RE: Maintenance Recommendations

[Guest guest]

Patient probably should be expending more

energy via exercise. The National Wt Loss Registry (not specific for bariatric

surgery) shows that for successful maint. after loss, people engage in moderate

activity 60-90 minutes per day.

There is a pyramid posted in the files

section of this groups website which has protein as the base.

Pt definitely needs additional calcium

(citrate preferable), taken separately from prenatal

From:

[mailto: ]

On Behalf Of Margaret Pieper

Sent: Wednesday, February 28, 2007

3:52 PM

Bariatric Nutrition Dietitians

Subject:

Maintenance Recommendations

Hello. I'm new to the group. I work in a small community

which is home to a number of individuals who have undergone bariatric

surgeries. Patients have had different procedures performed at different

hospitals in larger communities. I joined the group so that I could gain

knowledge from dietitians who specialize in bariatric nutrition.

At issue currently: A patient 2-yr post Roux-en-Y is seeking help

to get back on track following an 8# weight gain. She takes a prenatal

vitamin with iron. Reports exercise goal of 30 minutes 4 days a

week. We've had an initial, brief encounter. I've asked that she

complete a food record for the next week and return for a more detailed

discussion.

I'm looking for information on maintenance recommendations, with some

specific questions as follows:

1. Multivitamin: Chewable or tablet? (seen differing opinions in

research)

2. Is prenatal + Fe adequate, or should additional calcium be

included?

3. Should calorie needs be based on new REE, or continue to be

restricted?

4. Should protein continue to be emphasized first, or now that pt

is a couple years post-surgery, should she be following more closely to general

MyPyramid recommendations?

Thank you for your help, and I apologize if you've gotten this question

on another list-serv.

Regards,

Margie Pieper

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