RE: Bariatric Advantage shakes

[Guest guest]

We follow the same protocol, although we do allow them to use other shakes as long as they are similar in content to the Bariatric Advantage shakes. We strongly recommend the BA (Bariatric Advantage) shakes, but try to be a little flexible if someone is really struggling with not liking them. In their pre-op education, I strongly emphasize the importance of shrinking the liver prior to surgery, so that they understand the "why" of what they are doing with the pre-op diet I also make sure I take time to explain that after surgery, shakes are an absolute necessity for the first 2 weeks in order to prevent complications with the band, as well as nutritional complications. I remind them that if for any reason (even taste aversion), they are unable to find a way to use the shakes correctly BEFORE surgery, that this will be a tremendous problem AFTER surgery. Helping them to see that the pre-op liquid diet is not just a hurdle to jump through to get surgery, but is a health and safety issue AFTER surgery seems to really help their attitude about it. I also make sure that I explain a bit about the ketogenic state that the diet produces and how it helps reduce appetite and cravings. I explain that any time they "cheat", they will kick themselves out of ketosis and will have to deal the appetite and cravings all over again. There was a really good webinar put on by Bariatric Advantage a few months ago about ketosis and the pre-op diet that made me realize that explaining this to patients can be helpful. It should still be in the archives on their website if you wanted to check it out. Kirkpatrick, RD, LD PS--We also require a 30-day pre-op diet for anyone with a BMI over 50, which includes 5 BA shakes, 1 BA bar, a 350-calorie healthy frozen entree, other calorie-free clear liquids, and up to 1-cup of fruit and 2-cups of veggies per day. This is actually the BA pre-op protocol that we began using in place of Opti-Fast, as we constantly had complaints about the price and the taste of the Opti-Fast. ----- Bariatric Advantage shakesDate: Thu, 17 May 2012 19:06:35 +0000 Hello everyone! I am new to the bariatric field and so I am trying to learn as much as I can right now. J I work as an outpatient RD at a bariatric clinic and we only see lap band patients. The 14 day pre op diet we have our patients follow is 5-6 of the Bariatric Shakes daily along with any SF clear liquid as long as they do not exceed 160 kcal total of these items. Obviously this diet is low kcal/high protein to shrink the liver prior to surgery. I was just curious as to what other facilities use as their pre op diet protocol. I’m finding some patients want to “bend” the rules a little when it comes to drinking the shakes and plus many of them just don’t like them. Any advice would be greatly appreciated! Thanks! Goodwin RD CDBariatric DietitianOffice of Dr. McEwenCommunity Bariatric SurgeonsT:(317)621-2500Fax(317)621-2503

____________________________________________________________53 Year Old Mom Looks 33The Stunning Results of Her Wrinkle Trick Has Botox Doctors Worriedconsumerproducts.com

[Guest guest]

Thanks this was helpful. In regards to your 30 day pre op diet for pt’s with BMI over 50 a few questions I have are: 1. Do you have a goal BMI they

need to get down to in order to proceed with surgery? 2. How do you track their compliance 3. How often do you have them come in for f/u?. Thanks again for all your help!!

Goodwin RD CD

From: [mailto: ]

On Behalf Of Kirkpatrick

Sent: Thursday, May 17, 2012 3:38 PM

Subject: Re: Bariatric Advantage shakes

We follow the same protocol, although we do allow them to use other shakes as long as they are similar in content to the Bariatric Advantage shakes. We strongly recommend the BA (Bariatric Advantage) shakes, but try to be a little flexible

if someone is really struggling with not liking them. In their pre-op education, I strongly emphasize the importance of shrinking the liver prior to surgery, so that they understand the " why " of what they are doing with the pre-op diet I also make sure I

take time to explain that after surgery, shakes are an absolute necessity for the first 2 weeks in order to prevent complications with the band, as well as nutritional complications. I remind them that if for any reason (even taste aversion), they are unable

to find a way to use the shakes correctly BEFORE surgery, that this will be a tremendous problem AFTER surgery. Helping them to see that the pre-op liquid diet is not just a hurdle to jump through to get surgery, but is a health and safety issue AFTER surgery

seems to really help their attitude about it. I also make sure that I explain a bit about the ketogenic state that the diet produces and how it helps reduce appetite and cravings. I explain that any time they " cheat " , they will kick themselves out of ketosis

and will have to deal the appetite and cravings all over again. There was a really good webinar put on by Bariatric Advantage a few months ago about ketosis and the pre-op diet that made me realize that explaining this to patients can be helpful. It should

still be in the archives on their website if you wanted to check it out.

Kirkpatrick, RD, LD

PS--We also require a 30-day pre-op diet for anyone with a BMI over 50, which includes 5 BA shakes, 1 BA bar, a 350-calorie healthy frozen entree, other calorie-free clear liquids, and up to 1-cup of fruit and 2-cups of veggies per day.

This is actually the BA pre-op protocol that we began using in place of Opti-Fast, as we constantly had complaints about the price and the taste of the Opti-Fast.

----- Bariatric Advantage shakes

Date: Thu, 17 May 2012 19:06:35 +0000

Hello everyone! I am new to the bariatric field and so I am trying to learn as much as I can right now.

