With a surge in weight-management ‘solutions’, diet shakes are everywhere these days. You’ve probably encountered them at your local pharmacy counter. And they certainly don’t compare to the old malted milk from the diner. Did you know that they can play an active role in weight loss or bariatric surgery? And that you need to proceed with caution when choosing to shake, rattle and roll? Let’s explore:
About our expert
Sally Johnston is Your Bariatric Dietitian, Accredited Practising Dietitian and Accredited Nutritionist providing specialist dietetic advice for individuals undergoing bariatric (weight loss) surgery. Sally is the author of Knife, Fork and Band: Your Healthy Living Plan with a Gastric Band. For more details on Sally and Knife, Fork and Band, head to her website. You can also follow her on Facebook and Twitter for regular updates on weight loss surgery and tasty recipes.
Worth the wait?
Many people heading for weight loss surgery are put on a meal replacement program first. And if that sounds a little bizarre let us explain. You see people store fat all over the body, including organs such as the liver. When the surgeon comes to operate, the liver must be moved aside so the stomach can be accessed. A fatty liver is enlarged and floppy and therefore difficult to move during surgery, similar to moving a lump of jelly with chopsticks. Hence it is useful to reduce the size of the liver before surgery to prevent damage. A specially formulated meal replacement program, such as the Optifast® program that includes shakes and bars, is recommended to do this as part of a medically supervised rapid weight loss program.
Meal replacement programs are very low in energy (kilojoules or calories). When you gain little energy from food, the body has to find energy from elsewhere to perform all of its normal functions. This energy is found in stored body fat, some of which is stored in the organs, including the liver.
Other benefits of waiting to lose weight prior to surgery include reduced operating time, improved recovery, improved mobility following surgery and potentially improved management of other medical conditions such as diabetes or high blood pressure.
Too easy?
You may be thinking that meal replacement programs sound too easy and are the perfect tool for anyone wanting to lose some weight? Yes, they can be, but it is important to proceed with caution.
Meal replacement programs can be safe and beneficial, however a dietitian and GP should supervise the program, particularly if you have a medical condition such as type 2 diabetes or high blood pressure. When following a meal replacement program prior to surgery you should not need to seek out a support team as your weight loss surgery crew should provide monitoring and advice. If you are using a meal replacement program for general weight loss, regular monitoring by your GP is essential. He or she will review your medications as you may need to decrease doses. There can also be a range of side effects that you may need advice in managing.
Meal replacement programs cause the body to burn your fat stores for ‘fuel’. When we burn our fat stores we produce chemicals called ketones in a process called ketosis. Ketosis helps reduce appetite and prevents the loss of lean muscle tissue as you lose weight. However, you are likely to experience a ‘three day challenge’ when you first begin a meal replacement program. As the body systems move into ketosis some people experience fatigue, hunger, headaches, nausea and lack of concentration. Usually these symptoms pass by days four to six. Keep focused and positive during the three day challenge, knowing it will soon pass.
When meal replacement programs are used for two weeks prior to surgery, extensive side effects are unlikely. However, if you continue a program for longer than this, side effects that may occur include:
- Sensitivity to cold
- Dry skin
- Temporary rash
- Temporary hair loss
- Low blood pressure on standing
- Fatigue
- Diarrhea
- Constipation
- Muscle cramps
- Bad breath
- Irritability
- Menstrual disturbances
So make sure you proceed with caution and don’t be tempted to go it alone. See your doctor and Registered or Accredited Practising Dietitian to help you manage a meal replacement program, including medical management, practical advice and support.
Editor’s note:
Thanks Sally, great advice to consider meal replacements only under the care of a health professional. I know I would struggle without some “real” food. Some products are part of broader weight-loss programs, but others taken purely as a diet shake, lack the fundamentals of weight-loss success. They do not teach portion control and healthy food choices, involve an active lifestyle, provide a supportive environment or promote habit change. Once meal-replacements are stopped, many people find themselves back at square one and weight regain occurs. It’s also important to realise that a few products are formulated by government guidelines, with appropriate levels of vitamins, minerals, fibre, omega-3s and more, others are lacking in key nutrients and are not nutritionally complete. So here’s your chance to ask Sally a question about weight loss surgery or meal replacements? Or simply share your views or news on the shake scene. We’d love to hear. Drop us a comment below.
