We are committed to helping you reach important weight loss goals and we are here to support you. Surgery is just one step on your journey.Following surgery, many patients lose weight rapidly.But it's important to make the commitment to a lifestyle of healthy eating and regular exercise.

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Introduction
 As we all know everyone must eat
for survival.
 Problem arises when the choice of
foods leads to either health
benefits or adverse effects

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Topics of Discussion
 Healthy diet
 Effects of imbalanced diet
 Causes of obesity,
Factors effecting healthy eating
 Problems related to obesity
 Strategies for healthy eating

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Healthy diet
 Which includes all nutrients in
correct proportion to promote and
preserve health.
 Healthy diet should contain all food
groups while staying within energy
needs.

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Food
Pyramid

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 Energy giving foods includes cereals and millets –
rice, maize, wheat, jowar, bazra, noodles, pastas.
 Body building foods includes milk, meat, poultry,
fish, pulses and legumes, nuts.
 Protective food includes green leafy vegetables
and fruits.
 Other vegetables includes roots and tubers.
 Fats and oils, sugar and jaggery.

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NUTRITION DISORDERNUTRITION DISORDER
Obesity and its health
consequences

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Effects of imbalanced diet
 Over weight or obesity
 If the amount of food intake
remains constant but energy
expenditure is less there will
be gain in weight.
 Under weight
 If the intake of food is less or
energy expenditure is more
than there will be loss in
weight.

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 Shortage of time
 Stress
 Lack of sleep

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Causes of obesity
 Easy availability of
junk food
 Modernization
 Economic status

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 More prone to diseases
 Diabetes
 Cardio-vascular
 Dyslipidemia
 Hypertension
 Stroke
 Gallbladder
 Depression
 Osteoarthritis
 Infertility
Following a healthy lifestyle is best prevention of these
Problems related to obesity

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Technological advances
have taken away much of
the activity in our lives
 Fewer active jobs
 Greater reliance on motorised transport
 Energy-saving devices in the home, at work and
shopping environment
 Attractive and cheap home screen entertainment
CHALLENGE IS TO COUNTERACT THESE
EFFECTS

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Cellular phones and remote controlsCellular phones and remote controls
deprive us from walking!deprive us from walking!
20 times daily x 20 m = 40020 times daily x 20 m = 400
mm
Walking distance lost/yearWalking distance lost/year
400x365 = 146,000 m400x365 = 146,000 m
146 km = 25 h of146 km = 25 h of
walkingwalking
1 h of walking = 113-226 kcal1 h of walking = 113-226 kcal
Energy saved =2800-6000 kcalEnergy saved =2800-6000 kcal
Rössner, 2002Rössner, 2002
High-Tech increases
Body Weight
 0.4-0.8 kg adipose tissue0.4-0.8 kg adipose tissue

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Biological and cultural
mismatches to the modern
environment
FOOD
 Strong signals to eat
 Weak signals to stop
 Increased availability
 Eating is rewarding
 No viable alternatives
 Eating well is high
status
ACTIVITY
 Weak activity signal
 Strong signals to stop
 Reduced availability
 Inactivity is rewarding
 Inactivity is a viable
alternative
 Inactivity is high status

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Spectrum of obesity management

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Weight loss has
beneficial health effects
 Improved glycaemic control
 Reduced blood pressure
 Improved lipid profile
 20% reduction in premature mortality in
overweight women with obesity-related health
conditions
Goldstein DJ. Int J Obesity, 1991
A weight loss ofA weight loss of ≥≥ 5% in obese individuals5% in obese individuals
with comorbid type 2 diabetes, hypertensionwith comorbid type 2 diabetes, hypertension
or dyslipidaemia resulted in:or dyslipidaemia resulted in:

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Obesity management:
objectives
 Promotion of weight loss
 Long-term weight maintenance
 Long-term prevention of weight gain
 Improvement of risk factors
 Encouragement of active lifestyle
 Improvement in quality of life
 Change in eating pattern

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THE MANAGEMENT OF OBESITY:
AN INTEGRATED APPROACH
 Obesity is a serious medical condition requiring
long-term management
 Management needs to be flexible and integrate
different therapeutic approaches according to
individual patient needs including
 Dietary management
 Lifestyle modification
 Physical activity
 Drug therapy
 Surgery

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Strategies for healthy eating
 Eat enough calories but not too
many
 Eat wide variety of foods
 Keep portions moderate
 Drink more water
 Limit sugar, salt and refined
grains
 Eat regular meals
 Make changes gradually
 Daily exercise 30 – 40 minutes

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What are your options??
1. Diets, exercise, and behavioral change
 Up to 10% loss of excess body weight
 Ineffective long-term: less than 5% sustain any
significant weight loss
2. Weight Loss Surgery
 Average 55-75% loss of excess body weight
Source: Adkinson, Am J. Clinical Nutrition, 1994

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Who Qualifies for Weight-Loss
Surgery?
Clinical Terms Used to Describe Various Levels of Body Fat
Normal Weight
(BMI 18.5 to 24.9)
Overweight
(BMI 25 to 29.9)
Obese
(BMI 30 to 34.9)
Severely Obese
(BMI 35 to 39.9 )
Morbidly Obese
(BMI 40 or more)
BMI 18.5-24.9 BMI 25-29.9 BMI 30-34.9 BMI 35-39.9 BMI>40

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Home Diet Following Surgery
Specific details about diet following
weight loss surgery as diet need to be
modified in all nutrients. Generally this
consist of:
 Drastically limiting volume
 Limiting the consistency of food
 Limiting the types of food
 Chew food well
 Eat meals over a 30 to 45 minutes time span

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Last but not the least,
remember great souls
have wills, feeble ones
only have wishes.