We have all read this conventional diet tip - and we've heard it before:

"Burn away fat with ice cold water! Ice cold water is calorie-free and fills you up so you can eat less. Drink ice-cold water and you'll even burn a few extra calories as your body warms it up!"

If you are in the phase of rapid weight loss or have lost quite a bit of weight you know exactly why gastric bypass patients don't drink ice cold water - we're already freezing - even in the heat of summer. The last thing we want to do is get colder!

People who experience the massive weight loss associated with weight loss surgery experience feeling cold for two reasons: loss of insulation and less energy generation.

Fat is a highly efficient insulator. When gastric bypass patients follow the rules: eating protein and exercising, the weight lost can only come from fat or stored energy: insulation. Less insulation increases the likelihood of feeling cold.

Most weight loss patients report that their body temperature regulates after their weight is stabilized, usually eighteen to twenty-four months after surgery. Patients who incorporate exercise in their weight loss program experience less chilling than patients who do not exercise.


Serve a cup of herbal tea instead:

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How much protein have you had so far today? "As a group, we are not eating enough protein and this shortfall is putting our health at risk." We know that after weight loss surgery we should follow a high protein diet. We call this "Protein First" - the first of the Four Rules of WLS. Mainstream studies of people managing their weight without bariatric surgery continue to indicate a diet high in protein supports weight loss and weight management in addition to promoting health.
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This month's 5DPT Bulletin takes a look at some of the pitfalls that derail us on Days 1 and 2. I then give solutions and suggestions to avoid these pitfalls so we all may successfully get back on track with our health and weight management using the weight loss surgery tool in the manner that serves us best. Little things make a difference and I think if you give Days 1 and 2 another try a pleasant surprise awaits you come Day 3.

This month we move to Rule #2 - Drink Lots of Water.  The advice to drink lots of water is universal across the diet spectrum. Water flushes toxins, including the body fat we shed, improves circulation, promotes skin health, brain function, kidney function -- the list is long. With all the great benefits that come from drinking lots of water you'd think it would be easy to get it done. But drinking lots of water every day can be very challenging.  The more we drink, the more we eliminate (not always convenient). Water is tasteless and can seem tedious. There are many other better flavored beverages tempting us. And then there are the liquid restrictions: no water with meals; no water for 15 to 30 minutes before and after meals. And what actually counts as water?

It seems like almost everyone has their own standard for what counts as water and what doesn't.  Even from one bariatric center to the next it is difficult to get a consistent answer about how much water we need and what counts as water. Over the years I've come to my own conclusion about what "counts" as water for me. First, water counts. Next, if there are nutrients in the beverage such as Green Tea or a protein drink, I count it toward my fluid intake. One glass of red wine with its health promoting antioxidants counts -- four glasses of red wine do not count. Coffee with protein powder blended in counts; black coffee doesn't (because of the caffeine).  I aim for 60 to 80 ounces of water or countable fluid a day. This puts me in the bathroom about every 2 hours and I am able to maintain my weight without frustrating water weight gain or false weight loss.

I imagine that is the real bottom line regarding water intake is answered with this question:  What does it take to help us feel our very best? It will be different for each one of us but it certainly helps to learn what is working for others traveling this not-so-easy WLS terrain. I hope you will find some nuggets of helpful information in this month's 5DPT Bulletin. Thanks for joining me!

We are all in this together!
You are more powerful than you think and
You Can Do This!
Kaye




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From the 5DPT Articles Collection
In a country where food and drink go hand in hand weight loss surgery patients are challenged to follow the liquid restrictions as instructed by their bariatric center. But understanding and following the liquid restrictions plays a key role in long-term weight maintenance following gastric bypass, gastric sleeve, or adjustable gastric banding (lap-band) surgeries.

In general, bariatric centers instruct weight loss surgery patients to avoid drinking liquids for thirty minutes before a meal, during the meal, and for thirty minutes following the meal. This easily adds up to 90 minutes of no liquids three times a day: four-and-one-half waking hours. It is easy for patients to become frustrated with these restrictions because another rule of weight loss surgery is to drink lots of water, at least 64 ounces a day. Understanding why the liquid restrictions are necessary and how water intake affects weight management will increase the likelihood a patient will follow the guidelines.

