The medical treatment of Severe Obesity has always been based on a combination of calorie intake reduction – usually a Very Low Calorie Diet – and an increase in calorie utilization – an exercise program. A goal to aim for is less than 1200 calories per day for women and 1400 calories per day for men. There are literally hundreds of variations on how to achieve these goals, e.g. liquid meal replacement formulas, diet fads. Unfortunately, these diets are a radical departure from “normal food” choices and have not been shown to be very effective after a year or so. Data from long-term studies – from 3 to 5 years – show that most patients with higher BMIs (>35) will not maintain weight reduction, and, therefore, do not reduce their long term medical risk.* More than 90% of morbidly obese patients will not have sustained weight loss on a medical weight loss regimen. This is the main reason that surgery has been recognized as a more effective means of treating morbid obesity. Surgery has a better chance of keeping weight off for the long run.*
Importantly, an Aftercare (managed nutrition program) is part of the comprehensive care of a person with morbid obesity (BMI > 35). Many insurance plans will require the patient to undergo a physician supervised diet for a period of months (usually 3 to 6 months), prior to authorizing a surgical procedure. A common perception is that if the person does well on the diet, he or she will have adequate weight loss with the operation later. Data on this subject is conflicting and we do not feel that this point carries much merit. A better reason to institute a supervised weight loss program is to begin the education and training that a person will need to make better food choices after the operation. Many obese people have developed unhealthy eating habits based on misperceptions or misinformation. Some of this can be corrected preoperatively.
Our approach is to connect the patient with carefully selected Registered Dietitian who are experts in managing patients both pre-op and post op. We are pleased to announce a partnership with PsyMed, Inc to offer a managed nutrition program, under the leadership of Renell Cronk, RDN LD. With a team of Registered Dietitians ready to educate and motivate you will learn how to nourish your body to a healthy weight.
Recommendations are patient specific, but there are general rules that apply to almost everyone. Keeping a food diary is essential to account for all sources of those calories. The registered dietitian will review the food diary with the patient during scheduled sessions.
