Coming into this role mid last year, I didn’t really know what to expect, I hadn’t really ever worked with patients undergoing weight loss surgery before. I was stepping into the unknown.
As a new grad dietitian, I dabbled in a few things before finding the perfect job. I knew I never wanted to be a “hospital dietitian”. I didn’t want to be around “sick people” all day long. I wanted to see people who choose to walk through the doors and talk to me, people who wanted to take charge of their health and who were willing to put their best foot forward doing so. I was in a job I was content with and I never really thought I would leave it honestly. But then life happens, two kids later I got the 7-year itch, we relocated and 1126km later, we arrived on the Gold Coast. The decision had already been made to move and I am so lucky to have secured my job at WLSA during our transit.
I had been doing the same thing day in and day out for years, it was time to start using my brain again! I envisioned so many similarities between my old job and my new job. However, nothing could have prepared me for the overwhelming sense of achievement of watching my patients transform from the first time they sat in our rooms, nervous, sometimes hesitant to the confident people exhubing self-love that they become along the way.
At this point in time, bariatric surgery is the only effective and sustainable option for weight loss in morbidly obese patients. As health professionals, we often read about how doing this can result in that but it’s not until you really experience how profound an effect that has on your patients that you truly start to appreciate how life-changing weight loss surgery can be and how pivotal your role as a dietitian is in that patient’s weight loss journey.
It is well documented that weight loss can improve health outcomes, for example, we know weight loss can improve blood glucose levels by enhancing insulin sensitivity. During my time at WLSA, I have seen all my patients with type 2 diabetes come off their oral medication just weeks after their surgery. Whilst there is no official term such as remission of diabetes, this is life changing for them. I remember seeing one older male patient not long after I started who was on extremely high amounts of insulin in addition to his oral hypoglycemics with a weight of 220kg. Having worked for the diabetes service, I instantly knew that those doses of insulin were yes, controlling his diabetes and minimising those long term micro and macrovascular complications, however, they were also preventing him from losing weight, if not, contributing to further weight gain. Six months after surgery, he is now 50kg lighter and completely off his insulin and one of his oral hypoglycemic agents however I am sure in time, he will no longer require any diabetes medication. I’d like to think I’ve made a significant contribution in enabling him to achieve all the milestones he has so far. This is a gentleman who called me 1 week into his pre-op diet just to tell me that after living in his unit for 7 years, he has just worked out how to use his oven!!!! I’ve guided him through some of the initial changes he had to make, specifically throughout his pre-surgical diet, in the initial phase after surgery whilst he transitioned back to a normal textured diet, along with educating him on how he will be able to meet his nutritional requirements with the constraints of the procedure.
Whilst bariatric surgery gives our patients their tool for weight loss- it restricts the volume of food eaten, there is no single procedure which necessarily improves the quality of food consumed. We know bariatric surgery is most effective when combined with an intensive follow-up care package involving a multidisciplinary team, particularly one that places a high importance on nutritional care post surgery which enables the patient to continue to feel supported in developing healthy food and lifestyle choices for the rest of their life.
My experience working in the diabetes service and now the surgical weight loss industry has given me an appreciation of the web of factors that contribute to obesity. I am passionate about delivering the highest level of care to all my patients by providing practical, individualised and evidence-based care in order to support the team I work with to achieve the best outcomes for all our patients and there is no other job in the world I would rather be doing.
Happy Dietitians Day 2017 xo