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Vitamins and Bariatric Surgery: What To Know

Bariatric surgery is a weight loss procedure that works by limiting the amount of food the stomach can hold, causing malabsorption of nutrients or a combination of both. While these procedures will cause the weight to be lost, they are not a cure for obesity. In order for the weight loss to be successful over the long-term, a patient will need to follow diet guidelines, as well as adhere to lifestyle changes.

One of the postoperative requirements is daily vitamins. Below are some of the most important vitamins for long-term weight loss success after a bariatric weight loss procedure.

Multivitamin

Following bariatric surgery, you will need to take a multivitamin for the rest of your life. This multivitamin should include iron, folic acid, selenium, copper and zinc. In the months directly following the surgery, these multivitamins will be chewable.

Calcium

The daily calcium intake post-bariatric surgery will help to prevent bone disease and calcium deficiency. In some cases, the calcium doses will need to be spread throughout the day to enhance the absorption. The daily calcium intake will need to be between 1,200 and 2,000 mg, so breaking this into 500 or 600 mg doses can be helpful.

Vitamin D

The recommended daily dosage of Vitamin D for post-bariatric surgery patients is 800 to 1,000 international units. This should be split into two daily doses and should be taken with the calcium daily. You may also substitute a calcium-vitamin D supplement to avoid multiple pills everyday.

Iron and Folic Acid

Your dietitian may also recommend additional iron and folic acid supplements. For females that are still menstruating, it is particularly popular for a dietitian to suggest this additional vitamin intake.

Vitamin B12

One very common deficiency following bariatric surgery is vitamin B12. For this reason, it is recommended to have a B12 injection every other month following bariatric surgery to ensure adequate vitamin levels.

The goal of the daily vitamins is to prevent nutrient deficiencies. While bariatric surgery will cause weight loss, sticking to the postoperative regiment suggested by your dietitian is the best way to ensure the weight stays off.

If you are interested in learning more about bariatric surgery, contact us at Nanticoke Weight Loss and General Surgery.

Sneaky Ways to Lose Weight Without Even Trying

For many, losing weight is easier said than done. There are so many different diets available that it can be hard for the 66% of Americans who are on a diet to choose which one works the best for them.

However, to achieve their weight loss goals, it is crucial for dieters to adopt a healthy lifestyle instead of only a change in diet. This is because the best way you to lose weight sustainably is to make a complete lifestyle change, rather than a temporary switch (like eliminating fatty food from your diet for a few months or so).

But some dieters are apprehensive to make an overhaul in their lifestyle. They often believe this dramatic change is just too hard to maintain. This is simply untrue. It’s a lot easier to accomplish than you might think. These tips and tricks will help you lose weight in no time at all:

    • Try to get moving as often as possible
      No, we don’t necessarily mean get up and run a marathon every day. Instead, just try to fit in a couple extra “healthy steps” – whether it is parking your car farther away from a building entrance, walking in place during television commercials, or taking a walk around the block on your lunch break. Everything counts! Soon, it will become a habit for you and you won’t even notice all the extra activity.

 

    • Keep the food away from the television
      It is all too easy to overeat when you’re doing a mindless activity like watching TV or scrolling on your laptop. If you’re going to eat while you watch or scroll, then make sure to measure out your portions before you sit down. Ideally, you should make meals your main activity, rather than using your food as a way to accompany other things.

 

    • Keep your goals short term
      If you concentrate too much on one large goal, it can be all too easy to give up when you aren’t seeing results right away. So keep your goals simple and reset them every six months to amp up your inspiration. Instead of setting goals that feel out of reach, set smaller, realistic ones that will give you a sense of accomplishment and will encourage you to keep moving forward.

 

  • Don’t concentrate on fad diets
    As we mentioned before, the only way to have a truly healthy lifestyle is to combine healthy foods and exercise to meet your goals. This means you should stay away from fad diets that promise results right away. You will need something that is much more sustainable and designed to benefit you in the long run.