J I work as an outpatient RD at a bariatric clinic and we only see lap band patients. The 14 day pre op diet we have our patients follow is 5-6 of the Bariatric Shakes daily along with any SF clear liquid as long

as they do not exceed 160 kcal total of these items. Obviously this diet is low kcal/high protein to shrink the liver prior to surgery. I was just curious as to what other facilities use as their pre op diet protocol. I’m finding some patients want to “bend”

the rules a little when it comes to drinking the shakes and plus many of them just don’t like them. Any advice would be greatly appreciated! Thanks!

Goodwin RD CD

Bariatric Dietitian

Office of Dr. McEwen

Community Bariatric Surgeons

T:(317)621-2500

Fax(317)621-2503

____________________________________________________________

53 Year Old Mom Looks 33

The Stunning Results of Her Wrinkle Trick Has Botox Doctors Worried

consumerproducts.com

[Guest guest]

We do not have a goal weight or BMI for them that is "standard". Our surgeon actually handles that part and it seems to be pretty subjective. As long as patients have lost at least 12 to 15 pounds, he goes ahead with surgery, although we have had people lose as much as 30 pounds during that time if they start out with BMI's nearer to 60. And I have to say, we have had people lose less than that and he has still gone forward, so I am not always sure what he is basing his decision on. :-) The surgeon sees the patient 1 week before surgery (3 weeks into the diet) for a weigh-in and follow-up, which is when he makes a final decision about surgery based on their progress. I typically call the patient at the 2-week mark to touch base and see how things are going. I tell them that they can expect a minimum of 3 to 4 pounds of weight loss per week and that if this is not happening, they should call ASAP. I also tell them that if they are following the diet correctly, this WILL happen. The diet is based on 1200 calories, and believe it or not, I often get calls from people saying that it is too much food and that they are having trouble getting all the shakes in. I honestly feel like we get better compliance with the 30-day plan than with the 14-day plan. I think there is something about being able to have the 300-calorie meal and the fruits and veggies that seems to help people relax. They are a lot less intimidated and anxious about it. That being said, there is really no way to prove that people are being 100% compliant. Kirkpatrick, RD, LDPlease note: message attachedFrom: "Goodwin, M" <ggoodwin@...>" " < >Subject: RE: Bariatric Advantage shakesDate: Thu, 17 May 2012 19:57:48 +0000

____________________________________________________________57-Year-Old Woman Look 27Local woman discovers wrinkle secret that has doctors angry.TheSmartStyleLiving.com

Thanks this was helpful. In regards to your 30 day pre op diet for pt’s with BMI over 50 a few questions I have are: 1. Do you have a goal BMI they

need to get down to in order to proceed with surgery? 2. How do you track their compliance 3. How often do you have them come in for f/u?. Thanks again for all your help!!

Goodwin RD CD

From: [mailto: ]

On Behalf Of Kirkpatrick

Sent: Thursday, May 17, 2012 3:38 PM

Subject: Re: Bariatric Advantage shakes

We follow the same protocol, although we do allow them to use other shakes as long as they are similar in content to the Bariatric Advantage shakes. We strongly recommend the BA (Bariatric Advantage) shakes, but try to be a little flexible

if someone is really struggling with not liking them. In their pre-op education, I strongly emphasize the importance of shrinking the liver prior to surgery, so that they understand the " why " of what they are doing with the pre-op diet I also make sure I

take time to explain that after surgery, shakes are an absolute necessity for the first 2 weeks in order to prevent complications with the band, as well as nutritional complications. I remind them that if for any reason (even taste aversion), they are unable

to find a way to use the shakes correctly BEFORE surgery, that this will be a tremendous problem AFTER surgery. Helping them to see that the pre-op liquid diet is not just a hurdle to jump through to get surgery, but is a health and safety issue AFTER surgery

seems to really help their attitude about it. I also make sure that I explain a bit about the ketogenic state that the diet produces and how it helps reduce appetite and cravings. I explain that any time they " cheat " , they will kick themselves out of ketosis

and will have to deal the appetite and cravings all over again. There was a really good webinar put on by Bariatric Advantage a few months ago about ketosis and the pre-op diet that made me realize that explaining this to patients can be helpful. It should

still be in the archives on their website if you wanted to check it out.

Kirkpatrick, RD, LD

PS--We also require a 30-day pre-op diet for anyone with a BMI over 50, which includes 5 BA shakes, 1 BA bar, a 350-calorie healthy frozen entree, other calorie-free clear liquids, and up to 1-cup of fruit and 2-cups of veggies per day.

This is actually the BA pre-op protocol that we began using in place of Opti-Fast, as we constantly had complaints about the price and the taste of the Opti-Fast.

----- Bariatric Advantage shakes

Date: Thu, 17 May 2012 19:06:35 +0000

Hello everyone! I am new to the bariatric field and so I am trying to learn as much as I can right now.

J I work as an outpatient RD at a bariatric clinic and we only see lap band patients. The 14 day pre op diet we have our patients follow is 5-6 of the Bariatric Shakes daily along with any SF clear liquid as long

as they do not exceed 160 kcal total of these items. Obviously this diet is low kcal/high protein to shrink the liver prior to surgery. I was just curious as to what other facilities use as their pre op diet protocol. I’m finding some patients want to “bend”

the rules a little when it comes to drinking the shakes and plus many of them just don’t like them. Any advice would be greatly appreciated! Thanks!

Goodwin RD CD

Bariatric Dietitian

Office of Dr. McEwen

Community Bariatric Surgeons

T:(317)621-2500

Fax(317)621-2503

____________________________________________________________

53 Year Old Mom Looks 33

The Stunning Results of Her Wrinkle Trick Has Botox Doctors Worried

consumerproducts.com