Talk:Gastric bypass diet

Probably Should Be Deleted

I tried to clean this article up to make it sound more encyclopedic and less like a how to or an advert. However, this probably should be deleted, as many of the facts are unconfirmed. I nominated article for deletion. 207.210.15.85 08:46, 27 July 2006 (UTC)

I agree that the article should be deleted. It was initiated as an offshoot of the Gastric Bypass surgery topic, and contains numerous generalizations and inaccuracies. The whole structure and format is non-encyclopedic, and is more appropriate to a cookbook. I'm particularly concerned that its pretense of authority would lead a newly post-operative patient to violate his/her own surgeon's instructions, with possible dire consequences. Responsible surgeons give their patients detailed instructions regarding diet and behavior after surgery (my own manual runs over 50 pages). Citing one surgeon's manual as authority for not following the primary surgeon's instructions is invalid and reprehensible. When another surgeon's patient contacts me for advice, I tell him to consult the doctor who did his operation, and I do not presume to interfere. Patients do deviate from valid instructions, and do not need encouragement to do so.

In a nutshell, the primary author of this article knows too much, but not enough! In the early postsurgical setting, giving this type of advice is practicing medicine without a license. If you want to give medical advice, go to medical school and become a doctor first.

Topnife 21:16, 31 July 2006 (UTC)

{{Unencyclopedic}}

I believe the creator of this article did so in order to spell their product, I also belive it fails WP:NOT: Wikipedia is not a how-to guide. Viridae^Talk 02:02, 28 June 2006 (UTC)

I created this article to give insight to one of the biggest problems facing people after this type of surgery. I have been in the health food business for years now and see this as a constant serious issue.

First most people whom become so obese they have to have surgery to help them try to get back their life back 99.999% of the time have no clue on nutrition, the importance of protein and a host of other facts.

Lack of protein hair falls out nails become brittle, lose bone, muscle fact is your body is run from amino acids digested protein without it you will have serious health issues.

Gastric Bypass is the fastest growing surgery today so I really feel this type of article is extremely important to help educate proper nutrition and the importance of getting a protein supplement to take.

Eating meat won't work for these people can't digest it fast enough to adsorb enough protein and into the waste.

I hope you will do some looking and see this is good solid information for anybody after this type of surgery and this article has a place here on Wikipedia.

The link to the protein page is a self serving I agree but this will at least let them see what a protein supplement is and they can go to any store and purchase they will know what to look for.

6-28-06 i have added references to published guides for after gastric Bypass Surgery Diet Guidlines, the Importance of it for several colleges. I feel this has a place in the Wikipedia Information Directory as it is very important for this to be a part of any surgery to be successful.

Misinformative, Unethical, Commercial

This recently opened page contains numerous factual errors. If a patient follows them during the early post-operative period, rather than following specific physician instructions, it could potentially result in serious injury. It is unethical to interfere in the essential physician-patient relationship, and it is unethical to practice medicine without either a medical degree or a license, which one does when giving instructions to patients who are within a day of major surgery. Although the author avows good intentions, he has a clear commercial stake, even promoting his proprietary products within the article. Although some of the information is certainly correct, there are numerous errors. Examples:

• “If you tolerate clear liquids, the next day you will be advanced to 2 oz. (60cc) per hour of full liquids.” This statement is incorrect for a majority of surgeons performing this type of surgery, and for good reasons.
• “Try to consume at least .5 (1/2) gram of protein per pound of bodyweight per day.” For a 500 lb person, this amounts to 250 grams a day! Protein intake is properly calibrated to either Ideal Body Weight, or Lean Body Mass. Following this instruction would result in gross excess of protein intake, and unwarranted expense.
• Recommends “… Carnation Instant Breakfast …”. This product contains 24 to 40 grams of sugar per serving, and will cause severe Dumping Syndrome in many patients, particularly when taken on an empty stomach and soon after surgery.
• Utterly fails to acknowledge the specific alterations in nutrient absorption which occur following gastric bypass, which make some supplements completely ineffectual.