Nanticoke Weight Loss provides several useful tips and tricks to help you achieve a healthy lifestyle. Keep an eye out for our next blog which will give you more inspiration!

4 Reasons to Consider Visiting a Weight Loss Surgery Center

weight loss surgery centerWeight loss isn’t always an easy journey, but it is a long one. Whether you opt for gastric sleeve surgery or choose a non-surgical plan, the road is sure to come with its fair share of challenges. That being said, every journey begins for a reason.

If you haven’t considered your “why” yet, you may want to reevaluate your plan. If you’re looking for a new option, here are a few good reasons to consider visiting a weight loss surgery center.

Nothing Else Works
For most people, weight loss procedures like gastric bypass surgery and other forms of bariatric surgery are used as a last resort. Traditional methods of weight loss such as exercise combined with a healthy diet and adequate sleep may not be enough for you. If this is the case and you’ve exhausted all other medical weight loss clinic options, surgery could be the solution you’ve been looking for.

Surgery Is Medically Necessary
Unfortunately, weight loss surgery might not be a voluntary choice for some patients. If a patient’s weight poses legitimate medical threats to their health, weight loss surgery centers may be the safest route to go.

Desire for a Permanent Solution
Bariatric surgery is not a cosmetic procedure. While operations like liposuction and tummy tucks tackle the outer layers of fat, weight loss surgery is only for those looking into a permanent solution to a medical issue they’re living with. As such, a weight loss surgeon will likely ask you what your motivations are for opting into a surgical procedure.

Looking for a Healthier Life
Operations like gastric sleeve surgery reduce the size of the stomach by almost 80% in some cases. This ensures a permanent lifestyle change, which is often the goal of patients. While simple eating less isn’t a permanent solution, it can work in conjunction with a doctor-approved diet and effectively help change a person’s lifestyle.

Weight loss surgery isn’t the only weight loss option out there. In fact, as previously stated, it’s often a last resort for patients. But there are good reasons to consider it. If you’re ready to discuss weight loss surgery, visit Nanticoke Weight Loss & General Surgery or call the office at 302-536-5395 today!

Listening to Your Gut Feeling: The Scoop on Fiber

While most know that fiber is beneficial for healthy digestion, many often miss the other benefits of fiber and why it is such an important part of a healthy diet. How is it that something that we don’t even digest can help to keep us healthy? Let’s take a look.

Fiber is actually the part of the plant that we cannot break down, digest, and use for energy. There are lots of different types of fiber, many of which you might have heard of. Starch, bulk, roughage, pectins, and others are often used interchangeably with the word fiber. However, all of the different types of fibers can be classified into two groups: soluble and insoluble. Soluble fibers dissolve in water (hence the soluble part) and form a gel. Insoluble fibers do not do this. Instead they aid in the movement of materials through the intestinal tract. Both are an important part of our intestinal and overall health.

Fiber is primarily found in plants, therefore fruits, vegetables, grains, and beans are great sources. Other foods such as meats, dairy, refined grains, and many processed foods are low in fiber. Look on the Nutrition Facts Panel to see just how much fiber your foods contain. It is recommended that men get 30-38 grams of fiber per day and women get 21-25 grams of fiber. There are fiber supplements, but these are mostly soluble fibers only. Check out the label to make sure you know what’s in your supplement.

Fiber is best known for keeping us all regular. Regular bowel movements are of course a healthy part of life, but fiber is more helpful than that! A high fiber diet can help manage irritable bowel disease and some studies have shown a relationship between high fiber and lower risks of certain cancers. Did you know that fiber helps us feel full, so we’re less likely to overeat during and in between meals? It does this by slowing down contents in our intestines so we feel fuller for a longer period of time.  Fiber has also been shown to better control blood sugar in those with diabetes. Better blood sugar control can mean less insulin and fewer long term consequences of diabetes. Fiber also helps to protect against heart disease, which is the #1 cause of the most fatalities in the United States. Soluble fiber binds to cholesterol (in the form of bile) and carries it out of the body, therefore reducing the amount of overall cholesterol.

