Protein is the most important macronutrient for the bariatric patient. For this reason, patients should be instructed to consume protein at the beginning of a meal to ensure adequate intake if the patient becomes sated prematurely. During pregnancy, protein needs are 1.1 g/kg/day. There are no published protein guidelines for bariatric patients during pregnancy. Therefore, protein recommendations may vary among institutions. Our program recommends 60-80 g/day for the RYBG, 80-120 g/day for the BPD-DS, and 0.8-1 g/kg/day of adjusted body weight for AGB in nonpregnant women. Each pregnant bariatric patient should be encouraged to meet the upper end of the protein range specified for her type of surgery. If needed, protein intake may be supplemented with sugar-free protein shakes.
Patients are instructed to avoid pregnancy during the first year after surgery, since this is the period of most rapid weight loss. If there is an unplanned pregnancy during this time, protein requirements should be increased to 1.5 g/kg/day of ideal body weight.
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