Bypass Nutrition

Question
I had an MGB (Mini Gastric Bypass) in September and am doing well.  If you are not familiar with the MGB see clos.net for more information on this type of surgery.  I was educated very well about how to progress with foods, what foods to eat, what to wait on eating until more healing takes place, supplements needed, etc.  Also I know that using whey protein is important.  Is there anything more I can take to reduce the amount of loose skin I will have once my weight is normal?  I started at 247, now weigh 186, still have about 40 more pounds to go.  I am working out (resistance and cardio).  I am 50 years old but in the past have always been able to snap my tone back after several months of training.  I hope I can do it this time too.  I want to know if hydration is important for the skin.  We are supposed to drink mostly Gatorade, very little water.  I think further down the road water will be okay, but what to do in the meantime?  Now I take a multi vitamin, B-Complex, Flaxseed oil, Calcium w/D three times a day.  Any other supplements you suggest I can take?  
Thank you for your time.

Cheryl

Answer
Cheryl,

I am going to be really honest and tell you that  there is nothing sure-fire to ensure that skin will snap into place.  There are simply too many factors that impact skin integrity - genetics, how you carried your excess weight, skin thickness, hormone status, lifetime sun exposure, and more.  Even if you had been taking preventive measures for the past 3 decades, there is just no guarantee that that after you lose weight you will be happy with how much loose skin you will have and what it will look like.  Probably the most valuable things you are doing are following a good nutrition program and exercising regularly.  A lot of people mistake sagging muscle for sagging skin - and if you do end up having cosmetic surgery you will get a much better result if you have toned muscles.  

To your question: hydration is very important for skin.  You not only want good oral hydration, but keeping skin topically hydrated does help with elasticity.  There is some science to creams like the Dove body firming products - people often mistakenly think they will make them thinner or get rid of cellulite, which they don't.  What they do, however, is really increase the moisture content of skin and add some factors that nourish collagen and elastin.  At worst, they keep your skin soft, which is completely harmless.

There is minimal study on internal products that improve collagen and elastin.  They include glucosamine sulfate, Pycnogenol and phosphatidyl choline.  There are a couple of companies like Murad and Perricone that make supplements for this purpose - but I could not attest to how well they work.  If I was going to pick a single thing, I'd probably choose Pycnogenol.  The studies on collagen and elastin use between 50 and 100 mg per day.  There is also a combination product called Evelle - but I am not sure if it is available in the US yet.  It has Pycnogenol and a mix of other ingredients - and decent research on skin appearance and elasticity.

Finally, based on your age, I'd think about your hormones.  Estrogen has HUGE impact on skin elasticity and hydration.  HUGE.  If you are in menopause or close (based on age alone you have to be at least close) then I would talk to your doctor about hormones.  Even if you are doing them short term, they probably have a bigger impact than almost anything else.

Finally, I'd suggest that you get familiar with the options for cosmetic surgery.  You may or may not want or need it, but understanding it is a good idea.  There are some great books like Body Contouring Surgery After Weight Loss (Sebastian, Capella and Rubin) or Body Contouring After Massive Weight Loss (by Al Aly, MD).  So many people decide that they want cosmetic surgery after WLS that I just think being familiar with the procedures, the costs and other issues is a good idea.

Please let me know if I can assist with anything else!

In Health,

Dr. Jacques

1. Prev:18 months post op  (RNY)
2. Next:lap band procedure