In order to keep our intestines happy and our bodies healthy, include fiber into each meal of your day. Remember to start slowly and include adequate fluids throughout the day. Eating a lot of fiber without enough fluids can actually cause more stomach upset than relief. It is best to start slowly by adding a few new high fiber foods per day. Start adding small portions of things like fresh fruits or nuts or seeds to your meals. Then take a look at your cereals, pastas, and other packaged products and make sure they have at least 3-4 grams of fiber per serving. Before you know it, you’ll reach your daily recommendation of fiber.  Trust your gut!

Nanticoke Weight Loss Earns National Accreditation from MBSAQIP

Seaford, Delaware: Patients seeking surgical treatment for severe obesity and its related conditions have a high-quality choice for receiving treatment at a nationally-accredited program that meets the highest standards for patient safety and quality of care in Sussex County, Delaware.

Nanticoke Weight Loss and General Surgery is pleased to announce that its bariatric program has been accredited as a Comprehensive Center under the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP®), a joint program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS).

Nanticoke Weight Loss and General Surgery’s commitment to quality care begins with appropriately trained staff and the leadership surgeons who participate in meetings throughout the year to review its outcomes. They seek continuous improvement to enhance the structure, process and outcomes of the center.

To earn the MBSAQIP designation, Nanticoke Weight Loss & General Surgery met essential criteria for staffing, training and facility infrastructure and protocols for care, ensuring its ability to support patients with severe obesity. The center also participates in a national data registry that yields semiannual reports on the quality of its processes and outcomes, identifying opportunities for continuous quality improvement.

After submitting an application, centers seeking MBSAQIP accreditation undergo an extensive site visit by an experienced bariatric surgeon, who reviews the center’s structure, process, and clinical outcomes data. Centers are awarded a specific designation depending on how many patients it serves annually, the type of procedures it provides, and whether it provides care for patients under age 18.

In the United States, around 15.5 million people suffer from severe obesity, according to the National Institutes of Health, and the numbers continue to increase. Obesity increases the risks of morbidity and mortality because of the diseases and conditions that are commonly associated with it, such as type II diabetes, hypertension, and cardiovascular disease, among other health risks. Metabolic and bariatric surgical procedures have proven to be effective in the reduction of comorbid conditions related to severe obesity.* Working with ASMBS, the ACS expanded this quality program for bariatric surgery centers so that it can assist bariatric patients in identifying those centers that provide optimal surgical care.

To learn more about services provided by Nanticoke Weight Loss and General Surgery, visit www.nanticokeweightloss.org or call 302-536-5395.

*Buchwald H, Avidor Y, Braunwald E, et al. Bariatric Surgery: A Systematic Review and Meta-analysis. JAMA. 2004;292(14):1724-1737. DOI:10.1001/jama.292.14.1724.
About the American College of Surgeons
The American College of Surgeons is a scientific and educational association of surgeons that was founded in 1913 to raise the standards of surgical education and practice and to improve the quality of care for the surgical patient. Its achievements have placed it at the forefront of American surgery and have made the College an important advocate for all surgical patients. The College has more than 80,000 members and is the largest organization of surgeons in the world.
About the American Society for Metabolic and Bariatric Surgery
The American Society for Metabolic and Bariatric Surgery, founded in 1983, was formed to advance the art and science of metabolic and bariatric surgery by continually improving the quality and safety of care and treatment of people with obesity and related diseases through educational and support programs for surgeons and integrated health professionals.

Nanticoke Weight Loss Receives Center of Excellence Award for Non-Surgical Program

Nanticoke Weight Loss and General Surgery has received the Center of Excellence award from Robard Corporation for its New Direction medical (non-surgical) weight loss program. To achieve this designation, a New Direction program must have written patient management plans and protocols in place that follow the Standard Recommended Guidelines for the Robard New Direction Weight Management Program – the same standards that recognized by the American Society for Metabolic and Bariatric Surgery (ASMBS) and Obesity Medicine Association (OMA).

