Penn Metabolic & Bariatric Surgery Program

Penn Metabolic & Bariatric Surgery Update

Tuesday, September 16, 2014

What to Eat After Weight-Loss Surgery


Vince Benchino, MBA, RD, LDN, is the Penn Metabolic & Bariatrics Program Coordinator at Pennsylvania Hospital. He also runs information sessions and support groups at Pennsylania Hospital, and works with patients throughout their entire weight-loss journey.

He tells patients that immediately after surgery, they need to stock up their pantries and refrigerators with that they need to succeed.

“Immediately after surgery, and for the first two weeks, patients will eat protein shakes, sugar-free and fat-free puddings, yogurt and cream-based soups made with skim milk – not cream,” says Vince. “Then, patients can progress to a pureed diet for one to two weeks.”

Vince says it’s not as bad as it sounds.

“People can have scrambled eggs, or tuna fish – or even chicken salad, but it’s important to blend everything out,” he says. “No hard chunks of food.”

After that period of time, patients will transition to soft foods, which is almost the same thing as pureed foods, but not put through a food processor or blender.

“Then you just progress,” Vince continues. “Within a month and a half or so, patients will try new foods.” Some people go right into eating raw vegetables, and others may take more time to get to that point.

“A lot of people think they will never be able to eat foods with the same consistency and texture as before surgery, but they can,” Vince explains. “We educate a lot and everyone goes at their own pace.”

Learn How Penn Medicine Can Help You Lose Weight for Good

Let Penn Medicine help you lose weight. Learn about weight-loss surgery and if weight-loss surgery at Penn is right for you at a free information session.

Friday, September 12, 2014

How to Pick a Protein Shake and Supplement

After bariatric surgery, you can no longer accommodate large amounts of food. That’s why it’s important to eat the right kinds of food. This means foods rich in protein and low on fat and sugar.

Protein is an essential dietary nutrient. It builds tissue and regulates various bodily processes necessary for good health. After weight-loss surgery, all patients follow a liquid diet for two weeks. It is important to include adequate protein intake in the post-surgical diet to facilitate recovery. Patients are encouraged to find a preferred protein drink before surgery to ensure optimal nutrition and safe weight loss in the recovery stage, or find recipes to make their own.

You can find protein supplements at local supermarkets, pharmacies or specialty nutrition stores. There are a variety of choices and these tips can help you find your favorite, nutritious protein supplement:

Read the ingredients. Complete protein products containing whey, casein or soy provide more benefit than products that are mixed with less nutritious ingredients, such as collagen.

Determine if you prefer a powder or liquid protein supplement. There are pros and cons to each type of supplement. Powder products are mixed with eight ounces of water, low-fat milk or another low-calorie liquid to produce a beverage with the recommended concentration of protein. Liquid products come premixed and some have screw tops for easy storage after opening.

Sample a small quantity of the protein supplement. Purchase a single serving to taste test before committing to a full container or case of the product.

Make sure the products are low in fat and sugar. The concentration of protein, fat and carbohydrates varies from product to product. It is important to select a product that is low in fat, calories and carbohydrates. Make sure the product contains 15 grams or less of sugar per serving. Keep in mind that a typical protein drink contains 150 to 200 calories per 8 ounce serving.

Check the expiration date. Like all food, protein drinks have a limited shelf life. Do not use products that have expired.

Learn How Penn Medicine Can Help You Lose Weight for Good

Let Penn Medicine help you lose weight. Learn about weight-loss surgery and if weight-loss surgery at Penn is right for you at a free information session.

Wednesday, September 10, 2014

What’s Hunger, and What’s “Head Hunger"?

penn bariatricsVince Benchino, MBA, RD, LDN, is the Penn Metabolic & Bariatrics program coordinator at Pennsylvania Hospital. He also runs a lot of information sessions, and works with patients throughout their entire weight-loss journey.

He says that hunger and the feeling of full aren't always what they seem.

“There’s a thing we call ‘head hunger,’” he says. “Patients will tell us they think they are hungry, simply because they haven’t eaten, but physically, they aren’t hungry.”

Vince adds, “We have plenty of patients that come in and say that despite the fact they are eating a lot, they never feel full, or they feel hungry a half an hour later – even though they realistically know they should not be hungry.”

