Looking back, I don't think my nutritionists (NUT) added all that much to my journey. Both of them offered very basic information that I learned in high school back in the dark ages and already knew from a lifetime of dieting.

I don't especially regret the 3-4 hours I've spent with them over the last year, but wish they'd offered more.

Plus, I see threads here from time to time that make me think some NUTs don't understand much about bariatric surgery or the differences in nutritional requirements for bypass patients and sleeved patients.

Your thoughts?

@@jenn1 If you are still losing hair at over a year post op, I was advised that is most likely nutritional based. Hair loss occuring in the first year are quite likely more related to the surgery itself.

My guidebook - which I still keep beside my desk by the way even after all these years - says to first suspect Iron and zinc deficiencies. Protein, especially the amino acid l-lysine might be the culprit too.

My data is like 4 years old at this point but I think this info is still true. Look into the iron and zinc if you believe you are consuming adequate high quality protein. When I had surgery they said 60grams plus on the protein but my center has now revised to 80 g plus. I have a new friend who is a dietician at a different bariatric program and she told me that due to my high muscle mass type build I seriously need to be in the 80-100gram range.

My nutritionist is great. I had a lot of dietary issues to tackle. I'm a vegetarian and I have multiple food allergies. That means I can't eat artificial sugars, stevia, and food dyes to name just a few. Crafting an eating plan was challenging. Our sessions had to be very conversational as I needed to ask a lot of questions to figure out what I could safely eat. I also like that my program utilizes a patient email portal. When I needed to increase my calories or share info and it was not time for a follow up appointment I could shot an email and get a response either by email or a phone call within 2 days. The fact that I have no had an ER visit or hospitalization because of my allergies since surgery has a lot to do with how helpful my nutritionist has been.

@@jenn1 If you are still losing hair at over a year post op, I was advised that is most likely nutritional based. Hair loss occuring in the first year are quite likely more related to the surgery itself.

My guidebook - which I still keep beside my desk by the way even after all these years - says to first suspect Iron and zinc deficiencies. Protein, especially the amino acid l-lysine might be the culprit too.

My data is like 4 years old at this point but I think this info is still true. Look into the iron and zinc if you believe you are consuming adequate high quality protein. When I had surgery they said 60grams plus on the protein but my center has now revised to 80 g plus. I have a new friend who is a dietician at a different bariatric program and she told me that due to my high muscle mass type build I seriously need to be in the 80-100gram range.

Glad to hear this. I am experiencing some thinning in the front of my hair. I have increased my protein to 100gms a day. Hopefully this helps. I just sent an email to my doctor. I may get repeat bloodwork when I go in next month to check my zinc and magnesium levels.

My NUT was ok as I thought she was a nice lady and I enjoyed the conversation.

But

I do think that the Nutritionist and the Excersize appointents were a waste of money and time. Neither were covered by insurance so I had to pay $100 a visit. and my excersize appointment had the nerve to schedule an extra appointment. I was actually mad, took a day off work and had to keep paying that $100 and got absolutely nothing out of it.

but the NUT gave basic information. I guess if there was a person that hadn't done any research at all it would be helpful...but then again, my doc had a free 2 hour class for every patient that covered everything that the NUT or any other research you may have done.

I really felt like those 2 were just things that opportunist used to make some extra money not because they were helpful, but because they knew insurance companies required it.

It really depends on the program. Mine is affiliated with the program so she specializes in bariatric. They also facilitate the support groups so they are very in tune with the patients. I saw her one on one at each pre-op visit. She reviewed my daily diary and gave suggestions catered just to my specific needs. The nutrition class was required by my insurance. The one on one visits were part of the program.

I'm one of the lucky ones too. Love my dietitian. I had to attend an 8 week mandatory class with her and the psychiatrist prior to surgery. We left with a giant binder of information. She's checked in with me in every post op appointment and offers advice for my current stage. For example, at my 9 month appointment, she told me to keep an eye on my carbs because this is around the time people start relaxing on the plan and the carbs creep back in and the weight loss slows.

Hmmm. Sounds like we need to do some work on rating nuts, psychologists, and support staff with the surgeons? That would be more helpful to know because the surgeon you see less than the support staff.

Mine is great! She has a certification in bariatric nutrition (as well as being an RD) and works exclusively with bariatric patients.

