By Jennifer Kyser, R.D., CSOWM, L.D.

Patients receive extensive counseling on diet and behavioral issues at Norton Weight Management Services before and after bariatric surgery to maximize their chance for a successful outcome.

Prior to surgery, all patients undergo a detailed readiness assessment. They see a nurse, a licensed clinical social worker and a dietitian, who evaluate their readiness to change. The assessment is required by insurance. We educate patients on lifestyle changes they will need to make. If they’re not ready to make those changes, we put their surgery plans on hold because they’re not going to be successful.

Patients deemed ready for surgery are educated on the procedure they’ll be undergoing and what they can expect in terms of diet and lifestyle changes. To make the transition easier, I coach patients on how to begin moving toward the diet they’ll follow after surgery. For example, I’ll encourage them to avoid sugary drinks and to eat smaller meals throughout the day instead of a single big meal.

We want them to work on a better meal pattern. They’ll claim they’re eating once a day and snacking a lot. They can’t eat just once a day after surgery. Their stomach will be the size of an egg.

During the presurgery evaluation, patients must pay a nonrefundable $300 program fee, which gives them lifetime follow-up with a dietitian and licensed clinical social worker. For patients who undergo bariatric surgery, studies have shown that strong follow-up greatly increases the chance of a successful outcome.

Even if patients choose not to undergo surgery, they still can take advantage of counseling from me and the two behavioral weight management specialists at Norton Weight Management Services, Melissa Moody, LCSW, and Mary Hargadon, LCSW.

I’ve worked with overweight and obese patients for more than a decade, and the follow-up is probably the most important thing. We want patients to lose weight after surgery and we want them to keep it off. That means staying away from old eating habits and patterns.

Our licensed clinical social workers help them work toward making behavioral changes if they’re stress eaters. Patients typically underestimate the emotional component food plays in their lives. They may know they use food as a coping mechanism, but they don’t realize how much they use food to soothe them. That’s a major struggle for some people, and that’s why the follow-up is so critical after surgery.

Because the social workers and I meet with patients one-on-one, we’re able to develop trust with them. Patients who live far away or have transportation issues can receive phone or email consultations. If a patient’s primary language is not English, Norton Healthcare will provide a translator free of charge.

As a dietitian, my role is education. Many people assume they’re eating a healthy diet when they are not. Because many people aren’t aware of what they’re eating during a typical day, I’ll urge patients to track what they eat by keeping a food diary or using a phone app.

A lot of these patients have been obese for years and years. They have a lot of medical conditions. They’ve always been told what to do, but feel like they’ve never gotten help with their weight issues. I work with patients to find healthy foods they want to eat.

The diet is tailored to them to help them be successful. I don’t hand them a sheet of paper telling them what they can’t eat. That’s not going to work long-term.

Staying positive with patients is important. Patients feel comfortable coming to us and know we’re not here to judge them. Our role is to support them in whatever fashion they need.

Jennifer Kyser, R.D., CSOWM, L.D., is a registered dietitian with Norton Healthcare.