Nanticoke Health Services recognizes the importance of offering our community a physician-supervised weight loss program that provides treatment in a clinical setting with licensed healthcare professionals including board-certified physicians and a registered dietitian. Nanticoke Weight Loss & General Surgery offers services including medical evaluation, nutrition education, pharmacotherapy, physical activity and behavioral therapy, as well as bariatric (weight loss) surgery.

The medical weight loss program at Nanticoke Weight Loss & General Surgery is led by Dr. Sandra Palavecino, a Board Certified Internist and Diplomate of the American Board of Obesity Medicine. Dr. Palavecino helps with the diagnosis and staging of the disease and develops an individualized program to achieve each patient’s weight loss goal.

As part of the individualized program, patients will have the possibility of supervised, low carbohydrate, low calorie diets based on protein supplements by New Direction which may promote more rapid weight loss. Patients will also receive several tools and education to help create and maintain positive lifestyle changes and behaviors that promote a fat-burning diet and maintain a lean body mass and healthy weight. These steps are key to improve health complications associated with obesity such as diabetes, high cholesterol and heart disease.

“Working with New Direction products has been a great addition to our program,” notes Dr. Palavecino. “Patients enjoy the variety of flavors and how easy they are to use. This program is designed to achieve more rapid weight loss with meals that are easy to plan and make while our team educates patients on continuing the complete nutrition program.”

For more information about this program or other services provided by Nanticoke Weight Loss & General Surgery, visit www.nanticokeweightloss.org or call 302-536-5395.

Savvy Shopper: Understanding Food Claims and What They Mean for Our Health

This month’s nutrition topic is all about debunking the myths and popular beliefs about the packaging of our foods. Let’s face it: Sometimes we buy certain products just for the way the package looks or the claims written on them. How can we be sure that we’re picking the right foods and that we’re getting what we think we’re getting? The key is to become a smart consumer by understanding packaging claims.

First and foremost, it is important to remember that companies that produce foods, beverages, supplements, and other nutritional products are not necessarily dishonest or deceitful. However, we do need to recognize that their primary role is to sell a product. Companies need their product to be marketable in order to make profits. And what’s one of the best way to market your product? Give it an attractive look with eye-catching slogans and claims.

Here are a few of the most popular labeling schemes and what they really mean:

  1. “All Natural”: What does it mean to be all natural? If you find out, let ME know. It’s a claim that appeals to the masses, but its meaning is ambiguous and it doesn’t tell us anything about the product. All natural doesn’t mean it’s a health food and it does not represent what is actually in the food. It’s just one of those “feel good” phrases that entice consumers to buy a product.
  2. “Made with real fruit”: This may be true, but turn the package over and look at the list of ingredients to see where exactly the fruit is. If it’s toward the bottom of the list of ingredients, and the product does not have a significant source of vitamins or fiber, it’s not likely to offer any health benefits.
  3. “No Sugar Added”: This does NOT mean it is sugar free! I repeat, a food with this on its label is NOT sugar free. It simply means that no extra sugar was added to the product; not that the product didn’t contain sugar already.
  4. “100% Organic”: A food must be made with 100% organic ingredients to get the USDA organic seal. Some foods will say they contain organic ingredients, but this could be anywhere from 70-95% organic, with the rest being other ingredients. These products will not have the USDA seal.
  5. “Reduced sodium”: This means that the product has 25% less sodium than the original product. It does not mean that there is no sodium, or that is the lowest sodium food of its type. This is like taking an original soup and cutting out ¼ of the sodium and then reselling it. It may still be too high in sodium for some individuals.

When shopping, look at the foods you are putting in your cart. The best advice for being a smart consumer is to ignore the front of a package and immediately turn it over. Make sure that you read the Nutrition Facts Label and the ingredient list to find out what you are really buying.

