Paleo, keto, Atkins – if you’ve spent years trying them all, you’ll probably agree with Accredited Practising Dietitian Tania Chaanine that “these diets don’t work in the long run.
“If you have to follow a piece of paper that tells you what to eat for breakfast, lunch and dinner, you might follow it at first and lose weight because of the calorie restriction, but you’re likely to give up soon after because it doesn’t work with your lifestyle.”
If you've tried all the diets under the sun and are still battling obesity - with all its associated health worries - then weight loss surgery may be something to consider.
With a special interest in nutrition and weight loss management following bariatric or weight loss surgery, Ms Chaanine practises with the Upper GI Surgery bariatric team at St George Private Hospital.
What does bariatric surgery involve?
There are three bariatric keyhole surgery options available in Australia: lap band surgery, gastric bypass, and gastric sleeve surgery – where most of the stomach is removed, including its contents of the “hunger hormone” ghrelin.
“A lap band is an adjustable band placed around the top part of the stomach that helps to reduce hunger and eating capacity,” Ms Chaanine explained. In a gastric bypass, “the stomach is bypassed and food enters a small gastric pouch [before going] into the small bowel for digestion”.
At what point would a bariatric team suggest an individual resorts to the surgery?
“It is [only] for those with severe obesity or a high BMI (Body Mass Index) suffering obesity-related comorbidities, who have failed all other means of losing weight,” Ms Chaanine stressed. The dietician educates her patients on healthy eating and portion control (rather than dieting), while also encouraging them to move more if they haven’t yet attempted to do so.
Life, and eating after bariatric surgery
“It is [stomach] reduction surgery so it is quite restrictive with the amount you can eat,” Ms Chaanine acknowledged. “Portion sizes in the early post-surgery phases are about a quarter to half a cup of food per meal. [The patient] physically can’t take in more.”
This gradually increases to a three-quarter to one-cup portion, the equivalent of a small entrée-sized plate.
“The benefit of the surgery is that you’re content with a small portion [instead of] a whole three-course meal. Patients adapt quite easily.”
A higher protein diet is recommended post surgery “ because it’s crucial during the healing process but equally important to prevent muscle and hair loss during the weight loss phase,” Ms Chaanine said.
“In the early stages following surgery, patients are eating small amounts of food so it’s difficult to get the full range of nutrients. As portions increase, we focus on a balanced approach, lean protein sources including low-fat dairy, fresh fruit and vegetables and small amounts of low-GI carbohydrates and of course the heart-healthy fats in moderation.”
Keeping the weight off
“I believe bariatric surgery remains the most effective tool in achieving significant weight loss and metabolic improvements, including reduced type 2 diabetes risk,” Ms Chaanine said.
“Regardless of the type of bariatric surgery, the surgery itself does not guarantee that you will lose the weight. It is only a tool; a great tool though if used to its potential. When combined with lifestyle changes, the surgery can assist patients in achieving long-term weight loss, and improved health outcomes and quality of life.”
Ms Chaanine’s patients see exercise physiologists, and counselling can address a missing piece of the weight loss puzzle.
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