3 year post gastric bypass

[Guest guest]

I do not work with bariatric pts regularly so I need some advice.

I have a pt coming in this week for diabetes and what I know is:

he is 3 years post gastric bypass. States he did not have any nutrition counseling before or after surgery. He lost 130# but has since gained back 30#. He is taking multivitamin with mineral, B12- 1000 mcg, ferrous sulfate-325 mg and folic acid-1mg. He states he was not supplementing at all after surgery and has only begun these supplements in the last year.

Review of his diet indicates he is eating soft, soupy foods such as soup and stew which he decribes as "soupy". He eats rice and other starches. He drinks a lot of liquids with his meals.

He states he is now able to eat large quantities of foods with no problem.

He has diabetes, with hypoglycemia even when not on diabetes meds.

Should he be consuming more solid foods, less watery foods? Should he be consuming liquids with meals or not?

What about his supplements?

He appears pretty motivated to resume his wt loss and is eager to know what he should do at this point.

Thanks for any input anyone can offer.

Michele , RD, CDE