Abstract
In this chapter we discuss the nutritional management of the severely obese patient. Section 14.1 begins with an overview of the non-surgical nutrition management of obesity including how to talk to your patients about their weight, what types of diets work and what don’t, the role of meal timing, physical activity, and how the Registered Dietician (RD) is your best resource for weight management. This is followed by an overview of the nutritional management of the bariatric surgery patient. Section 14.2 will include pre- and post-surgery dietary guidelines, nutrition-related complications including weight regain and the role of the RD on the Bariatric Surgery Team. Both sections will include information on prevalence, diagnosis and treatment of micronutrient deficiencies. We finish the chapter with a case to help integrate the information learned into a clinical scenario.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Wadden TA, Didie E. What’s in a name? Patients’ preferred terms for describing obesity. Obes Res [Internet]. 2003;11(9):1140–6. doi:10.1038/oby.2003.155. [cited Sep 2003].
American Medical Association. AMA adopts new policies on second day of voting at annual meeting [Internet]. Chicago: AMA; 2013. http://www.ama-assn.org/ama/pub/news/news/2013/2013-06-18-new-ama-policies-annual-meeting.page
Canadian Medical Association. CMA recognizes obesity as a disease [Internet]. Ottawa: CMA; 2015. [cited 14 Apr 2016]; [about 1 screen]. https://www.cma.ca/En/Pages/cma-recognizes-obesity-as-a-disease.aspx
Freedhoff Y, Sharma AM. Best weight: a practical guide to office-based obesity management. La Vergne: Lightning Source; 2013.
Canadian Obesity Network. The 10 checks of a healthy weight-management program. Edmonton: CON; 2016. [cited 14 Apr 2016]; [about 1 screen]. http://www.obesitynetwork.ca/managing-obesity. Accessed 14 Apr 2016.
Wadden TA. Eight-year weight losses with an intensive lifestyle intervention: the look AHEAD study. Obesity [Internet]. 2014;22(1):5–13. doi:10.1002/oby.20662.
Raynor HA, Champagne CM. Position of the academy of nutrition and dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet [Internet]. 2016;116(1):129–47. doi:10.1016/j.jand.2015.10.031. [cited Jan 2016].
Mayo Clinics. Weight loss: strategies for success [Internet]. Rochester: Mayo Clinics; 2016. [cited 14 Apr 2016]; [about 1 screen]. http://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/weight-loss/art-20047752. Accessed 14 Apr 2016.
Jakubowicz D, Barnea M, Wainstein J, Froy O. High caloric intake at breakfast vs. dinner differentially influences weight loss of overweight and obese women. Obesity [Internet]. 2013;21(12):2504–12. doi:10.1002/oby.20460.
Centers for Disease Control and Prevention. Division of Nutrition, Physical Activity, and Obesity. The benefits of physical activity [Internet]. Atlanta: Centers for Disease Control and Prevention; 2015. [cited 14 Apr 2016]; [about 1 screen]. http://www.cdc.gov/physlactivity/basics/pa-health/index.htm.
The National Weighr Control Registry. NWCR facts [Internet]. Providence: The National Weigh Control Registry; 2016. [cited 14 Apr 2016]; [about 1 screen]. www.nwcr.ws/Research/default.htm.
Stein J, Stier C, Raab H, Weiner R. Review article: the nutritional and pharmacological consequences of obesity surgery. Aliment Pharmacol Ther [Internet]. 2014;40(6):582–609. doi:10.1111/apt.12872. [cited Sep 2014].
Moize V, Deulofeu R, Torres F, de Osaba JM, Vidal J. Nutritional intake and prevalence of nutritional deficiencies prior to surgery in a Spanish morbidly obese population. Obes Surg [Internet]. 2011;21(9):1382–8. doi:10.1007/s11695-011-0360-y. [cited Sep 2011].
Canadian Institute for Health Information. Bariatric surgery in Canada report. Ottawa: CIHI; 2014. 34p. [cited 5 Apr 2016]. https://secure.cihi.ca/free_products/Bariatric_Surgery_in_Canada_EN.pdf.
Esteban Varela J, Nguyen NT. Laparoscopic sleeve gastrectomy leads the U.S. utilization of bariatric surgery at academic medical centers. Surg Obes Relat Dis. 2015;11(5):987–90.
