Sorry if this comes off rude but....

I've been here for a little while and have read a lot of topics. Some things I've seen have really surprised me. I'm referring to topics where people ask questions that seem so basic that their surgeon or NUT should have explained to them on day 1. For example, I've seen people ask how much Water they're supposed to drink or how much Protein they need to get. Personally I had to meet with my NUT several times and sign papers saying that they explained everything to me, I got pamphlets and booklets and printouts and powerpoint presentations on what to eat and when along with meal ideas. This was all before I was given a date for surgery.

I'm just wondering if people simply aren't doing enough research ahead of time or if the doctors and nutritionists are dropping the ball.

I didn't have a center of excellence. I just personally felt that I WANTED to know as much as possible. I was educated about a lot through the program.

I have dieted most of my life so stalls, plateaus, whatever....happen. if you are still shoving crap in your mouth and NOT admitting to it, well...that's why the scale isn't moving, duh?

I answer some of the repeat questions because I feel the new person needs someone to answer, tomorrow @@Babbs, @VSGAnn, @InnerSurferGirl or @Blerd can answer the next time....

There are two kinds of people in the world ... in fact, there are about a million sets of "two kinds of people in the world.

In the world of WLS there are two kinds of patients who don't know what in the world they should be doing at any given time: (1) people who figure things out go on to maintain their weight loss and (2) those who won't figure things out and won't be successful with WLS.

The ones who will be successful long-term are those who ask questions (here and in nutritional classes and in their doctors' offices and on the Internet) and are good learners. And they can do the right things dozens or hundreds of times in succession -- and build new, better habits.

And the other folks aren't good students and don't have good learning skills. Even when you tell them what to do, they still don't "get it." They don't read food labels (or understand them) or make good food-purchasing decisions. They also may have more life problems and weaker coping skills to deal with the slings and arrows life throws at all of us. And they can do the right things twice in a row before falling back on the wrong things -- and can't build new, better habits.

Of course, there are not just "two kinds of people" -- there are many kinds of WLS patients. Some have WLS complications or post-op medication issues or illnesses. Some are fast losers, some are slow losers. Some have to eat low-carb to lose weight, others can tolerate more carbs and still lose. Some can maintain only on low-calorie diets, others can eat more calories than they could pre-op and still maintain because they're so much more physically active than they were before.

@@CowgirlJane -- That's what I thought you were referring to, but wanted to verify.

Your skinny, tiny dietitian friend reminds me of another problem patients encounter in their bariatric practices (not to say that it applies to your friend). Some RD's and NP's who've never had weight problems and "run" support groups are utterly clueless beyond the nuts & bolts do's and don't's and seem not to care much. They are robotic when doing their presentations and answering questions or commenting on the patient discussions. Others, however, are super; they really do care and make it their business to somehow gain insight into the souls, if you will, of obese people. I had a long talk with one about this. Slim all her life, she learned by listening and asking and, as an actor, tapping her own experiences that gave her similar emotions.

@@MissRobin -- "Who are we do judge HOW people educate themselves."

You're correct. Speaking for myself, though, and perhaps for some of the others, there's sadness and frustration when it becomes apparent how many people in the world are ill-equipped to navigate the ordinary tasks of living. Not that bariatric surgery is ordinary, but taking initiative to get needed info from first-string sources is. So many people are unable to connect the dots. I recognize that surgical offices are remiss, too. When some BP participants appear to judge, it's more a matter of frustration and letting off steam. Someone always comes along to answer the endlessly-repeated questions that would properly have been answered elsewhere.

I completely agree that no question is dumb or silly. What matters is that they are asked and correct answers obtained. That said, there's no way around the human element. Maybe it takes a little steam-blowing to get down to business.

P.S. (came back to add this): Why are people timid about requesting the information they need? Will we be fired by the surgeon's office? It's the job of the staff to provide info. We employ them. I'm not suggesting a power struggle, but it is more than reasonable to expect a complete package, especially when the subject matter is unknown to us.

P.P.S. (and this): If resentment accompanies the answers, perhaps it's time to fire that practice? Much has been made here not only about patients who don't do their homework, but also WLS offices that are negligent.

Edited December 11, 201510 yr by WLSResources/ClothingExch

I think using this site is how they are educating themselves. I find the lack of information that many are given appalling, but I would rather that they get the needed info here than not get it at all.

Sorry if this comes off rude but....

I've been here for a little while and have read a lot of topics. Some things I've seen have really surprised me. I'm referring to topics where people ask questions that seem so basic that their surgeon or NUT should have explained to them on day 1. For example, I've seen people ask how much Water they're supposed to drink or how much Proteinthey need to get. Personally I had to meet with my NUT several times and sign papers saying that they explained everything to me, I got pamphlets and booklets and printouts and powerpoint presentations on what to eat and when along with meal ideas. This was all before I was given a date for surgery.

I'm just wondering if people simply aren't doing enough research ahead of time or if the doctors and nutritionists are dropping the ball.

In my personal opinion only, I think sometimes even though we already have the answer, it feels good to have someone other than a Dr. Or nut tell you! Kind of like a positive reaffirmation

I was self-pay, but nutrition education was still a required part of the program. There is really no excuse as far as I can see for any surgeon not to provide nutrition education as it is critical for success and a healthy outcome.

Classes are not a requirement everywhere for self pay, the experience in different places in the US seems to be very different, not to mention outside of the US. I'm self pay from the UK, will be flying to Prague for surgery, and there is really not other support, I fly over, turn up the day before surgery for all the tests, and assuming everything is OK will have surgery the next day. There is no pre-op diet aside form don't eat from X time the day before, I have been given basic information in terms of the fact that there are 3 phases after for eating, and been told to stop certain Vitamins one or two weeks before.