When a person undergoes any of the currently practiced bariatric and metabolic surgeries for weight loss the size of the stomach is reduced significantly to restrict the amount of food which may be eaten at a given time. The size of the restricted pouch varies by procedure, surgeon and patient. What is consistent, however, is that the smaller stomach pouch fills quickly and the patient experiences a feeling of fullness andsatiation, which must be sustained following the meal to avoid hunger and cravings later.  This is to keep the patient from over eating.  In addition, the longer food is kept in the digestive system the more opportunity the body has to absorb and metabolize nutrients. The best way to sustain this fullness is to eat lean protein and low-glycemic complex carbohydrates in a ratio of two bites protein to one bite carbohydrate.

For many weight loss surgery patients the feeling of tightness or restriction that results following eating is unfamiliar and uncomfortable. In weight loss surgery street talk these patients learn to "eat around the pouch". In many cases that means drinking liquid with solid food which relieves the tightness as the chewed food (chyme: semi-liquid mass of partly digested food) mixes with liquids to form a more fluid liquid slurry which passes through the new stomach outlet more rapidly. The result is increased food intake because patients can eat more food during a planned meal and they are likely to eat again later because they are hungry and the slurry meal failed to satiate hunger for a reasonable amount of time.

As important as it is to follow the liquid restrictions it is equally important to drink adequate water. The body is made up of about 60 percent water. Water assists with the transport of nutrients and waste products throughout the body. Water is present in every process of human biology. Most centers recommend a minimum intake of 64 ounces a day. Others suggest morbidly obese patients drink one ounce of water for every two pounds of body weight.

Organized planning is helpful when following liquid restrictions and drinking lots of water. Begin the day with water and enjoy water between meals, which will also help keep cravings away. Keeping a glass or bottle of water at arms reach is a steady reminder to sip often and stay hydrated. Newly post-operative patients report drinking tepid or room temperature water is easier on the pouch thus making it possible to drink more.

Many weight loss surgery patients report frequent spells of dizziness. In general they are using the word dizzy to describe everything from feeling faint or lightheaded to feeling weak or unsteady.  

Research indicates a state of chemical imbalance can lead to temporary bouts of dizziness. When a bariatric patient feels dizzy it could very well be related to the restricted diet. Most commonly going too long between meals or not drinking enough water causes bariatric patients to become dizzy or have a mild electrolyte imbalance. Many patients self-treat dizziness by drinking water or little sips of a sports drink such as Gatorade. I use Emergen-C energy booster for the vitamins and electrolytes, and I like the portability of the drink mix in a sealed portion-perfect envelope.

Dizziness may occur when too much time passes between meals, or as an early warning sign of dehydration. Lack of food or loss of bodily fluid interrupts the body's physiological process; the electrolytes get out of balance.

Potassium, sodium and chlorine are the three dominant electrolytes in the human body. Beneath our conscious awareness the electrolytes are very busy jumping in and out of cells making it possible for nerve impulses to travel from one nerve cell to the next. When we are eating correctly, staying hydrated and pursuing a healthy lifestyle it is likely the electrolytes will stay balanced and we can enjoy a dizzy-free existence.

It is extremely dangerous when electrolytes become severely imbalanced. Infants suffering from dehydration have died from electrolyte imbalance. So have sufferers of anorexia.

If flu symptoms cause dehydration to the point of extreme dizziness and disorientation one must seek medical help. Dehydration will force a greater loss of potassium, which raises the sodium level in all muscle tissues. At greatest risk is the heart muscle where an increase of sodium may cause arrhythmia and death.

The sports and nutrition industry's guideline for water consumption is one ounce of water for every two pounds of body weight. Carefully monitoring fluid intake will help weight loss surgery patients avoid chronic dizziness.

Refresher:
Four Rules

 LivingAfterWLS Weekly Digest January 20, 2011

   

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  

 

LivingAfterWLS Weekly Digest February 24, 2011.

The health content provided by LivingAfterWLS is intended to inform, not prescribe, and is not meant to be a substitute for the advice and care of a qualified health-care professional.