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Bill Klaproth: Nutrition after a bariatric procedure is critical for success and here to talk with us about bariatric nutrition is Wynnie Hoodis, a registered dietician at Garden State Bariatrics and Wellness Center.

Thanks for your time. How is bariatric nutrition different from regular nutrition?

Wynnie Hoodis, MS, RDN: Good question. I would say bariatric nutrition is different because after surgery, depending on the type of surgery you had, your portions are going to be a lot smaller. You're just not able to consume as much food as you were prior to, so we have to make sure that what you are consuming is nutrient dense. I always say the most bang for your buck, so you really want to pick some healthy choices. Weight loss surgery does require more protein intake, so we discuss different ways of getting protein in, but otherwise, it’s really just smaller portions and just having a really good understanding of what healthy eating and making those healthy choices are.

Bill: That understanding is very important. Nutrient dense and pay attention to protein. Are there other nutrition guidelines someone should follow after bariatric surgery?

Wynnie: There are. We definitely go through that before every patient has surgery. We want to make sure, I always encourage everybody to make sure they're getting enough fluid, meeting their hydration needs from good old-fashioned water is what I always tell folks, but in general, things that are sugar-free, non-carbonated beverages, that’s one guideline. Another guideline is making sure you meet your protein goals, so we go over what those are and the different ways they can meet those needs. We want to make sure that you understand eating slowly, small portions and just making sure you're getting enough protein, the veggies and cutting out a lot of those simple carbohydrates, a lot of the added sugar in foods, really understanding that, limited bread, pasta, rice and getting most of your calories from protein, vegetables, fruit and healthy fats and certain grains like oatmeal, maybe quinoa and tofu and soy and things like that.

Bill: Very good advice. You mentioned beverages and fluids. I was just thinking when you were answering that when a latte and Frappuccino have derailed a diet. You mentioned non-carbonated, but what about all the sugar drinks too? Probably stay away from those?

Wynnie: Yes, definitely. The very first time that a patient comes in and we talk, one of the first things I do is I ask them to give me a dietary recall so that I can understand where their calories are coming from, what their eating patterns are, what their behaviors are. A lot of times, people bring up that they stop at Starbucks or Dunkin Donuts as the number one place people tend to stop in the mornings and they don’t realize how many calories are in those drinks. There's a lot of sugar that’s added to those beverages. I even have a poster in my office that says ‘are you drinking candy,’ and it has pictures of all these different drinks, coffee drinks, tea, soda, sports drinks even and gives everybody an understanding of how much sugar is in these drinks. Those can very easily derail any healthy diet plan because you're just consuming a lot of excess calories that are not providing any nutritional value.

Bill: Really good information. Be cognizant of what you're drinking. When it comes to bariatric nutrition, do supplements play a role in this as well?

Wynnie: Yes, definitely they do. I mentioned before that we want to make sure all our patients take and consume a certain amount of protein after surgery and primarily all of our patients as their progressing, the diet progression week by week, they're drinking a lot of liquids. The very week is most clear liquids and starting that second week after surgery for most of the surgeries, you're going to start drinking a protein shake. That's a protein supplement making sure you're getting that good protein in, but it is a liquid. We help our patients choose protein shakes that taste good, that they'll drink after surgery to meet those protein needs because that's important, and then vitamins and minerals are really important as well. We always recommend, depending on the surgery, we go through what vitamins are important to get, but it is with any of the weight loss surgeries, it's Vitamins for Life, a bariatric multivitamin, calcium is really important and always making sure that you're getting blood work done every year so we can check to see if you have any nutritional deficiencies and see if we need to further supplement any low levels of vitamins or minerals.

Bill: It sounds like you devise a personalized plan for each individual, and then specific follow-up as well, is that right?

Wynnie: Yes. I focus on the diet plan. We have the general guideline and when most people come in, I help them tweak here and there to see where they are in the process, how much change they're willing to make. For the most part, you're correct that it’s not a one size fits all. The guidelines are not always just black and white because I have to understand the patient where they are in the process, but I do try to personalize things to keep our patients motivated, wanting them to make healthy choices. If somebody really dislikes broccoli, I'm not going to force them to eat broccoli. We do go through what are some good options for them, how they're going to be able to meet their needs, what their work schedule and sleep schedule so I can help them gauge a better easier way for them to plan out their menus.

Bill: You mentioned motivation. How do you deal with the mental aspect of this changing habits are hard? How do you help people through that?

Wynnie: It is hard. Part of our process in our clinic is most patients have to come and see me at least three times. For some patients, more, and I'm always available to patients even after surgery for that follow-up. What I always tell my patients is weight loss surgery works. You will lose weight, but to get to the goal that you want to achieve to maintain that weight loss, you really have to think long-term. You have to think about either really changing up your eating patterns and picking healthier choices if you're not exercising, that's a great motivator. Start getting into exercise, even if it's a walking program, but I always encourage exercise. I find that to be very motivating, staying focused, feeling good about yourself, diet, exercise, and joining a support group. We have a support group at Barnabas Ambulatory Care Center once a month and I always encourage our patients to participate in that support group as another tool to stay motivated and just living a healthier life.

Bill: If you could wrap this up for us, what is your best piece of advice on bariatric nutrition?

Wynnie: I would say my best piece of advice for all of our patients is don’t drink your calories. Definitely stick to smaller portions. No snacking or grazing. It’s really important to not get back into those habits of snacking and grazing on food throughout the day and just have a good attitude because when you go into it, your goal is to just live a healthier life. Coming in with a good attitude, feeling good about everything you're going through, feeling really positive can go a long way.

Bill: That is so true. Thank you so much for your time today. For more information about bariatric nutrition, please visit the Garden State Bariatrics and Wellness Center website at gsbwc.org. That’s gsbwc.org. This is Winning through Losing, a weight loss surgery podcast with Garden State Bariatrics. I'm Bill Klaproth. Thanks for listening.