Recent literature currently supports that there is a significant rise in our population suffering from both obesity and morbid obesity. Generally, obesity is defined as having a Body Mass Index (BMI) of more than 30, and morbid obesity as those with BMI greater than 40. BMI is a calculation based on height and weight. For example, a height of 5’ 4” and weight of 235 lbs. results in a BMI of 40. Given these definitions, obesity rates have grown 24% in the last 5 years, and morbid obesity rates more than 50%.

These statistics are alarming, and even more so once the secondary effects on health are considered. Just to identify a few, obese persons are substantially higher risk for high blood pressure and heart disease, type II diabetes, mellitus, degenerative joint disease, obstructive sleep, apnea syndrome, asthma, depression, as well as post-operative complications after general anesthesia. While many of these conditions have medical and surgical therapies that can be quite successful, preventative treatment is always preferable.

 Nutritional approaches for obesity and morbid obesity are geared at reducing caloric intake and increasing energy consumption, while providing psychological education and support to change a person’s eating habits and lifestyles over time. Despite multiple weight loss supplements that are available and can help, the key is to first establish a sensible diet.

 One of the pitfalls during caloric reduction is to neglect the key vitamins and minerals that our bodies need to optimally perform. Most notably these include the water-soluble vitamins B6, B12, thiamine, riboflavin, niacin, biotin, choline, and vitamin C. These are not well stored by our bodies and therefore must be replenished frequently, if not daily. In addition, Vitamin E, although a fat-soluble vitamin that is well stored, is not necessarily plentiful in many diets. Key minerals that are often in short amounts from our nutrition include calcium, folate, iron, phosphorous, zinc, selenium, and magnesium.        

These key micro-nutrients are needed for our bodies to function well, especially in regards to our immune system, blood cells, bones and muscles, and our nervous system. Some studies have supported that obese individuals are more prone to deficiencies specifically in anti-oxidants (Vitamin E, A and C), B vitamins, folate, and fiber. Given the associated medical conditions with obesity listed above, deficiencies in these could add insult to injury. Furthermore, People with a RYGB operation will be dependent on a life long supply of Iron, Calcium and Vit. B12.

In order to maintain adequate intake of these needed vitamins and minerals, the recommended servings of daily fruits and vegetables are five a day. Because most people fail to meet these guidelines, nutritional supplements are encouraged as a safety measure. It is noteworthy however that there are still unidentified micro-nutrients in whole foods and grains that our bodies likely require, so even supplementation does not alleviate the need to eat sensibly.

 Fruits and vegetables are a great source of fiber as well, and generally are less in calories compared to other food groups. Fiber not only has many wonderful health benefits long term, but also speeds the transit time through the stomach and intestines. This in turn reduces the time for food absorption into to body, and secondarily reduces calorie consumption. If you have had gastric bypass surgery however, this may not be recommended since “dumping syndrome” can occur as a result of the bowel already being surgically shortened.

The main key is to reduce the amount of calories while instituting a balanced amount of healthy food groups that provide adequate proteins, amino acids, vitamins, minerals and carbohydrates. In addition, vitamin and mineral supplementation is encouraged to maintain optimal health.

Second line of defense and equally as important as good nutrition, is daily exercise along with lifestyle changes, natural weight loss supplements if needed, and dedication to this plan. There are other options of treatments if these measures fail which you should discuss with your physician or dietician, but establishing a good diet and nutritional plan will even allow these measures a higher chance of success.

All nutritional and vitamin intakes should be consulted with one’s physician especially the patients after Morbid Obesity operations.