What helped me the most was the fact that she is super-strict. I had to have regular follow ups with her, she had very strict and conservative plans about what to eat, when to eat, how much to eat, and she made sure I logged everything. At every visit I had to sign into MFP on her computer and she went over everything in my diary with a fine tooth comb. She was really important to me. I'm looking forward to checking in with her next month at my 2 year post-op appointment.

Yes! Mine reviews my MFP diary as well.

When I had surgery they said 60grams plus on the Protein but my center has now revised to 80 g plus. I have a new friend who is a dietician at a different bariatric program and she told me that due to my high muscle mass type build I seriously need to be in the 80-100gram range.

Yeah, I know someone who had surgery with the same surgeon as me and had the same nutritionist and was told 65 grams of protein, but by the time I had MY surgery, they were saying 100 grams. I think it's definitely best to aim high. I usually get 85-100 grams of protein per day no problem and haven't had any hair loss beyond month 5. Of course, there are so many other things that could be a factor in that as well....

Seriously?!? You asked about Type I DM with a BS of 35 & she didn't know or get back to you?!? While a label of "nutritionist" doesn't imply any specific level of education or licensing; that is just beyond the pale. Perhaps you should mention this to your surgeon? She (your NUT) definitely should not be counselling anyone...

To get back to the original question - my NUT was not the greatest, but would seem like a genius compared to PP's!

She also recommended all sorts of foods with artificial sweeteners and other ingredients I consider almost harmful to one's health. When I asked how she could consider them "healthy" she changed tactics and proffered using instant brown & wild rice (just 2 examples). Sorry - what's the point of that? And I'll pass on using Aspartame & the like in the Quest for "health". Just sayin...

She also told my son (who is going thru the process as well) that he should change his career because he's a shift worker and mentioned that he probably couldn't give up caffeine forever. Right - like that's gonna happen.... (He's in his mid-forties & makes a good living.)

In the end, I think it's up to us, as educated consumers, to follow the advice of the professionals - but also to know the difference between a professional & someone who may not know his/her head from a hole in the ground.... Research & education are good things - especially under the guidance of a good physician.

@@VSGAnn2014

I had four consults wit my dietician/nutritionist. It was good information for beginners in WLS. Protein and Water requirements. Vitamin supplements. food portions and stages.

My team from our hospital is great. With this exception. All answers are cookie cut for people in the weightloss stage. Its a one size fits all.

I talked to my dietician at a meeting. I asked about my blood sugars dropping to 35. I'm a type one diabetic. She did not know. Took my information and said she would call me...Never returned my call

I talked with the same nutritionist at another meeting. My hair loss is ridiculous at this point. I'm over a year out and its still falling. She gave me the cookie cut answers that we all get. Biotine, protein intake.. i had to explain how far I'm out again and I have tried more that what she had mentioned. She took my contact information said she would call me back ....Still have not received a call back.

Edited July 31, 201511 yr by gigito2

my nuts, ive had 3 because one went on sabbatical hen came back then left for a triathlon etc, but they have been very supportive and offering me alternatives i never thought of, in Vitamins, shakes etc, and they also talk to the surgeon to get any scripts i need for Vitamin d etc. The nut i have now is great he is a triathlon trainer, for several olympic athletes, and he is behind me in the couch to 5k app, helping me get ready for my first 5k which is still a few months away. Ive enjoyed them thoroughly. The key i feel is not to just sit there passively but to ask questions write them down before you go in, so you dont forget things, and tell them what you are having problems with.

Nope! My lady was nice but I didn't learn a thing from her. I had already done so much of my own research I could have taught her a thing or two

Well. I feel like a lot of you had some good advisors.

I had the wife of my surgeon for one hour with 2 other WLS patients. She talked about portion size...period.

No grams of Protein, carbs, etc.

I did have paperwork indicating the food that was a yes or no for the first

3 weeks. There was a list of protein sources.... A weak list...

This was 2006 and I'm so thankful the process has changed for the better. I'm glad to hear more on these boards too.

I actually had the bariatric surgeon give an RD recommend to a previous PCP. This person even admitted she knew nothing about it, no one in that group did. Considering what I said about the previous one, this doesn't surprise me. Like I said, the $$$ aren't in that.

@@jenn1 if you are still losing hair after a year, have your thyroid checked. I'm hypothyroid, and the change in vitamins and diet put my thyroid into a tailspin. Worth having a simple blood test.