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RE: lap band post op diet

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alyssa,This looks like a nice menu for pts 1 year out, but may be too much food for new band patients. I like to keep portion size to no more than ½ - 1 cup food in volume and have them drink between meals only, not with the meals.jdm Janelle D. McLeod, RDGastric Bypass CoordinatorPenn State Hershey Medical Center717-531-6321 This message (including any attachments) contains information intended for a specific individual(s) and purpose that may be privileged, confidential or otherwise protected from disclosure pursuant to applicable law. Any inappropriate use, distribution or copying of the message is strictly prohibited and may subject you to criminal or civil penalty. If you have received this transmission in error, please reply to the sender indicating this error and delete the transmission from your system immediately. >>> "alyssabixler" <alyssabixler@...> 3/27/2007 3:26 PM >>>I'm working on a sample menu for lap bands for 2 months post op and beyond. Does anyone have any input for the menu below. I am new to lap bands and would welcome any ideas. Thanks!Alyssa RDBreakfast 1 egg or ¼ cup egg substitute1 slice toast1 tsp Light Margarine½ cup melon6 oz ( ¾ cup) skim milk Lunch 2 oz ( ½ cup ) tuna1 tsp light mayonnaise½ cup grapes4 oz ( ½ cup) light yogurt6 low fat crackers¼ cup green beansDinner 2 oz tender chicken breast½ cup steamed asparagus½ cup pasta with tomato sauce4 oz ( ½ cup) skim milk

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We discourage drinking with meals for lap-band patients so I would take out the milk. My experience with lap band is that patient's portions vary widely!!! So I would either do away with some of the portion sizes or I would make a note that the patient may not be able to eat the portions listed. otherwise the menu looks good!

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of alyssabixlerSent: Tuesday, March 27, 2007 12:26 PM Subject: lap band post op diet

I'm working on a sample menu for lap bands for 2 months post op and beyond. Does anyone have any input for the menu below. I am new to lap bands and would welcome any ideas. Thanks!Alyssa RDBreakfast 1 egg or ¼ cup egg substitute1 slice toast1 tsp Light Margarine½ cup melon6 oz ( ¾ cup) skim milk Lunch 2 oz ( ½ cup ) tuna1 tsp light mayonnaise½ cup grapes4 oz ( ½ cup) light yogurt6 low fat crackers¼ cup green beansDinner 2 oz tender chicken breast½ cup steamed asparagus½ cup pasta with tomato sauce4 oz ( ½ cup) skim milk

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

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does anyone have sample menus for lap-band patients from the first

weeks and beyond that they could share. thank you!

>

> We discourage drinking with meals for lap-band patients so I would

take out

> the milk. My experience with lap band is that patient's portions

vary

> widely!!! So I would either do away with some of the portion sizes

or I

> would make a note that the patient may not be able to eat the

portions

> listed. otherwise the menu looks good!

>

> Laschkewitsch RD LD

> Dietitian, Legacy Obesity Institute

> (503) 413-8135

>

> lap band post op diet

>

>

>

> I'm working on a sample menu for lap bands for 2 months post op and

> beyond. Does anyone have any input for the menu below. I am new to

> lap bands and would welcome any ideas.

> Thanks!

> Alyssa RD

>

> Breakfast 1 egg or ¼ cup egg substitute

> 1 slice toast

> 1 tsp Light Margarine

> ½ cup melon

> 6 oz ( ¾ cup) skim milk

>

> Lunch 2 oz ( ½ cup ) tuna

> 1 tsp light mayonnaise

> ½ cup grapes

> 4 oz ( ½ cup) light yogurt

> 6 low fat crackers

> ¼ cup green beans

>

> Dinner 2 oz tender chicken breast

> ½ cup steamed asparagus

> ½ cup pasta with tomato sauce

> 4 oz ( ½ cup) skim milk

>

>

>

>

>

>

>

> IMPORTANT NOTICE: This communication, including any attachment,

contains

> information that may be confidential or privileged, and is intended

solely

> for the entity or individual to whom it is addressed. If you are

not the

> intended recipient, you should contact the sender and delete the

message.

> Any unauthorized disclosure, copying, or distribution of this

message is

> strictly prohibited. Nothing in this email, including any

attachment, is

> intended to be a legally binding signature.

>

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I agree with the beverage (never drink w/ meals!) and the portion sizes. Depending which adjustment the patient is on, the portions below are too large. A patient with a lap band, and their adjustments, cannot eat all of that - at least our patients can't! Most patients can only have 1/2 cup or less TOTAL per meal if they are keeping up w/ adjustments.

Also, be sure to emphasize that the toast be "toasted" and not fresh, spongy bread, which can cause toleration issues.

