IMPORTANCE OF DIET JOURNALS
IMPORTANCE OF ROUTINE DIET JOURNALS TO AIDE IN NUTRITIONAL COUNSELING FOR POST-OP BARIATRIC PATIENTS
Susan Champion BS, Mike Williams MD, J. K. Champion MD
Videoscopic Institute of Atlanta, Atlanta Georgia, USA
Presented ASBS 2003
Background: Simple monitoring of post-op weight loss after bariatric surgery is inadequate to identify most dietary problems and provide appropriate counseling. This paper reviews our experience utilizing a routine diet journal to improve outcomes after laparoscopic gastric bypass.
Methods: From March- October 2002, we followed 89 patients at their three-month post-op visit and also identified 11 patients at one year or later with < 50% EWL. Three month patients were assessed with weight, %EWL, and a two day diet journal to identify patients who have not advanced to solids, skip meals, don’t exercise, or eat soft high carbohydrate diets. The late group was assessed with 30 day diet journals and monthly counseling visits for three months to re-establish weight loss. We anticipated at least 30% EWL at three months.
Results: Only 14 patients (16%) lost less than 30% EWL at 3 months. 44 patients were identified with compliant diet journals and mean %EWL was 40.1%. 45 patients (51%) were identified as non-compliant, but mean %EWL was 39.2%. Initial BMI was similar between the groups (49.7 vs. 48.7 respectively). In the late group five of 11 patients (45%) failed to return for counseling. Mean %EWL in the cooperative 6 patients was 9% (range 4-20%) after three months.
Conclusion: Mean %EWL is a poor indicator of dietary compliance early after laparoscopic gastric bypass, and a routine two-day dietary journal can more accurately identify problem patients. Late patients benefit from more intensive 30 day diet journals and monthly counseling to re-establish weight loss.
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