But after surgery, that changes. Vince says for most people, within the first six to eight months after a bypass or a sleeve gastrectomy they don’t feel hungry at all.

“This is the honeymoon period,” he says. “But when that period is over, real life starts to kick in.”

When their hunger comes back Vince reiterates the importance of eating well with patients and going back to what they learned before surgery.

“When you start eating more and adding more snacks, you’re adding calories that you didn’t have before, and you start potentially regaining weight,” Vince explains. “So, it’s important to get into good habits right from the start. The ‘Cloud Nine’ feeling so many experience doesn’t last forever.”

 

Learn How Penn Medicine Can Help You Lose Weight for Good

Let Penn Medicine help you lose weight. Learn about weight-loss surgery and if weight-loss surgery at Penn is right for you at a free information session.

Monday, September 8, 2014

When Weight-Loss Surgery Doesn’t Work

Weight-loss surgery isn’t a magic pill, or a quick fix to lose a lot of weight. Just ask anyone who has had bariatric surgery and they will tell you it is a lot of work.

And, like anything that requires a lot of work, there are times when it can be too challenging. When you feel like giving up.

“That's something we stress with our patients- no one's going to be perfect,” says Alan Schurict, MD, FACS, Penn bariatric surgeon. “Everyone's allowed to have that digression every once in a while.”


This means exercising and making healthy food choices most of the time.

“Post-operative success is a bell shaped curve,” says Dr. Schuricht. “And just like in school, not everyone gets A's, not everyone gets B's, some people get C's and they're happy with it. But there are some that fall behind the curve.”

The important thing, he says, is that you recognize it, and get back on track immediately.

penn bariatrics
Alan Schurict, MD, FACS
“If you exercise enough you can make up for eating bad once or twice a week,” says Dr. Schuricht. “If we make people so miserable that they don't want to do what they need to do, they're not going to do it. It’s human nature, so you have to find that balance between having fun once in a while, enjoying life, and making sure that you stay on track.”

However, there are occasions when getting back on plan isn’t enough. Some patients Dr. Schurict and the Penn Bariatric and Metabolic Surgery team see require revision surgery, or a second bariatric surgery.

“We see quite a few revision band surgeries, or people who have fallen back into unhealthy habits, and need their band adjusted, or removed to have a sleeve gastrectomy or gastric bypass,” says David Wernsing, MD, FACS, bariatric surgeon at Penn. “Whether their issues are just in affected weight loss or, you know, complications from the band itself, we do see a lot of revisions related to the band. However, we have other patients who are super stars of the band and are doing great.”

 

Learn How Penn Medicine Can Help You Lose Weight for Good

Let Penn Medicine help you lose weight. Learn about weight-loss surgery and if weight-loss surgery at Penn is right for you at a free information session.

Friday, September 5, 2014

Submit Your Questions for a Q & A Chat With Our Bariatric Surgery Team

Are you thinking about bariatric surgery?

Do you have questions about bariatric surgery?

Do you want to learn more about your options for bariatric surgery, and bariatric surgery at Penn?

Join us and 6ABC for a special one-hour live web chat featuring members from the Penn Metabolic & Bariatric Surgery Program team. Submit your questions, and our panelists will answer them.

Mark Your Calendars

Date: Tuesday, September 9
Time: 4 to 5 pm ET
Location: 6ABC

Web Chat Panelists

Panelists for the web chat will include:
  • Noel Williams, MD, director of the Penn Metabolic & Bariatric Surgery Program, and bariatric surgeon. Dr. Williams has been recognized by Best Doctors in America, and in Philadelphia Magazine's Top Docs issue.
  • Colleen Tewksbury, MPH, RD, LDN, Penn Metabolic & Bariatric Surgery Program program manager and dietitian
  • Jacqui Zipay, CRNP, nurse practitioner with the Penn Metabolic & Bariatric Surgery Program

Submit Your Questions

Submit your questions here.  Then, join us on Tuesday, September 9 from 4 to 5 pm ET to get answers from our three panelists during the live web chat.

You may send your inquiries at any time before or during the live web chat.

Penn Bariatric Surgery

Thursday, September 4, 2014

Pregnancy After Bariatric Surgery

For couples struggling with fertility, there’s an often overlooked tool that could help—the scale. That’s right. Being overweight or obese can affect a couple’s ability to get pregnant.