-------------- Original message -------------- From: "Laschkwitsch, :LPH Obes Inst" <KLaschke@...>

We discourage drinking with meals for lap-band patients so I would take out the milk. My experience with lap band is that patient's portions vary widely!!! So I would either do away with some of the portion sizes or I would make a note that the patient may not be able to eat the portions listed. otherwise the menu looks good!

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of alyssabixlerSent: Tuesday, March 27, 2007 12:26 PM Subject: lap band post op diet

I'm working on a sample menu for lap bands for 2 months post op and beyond. Does anyone have any input for the menu below. I am new to lap bands and would welcome any ideas. Thanks!Alyssa RDBreakfast 1 egg or ¼ cup egg substitute1 slice toast1 tsp Light Margarine½ cup melon6 oz ( ¾ cup) skim milk Lunch 2 oz ( ½ cup ) tuna1 tsp light mayonnaise½ cup grapes4 oz ( ½ cup) light yogurt6 low fat crackers¼ cup green beansDinner 2 oz tender chicken breast½ cup steamed asparagus½ cup pasta with tomato sauce4 oz ( ½ cup) skim milk

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

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How do you teach your patients to measure their food for things such as fresh fruit, bread, crackers, etc? I get a lot of resistence from patients who do not want to take the time. I always tell them that if their portion sizes are too large, their weight loss will be suboptimal and they may forfeit a band adjustment if the surgeon is told they are only eating 4 oz. when they actually are eating more like 6-8 oz. Thank you Beth Taschuk RD kgleon@... wrote:

I agree with the beverage (never drink w/ meals!) and the portion sizes. Depending which adjustment the patient is on, the portions below are too large. A patient with a lap band, and their adjustments, cannot eat all of that - at least our patients can't! Most patients can only have 1/2 cup or less TOTAL per meal if they are keeping up w/ adjustments. Also, be sure to emphasize that the toast be "toasted" and not fresh, spongy bread, which can cause toleration issues. -------------- Original message -------------- From: "Laschkwitsch, :LPH Obes Inst" <KLaschkeLHS (DOT) ORG> We discourage drinking with meals for lap-band patients so I would take out the milk. My experience with

lap band is that patient's portions vary widely!!! So I would either do away with some of the portion sizes or I would make a note that the patient may not be able to eat the portions listed. otherwise the menu looks good! Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135 -----Original Message-----From: [mailto: ]On Behalf Of alyssabixlerSent: Tuesday, March 27, 2007 12:26 PM Subject: lap band post

op diet I'm working on a sample menu for lap bands for 2 months post op and beyond. Does anyone have any input for the menu below. I am new to lap bands and would welcome any ideas. Thanks!Alyssa RDBreakfast 1 egg or ¼ cup egg substitute1 slice toast1 tsp Light Margarine½ cup melon6 oz ( ¾ cup) skim milk Lunch 2 oz ( ½ cup ) tuna1 tsp light mayonnaise½ cup grapes4 oz ( ½ cup) light yogurt6 low fat crackers¼ cup green beansDinner 2 oz tender chicken breast½ cup steamed asparagus½ cup pasta with tomato sauce4 oz ( ½ cup) skim milk IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is

addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

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I may take a different approach than most of you but I do not advocate measuring all the time, we spend a lot of time talking about awareness of body signals, when a person's hunger is gone they are done (not full, not stuffed). The reason is two fold....1 cup of soup vs 1 cup of meat is not the same to a band patient so sticking with a certain measurement is not going to workout and often confuses them. Also we are not just helping them to optimize their weight loss but to learn to live differently so that they can maintain their weight loss, they need to be able to maintain any changes they make to lose weight....how practical is it that they will always measure their food? Could you do that always and forever? I do encourage them to occasionally measure to have a good idea of what they can eat and as often as possible to use dishes that match what they can eat but they also need to learn to trust their body and be able to do so no matter what situation they are in.....JUST my two cents.

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of Beth TaschukSent: Wednesday, March 28, 2007 5:39 AM Subject: RE: lap band post op diet

How do you teach your patients to measure their food for things such as fresh fruit, bread, crackers, etc? I get a lot of resistence from patients who do not want to take the time. I always tell them that if their portion sizes are too large, their weight loss will be suboptimal and they may forfeit a band adjustment if the surgeon is told they are only eating 4 oz. when they actually are eating more like 6-8 oz.

Thank you

Beth Taschuk RD kgleoncomcast (DOT) net wrote:

I agree with the beverage (never drink w/ meals!) and the portion sizes. Depending which adjustment the patient is on, the portions below are too large. A patient with a lap band, and their adjustments, cannot eat all of that - at least our patients can't! Most patients can only have 1/2 cup or less TOTAL per meal if they are keeping up w/ adjustments.

Also, be sure to emphasize that the toast be "toasted" and not fresh, spongy bread, which can cause toleration issues.

