What does a bariatric dietitian do?

If you missed it, I recently got a new job as a bariatric dietitian! I’m really enjoying the role so far.

Bariatric dietitians support patients with their dietary needs before and after weight loss surgery. 

Each day is different, but I wanted to do a day in the life of a bariatric dietitian to give you an idea. I’ve also kept things confidential by not talking about a specific day.

8am: I start work at 8am. I eat my breakfast at my desk and with a cup of tea and I’ve come to love this little routine! I alternate between yoghurts and granola or porridge pots. I add protein powder to keep me fuller for longer too.

As I’m eating, I check my emails and plan out my day. 

Today I have a morning clinic that’s joint with the bariatric nurses. This is 3 months after the patient has had surgery, giving us a chance to check in and see how they’re doing. We weigh the patient, take their blood, check any clinical problems, and see how they’re eating.

9am: the first patient arrives for their appointment. They are doing well with no issues like nausea or constipation. They also losing weight as we’d expect at this stage. I go through their diet and identify they’re not getting enough protein. 

After surgery it’s crucial to get enough protein to help maintain your muscles. When you lose weight, you’ll lose fat and some muscle too, so keeping on top of your protein can help minimise this.

We talk through ways for them to increase protein at each meal and add a high protein snack between meals too.

10am: the next patient arrives. They’re not happy with their weight loss and feel they should be losing more. We go through realistic weight loss targets and explain that most of the weight loss is in the first 6 months, so they still have time to lose more. 

They also say they feel nauseous at times. This can be common after surgery as people aren’t used to eating a smaller quantity. If you overeat, or eat too quickly, you’ll feel sick. 

We go through ways to manage this by slowing down when eating, chewing each mouthful 20 times, putting cutlery down in between each mouthful, and eating with no distractions. 

11am: the next patient is here. We go through their typical diet, and it’s revealed they’re swapping meals for protein shakes instead. Their weight loss is steady, but they also feel a bit constipated. 

We talk about the fact that we want them to be eating actual food by this stage and getting protein from lean sources like fish or chicken. They also need to include vegetables at each meal as these are a source of fibre which can help with their bowels. 

12pm: we normally have a patient at this time, but they had rescheduled. I take this time to tidy up the notes I wrote during the consultation and do my dictations. 

We use a Dictaphone to record our letters to the patients GP, and it’s then typed up by the admin team. The letter is summary of the appointment, and includes the patients weight history.  

1pm: lunch time! Today I’ve got a veggie chilli with rice and an apple. I try to get 2 different vegetables in at lunch and have a piece of fruit after to help me get to my 5 a day.

1.30pm: there’s no more clinic patients for today so it means I can do some ad hoc phone calls for the rest of the afternoon. We do 2 types of calls: liver reduction and 2 week post-surgery calls. 

The liver reduction diet is a low calorie, low carbohydrate diet done for a minimum of 2 weeks before the surgery to shrink the liver. 

This allows it to be moved to the side so the surgeon can access the stomach for the operation. We call patients to talk them through the diet, let them know what to expect, and answer any questions before surgery.

The 2 week post-surgery calls are a check in to see how the patient is feeling after their surgery. It also gives us a chance to talk through the post-surgery diet stages. After the surgery it’s 2 weeks of high protein liquids, then 2 weeks of puree food, 2 weeks of soft/minced food and then onto a normal textured diet. 

The patients are already aware of the diet stages, but it gives them a chance to ask any questions, and we can see how they’re doing. If they’re having issues like nausea, pain, or constipation we can give them tips to manage it.

After each call, I write up my notes and log who I’ve spoken to. 

4pm: home time

And that’s my day done! We do other clinics during the week and we have to check the patients’ blood results after they’ve had them, but I thought this was a good insight into a typical day.

I hope you enjoyed this, let me know if you’d like more days in the life.

Bye for now! 👋