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Laura Kiely
APD, AN, MDAA, Gestalt Therapist (trainee)

Laura has been involved with obesity management for several years. She is experienced in:

• Preoperative assessments and counselling
• Managing low calorie diets preoperatively
• Counselling post surgery for the long term management of laparoscopic band procedures or tube / sleeve gastrectomies
• Running support groups for Bariatric Patients

You can read more about Laura here: www.thefoodie.com.au

Read on for some common questions asked by sleeve patients:

Are there any foods that I won’t be able to eat with the sleeve?

Gastric sleeve patients are encouraged to eat and enjoy all foods in appropriate quantities. Patients do experience early satiety with bulky foods such as bread, rice and pasta. While you can still enjoy these foods, it will be in small amounts. It is recommend these foods are eaten last, following the meat/protein and vegetable portions of the meal.

Is it possible to not lose any weight with the sleeve?

There are certain factors that will predict success with the sleeve, such as:

• How ready a person is for surgery
• The individual’s level of awareness of the reasons for their weight gain
• A person’s level of commitment to support and follow up
• Personal responsibility for the lifestyle adjustment that’s required

As part of the program and Western Obesity surgery you will discuss these things with your Surgeon and Dietitian and decide if surgery is right for you.

I eat very quickly – will this be a problem?

It’s important to chew your food well and eat slowly enough so that you can sense the feeling of fullness. If you eat too quickly, you may experience discomfort and even vomiting. It’s also recommended that you wait leave about 20 minutes either side of eating before drinking anything.

How much will I be able to eat?

The quantity does vary between individuals and also depending on the texture of a food. A tall person will eat more, because their stomach “sleeve” will be longer. If a food is in a liquid form such as soup, more will be tolerated than if it is a more solid food. For example egg nog (or egg mixed in milk) will be less filling than eating a boiled egg.

How much weight can I expect to lose?

On average, people lose about 65% of the excess weight they are carrying. So, if someone was carrying an extra 50kg for their height, they can expect to lose about 32kilos. It is possible for someone to lose all of their excess weight.

Will the sleeve cure my diabetes?

Because excess weight plays such a large role in the development of metabolic diseases such as diabetes, high blood pressure /cholesterol, it is possible that by restoring a healthy body weight, the severity of these conditions and dependence on medication can be reduced and in many cases reversed completely.

Will I be able to get all the nutrients I need?

Given that sleeve patients are not able to consume regular quantities of food, it is even more important to ensure that the choices that are made are nutritious ones. All patients will need to take vitamins post operatively and levels will be checked annually via a blood test. A fibre supplement is also recommended. Patients are encouraged to see the Dietitian for meal planning and lifestyle support to ensure that they make the best of sleeve.

What about fluids? Will I be able to get enough?

It can be difficult to guzzle down lots of fluid in one sitting and It’s also a good idea to wait 20 minutes either side of eating before drinking because the two don’t fit in the small stomach together! So the trick is to
drink regularly.

How does my body know when to stop losing weight?

Eventually the body adapts to the reduced intake of calories and weight loss stabilises. Your body stabilises at a new “set point” by re-prioritising the way it burns up calories. In order to prevent early weight stabilisation, it is recommended that “sleevers” do regular exercise, especially the sort that builds muscle as muscle is a good fat burner.

Do I have to exercise?

People report an improved tolerance for exercise with the reduction in body weight. They generally become more active because it’s easier to move around, so they are doing more “accidental” exercise. Planned exercise is also recommended, as this will support long term maintenance of body weight. Research has shown that those who don’t exercise will not be as healthy and lose as much weight as those who do.

Why is it called a gastric sleeve or tube?

Quite simply, because the shape of the newly shaped stomach looks like a shirt sleeve or “tube”

Will the staples set off airport security systems?

No, they are non-magnetised titanium so they will not set off airport detectors.

Can the staples fall out?

No, they are initially used to hold the new stomach in place but within two weeks they do not have a structural role. If you were to go in and have a look at the stomach two weeks after the operation, you would not see the sta ples. The stomach tissue grows around them like a lattice or framework and they are then incorporated into the stomach, permanently.