Rule #2 - Lots of Water

  LivingAfterWLS Weekly Digest February 2, 2011 

Rule #3 - No Snacking

LivingAfterWLS Weekly Digest February 9, 2011  

Rule #4 - Daily Exercise

LivingAfterWLS Weekly Digest February 18, 2011 

The Four Rules: Before surgery most of us were taught the Four Rules we must follow in order to achieve the best results with weight loss surgery - any procedure. Those rules (with minor variations from one bariatric surgeon to the next) are:

• Protein First
• Lots of Water
• No Snacking
• Daily Exercise  

In order to maintain weight loss and keep the obesity from which we suffer in remission we must follow these rules for life. When we meet patients who have maintained a healthy body weight for several years with weight loss surgery we learn that in most cases they live by the Four Rules. 

If it has been a while since you have given consideration to the Four Rules I invite you today to spend a little time refreshing your knowledge and enthusiasm about Protein First. Actually, this is my favorite rule because it means good food without the guilt! Link to the articles of interest and take a look at some of our great WLS recipes. There is something for everyone as we get excited again about the Four Rules!

Understand the Four Rules of WLS Before Going Under the Knife 

Weight loss surgery is frequently perceived as an easy means to weight loss that requires little or no effort by the patient. However, patients who undergo bariatric surgery are prescribed Four Rules of dietary and lifestyle management that they will follow for the rest of their life if they wish to lose weight and maintain a healthy weight. Here is what you need to know about the Four Rules of weight loss surgery before going under the knife.

Link to Article  

Myth:

Weight Loss Surgery Patients Can Never Be Nutritionally Healthy   

Have you ever felt like you were completely losing your mind? Like the world was swallowing you up and little things were out of your control and unmanageable? Like you were confused, tired, out of sorts and simply wanted to collapse? Has everyday noise become intolerably loud in your head?

That's how I was feeling a few months ago. I was confident I'd lost my mind and suffered a serious change of personality (for the worse, I may add).

My husband noticed my personality change too. He's a good and wise man and quietly did some research. This is what we learned and how we set about correcting my "problem."

As we know the gastric-bypass patient is at risk for vitamin and mineral deficiency. I religiously take my supplements.  However, I was not taking the RDI of Magnesium which is 400 milligrams/day. Magnesium rich foods are raw rice bran, raw wheat germ, yellow cornmeal, corn, soybeans, soy milk, tofu, raw seeds and nuts, leafy greens, yellow vegetables and fruits, whole cereal grains, milk products & seafood. Meat and poultry are not particularly good sources of magnesium.  Clearly, a weight loss surgery patient will not meet their magnesium requirements through diet.

From Dr. Bernard Jensen's Guide to Body Chemistry & Nutrition" I quote:

 "I want to point out here that the classical deficiency symptoms for magnesium include neuromuscular signs, such as tremors, weakness, muscle spasms and irregular heartbeat; gastrointestinal signs such as nausea and vomiting; and personality changes that display confusion, apprehensiveness and depression. In the "old days" people with magnesium deficiency were often (mistakenly) taken to mental institutions because they acted so radically different that they literally seemed to be mentally ill."

In other reading we learned magnesium deficiency leads to a hyper-sensitivity to sound:

 "It is well established that nutritional effects may result in hypersensitive hearing. Many individuals who are deficient in magnesium suffer from sound sensitivity, and they often experience an improvement after receiving magnesium supplements. A suggested 20 milligrams per each 10 pounds of body weight per day, is an appropriate amount of magnesium. Improvement would occur within a few days if the cause of the sensitivity is a magnesium deficiency." This statement appeared in The Sound Connection, 1998, Vol. 5, No. 3.

I started immediately taking a magnesium supplement  and within a few weeks I felt like a new woman back to my old self again. The hyper-sensitivity to sound diminished and life did not seem so overwhelming. Case in point - exactly two weeks after beginning the magnesium supplement my stepsons and their children arrived unexpectedly at our home for dinner. To make matters worse, we had the kitchen disassembled for a minor remodel project.  I happily adapted and cooked dinner for 7 without having a breakdown. That's when I knew the magnesium was working.

