This role statement was developed by members of the Bariatric Surgery Interest Group.

It lists the knowledge and skills of an Accredited Practising Dietitian (APD) working in Bariatric Surgery.

Knowledge

  • Current national obesity management guidelines and the role of bariatric surgery on the weight loss continuum.
  • Eligibility criteria to qualify for bariatric surgery, common types of surgery and the risks, complications and nutritional implications of each.
  • Perioperative and post-operative dietary prescriptions including Very Low Energy Diets to reduce surgical risk, texture modifications, prevention of dumping syndrome, gastrointestinal healing, safe recovery, and addressing/preventing nutritional deficiencies.
  • Aspects of long-term patient management such as management of post-operative pregnancy, maintaining nutritional status and prevention of late weight regain.1
  • Common mental health issues and their relationship with nutrition and eating behaviour, including an understanding of disordered eating in the development of morbid obesity.
  • Recognise the impact of medications on weight management, such as psychotropics and steroids.

Skills

  • Employ a patient-centred counselling approach that includes a non-judgemental attitude with respect to an individual’s choice to undergo bariatric surgery.
  • Determine appropriate and realistic bariatric surgery outcomes taking into consideration individual variables such as type of surgery, medical history and weight history.
  • Identify barriers and enablers to post-operative adherence to nutritional recommendations that may jeopardise long-term weight loss and psychosocial outcomes and use this information to advise the care team on the appropriateness of surgical intervention and to inform a patient’s decision to proceed with surgery.
  • Identify history of disordered eating behaviours and address the re-emergence of disordered or maladaptive eating behaviours through management and referring on if needed.
  • Employ behaviour change and counselling techniques to facilitate nutritional adequacy perioperatively and achieve longer term patient centred goals around health improvements postoperatively.
  • Ability to recognise that mental health is a complicating factor in weight management and to seek regular clinical supervision with an appropriate clinician (either intra or inter-disciplinary).

Activities entry level APDs would conduct

  • Apply the required skills and knowledge to the nutrition care process when working with bariatric surgery patients prior to and following bariatric surgery.
  • Determine realistic healthy eating and weight goals in collaboration with the patient taking into consideration type of surgery, medical history and weight history.
  • Provide appropriate nutritional education prior to and following surgery to support post-operative adherence to nutritional recommendations.

Activities APDs working at a higher level would conduct

  • Provide comprehensive dietetic consultations with consideration of the psychosocial aspects of seeking surgical intervention, readiness for change and understanding emotional connections with food.
  • Read and interpret body composition data and changes within this data over time.
  • Implement advanced nutrition counselling skills such as motivational interviewing and cognitive behavioural therapy to engage patients in a long-term therapeutic relationship to enhance treatment outcomes.
  • Management of post-operative nutritional complications associated with various surgeries
  • Plan appropriate menus for bariatric patients in institutional food services relevant to perioperative or postoperative stage.

 

For more, download the full role statement. The full statement includes a list of document references.

Get in touch

If you have questions about this role statement, contact us at policy@dietitiansaustralia.org.au

Our role statements describe the skills and knowledge of an APD working in a particular area of practice.
Dietitians treat a range of health conditions. They understand how nutrition affects the body and will give you expert nutrition and dietary advice.