-------------- Original message -------------- From: "Laschkwitsch, :LPH Obes Inst" <KLaschkeLHS (DOT) ORG>

We discourage drinking with meals for lap-band patients so I would take out the milk. My experience with lap band is that patient's portions vary widely!!! So I would either do away with some of the portion sizes or I would make a note that the patient may not be able to eat the portions listed. otherwise the menu looks good!

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of alyssabixlerSent: Tuesday, March 27, 2007 12:26 PM Subject: lap band post op diet

I'm working on a sample menu for lap bands for 2 months post op and beyond. Does anyone have any input for the menu below. I am new to lap bands and would welcome any ideas. Thanks!Alyssa RDBreakfast 1 egg or ¼ cup egg substitute1 slice toast1 tsp Light Margarine½ cup melon6 oz ( ¾ cup) skim milk Lunch 2 oz ( ½ cup ) tuna1 tsp light mayonnaise½ cup grapes4 oz ( ½ cup) light yogurt6 low fat crackers¼ cup green beansDinner 2 oz tender chicken breast½ cup steamed asparagus½ cup pasta with tomato sauce4 oz ( ½ cup) skim milk

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

Sucker-punch spam with award-winning protection.Try the free Beta.

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

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I agree 1000%. I think we do a diservice to our patients if we do not teach

them how to deal with food normally instead of continuing the cycle of diet

thinking patterns and approaches. I find that my patients respond incredibly to

this approach and are relieved to not have to be that kind of obsessed anymore.

They then are willing to keep a useful food journal when helpful for the right

reasons.

My surgeons don't ask about actual food volumes but rely more on info about what

kinds of foods they tolerate and amounts of the more difficult foods to gauge

the level of restriction they have. We spend a lot of time discussing the

pitfalls of thinking they have good food tolerance when they are in fact eating

soft mushy foods to avoid the discomfort of the restriction they are actually

seeking!

Diane Olson MS RD CDE

UW Health Bariatric Surgery Program

University of WIsconsin Hospital and Clinics

________________________________

From: on behalf of Laschkwitsch,

:LPH Obes Inst

Sent: Wed 3/28/2007 10:39 AM

Subject: RE: lap band post op diet

I may take a different approach than most of you but I do not advocate measuring

all the time, we spend a lot of time talking about awareness of body signals,

when a person's hunger is gone they are done (not full, not stuffed). The

reason is two fold....1 cup of soup vs 1 cup of meat is not the same to a band

patient so sticking with a certain measurement is not going to workout and often

confuses them. Also we are not just helping them to optimize their weight loss

but to learn to live differently so that they can maintain their weight loss,

they need to be able to maintain any changes they make to lose weight....how

practical is it that they will always measure their food? Could you do that

always and forever? I do encourage them to occasionally measure to have a

good idea of what they can eat and as often as possible to use dishes that match

what they can eat but they also need to learn to trust their body and be able to

do so no matter what situation they are in.....JUST my two cents.

Laschkewitsch RD LD

Dietitian, Legacy Obesity Institute

(503) 413-8135

RE: lap band post op diet

How do you teach your patients to measure their food for things such as fresh

fruit, bread, crackers, etc? I get a lot of resistence from patients who do not

want to take the time. I always tell them that if their portion sizes are too

large, their weight loss will be suboptimal and they may forfeit a band

adjustment if the surgeon is told they are only eating 4 oz. when they actually

are eating more like 6-8 oz.

Thank you

Beth Taschuk RD

kgleon@... wrote:

I agree with the beverage (never drink w/ meals!) and the portion sizes.

Depending which adjustment the patient is on, the portions below are too large.

A patient with a lap band, and their adjustments, cannot eat all of that - at

least our patients can't! Most patients can only have 1/2 cup or less TOTAL per

meal if they are keeping up w/ adjustments.

Also, be sure to emphasize that the toast be " toasted " and not fresh, spongy

bread, which can cause toleration issues.

--------- lap band post op diet

I'm working on a sample menu for lap bands for 2 months post op and

beyond. Does anyone have any input for the menu below. I am new to

lap bands and would welcome any ideas.

Thanks!

Alyssa RD

Breakfast 1 egg or ¼ cup egg substitute

1 slice toast

1 tsp Light Margarine

½ cup melon

6 oz ( ¾ cup) skim milk

Lunch 2 oz ( ½ cup ) tuna

1 tsp light mayonnaise

½ cup grapes

4 oz ( ½ cup) light yogurt

6 low fat crackers

¼ cup green beans

Dinner 2 oz tender chicken breast

½ cup steamed asparagus

½ cup pasta with tomato sauce

4 oz ( ½ cup) skim milk

IMPORTANT NOTICE: This communication, including any attachment, contains

information that may be confidential or privileged, and is intended solely for

the entity or individual to whom it is addressed. If you are not the intended

recipient, you should contact the sender and delete the message. Any

unauthorized disclosure, copying, or distribution of this message is strictly

prohibited. Nothing in this email, including any attachment, is intended to be a

legally binding signature.

