Am Confused - Dr.'s "nutritionist" vs. regular nutritionist

[mmcclure 3]

My daughter and I recently found out that we have to do the intensive diet and behavior modification program for three months in order for Aetna to cover any part of our surgeries. (This after we were told repeatedly that we didn't. - Sigh).

When we saw the nutritionist (I think that is what she is) in the surgeon's office, she told us to go on very high Protein, low carb diets. 60-70 grams of Protein a day for me and 70-80 grams for my 21 year old daughter. She also told us to make sure we drink 32 oz of skim milk a day and a total of 64 oz of liquids (water making up most of the rest). She said that it is really important that we start upping our protein now and it will also help us get in the right mindset for after surgery.

Then, later that day, we went to see the nutritionist that the doctor's office recommends for the 3-month diet counseling. She did a practically 180 degree about-face and told us to follow a 1200 - 1500 calorie diet and her diet meal plan (that only shows 5 days worth), has a lot of carbs in it. When I said something to her about the other person's diet, she only looked at me and kind of shook her head yes.

So - now I am totally confused. It has been a week since we saw both of them and my daughter and I are trying to do a higher-protein diet with limited calories and carbs. I need to work harder at getting all of my liquids in but my daughter is doing great with her milk and Water.

I know that everyone seems to get a different pre-op to follow but, if you were asked for your advice on doing a three-month diet prior to surgery and losing some weight in the process, while getting two conflicting diets to follow, which one would you do? BTW, I did call the surgeon's office and asked them which one we should follow and was told, "the nutritionist" (meaning the one NOT in their office). However, the five day diet really isn't much help, especially since Breakfast and lunch are kind of prohibitive since we are both out of the house for 10 hours a day, 4 days a week and are usually in a hurry to get out the door in the morning and neither one of us really likes to eat Breakfast. We certainly don't have time to put together the meals she has listed (and they can't be made ahead). However, I suppose we could try to improvise if we need to.

So - votes, please. Follow the high protein, low carb easy to do diet, or the "usual" balanced diet of protein, carbs, fruits, etc that you usually see from nutritionists? Oh, and BTW, not that this should make much difference, but the high-protein advocate said that, if we really wanted something, we could have it once a week.

Those of you who were required to do the three or six month pre-op diets for insurance approval - what kind of diets were you told to follow?

Thanks!

Marilee

[educationrulz 18]

Marilee, I think you've got two separate issues going on here and that's why there appears to be a conflict. It sounds like the second "typical" diet IS the type of diet you would follow for long term weight loss, like a 3-month or 6-month supervised diet for insurance purposes. I didn't have to see a nutritionist beforehand for UHC but this is the type of diet that my PCP recommended.

The high Protein, low carb diet sounds more short term, like what you will need to do 2 weeks before your surgery. I suspect that's why the doctor's office told you to follow the out of office nutritionist's diet. The in-house nutritionist is probably used to working from the preop/postop diet perspective as opposed to the long term insurance hoops diet. But, this is all conjecture on my part.

I think we are using the same surgeon so I can verify that I was told to do the high Protein, low carb diet for 2 weeks prior to my surgery. This is the only dieting advice I was given by the surgeon's office as related to my eating before the surgery. Everything else they gave me was about the postop diet. I did lose 14 pounds! on the preop diet over the course of 2 and 1/2 weeks. I started a little early to drop some weight I had gained since my initial consult. It really did the job. But, it's not something I could have done for 3 or 6 months. It's just not varied enough.

I think right now you should focus on doing what your insurance wants you to do. Do they expect you to lose weight before surgery, or just to provide documentation that you ATTEMPTED some type of doctor/nutritionist prescribed diet? For me it was the latter. If that's the case, it doesn't matter which diet you choose. Pick the one that you can follow the most or use a combination of the two. Just be sure you don't drop below the mandatory BMI for surgery or the insurance will deny you. That's what I was most concerned about in terms of my 6 month supervised diet.