Persons undergoing bariatric surgery should seek a surgeon with extensive experience, with a comprehensive follow-up and management program, and then trust and follow the surgeon's advice, ignoring well-meaning and "helpful" suggestions from unqualified sources. Incidentally, since I'm now retired from doing surgery, I have no commercial interest, but I live with my own Gastric Bypass every day, and I follow my surgeon's advice, not my own. Topnife 19:02, 6 July 2006 (UTC)

Providing fact to back up the article with links and articles

I will stand corrected I inadvertently left off sugar free on the carnation actually I meant to take it out altogether as the hospital I did the research from recommended it. Funny I found another Hospital recommending the same protein supplement as in the article, but I will remove to become more unbiased on the article.

• Here is example one to validate my article as good sound nutrition backed by hospitals, Doctors who as well perform this procedure.

I feel Dr. Wren is meaning well just his advice on nutrition is outdated as is the food pyramid has changed many times as nutrition information has become available so has the recommend diet for GP patients has changed since he was performing this procedure.

• Highland Hospital recommended after GP surgery 5 meals

http://www.stronghealth.com/services/surgical/bariatric/images/GASTRIC%20BYPASS%20DIET%5B1%5D.pdf

This paper from the below link is a North Dakota State University article I have pulled some information on protein recommended per pound bodyweight. This article recommends a little under mine .4g per pound of bodyweight. Again there is a misunderstanding of the importance of protein and this is sound proof the article is correct and should stand as is. I will if need adjust it to .4 as this article states as it isn't written in stone .5 just a good target number for protein consumption.

Comment: Whatever the article says, it's still wrong. Calculate how much protein, in grams, a person with a body weight of 500 lb should eat. According to this formula it's 200 to 250 grams per day! Ridiculous! These recommendations are derived for persons of normal body habitus, and cannot be mindlessly extrapolated to the severely obese. Topnife 21:44, 31 July 2006 (UTC)

• http://www.bariatricadvantage.com/information/inthenews-TheSkinnyonGastric%20BypassWhatPharmacistsNeedtoKnow.htm

Pulled from the above link North Dakota University Protein Malnourishment Protein malnourishment can be a common risk in the first 12 months following RYGB as well, as the amount of calories patients are able to consume is extremely diminished given the small pouch size. In addition, animal proteins may be more difficult for bypass patients to digest and absorb, as the bulk of digestion (following breakdown in the stomach) occurs in the small intestine. This occurs when pancreatic enzymes are released into the small intestines, which break the protein down into absorbable peptides and amino acids. Following the surgery, the 1-ounce pouch may have difficulty churning/digesting animal proteins adequately, given its small size, and when a portion of the small intestine is bypassed, the digestive process is also consequently reduced. Thus, it is important to ensure adequate protein intake from easily absorbable and complete (high quality) protein sources, such as whey or egg albumen/egg whites.5,7,12-15,35 Supplements such as whey are complete protein sources that provide all the essential amino acids needed in the diet and are easier for bypass patients to efficiently break down in the months immediately after surgery when their protein intake is the most impaired. The highest quality whey proteins on the market are whey protein isolate, ion exchange whey protein, whey hydrolysate, or whey peptides. These contain very high levels of branched chain amino acids (leucine, valine, isoleucine), which can prevent muscle catabolism or wasting that can occur with protein malnourishment. These supplements also have a high Net Protein Utilization (NPU), a high Protein Efficiency Ratio (PER), and a high Biological Value (BV), which indicate that they are utilized very efficiently by the body. The maximum amount of protein that can be absorbed by the average person per meal is 30 g, which most of these provide in one to two 4-ounce servings. All of these characteristics can be found by examining the supplement's product label.5,7,12-15,35 It is important to note that many RYGB patients may need protein supplementation for life to ensure proper intake, but after one year postsurgery some may be able to take in adequate amounts of protein through their diets (approximately 0.81 g of protein per kg body weight, or a minimum of 60 g daily), after their pouches are fully healed, and these liquid supplements will no longer be necessary. It is also important to remember to check the supplement label for sugar content, to ensure it contains less than 16 g of sugar per serving, in order to prevent dumping syndrome.5,7,12-15,35