________________________________

Sucker-punch spam

<http://us.rd./evt=49981/*http://advision.webevents./mailbeta/\

features_spam.html> with award-winning protection.

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IMPORTANT NOTICE: This communication, including any attachment, contains

information that may be confidential or privileged, and is intended solely for

the entity or individual to whom it is addressed. If you are not the intended

recipient, you should contact the sender and delete the message. Any

unauthorized disclosure, copying, or distribution of this message is strictly

prohibited. Nothing in this email, including any attachment, is intended to be a

legally binding signature.

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I agree 1000%. I think we do a diservice to our patients if we do not teach

them how to deal with food normally instead of continuing the cycle of diet

thinking patterns and approaches. I find that my patients respond incredibly to

this approach and are relieved to not have to be that kind of obsessed anymore.

They then are willing to keep a useful food journal when helpful for the right

reasons.

My surgeons don't ask about actual food volumes but rely more on info about what

kinds of foods they tolerate and amounts of the more difficult foods to gauge

the level of restriction they have. We spend a lot of time discussing the

pitfalls of thinking they have good food tolerance when they are in fact eating

soft mushy foods to avoid the discomfort of the restriction they are actually

seeking!

Diane Olson MS RD CDE

UW Health Bariatric Surgery Program

University of WIsconsin Hospital and Clinics

________________________________

From: on behalf of Laschkwitsch,

:LPH Obes Inst

Sent: Wed 3/28/2007 10:39 AM

Subject: RE: lap band post op diet

I may take a different approach than most of you but I do not advocate measuring

all the time, we spend a lot of time talking about awareness of body signals,

when a person's hunger is gone they are done (not full, not stuffed). The

reason is two fold....1 cup of soup vs 1 cup of meat is not the same to a band

patient so sticking with a certain measurement is not going to workout and often

confuses them. Also we are not just helping them to optimize their weight loss

but to learn to live differently so that they can maintain their weight loss,

they need to be able to maintain any changes they make to lose weight....how

practical is it that they will always measure their food? Could you do that

always and forever? I do encourage them to occasionally measure to have a

good idea of what they can eat and as often as possible to use dishes that match

what they can eat but they also need to learn to trust their body and be able to

do so no matter what situation they are in.....JUST my two cents.

Laschkewitsch RD LD

Dietitian, Legacy Obesity Institute

(503) 413-8135

RE: lap band post op diet

How do you teach your patients to measure their food for things such as fresh

fruit, bread, crackers, etc? I get a lot of resistence from patients who do not

want to take the time. I always tell them that if their portion sizes are too

large, their weight loss will be suboptimal and they may forfeit a band

adjustment if the surgeon is told they are only eating 4 oz. when they actually

are eating more like 6-8 oz.

Thank you

Beth Taschuk RD

kgleon@... wrote:

I agree with the beverage (never drink w/ meals!) and the portion sizes.

Depending which adjustment the patient is on, the portions below are too large.

A patient with a lap band, and their adjustments, cannot eat all of that - at

least our patients can't! Most patients can only have 1/2 cup or less TOTAL per

meal if they are keeping up w/ adjustments.

Also, be sure to emphasize that the toast be " toasted " and not fresh, spongy

bread, which can cause toleration issues.

--------- lap band post op diet

I'm working on a sample menu for lap bands for 2 months post op and

beyond. Does anyone have any input for the menu below. I am new to

lap bands and would welcome any ideas.

Thanks!

Alyssa RD

Breakfast 1 egg or ¼ cup egg substitute

1 slice toast

1 tsp Light Margarine

½ cup melon

6 oz ( ¾ cup) skim milk

Lunch 2 oz ( ½ cup ) tuna

1 tsp light mayonnaise

½ cup grapes

4 oz ( ½ cup) light yogurt

6 low fat crackers

¼ cup green beans

Dinner 2 oz tender chicken breast

½ cup steamed asparagus

½ cup pasta with tomato sauce

4 oz ( ½ cup) skim milk

IMPORTANT NOTICE: This communication, including any attachment, contains

information that may be confidential or privileged, and is intended solely for

the entity or individual to whom it is addressed. If you are not the intended

recipient, you should contact the sender and delete the message. Any

unauthorized disclosure, copying, or distribution of this message is strictly

prohibited. Nothing in this email, including any attachment, is intended to be a

legally binding signature.

________________________________

Sucker-punch spam

<http://us.rd./evt=49981/*http://advision.webevents./mailbeta/\

features_spam.html> with award-winning protection.

