must become ionized in an acid medium in order to be absorbed in the small intestine. In bariatric patients, certain forms of calcium such as calcium carbonate (found in many over-the-counter vitamins) are not likely to be well-absorbed after surgery because they require interaction with hydrochloric acid which is limited after common procedures. After bariatric surgery, there is less contact of food with stomach acid, making it difficult to absorb calcium carbonate. For this reason, calcium citrate is generally recommended after bariatric surgery to support absorption[2].

Tips for Bariatric Patients

The following suggested guidelines can help bariatric surgery patients ensure that they are taking calcium supplements that will meet their needs for life:

  • First, consult with your physician to be sure you understand the guidelines for nutritional supplementation before and after your surgery, and for the rest of your life.
  • When selecting a supplement, look for one that uses calcium citrate, the form most commonly recommended after bariatric surgery to support absorption.
  • Make sure that your calcium supplement also contains Vitamin D
  • Some patients may prefer a form of calcium other than the traditional tablets that are swallowed. “Chewy bites” are a tasty option with the texture of a caramel candy, and are available in different flavors. Powders and chewable tablets are also popular choices for those who dislike swallowing pills.
  • It is best to look for options that are low in sugar or sugar-free.. Lactose-free options are also available.
  • Because bariatric patients generally need more supplemental calcium than adults who have not had this surgery, selecting a dose with a higher amount of calcium – say 500 mg versus 250 mg – means taking fewer pills and may make adherence easier.

To learn more about Bariatric Advantage’s new 500 mg Calcium Citrate Chewy Bite, the first to combine 500 mg Calcium Citrate and 500 IU of Vitamin D3 in one tasty, sugar-free soft chew, read the official press release here. To learn more about calcium and bariatric nutrition call 800.898.6888 or visit www.bariatricadvantage.com.

[1] Berarducci A, Haines K, Murr MM 2009 Incidence of bone loss, falls, and fractures after Roux-en-Y gastric bypass for morbid obesity. Appl Nurs Res 22:35–41

[2] Goode LR, Brolin RE, Chowdhury HA, Shapses SA. Bone and gastric bypass surgery: effects of dietary calcium and vitamin D. Obes Res. 2004;12:40-47. [EL 2]

Reviewed and Prepared by:
The Science Desk
Bariatric Advantage

 

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