Patients should talk with their bariatric center if they experience these conditions or concerns. Annual blood tests will indicate if a patient is deficient in magnesium and other essential vitamins and minerals.

LivingAfterWLS Library: Diet, Nutrition, Vitamins

After WLS:

Special Vitamin Formulas Help Slow Hair Loss

TThe question of hair loss comes up all the time in the LivingAfterWLS community. Is there anything we can do to prevent hair loss or at least decrease the severity of it?

Some bariatric centers say there is nothing to be done, that patients have to just live with the hair loss as part of the gastric bypass experience. Other centers say a diet of 70g. protein a day will prevent hair loss. Still other centers recommend taking a daily multi-vitamin and supplemental vitamins intended to improve hair health. I believe in taking a supplemental vitamin that contains biotin and silica (horsetail extract) which is known to improve the health, texture and volume of hair.

Hair loss usually occurs in the fourth of fifth month following weight loss surgery. During the phase of rapid weight loss, caloric intake is marginal. This puts the body in a state of panic called starvation. A healthy body normally sheds ten percent of hair follicles at any given time. When a body is starving roughly thirty to forty percent of hair follicles are sacrificed as the body channels nutrition to more vital areas. During this phase hair loss is dramatic, often patients find clumps of hair on the shower floor. Remaining hair becomes drab and lifeless.

I knew hair loss was a potential result of weight loss surgery, but because I'm a "cup-half-full" person, I didn't believe that hair loss would happen to me! That just happens to other people, I told myself! Imagine my surprise when my blonde locks were littering the bathroom floor like hair saloon

The hair loss is a transient effect of your gastric bypass surgery and will be resolved when nutrition and weight stabilize. Many patients report favorable results from taking a nutritional supplement that contains calcium, magnesium, zinc, boron, betaine and horsetail extract.  Usually this vitamin and mineral supplement is marketed under the "healthy skin, hair and nails" category at vitamin stores and discount stores.

This is a large vitamin - I call it "the big ugly" and for new post-ops it will be nearly impossible to swallow. The pill can be split with a sharp kitchen knife or purchase a pill splitter at the drugstore. As always, check with your bariatric center if you are newly post-op before taking any nutritional supplement or medication.

In the Neighborhood: Diet, Nutrition, Supplements  

What Vitamin Supplement  is Best

for Surgical Weight Loss Patients

The multi-vitamin market is rich with choice. It's also very confusing. There are mega's, potents, super all-day's, vegetarian formulas, geriatric formulas, athlete's formulas, recipes for men and women and teens! There are some things gastric bypass patients must consider when selecting a multi-vitamin supplement.

The weight loss surgery patient must first ask, "Can I swallow this with a small amount of water?" The next question, "Will it absorb quickly enough for my short circuited system?" Adult chewable tablets are available, but the taste is often unpleasant. However, these may be used during the first few months after surgery. Capsules and gels are a good choice because they are more likely to absorb quickly. Time released tablets should be avoided, they dissolve slowly, that's what makes them timed release. They will pass through the shortened intestine before absorbing into the body.

There is no right or wrong form of supplement, just make sure to select a form you will take routinely.

Choose a gender and age specific formula. The more that is learned about nutrition, the more obvious are men and women's different dietary needs. For example women need more calcium and iron in their diets. Men, particularly over 50, must be careful to limit iron intake. Geriatric vitamins often included chelated minerals for better absorption in addition to glucosamine to help with bones and joints and herbs to improve memory and wellness.

Finally, look for a supplement that contains most of the vitamins and minerals essential for good health - but does not exceed the U.S. RDA by more than 150 percent. (Most multi-vitamin supplements do not contain vitamin K - it is naturally synthesized by the body.) The label on the supplement bottle lists the weight in milligrams of the vitamin and minerals contained in the supplement.

The label also shows the percent of the U.S. RDA the supplement supplies. Natural and synthetic vitamins are virtually identical and most supplements are synthetic. It would require heaps of natural foods to extract enough vitamins for supplements and the cost would be prohibitive. One exception is vitamin E: the natural form is actually biologically more active and better absorbed and utilized by the body.