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<http://us.rd./evt=49981/*http://advision.webevents./mailbeta/\

features_spam.html>

IMPORTANT NOTICE: This communication, including any attachment, contains

information that may be confidential or privileged, and is intended solely for

the entity or individual to whom it is addressed. If you are not the intended

recipient, you should contact the sender and delete the message. Any

unauthorized disclosure, copying, or distribution of this message is strictly

prohibited. Nothing in this email, including any attachment, is intended to be a

legally binding signature.

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Beth,

An alternative to those patients who are

resistant towards measuring their portions is to focus on type of food at each

meal. I have seen more success with teaching the band patients on how to

combine lean protein and high fiber complex carbohydrates at meals in addition

to eating adequate meals during the day then focusing on portion size.  If they include these types of foods with appropriate

timing of meals they will see results with fullness/satiety, feel like they

have control with less hunger and less resistance with dietary recommendations..Of course, exercise is included in these recommendations.  We have our band patients bring in food

diaries, exercise logs and meet with me to evaluate if they need a band

adjustment or focus on behavior changes.

Beth Whelan, MS,RD,LD

Outpatient Dietitian

Harbin Clinic

office: (706) 378-8163

fax: (706) 238-8037

From:

[mailto: ]

On Behalf Of Beth Taschuk

Sent: Wednesday, March 28, 2007

8:39 AM

Subject: RE:

lap band post op diet

How do you teach your patients to measure their food for things such as

fresh fruit, bread, crackers, etc? I get a lot of resistence from

patients who do not want to take the time. I always tell them that

if their portion sizes are too large, their weight loss will be suboptimal

and they may forfeit a band adjustment if the surgeon is told they

are only eating 4 oz. when they actually are eating more like 6-8 oz.

Thank you

Beth Taschuk RD

kgleoncomcast (DOT) net

wrote:

I agree with the beverage (never drink w/ meals!) and the portion

sizes. Depending which adjustment the patient is on, the portions below

are too large. A patient with a lap band, and

their adjustments, cannot eat all of that - at least our patients

can't! Most patients can only have 1/2 cup or less TOTAL per meal if they

are keeping up w/ adjustments.

Also, be sure to emphasize that the toast be " toasted " and

not fresh, spongy bread, which can cause toleration issues.

--------- [bariatricNutritionDietitian

s] lap band post op diet

I'm working on a sample

menu for lap bands for 2 months post op and

beyond. Does anyone have any input for the menu below. I am new to

lap bands and would welcome any ideas.

Thanks!

Alyssa RD

Breakfast 1 egg or ¼ cup egg substitute

1 slice toast

1 tsp Light Margarine

½ cup melon

6 oz ( ¾ cup) skim milk

Lunch 2 oz ( ½ cup ) tuna

1 tsp light mayonnaise

½ cup grapes

4 oz ( ½ cup) light yogurt

6 low fat crackers

¼ cup green beans

Dinner 2 oz tender chicken breast

½ cup steamed asparagus

½ cup pasta with tomato sauce

4 oz ( ½ cup) skim milk

IMPORTANT NOTICE: This

communication, including any attachment, contains information that may be

confidential or privileged, and is intended solely for the entity or individual

to whom i t is addressed. If you are not the intended recipient, you should

contact the sender and delete the message. Any unauthorized disclosure,

copying, or distribution of this message is strictly prohibited. Nothing in

this email, including any attachment, is intended to be a legally binding

signature.

 

Sucker-punch

spam with award-winning protection.

Try the free

Beta.

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Thank you Diane......I appreciate everyone's approach. Does anyone recall the handout in the files section that outlines partnering protein and fiber rich foods? I remember reading on the listserve there was a handout available in the files section but was unsuccessful in locating it. Thank you to all Beth Taschuk RD"Olson Diane L." <dolson3@...> wrote: I agree 1000%. I think we do a diservice to our patients if we do not teach them how to deal

with food normally instead of continuing the cycle of diet thinking patterns and approaches. I find that my patients respond incredibly to this approach and are relieved to not have to be that kind of obsessed anymore. They then are willing to keep a useful food journal when helpful for the right reasons. My surgeons don't ask about actual food volumes but rely more on info about what kinds of foods they tolerate and amounts of the more difficult foods to gauge the level of restriction they have. We spend a lot of time discussing the pitfalls of thinking they have good food tolerance when they are in fact eating soft mushy foods to avoid the discomfort of the restriction they are actually seeking!Diane Olson MS RD CDEUW Health Bariatric Surgery Program University of WIsconsin Hospital and Clinics________________________________From: on behalf of Laschkwitsch, :LPH Obes InstSent: Wed 3/28/2007 10:39 AM Subject: RE: lap band post op dietI may take a different approach than most of you but I do not advocate measuring all the time, we spend a lot of time talking about awareness of body signals, when a person's hunger is gone they are done (not full, not stuffed). The reason is two fold....1 cup of soup vs 1 cup of meat is not the same to a band patient so sticking with a certain measurement is not going to workout and often confuses them. Also we are not just helping them to optimize their weight loss but to learn to live differently so that they can maintain their weight loss, they need to be