As it is, I have done my research and have, I believe, a pretty good idea of what to ask and expect, but that isn't the case for everyone.

Okay, I answered this half way through instead of reading the rest of thread and I think the point I was making was pretty well covered, feel free to ignore me and continue.

My Surgeons office was extremely efficient and provided me with a big book on lapband. it contained information on nutrition, what to eat and when, information on how you should feel and when and Vitamins and what drugs you should and shouldn't take. They explained in depth why you should not use straws, drink carbonated beverages and shouldn't chew gum. This book is like my bible. I still refer to it if I have a question or a problem. I also have a nutritionist that works with my surgeon and she is very accessible and gives me suggestions. I am also fortunate to have a wonderful, understanding Dr. who listens to me and is conservative about fills. He doesn't believe in big fills. I also think people sometimes don't ask questions when they see their Dr. Information you find on the internet is not necessarily the most accurate or medically sound. Ask your Dr. and or PA and make sure they understand your concerns.

I would agree that if a bariatric patient didn't know how much Water and Protein they needed after surgery (basic info), they didn't put enough effort into obtaining/retaining this information.

However, there is plenty of blame to go around for not getting more complicated bariatric nutrition information. Here is my list:

- Bariatric Surgeon - Deferred almost all nutrition questions to the Registered Dietician (RD) in his practice.

- Primary Care Physician - Encouraged me to follow the recommendations of the RD in the Bariatric practice.

- Endocrinologist - Encouraged me to follow the recommendations of the RD in his practice.

- RD associated with Endocrinologist - Tried to talk me out of WLS and insisted that if I just followed her plan I could successfully lose weight.

- RD with Bariatric Practice - Met with her twice, once before and once about a week after surgery. The first time we met she would only discuss the pre-op diet. When we met after surgery she handed me some sheets of paper with the diet stages, showed me a plate with rubber food, and asked if I had any questions (while looking at her watch). She left the practice soon after that meeting.

- Nurse with Bariatric Practice - Met with her about a month after my surgery. Showed me plate with rubber food and gave me same handouts the RD gave me 3 weeks earlier.

- Bariatric Center of Excellence - The handouts at a pre-surgery information session were the most helpful that I had received to date and included sample menus and shopping lists. The person presenting the information didn't add much value and stuck to the powerpoint presentation.

Some of the most helpful sources of nutrition information have been this website, monthly support groups sponsored by my hospital's bariatric practice, and discussions with people who have had the surgery before me.

I'm often amazed when I see people on the forums asking basic questions (water/protein) that I know and I haven't even been on the pre-op diet yet. I'm even more amazed when I see people asking about what sounds like a serious medical problem (pain, fever) who ask here rather than bother their doctor.

Many people need the social element a forum provides. Sometimes they do "know" this information and might be stuck on the "how." You find that out when you read further comments from them. Sometimes people need the shared experience and reassurance that, yes, they are doing things right and, no, don't worry, you're body is behaving the way it ought to.

Some people just need the experience of others saying, "Yep. Been there, too. Understand what you're going through."

Others clearly have not been following nutritional guidelines (slider foods, amounts, food choices). They want someone to either kick them in the butt so they get back on track or for someone to tell them that WLS will work despite themselves. They seem to be in the minority here. Most are like the examples above. It's frustrating to read the latter. The former don't bother me. Who knows? I might be one of them in another month!

Sophie74656,

I think it’s a little bit of all of those, with their respective contributions varying by the person! I think some of the reasons are patients not doing their research and patients not understanding what they’re given, as well as doctors and nutritionists not doing their jobs.

I also think there may be some element, like James Marusek said, of wanting a personal touch. Patients may also expect a personal touch – they may feel unsure if what they research themselves online or in books is applicable to them, and may expect their healthcare team to explain it to them.

And there, I think there may sometimes be a breakdown in communications. For example, surgeons’ office may give patients a huge stack of papers to read, and patients may not read it. Patients expect it to be explained to them, while the offices may expect patients to the information they’re given.

All just my observations and guesses…but you’re right. Patient education – either self-education or education by their surgeons and nutritionists – is lacking somehow.

I've bitched here before about how little value I found the nutritionists in my surgeon's program to be -- although everyone else in the program has been great.

I hear the same thing here about many other patients' NUTs, although a few regulars here (including @@CowgirlJane ) have found much greater value in theirs.

Fortunately, my surgeon's bariatric P.A. is fabulous -- studies her ass off, has lots of good advice, and goes to beaucoups bariatric conferences and knows all the latest research. She's been tremendously useful.

And, of course, I read labels and track my food on www.myfitnesspal.com, which offers a great database about most foods and drinks out there.

Eventually, we all have to take personal responsibility for learning what foods are nutritious, promote weight loss, and weight maintenance. And we have to be willing to be our own little science experiment by trying things out and finding out what works for us.

What works best for me may not work best for you, and vice versa. For instance, my body tolerates a lot of carbs, but some others' bodies can only tolerate low-carb, even in maintenance.

The problem is that the more I studied, the more I questioned the ability of the bariatric group I had to really be able to do serious recommends. The RD that was there when I started left. After 10 months, they finally found a new one. The bariatric group could handle somewhat basic stuff but when you ran into problems, they expected you to solve them.

I keep thinking about this post and I'm not mad. But this website is a group of forums meant to help people isn't it? We can read all of the material in our books prepared for us, we can ask Dr. and nurses and nutritionists and get the answers we need. But how many of our Dr's or nurses or nutritionists have ever experienced this first hand? Isn't it good to be able to hear from others who live it everyday? For me at least, I like to hear about what others do or have done, that is why I come here. Maybe if there are those who are tired of reading same old questions, they have nothing further to learn or gain by being here?