In fact, obesity is the cause of fertility struggles in six percent of women who have never been pregnant before, says the American Society for Reproductive Medicine (ASRM).

Obesity affects infertility by changing the way a woman’s body stores sex hormones. Here’s how:
  • Fat cells convert a male hormone known as androstenedione into a female hormone called estrone.
  • Estrone affects the metabolism of the part of the brain that regulates ovarian function.
  • This can impair reproductive function.
  • And it’s not just the woman’s weight that affects fertility. Obese men are more likely to have low or nonexistent sperm counts, according to a March 2012 article in JAMA Internal Medicine.
This happens for several reasons:
  • Obesity can elevate body temperatures, especially around the scrotum.
  • It can also lead to hormonal imbalances. Obese men are more likely to have higher estrogen levels, combined with lower levels of sperm-producing hormones like inhibin b and androgen.
  • This can disrupt with sperm count, sperm concentration and the sperm’s ability to swim well, according to a March 2010 study in the journal Nature Reviews Urology.
The good news is that there is hope. Women who shed the weight with weight-loss surgery, or on their own, can get pregnant.

David Wernsing, MD, FACS
“From a biological standpoint, women who lose weight have better hormonal balance that may mean a better chance of pregnancy,” says David Wernsing, MD, FACS, bariatric surgeon at Penn. While Penn surgeons do not recommend getting pregnant in the first year after surgery, Dr. Wernsing says that it has happened.

“If you are trying to lose a significant amount of weight, growing a healthy baby is going to be a competing interest,” he says. “We recommend couples wait to start trying to get pregnant so the healthy habits have had a chance to settle in and they can focus on losing the weight, and being their healthiest before getting pregnant.”



There’s another reason why women may get pregnant easier after they’ve lost weight – with weight loss comes a more satisfying sex life.

That’s according to a study published by University of Pennsylvania, and Penn Metabolic and Bariatric Surgery program member David Sarwer, PhD, along with his colleagues in the Journal of American Medical Association Surgery.

Dr. Sarwer says improved sex lives probably occurred because weight loss improved how women felt physically, and improved their own feelings about their appearance.

"When it comes to sex and sexuality, our behavior lies at the intersection of what's happening with us physiologically and what we are experiencing psychologically," says Dr. Sarwer. “An improved sex life may also be the result of improved hormone levels, and how women are feeling about themselves.”

Learn How Penn Medicine Can Help You Lose Weight for Good

Let Penn Medicine help you lose weight. Learn about weight-loss surgery and if weight-loss surgery at Penn is right for you at a free information session.

Tuesday, September 2, 2014

Where You Get Your Bariatric Surgery Matters

You’ve seen the ads and billboards – bariatric clinics that offer weight-loss surgery and promise quick results for patients.

Of course any weight-loss surgery requires a lot of work and dedication, but it’s also important to know that where you have your surgery matters most.

“Typically, these types of clinics have only operated on patients that are low risk and fairly healthy to begin with,” says David Wernsing, MD, FACS, bariatric surgeon at Pennsylvania Hospital. “But many of our patients have co-morbidities, or other, compromising health conditions. Generally speaking, those clinics are not equipped or prepared to work with patients who have other health concerns.”

The problems, says Dr. Wernsing, come to surface if there is a medical complication.

“Some of these places are operating without a safety net, so to speak,” he says. “If they get into trouble, they have to load you into an ambulance and bring you to a hospital that is prepared to handle emergencies.”


While bariatric clinics may be okay for some people, Dr. Wernsing sees many patients who were denied treatment at those other clinics.

“People with diabetes, cardiovascular disease or other conditions that expected to come with obesity see us Penn Medicine because we have the whole package,” he says.

The whole package means experienced cardiologists, anesthesiologists,
endocrinologists, and bariatric surgeons that perform more surgeries than others in the Philadelphia region.

“It’s not just about the surgery, because you could have a great surgery that goes anywhere,” says Dr. Wernsing. “But ultimately it's the entirety of your resources that are surrounding you from the first appointment to the ongoing support classes and groups. That’s what makes those who come through our program so successful. ”

Learn How Penn Medicine Can Help You Lose Weight for Good

Let Penn Medicine help you lose weight. Learn about weight-loss surgery and if weight-loss surgery at Penn is right for you at a free information session.

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