able to maintain any changes they make to lose weight....how practical is it that they will always measure their food? Could you do that always and forever? I do encourage them to occasionally measure to have a good idea of what they can eat and as often as possible to use dishes that match what they can eat but they also need to learn to trust their body and be able to do so no matter what situation they are in.....JUST my two cents. Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135 -----Original Message-----From: [mailto: ]On Behalf Of Beth TaschukSent: Wednesday, March 28, 2007 5:39 AM Subject: RE: lap band post op dietHow do you teach your patients to measure their food for things such as fresh fruit, bread, crackers, etc? I get a lot of resistence from patients who do not want to take the time. I always tell them that if their portion sizes are too large, their weight loss will be suboptimal and they may forfeit a band adjustment if the surgeon is told they are only eating 4 oz. when they actually are eating more like 6-8 oz.Thank youBeth Taschuk RD kgleoncomcast (DOT) net wrote:I agree with the beverage (never drink w/ meals!) and the portion sizes. Depending which adjustment the patient is on, the portions below are too large. A patient with a lap band, and their adjustments, cannot eat all of that - at least our

patients can't! Most patients can only have 1/2 cup or less TOTAL per meal if they are keeping up w/ adjustments. Also, be sure to emphasize that the toast be "toasted" and not fresh, spongy bread, which can cause toleration issues.-------------- Original message -------------- From: "Laschkwitsch, :LPH Obes Inst" <KLaschkeLHS (DOT) ORG> We discourage drinking with meals for lap-band patients so I would take out the milk. My experience with lap band is that patient's portions vary widely!!! So I would either do away with some of the portion sizes or I would make a note that the patient may not be able to eat the portions listed. otherwise the menu looks good! Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135 -----Original Message-----From: [mailto: ]On Behalf Of alyssabixlerSent: Tuesday, March 27, 2007 12:26 PM Subject: lap band post op dietI'm working on a sample menu for lap bands for 2 months post op and beyond. Does anyone have any input for the menu below. I am new to lap bands and would welcome any ideas. Thanks!Alyssa RDBreakfast 1 egg or ¼ cup egg substitute1 slice toast1 tsp Light Margarine½ cup melon6 oz ( ¾ cup) skim milk Lunch 2 oz ( ½ cup ) tuna1 tsp light mayonnaise½ cup grapes4 oz ( ½ cup) light

yogurt6 low fat crackers¼ cup green beansDinner 2 oz tender chicken breast½ cup steamed asparagus½ cup pasta with tomato sauce4 oz ( ½ cup) skim milkIMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.________________________________Sucker-punch spam <http://us.rd./evt=49981/*http://advision.webevents./mailbeta/features_spam.html> with award-winning protection.Try the free Beta. <http://us.rd./evt=49981/*http://advision.webevents./mailbeta/features_spam.html> IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this

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Guest guest

Thanks for everyone's feed back.

I generally do have the philosophy of encouraging patients to listen

to their hunger and fullness cues and think that is very valuable.

With the sample menu what I did want to do is give patients an idea

of what to expect, encourage them to include a variety of food

groups, and demonstrate what that could look like. Do you use a

sample menu? Do you just list foods and not portion sizes? I'm just

curious how you communicate this philosophy while teaching these

other things?

Thanks!

Alyssa, RD

>

> I agree with the beverage (never drink w/ meals!) and the

portion sizes. Depending which adjustment the patient is on, the

portions below are too large. A patient with a lap band, and their

adjustments, cannot eat all of that - at least our patients can't!

Most patients can only have 1/2 cup or less TOTAL per meal if they

are keeping up w/ adjustments.

> Also, be sure to emphasize that the toast be " toasted " and

not fresh, spongy bread, which can cause toleration issues.

>

>

> --------- lap band post

op diet

>

>

> I'm working on a sample menu for lap bands for 2

months post op and

> beyond. Does anyone have any input for the menu

below. I am new to

> lap bands and would welcome any ideas.

> Thanks!

> Alyssa RD

>

> Breakfast 1 egg or ¼ cup egg substitute

> 1 slice toast

> 1 tsp Light Margarine

> ½ cup melon

> 6 oz ( ¾ cup) skim milk

>

> Lunch 2 oz ( ½ cup ) tuna

> 1 tsp light mayonnaise

> ½ cup grapes

> 4 oz ( ½ cup) light yogurt

> 6 low fat crackers

> ¼ cup green beans

>

> Dinner 2 oz tender chicken breast

> ½ cup steamed asparagus

> ½ cup pasta with tomato sauce

> 4 oz ( ½ cup) skim milk

>

>

>

>

>

> IMPORTANT NOTICE: This communication, including any

attachment, contains information that may be confidential or

privileged, and is intended solely for the entity or individual to

whom it is addressed. If you are not the intended recipient, you

should contact the sender and delete the message. Any unauthorized

disclosure, copying, or distribution of this message is strictly

prohibited. Nothing in this email, including any attachment, is

intended to be a legally binding signature.