Article written by: Kimberly Hyatt, RD, LDN.

Nanticoke Now Offering Medical Weight Loss Program

The growing number of adults and children with obesity has become a public health priority in the United States. Obesity is a chronic disease that goes beyond eating too many calories and lack of physical activity. Obesity is described as an imbalance in the signals for energy storage in fat tissues in our bodies, the excess of which causes chronic health complications such as diabetes, high cholesterol, atherosclerosis and heart disease, osteoarthritis, sleep apnea and even cancer.

The most common methods to measure obesity are Body Mass Index (BMI) and waist circumference. Although there is no perfect method to measuring obesity, clinicians frequently use these two indicators as a tool to diagnose weight-related issues. With a BMI over 30 kg/m2, the chances of developing complications increase exponentially. On the other hand, decreasing one’s BMI and weight may reduce the chances of developing diabetes by 30% or more.

Treatment options for obesity vary from person to person. Our providers strive to offer the best individualized solution for each patient, including medical and surgical management of obesity. It is important for providers to address the issue early in patients that are considered overweight (BMI over 25 kg/m2 but below 30 kg/m2) in order to delay complications, prevent obesity and kick-start their journey to a healthy weight. For patients, it is important to talk to your physician about your weight and develop an intervention plan.

Medical Weight Loss at Nanticoke Weight Loss & General Surgery

Nanticoke Health Services recognizes the importance of offering our community a physician-supervised weight loss program that provides treatment in a clinical setting with licensed healthcare professionals including board-certified physicians and a registered dietitian. Nanticoke Weight Loss & General Surgery offers services including medical evaluation, nutrition education, pharmacotherapy, physical activity and behavioral therapy, as well as bariatric (weight loss) surgery.

The medical weight loss program at Nanticoke Weight Loss & General Surgery is led by Dr. Palavecino, a Board Certified Internist and Diplomate of the American Board of Obesity Medicine. Dr. Palavecino helps with the diagnosis and staging of the disease and develops an individualized program to achieve each patient’s weight loss goal.

As part of the individualized program, patients will have the possibility of supervised, low-calorie diets based on protein supplements by New Direction which may promote more rapid weight loss. Patients will also receive several tools and education to help create and maintain positive lifestyle changes and behaviors that promote a fat-burning diet and maintain a lean body mass and healthy weight. These steps are key to improve health complications associated with obesity such as diabetes, high cholesterol and heart disease.

For more information about the programs and services offered by Nanticoke Weight Loss & General Surgery or to schedule an appointment with Dr. Palavecino, call 302-536-5395 or visit www.nanticokeweightloss.org.

Eating Healthy for Nutrition Month

March is National Nutrition Month. Dr. Palavecino, Certified Bariatrician at Nanticoke Weight Loss & General Surgery, provides some tips for eating healthy:

  • Healthy Snacks – Nuts and seeds are a great choice for snacks. Full of good fats, minerals and vitamins, these foods can help with weight loss and improve cardiovascular health. Healthy nuts include macadamia, pecans, walnuts and almonds and sunflower and pumpkin seeds. (Peanuts are not included, since they are not nuts, but legumes.)
  • Staying Hydrated – Sodas and juices are now recognized as just as dangerous for the young generations as cigarettes, so trying to keep good hydration with water and unsweetened drinks can be beneficial for the entire family. Also, sports drinks (drinks such as Gatorade/Powerade that contain electrolytes to replenish the body after physical activity) should be used only after at least 1 hour of moderate exercise.
  • Fruits & Veggies – Fresh fruits and vegetables are the only source of natural chemicals called Phytonutrients, which are known to prevent chronic diseases and keep your body working properly. Eating them several times during the day can be delicious and at the help your body treat and prevent illnesses.

For more information or to schedule an appointment with Dr. Palavecino, call 302-536-5395.