TLC's reality TV show "My 600-Lb. Life" documents the challenging journeys of individuals with class 3 obesity as they pursue weight loss surgery. These individuals, with a body mass index (BMI) of 40 or higher, often face significant health challenges and require a comprehensive approach to achieve a healthier lifestyle. The show highlights the importance of not only surgical intervention but also the necessary lifestyle changes and dietary modifications that are crucial for long-term success.
What is Bariatric Surgery?
Bariatric surgery encompasses various procedures performed on the digestive tract with the aim of regulating the number of calories a patient can consume and absorb. These surgeries reduce the stomach's volume, thus limiting food intake. Successful weight loss achieved through surgery can significantly improve chronic conditions linked to obesity, including sleep apnea, nonalcoholic fatty liver disease, and joint and back pain. Furthermore, it greatly reduces the risk of heart attack, stroke, and certain types of cancer.
While bariatric surgery can be highly effective, it is essential to recognize that it is not a simple, immediate solution. The procedure carries risks, such as bleeding, blood clots, bowel obstruction, malabsorption issues, and hernias. It demands a life-long commitment to lifestyle changes.
Requirements for Weight Loss Surgery
Initial Assessment and Qualifications
Bariatric surgeons consider multiple factors when determining the most suitable surgical option for a patient. Generally, individuals with gastrointestinal diseases, severe heart or lung disease, or substance use disorders may not qualify for the surgery. It is imperative to have a thorough evaluation by a trained medical specialist to ascertain if an individual is an appropriate candidate for the procedure.
Pre-operative Weight Loss
Many surgeons require patients to demonstrate their commitment to lifestyle changes by losing weight before surgery. This preoperative weight loss can reduce the risk of post-surgical complications and improve overall outcomes. Dr. Mir Ali, a bariatric surgeon, often advises patients to adopt eating habits that reduce calories, carbohydrates, and sugar to promote fat loss.
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The Dr. Now Diet
Dr. Younan Nowzaradan, known as Dr. Now on "My 600-Lb. Life," employs a strict, low-calorie, low-carbohydrate diet to prepare patients for bariatric surgery. This diet, often referred to as the Dr. Now Diet, is designed for rapid weight loss to reduce the risk of surgical complications. The Dr. Now diet is based on three primary principles often referred to as FAT: frequency, amount and type. Amount: Calories are limited to 1,200 a day. Type: The Dr.
The primary goal of the Dr. Now Diet is to shrink the size of the liver, making the surgery safer and more accessible. Studies suggest that a low-calorie diet effectively reduces liver size. Ideally, patients should aim to lose 5% to 10% of their body weight before surgery.
Foods to Eat and Avoid on the Dr. Now Diet
The Dr. Now diet emphasizes lean protein sources, specific whole-grain carbohydrates, non-starchy vegetables, and nonfat dairy. Foods to avoid include those high in calories, sugar, and saturated fat, as well as some healthy foods like certain whole-grain products, potatoes, fruits, nuts, and seeds.
Dr. Now encourages eating high protein, high fiber, low calorie, low fat, and sugar-free foods on his diet program. The diet bans several nutritious foods due to their calorie content, including oatmeal, olive oil, nuts, and eggs.
Here's a sample menu you could follow for 3 days on the Dr. Now Diet. Since there are no snacks allowed on the diet, you'll only see breakfast, lunch, and dinner suggestions below.
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Day 1
Breakfast: 2 ounces (57 grams) egg whites with spinach, mushrooms, and 1 ounce (28 grams) part-skim mozzarella on 2 pieces whole-wheat toast, ready-to-drink low carb protein shake
Lunch: 3 ounces (85 grams) grilled chicken, salad with 2 tbsp. (30 grams) vinaigrette dressing
Dinner: 3 ounces (85 grams) broiled salmon with asparagus
Day 2
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Breakfast: 1 cup (245 grams) plain nonfat yogurt with stevia and 1/2 cup (75 grams) blueberries, 1 cup (240 mL) skim milk, 2 pieces turkey bacon
Lunch: 1 cup (238 grams) tuna salad made with nonfat Greek yogurt instead of mayo, whole-grain pita, celery, and carrots
Dinner: spiralized zucchini with 4 ground turkey meatballs, marinara sauce, and 1 ounce (28 grams) part-skim mozzarella
Day 3
Breakfast: fruit smoothie with 1 cup (240 mL) skim milk, 1 scoop protein powder, 1 cup (150 grams) strawberries, 1/2 avocado
Lunch: 1 cup (240 grams) broccoli stir-fry with 3 ounces (85 grams) tofu
Dinner: 2 cups (478 grams) low fat chicken and vegetable soup, side salad with 1 tbsp. (15 grams) vinaigrette dressing
The above meal plan details 3 days of meals that provide approximately 400 calories in each meal and stick to the foods allowed on the Dr. Now Diet.
Cautions Regarding the Dr. Now Diet
The Dr. Now Diet is not suitable for individuals who are not preparing for weight-loss surgery. A diet of only 1,200 calories is not sustainable for most people. Ultra-low-calorie diets can lead to weight gain in the long run by slowing down metabolism and can cause fatigue, malnutrition, heart problems, and muscle loss.
It is critical to consult with healthcare professionals before starting such a restrictive diet to ensure medical stability and to address any vitamin and mineral deficiencies.
Post-operative Diet and Lifestyle
Following bariatric surgery, patients must adhere to a specific dietary progression. Immediately post-surgery, a liquid diet is typically required for at least two days. This is followed by a high-protein diet of pureed foods, gradually transitioning to soft foods before resuming a normal diet.
Long-term success hinges on adopting new, healthy habits. This includes eating smaller portions of foods high in protein and low in carbohydrates, while avoiding sugary and high-fat foods.
Support and Resources
Sustaining weight loss after bariatric surgery requires ongoing support and resources. Many centers, like Texas Laparoscopic Consultants, offer classes, pre-operative weight management, and post-operative nutrition counseling. Additionally, specialized vitamins and meal replacement products designed for bariatric patients can help meet their unique nutritional needs.