>

>

> ________________________________

>

> Sucker-punch spam

<http://us.rd./evt=49981/*http://advision.webevents.

/mailbeta/features_spam.html> with award-winning protection.

> Try the free Beta.

<http://us.rd./evt=49981/*http://advision.webevents.

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>

>

>

>

>

> IMPORTANT NOTICE: This communication, including any attachment,

contains information that may be confidential or privileged, and is

intended solely for the entity or individual to whom it is addressed.

If you are not the intended recipient, you should contact the sender

and delete the message. Any unauthorized disclosure, copying, or

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Guest guest

I teach all patients the hunger scale to help them learn about hunger and

satiety and ways to differentiate between physical and emotional hunger. I use

the plate method to help them learn how to plan a healthy meal with good portion

sizes.

Post-op I help them learn how to eat in this healthy approach once they have

restriction and use their skills with the hunger scale to eat according to their

body signals with the band. I spend a lot of time on mindful eating to help

them with cravings and changing their relationship with treat foods (taboo

foods) and encourage them to move these foods from " staple " status to " treat "

status. I spend a lot of time identifying the pitfalls of American snacking

mentality and that snacks must fill a nutrition need or be a mindful, active

decision to have a treat.

Our Health Psychologist has this same approach as well and supplements these

approaches. We do most of this work pre-op to help them out of " diet

mentality " . I do provide a sample menu with meal examples that basically mirror

the plate method. I tend to list amounts of meat to encourage protein and them

list the other foods as parts of the meals. A resource you may find helpful is

this website from The Center For Mindful Eating. They have great resources.

http://www.tcme.org/

I hope this helps. Good luck.

Diane Olson MS, RD, CDE

UW Health Bariatric Surgery Program

(608) 265-1718

dl.olson@...

Re: lap band post op diet

Thanks for everyone's feed back.

I generally do have the philosophy of encouraging patients to listen

to their hunger and fullness cues and think that is very valuable.

With the sample menu what I did want to do is give patients an idea

of what to expect, encourage them to include a variety of food

groups, and demonstrate what that could look like. Do you use a

sample menu? Do you just list foods and not portion sizes? I'm just

curious how you communicate this philosophy while teaching these

other things?

Thanks!

Alyssa, RD

>

> I agree with the beverage (never drink w/ meals!) and the

portion sizes. Depending which adjustment the patient is on, the

portions below are too large. A patient with a lap band, and their

adjustments, cannot eat all of that - at least our patients can't!

Most patients can only have 1/2 cup or less TOTAL per meal if they

are keeping up w/ adjustments.

> Also, be sure to emphasize that the toast be " toasted " and

not fresh, spongy bread, which can cause toleration issues.

>

>

> --------- lap band post

op diet

>

>

> I'm working on a sample menu for lap bands for 2

months post op and

> beyond. Does anyone have any input for the menu

below. I am new to

> lap bands and would welcome any ideas.

> Thanks!

> Alyssa RD

>

> Breakfast 1 egg or ¼ cup egg substitute

> 1 slice toast

> 1 tsp Light Margarine

> ½ cup melon

> 6 oz ( ¾ cup) skim milk

>

> Lunch 2 oz ( ½ cup ) tuna

> 1 tsp light mayonnaise

> ½ cup grapes

> 4 oz ( ½ cup) light yogurt

> 6 low fat crackers

> ¼ cup green beans

>

> Dinner 2 oz tender chicken breast

> ½ cup steamed asparagus

> ½ cup pasta with tomato sauce

> 4 oz ( ½ cup) skim milk

>

>

>

>

>

> IMPORTANT NOTICE: This communication, including any

attachment, contains information that may be confidential or

privileged, and is intended solely for the entity or individual to

whom it is addressed. If you are not the intended recipient, you

should contact the sender and delete the message. Any unauthorized

disclosure, copying, or distribution of this message is strictly

prohibited. Nothing in this email, including any attachment, is

intended to be a legally binding signature.

>

>

> ________________________________

>

> Sucker-punch spam

<http://us.rd./evt=49981/*http://advision.webevents.

/mailbeta/features_spam.html> with award-winning protection.

> Try the free Beta.

<http://us.rd./evt=49981/*http://advision.webevents.

