Hello all. This blog post is aimed at motivating you to maintain your weight while we’re in lockdown and preparing and guiding you through this phase with a bit of a protection plan.

I hope you’re doing okay so far. The theme of this blog is that “we’re all in this together,” and I’d like to share some thoughts with you to help with beating back old habits while you’re in the process of building new ones – even in lockdown. The main aim is weight maintenance right now.

Work like clockwork. Remember when I called the pre-op diet a rehearsal for life after surgery and post-surgery the guidelines wouldn’t change, so establishing a routine of 3 protein-based meals each day is essential. Remember, there’s still the same number of hours in each day – no more or no less. At home or at work, the principle remains the same for appetite management. Essentially, operate like clockwork and plan for your 3 meals to be spread evenly over the day to avoid real hunger at danger times like 4pm when head hunger can strike. What I’m finding helpful for me, is still packing my lunch each night ready for taking to work the next day. Rather than being at work, I’m now having my picnic at home and that’s helping me avoid the temptation for an all afternoon graze (which is tempting, but is also against my value of practicing what I preach to my patients).

Tackling head hunger is the crux of the weight loss surgery journey. Everyone has reasons for eating outside of their 3 main meals or having larger portions than they might need. It may be that you’re upset, bored, or angry to name a few. Try to get present and acknowledge your emotion before reaching for food. That can mean you’ve stopped your default coping mechanism – have a non-eating alternative ready to use instead. For example, I’m finding a quick walk around the block is helping me when my head hunger strikes. Other ideas are some indoor exercises like stretching, going to make a hot drink, or even calling a friend or family member. If you like reading, you might like to check out my old articles on this WLS website which have appeared in past newsletters. Whatever you do, tell yourself you’ve avoided an old habit and that’s one battle victory to you in your war of breaking old habits.

Remember to use mindful eating. Being at home eliminates a lot of distractions from the workplace, although it introduces many more (as I’m sure parents of young ones can agree). Your 20/20/20 technique is so important to use now. It also helps with learning to taste, savour and enjoy your meals rather than ‘wolfing’ it down and eating more than your body really needs. Make time for yourself to apply this, and use your home environment for everyone in the house to enjoy learning about the impact of mindful eating for enjoyment of meals and appetite management.

Re-visit your Mindprep videos and re-do the homework questions. This is so important for you to tap into and remind yourself of the drivers behind having embarked on the weight loss surgery journey. By doing so, you’re ‘gunning’ for the root cause of your old ways rather than putting a band aid over them with what’s known as a ‘fad diet.’. It won’t happen overnight, but lockdown is a perfect time for learning more about your old coping methods while building and maintaining the new way forward. Along with your Mindprep, you might like to also check out Maree’s Musings on this WLS website too (check Resources). Maree’s had surgery and shares great insight about the entire journey you’re all on.

I’ve also had a few patients asking me what they can do for protection from Covid-19. I’m sorry to say if I knew that answer, I’d be a very rich man (and hero to the world). Even with all that fame and fortune, I’d still be here doing my job because that’s what I love doing – helping WLS patients help themselves. So, rather than giving guidance I can’t guarantee will protect you, I’d like to focus instead on how to avoid you exposing an ‘Achilles heel’ with your protection plan for the next few months…

Bariatric quality supplements

Iron, zinc, and vitamin C are a few nutrients in particular known as crucial for a healthy immune system. The dose of these nutrients in bariatric supplements like those from AMS will provide you with enough for meeting the American Society for Metabolic and Bariatric Surgery guidelines. Remember, after surgery your intestinal absorption of nutrients is greatly affected and that’s what makes ‘over-the-counter’ supplements inferior to bariatric strength, let alone the funded ‘MVite’ being a ‘joke’ in terms of being incomplete with all the essential vitamins and minerals.
Avoid taking iron & calcium together. The way the body works, you need at least two hours between taking these two nutrients. Taken together is like trying to fit two people through a tiny door – both will miss out and get wasted.
Split your calcium dose. Your body needs a minimum of 1,000mg each day from supplements. Calcium citrate absorbs easier than calcium carbonate among the weight loss surgery population and therefore doesn’t require taking with food. However, the body can only handle 500mg at one time, so remember to have your two calcium doses at least two hours apart.
Try to avoid taking all three multivitamin capsules or both chewable tablets (with or without iron) together at the same time. This will affect the amount you can absorb and can compromise your body’s stores. Aim for having them at breakfast and lunch for instance. Rest assured that taking two capsules at the same time is quite okay. If you really struggle to do anything except three capsules at once, that will be better than only doing two each day.
Establish a reminder system for your supplements. Some people use phone alarms, others use blister packs, while others find placing supplements where they access food for each meal can help. Find whatever system works best for you at this important time to be doing your complete dose.
Please avoid ‘panic buying’ of supplements from AMS. The supply chain is working, but being like some of the supermarket shoppers with their toilet paper will mean that others in greater need for supplements more immediately will miss out. If you do run out, I suggest Centrum Women’s 50+ taken three times per day. This applies to men of all ages too because the Women’s 50+ has the highest level of nutrients compared to other varieties. Even then, this falls below the ASMBS guidelines. AMS Nutrition is trying to keep on top of the demand by ensuring ongoing shipments, however world-wide there are hold-ups and they are doing the best they can. Make sure you order what you need but be considerate of your fellow WLS community.
Plan and prepare. This is a stressful time for everyone. Your new habits being formed after weight loss surgery can easily be displaced by old coping mechanisms for stress management. For many, that involves emotional eating of high fat or sugar foods. Again, remember the reasons you started your weight loss journey and the hard work you’ve put in to develop new healthy habits. Your planning and preparation of protein-based meals is the crux of keeping these new habits alive in the times of adversity.

General Health & Wellbeing

Regular exercise for cardiovascular & respiratory system health.
Laughter – our current situation is far from a joke. Even so, finding moments in the day for some laughs is invaluable for your mental health.
Social connection like calling your friends or family is vitally important
Ministry of Health guidelines and daily updates will determine what happens next…

The Take Home

With uncertain times comes stress for everyone. Please remember to look after yourself so you can look after those that depend on you. In terms of self-care from the nutrition perspective, that means keeping up with your quality supplements as well as keeping with your eating routine for appetite management.

All the best.

Drew