At nearly 400 lbs and struggling to play with his young kids, MasterChef Graham Elliot decided to make a significant change in his life and have weight loss surgery. We wondered if a man who built a career on food would still be able to taste the richness of his work after the surgery, so we asked some of our LocateADoc.com doctors what affect would the surgery have on the diet of patients like the TV chef.
“My experience with sleeve gastrectomies is that patients tend to have very few food intolerances (common with the other procedures),” Newport News, VA Bariatric Surgeon, Dr. Thomas Clark said. “This by itself makes a sleeve gastrectomy a good choice for Mr. Elliot.
“A sleeve gastrectomy is a great choice for most people considering weight loss surgery. We tend to see very good weight loss without the long term problems that tend to go along with either gastric bypasses or adjustable bands. With a sleeve gastrectomy there is very minimal risk of nutritional problems which are common with gastric bypasses and there is no need for routine adjustments or worry about mechanical device problems common with adjustable bands.”
Elliot was an ideal candidate for the surgery as his children drove his desire to get healthy and live longer.
“I have a 6-, 3-, and one-year-old, and seeing them play and run around, the fact that I couldn't get down on the ground and roll around and play with them, I couldn't go to the park and play tag, or do any of those things,’’ Elliot told the TODAY show last month. “I realized that it wasn't about me anymore. It wasn't about just how I looked or anything else, but being healthy for my family was the trigger.”
Dr. Keith Marshall of the Michigan Institute of Bariatric Surgery said a patient that fits the ideal candidate profile has a 10 times higher mortality rate just from being obese.
“The ideal candidate is someone with BMI over 35 with high cholesterol, Diabetes and high blood pressure,” Dr. Marshall said. “After surgery, all these problems go away. Surgery is safer than gallbladder surgery or childbirth. Bariatric surgery (0.1 % mortality is about 1/1700). Gallbladder surgery mortality is 0.52% (or 1 / 250). Getting rid of obesity prolongs life at least 10-15 years.”
Dr. Michael Feiz who practices in Beverly Hills, CA noted that every patient will recovery differently.
“ I know you have heard this before but this is actually literal for this type of surgery,” Dr. Feiz said. “For example: there are patients who love the taste of eggs before surgery and then after they simply cant even stand the smell of eggs. Or there are patients that feel very little nausea after surgery and then there are those that have unexplainable nausea for the first several months.”
The surgery takes about an hour and is done laparoscopically.
“During the surgery about 75% of the stomach is removed but nothing is ‘bypassed’,” Dr. Clark said. “A good visual is taking a normal stomach, about the size of a 2 liter drink bottle, and making it about the size of a medium banana. So, you would have a much smaller stomach and can’t eat very much. Another important way the surgery works is that by removing most of the stomach a hunger producing hormone, called ghrelin, goes way down making hunger much easier to control.”
Dr. Marshall and Dr. Clark said that most patients go home after a day or two.
“There is very little pain,” Dr. Marshall said. “You are on clear liquids for about 5 days, then full liquids like soup, cereal and protein drinks. You begin puree/soft foods the second week, cooked veggies, fruit and ground meat and fish. Salad and dark meat chicken at six weeks. No chops, steak or breast for three months. [Patients] tend to not like anything too fatty or greasy, also wont like sweets as much.”
Dr. Feiz said the post-op diet is liquid only for the first month focusing on hydrating liquids with a sprinkle of other things like broths, soups, and protein shakes.
“I explain to patients that their stomach is like a funnel after surgery,” Dr Feiz said. “The mouth is like the wide portion of the funnel and the stomach is like the narrow portion. The patient has to try to take at least 32 ounces of water. But like pouring oil through a funnel when changing oil, if you pour too quickly it will overflow and for our patients if you drink too quickly they will overflow... i.e. throw-up. Therefore they have to be sipping all day long... this is a priority.”
After the first 4-6 weeks passes the patient will be able to drink more and feel less pressure, and this is when the purred food the consistence of cream of wheat are added into the diet, according to Feiz.
“The thicker it is the harder it is to get down,” Dr. Feiz said. “The reason for this is that the stomach is healing and tighter and stiffer. As time goes on, it will be softer and be able to accommodate more volume. I compare it to a new pair of shoes. It starts out a bit stiff and as you wear it in it softens up and then it fits just right.”
Between 2-3 months soft solid food can be added to the diet including items with the consistency of scrambled eggs or softer oilier fishes like salmon.
“It is important for the patients to understand that at this time they will feel stuffed only after one or two ounces of fish,” Dr. Feiz said. “It is important for patients to take advantage of this time to re-learn their perceived portion sizes and to not eat to the maximum capacity of their stomach. With time they will be able to eat everything but in smaller portion.”
Elliot, who had the surgery back in July and completed his first 5k at the end of November is working on the re-learning process Dr. Feiz describes.
"If friends are eating fast food or baking fresh chocolate chip cookies, it's difficult not to grab even a tiny piece. Mentally, I've got to start thinking of that stuff as the enemy,” Elliot said.
Learn about the advantages and disadvantages, doctor reviews and more within the Sleeve Gastrectomy Resource Guide, which includes an extensive before and after picture gallery. To consult with sleeve gastrectomy doctor, look through LocateADoc.com profiles to find a specialist in your area.
Graham Elliot photo from Celebuzz.com.