/mailbeta/features_spam.html>

>

>

>

>

>

>

> IMPORTANT NOTICE: This communication, including any attachment,

contains information that may be confidential or privileged, and is

intended solely for the entity or individual to whom it is addressed.

If you are not the intended recipient, you should contact the sender

and delete the message. Any unauthorized disclosure, copying, or

distribution of this message is strictly prohibited. Nothing in this

email, including any attachment, is intended to be a legally binding

signature.

>

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Guest guest

I think its important to have serving sizes on the menus. Of course

we want patients to respond to hunger and satiety cues, but we are

finding that people have strayed so far away from this way of eating

that they do not know what hunger feels like or fullness. These

people need to be reoriented to these feelings and in the meantime

they need to know approximately how much food is appropriate for

their pouch.

We have also found patients who have hit a plateau and when we stress

portion size in support group or follow up visits they get back on

track. I think it wouldn't kill people to take some time to actually

measure out things for a few days to get an idea of what the portions

look like, then they have a better idea and can eyeball their

portions after that.

We have such a skewed idea of portion sizes in this country its

important for patients to learn approximate portion sizes for

bariatric surgery and then to apply and adjust that to their specific

pouch.

Hickey, RD

> >

> > I agree with the beverage (never drink w/ meals!) and the

> portion sizes. Depending which adjustment the patient is on, the

> portions below are too large. A patient with a lap band, and their

> adjustments, cannot eat all of that - at least our patients can't!

> Most patients can only have 1/2 cup or less TOTAL per meal if they

> are keeping up w/ adjustments.

> > Also, be sure to emphasize that the toast be " toasted " and

> not fresh, spongy bread, which can cause toleration issues.

> >

> >

> > --------- lap band post

> op diet

> >

> >

> > I'm working on a sample menu for lap bands for 2

> months post op and

> > beyond. Does anyone have any input for the menu

> below. I am new to

> > lap bands and would welcome any ideas.

> > Thanks!

> > Alyssa RD

> >

> > Breakfast 1 egg or ¼ cup egg substitute

> > 1 slice toast

> > 1 tsp Light Margarine

> > ½ cup melon

> > 6 oz ( ¾ cup) skim milk

> >

> > Lunch 2 oz ( ½ cup ) tuna

> > 1 tsp light mayonnaise

> > ½ cup grapes

> > 4 oz ( ½ cup) light yogurt

> > 6 low fat crackers

> > ¼ cup green beans

> >

> > Dinner 2 oz tender chicken breast

> > ½ cup steamed asparagus

> > ½ cup pasta with tomato sauce

> > 4 oz ( ½ cup) skim milk

> >

> >

> >

> >

> >

> > IMPORTANT NOTICE: This communication, including any

> attachment, contains information that may be confidential or

> privileged, and is intended solely for the entity or individual to

> whom it is addressed. If you are not the intended recipient, you

> should contact the sender and delete the message. Any unauthorized

> disclosure, copying, or distribution of this message is strictly

> prohibited. Nothing in this email, including any attachment, is

> intended to be a legally binding signature.

> >

> >

> > ________________________________

> >

> > Sucker-punch spam

>

<http://us.rd./evt=49981/*http://advision.webevents.

> /mailbeta/features_spam.html> with award-winning protection.

> > Try the free Beta.

>

<http://us.rd./evt=49981/*http://advision.webevents.

> /mailbeta/features_spam.html>

> >

> >

> >

> >

> >

> >

> > IMPORTANT NOTICE: This communication, including any attachment,

> contains information that may be confidential or privileged, and is

> intended solely for the entity or individual to whom it is

addressed.

> If you are not the intended recipient, you should contact the

sender

> and delete the message. Any unauthorized disclosure, copying, or

> distribution of this message is strictly prohibited. Nothing in

this

> email, including any attachment, is intended to be a legally

binding

> signature.

> >

>

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Guest guest

for those of you working with lapband patients...do you use protein

drinks between meals to get protein needs met? what are your

recommendations for protein? do they change at certain points in

time? thank you for your input!

>

> I'm working on a sample menu for lap bands for 2 months post op and

> beyond. Does anyone have any input for the menu below. I am new

to

> lap bands and would welcome any ideas.

> Thanks!

> Alyssa RD

>

> Breakfast 1 egg or ¼ cup egg substitute

> 1 slice toast

> 1 tsp Light Margarine

> ½ cup melon

> 6 oz ( ¾ cup) skim milk

>

> Lunch 2 oz ( ½ cup ) tuna

> 1 tsp light mayonnaise

> ½ cup grapes

> 4 oz ( ½ cup) light yogurt

> 6 low fat crackers

> ¼ cup green beans

>

> Dinner 2 oz tender chicken breast

> ½ cup steamed asparagus

> ½ cup pasta with tomato sauce

> 4 oz ( ½ cup) skim milk

>

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