Bloomberg RD, Fleishman A, Nalle JE, Herron DM, Kini S. Nutritional deficiencies following bariatric surgery: what have we learned? Obes Surg. 2005;15(2):145–54.
Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. J Am Med Assoc [Internet]. 2004;292(14):1724–37. doi:10.1001/jama.2014.10706.
de Hollanda A, Ruiz T, Jimenez A, Flores L, Lacy A, Vidal J. Patterns of weight loss response following gastric bypass and sleeve gastrectomy. Obes Surg [Internet]. 2014;25(7):1177–83. doi:10.1007/s11695-014-1512-7.
Li J, Lai D, Wu D. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy to treat morbid obesity-related comorbidities: a systematic review and meta-analysis. Obes Surg [Internet]. 2016;26(2):429–42. doi:10.1007/s11695-015-1996-9. [cited Feb 2016].
Gerber P, Anderin C, Thorell A. Weight loss prior to bariatric surgery: an updated review of the literature. Scand J Surg [Internet]. 2015;104(1):33–9. doi:10.1016/j.appet.2014.06.009.
Taube-Schiff M, Chapparo M, Gougeon L, Warwick K, Weiland M, Plummer C, Shakory S, Sockalingam S. Examining nutrition knowledge of bariatric surgery patients: what happens to dietary knowledge over time? Obes Surg [Internet]. 2014;24(8):1138–9. doi:10.1007/s11695-015-1846-9.
Isom K. Standardizing the evolution of the postoperative bariatric diet. Diabetes Spectr [Serial on the Internet]. 2012;25(4):222–8. doi:10.2337/diaspect.25.4.222. [cited 4 Apr 2016].
Aills L, Blankenship J, Buffington C, Furtado M, Parrott J. ASMBS allied health nutritional guidelines for the surgical weight loss patient. Surg Obes Relat Dis [Internet]. 2008;4(5 Suppl):S73–108. doi:10.1016/j.soard.2008.03.002.
Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, Heinberg LJ, Kushner R, Adams TD, Shikora S, Dixon JB, Brethauer S, American Association of Clinical Endocrinologists, Obesity Society, American Society for Metabolic & Bariatric Surgery. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient—2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Endocr Pract [Internet]. 2013;19(2):337–72. doi:10.1002/oby.20662. [cited Mar–Apr 2013].
Moize V, Andreu A, Flores L, Torres F, Ibarzabal A, Delgado S, Lacy A, Rodriguez L, Vidal J. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-en-Y gastric bypass in a Mediterranean population. J Acad Nutri Diet [Internet]. 2013;113(3):400–10. doi:10.1016/j.jand.2012.11.013. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed11&NEWS=N&AN=23438491 (Embase).
Handzlik-Orlik G, Holecki M, Orlik B, Wylelol M, Dulawa J. Nutrition management of the post-bariatric surgery patient. Nutr Clin Prac [Internet]. 2015;30(3):383–92. doi:10.1177/0884533614564995.
Berg P, McCallum R. Dumping syndrome: a review of the current concepts of pathophysiology, diagnosis, and treatment. Dig Dis Sci [Internet]. 2016;61(1):11–8. doi:10.1007/s10620-015-3839-x.
Tack J, Deloose E. Complications of bariatric surgery: dumping syndrome, reflux and vitamin deficiencies. Best Pract Res Clin Gastroenterol [Internet]. 2014;28(4):741–9. doi:10.1016/j.bpg.2014.07.010.
Karmali S, Brar B, Shi X, Sharma AM, De Gara C, Birch DW. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg [Internet]. 2013;23(11):1922–33. doi:10.1007/s11695-013-1070-4.
Endevelt R, Ben-Assuli O, Klain E, Zelber-Sagi S. The role of dietician follow-up in the success of bariatric surgery. Surg Obes Relat Dis [Internet]. 2013;9(6):963–8. doi:10.1016/j.soard.2013.01.006.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Warwick, K., Gougeon, L. (2017). Nutrition Management of Severe Obesity. In: Sockalingam, S., Hawa, R. (eds) Psychiatric Care in Severe Obesity. Springer, Cham. https://doi.org/10.1007/978-3-319-42536-8_14
Download citation
DOI: https://doi.org/10.1007/978-3-319-42536-8_14
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-42534-4
Online ISBN: 978-3-319-42536-8
eBook Packages: MedicineMedicine (R0)