Comment: If one can absorb a maximum of 30 grams of protein per day, and if (supposedly) one needs 200 grams of protein per day (see above), that's at least seven high-protein meals per 24 hours, or one large meal almost every 2 hours of awake time. Furthermore, to consume 200 grams of protein daily, one will have to consume roughly 1500 - 1800 calories daily, which will defeat the weight loss purposes of the surgery. This is irrational and bad advice. Topnife 21:44, 31 July 2006 (UTC)

• http://www.mayoclinic.com/health/gastric-bypass-diet/WT00007 Recommends 6 meals a day They call them three meal and 3 snacks I call them meals. The fact is to eat meals throughout the day to get proper nutrition with protein being the first in all meals.
• http://www.gicare.com/pated/edtgs22.htm Again recommends 3-6 meals a day get proper nutrition with protein being the first in all meals. Back

The Gastric Bypass Diet. Taken from page backs up liquid consumption as well The gastric bypass diet unfolds in several stages, from "liquids only" to small meals of soft, high-protein foods. Meals on the new menu will be much smaller than normal, and the foods eaten must be very smooth in texture. On all stages of the diet, it is especially important to drink enough water, and to take vitamin and mineral supplements as prescribed.

• Clear Liquids -- The first stage of the gastric bypass diet, clear liquids (meaning beverages that you can almost see through), usually lasts for a day or two after the operation. The clear liquid diet starts with sips of water, and then allows foods like sugar-free juice, diet gelatin, boullion or clear broth, and flat (no fizz) diet soda in small amounts, usually 2-3 ounces at a time.
• Low-Fat Full Liquids -- If no problems are experienced with clear liquids, the gastric bypass diet advances to high-protein liquids like diet Carnation Instant Breakfast™, Ensure™, or Sustacal™. This stage of the diet is started before discharge from the hospital and lasts for 1 to 2 weeks. Most patients also begin taking a chewable multivitamin/ mineral supplement at this stage.
• Soft/Purée Diet -- The physician will indicate when it is time to advance to the soft or purée diet. Some patients are able to start this diet after they have been out of the hospital for about two weeks. Others may need to wait longer. The purée diet includes very soft, high-protein foods like scrambled egg, low-fat cheese or cottage cheese, or blenderized lean meats like tuna fish, chicken, or pork. Some patients find it more convenient to use strained baby foods. It is important to make sure that all foods are puréed or extremely soft and smooth in texture.
• Regular Diet -- The regular diet starts about 8 weeks or later after gastric bypass surgery. While this diet includes all 5 food groups, it is important to start with high-protein foods, like lean meats or milk, at every meal. Each meal or snack should be small, with liquids consumed in between meals. Ask a dietitian for advice on planning an individualized regular diet pattern.

• http://spectrum.diabetesjournals.org/cgi/content/full/18/2/82 Again read this more as there is a protein guide of 60 to 80 grams day as well as the below caption. 1. Meal Frequency Many patients in our clinic were in the habit of eating very large quantities in only one or two meals per day. Early postoperative food capacity is usually about one-half cup or less. Patients must learn to eat frequent, small meals consisting of healthful foods. Failure to modify this habit will result in poor nutrition and an inadequate calorie intake. Consuming too few calories can result in the "starvation mode" of metabolism, which will interfere with weight loss. Patients are encouraged to eat breakfast and to eat at least four to five small meals daily.
• https://www.gwhospital.com/p1407.html recommends 8 small meals

• I am confidant I have provided sound proof this is an article that has been researched, accurate information and has a place in the Wikpedia article base. I have adjusted the two minor objections Carnation Breakfast and .5 to .4 per pound bodyweight. There is just too much evidence to substantiate this article.

• I have address every complaint filed by Wes and have provided fact to back it up.

• Dr. Wers opinion. I highly respect it but it isn't fact now just as the food pyramid has changed numerous times over the last several years so has the way GB has changed the GB Diet.
• I have removed the tag and wait a positive reply.
• This is what separates Wikpedia from all other sites on the internet an article is challenged and proof is supplied making this the most accurate informational site available.

Supplements 21:14, 6 July 2006