Five Questions With: Jane Sylvestre

Jane Sylvestre, a dietary nutrition specialist with the Care New England Center for Surgical Weight Loss, was honored recently as this year’s recipient of the American Society for Metabolic and Bariatric Surgery Excellence in Nutrition Award.

Sylvestre accepted the award Nov. 14 in the Broadway Ballroom of The Omni Nashville Hotel in Nashville, Tenn., during the ASMBS Foundation’s inaugural Gala & LEAD Awards.

The Excellence in Nutrition Award honors an ASMBS member who has made significant contributions to preoperative and/or post-operative nutrition. Providence Business News asked her about her 10-year career in the field.

Please tell us about your work: What does a preoperative and post-operative nutritionist’s day look like?

- Advertisement -

SYLVESTRE: As a nutritionist, I have the opportunity to meet with patients at various points on their bariatric surgery journey. Many insurance companies require patients to meet with a dietician to prove they have made an effort to lose weight prior to proceeding with bariatric surgery, so I see several of these patients each day. For those who have been approved for surgery, we meet to discuss what their diet will look like after bariatric surgery, goal setting, eating patterns, diet changes/challenges and food habits that will ensure long-term success after surgery.

At each preop appointment, we set goals to help patients work toward a healthier diet and lifestyle closer to their post-surgery plan. In post-op appointments, we discuss tolerance to diet, satiety, adequacy of diet – especially protein, calories and fluids; compliance with recommended vitamin and mineral supplementation; GI-related issues; rate of weight loss; and physical activity. Emotional eating often comes up as a topic as well.

I also write a monthly newsletter for patients, manage an online support group, oversee a mentor program, maintain nutrition information for patients, schedule classes/support groups/cooking classes/supermarket tours, manage our Bariatric Boutique for patients to trade in for clothes that fit them, and coordinate events [such as] the Walk from Obesity coming up this May, and our “A New Beginning” celebration event, which will highlight many patients who have been very successful. I also try to stay on top of current nutrition research, as nutrition is a forever-changing field.

Please tell us a little about the New England Bariatric Surgery Dietitian Network and how you founded it.

SYLVESTRE: The New England Bariatric Surgery Dietitian Network is a group that stays connected via a Listserv and conferences highlighting current research in the field of nutrition and bariatric surgery.

I founded the network in 2012 when I was attending a similar meeting of nurses that was growing too large and was asked that the dietitians create their own group. I headed the group for the first three years and recruited two other leaders to assist me in this endeavor.  The three of us created a Listserv and invited all bariatric dietitians throughout New England.

We were able to coordinate care across New England, as well as learn and stay on top of the research with each other’s input. We then planned and executed an annual daylong bariatric conference that continues. Our Listserv is no longer active, but dietitians now connect throughout the country on the Academy of Nutrition and Dietetics Listserv, which did not exist at that time of inception of our network.

What is the Bariatric Boutique?

SYLVESTRE: The Bariatric Boutique is a room in our office, which was remodeled into a large closet to hold the clothes of patients who have lost weight throughout their weight-loss journey.

When a patient is losing weight rapidly, they change clothing sizes frequently and this can get quite costly – especially at larger sizes. We now have a large collection of jeans, dress pants, shirts, sweaters, coats and fancy event clothing for patients to take for free. We have sizes that range from 5X to small, and I noted large to smaller sizes intentionally, as that is how patients transition. I change out the clothes for each season.

When I took this position as lead dietitian at the Center for Surgical Weight Loss at Care New England, I realized we had the spare room and asked if we could put up bars and shelves to transform it into a large closet. Our program coordinator, Sherry Peter, and Care New England were happy to accommodate, and the room has been a big hit and huge blessing for many patients.

How long have you been running your “Back on Track” program providing hands-on cooking classes and supermarket tours? Can you tell us how this has helped your patients?

SYLVESTRE: I have been running my “Back on Track” classes since I first started working in bariatric surgery about 10 years ago.

I believe this program is essential for giving patients real-life experiences. I believe “hands-on” is the best way to learn. What better place to learn how to read a food label than in a supermarket? Also, I do not do all the cooking myself at my cooking classes – the patients do. Preparing ingredients, following simple recipes, and enjoying the final dishes gives patients autonomy and a feeling that they can go home and prepare their own meals.  Patients eat much healthier when they prepare their own food rather than purchasing takeout, convenience foods and especially fast food. Patients learn how to prepare foods.  They learn about clean eating.

I have some patients who come to class and are better cooks than I am and others who have never boiled an egg. We all have a great time. The best part of all these classes is building relationships. I build a closer, more personal relationship with patients, which makes it easier for them to open up to me and ask for help when needed, and they build relationships with each other, which helps form a community among our patients.

CNE noted that you’ve enhanced the preoperative and post-operative nutrition experience at the center. Can you explain how you did that?

SYLVESTRE: I believe I have added a sense of community for our patients. Bariatric surgery is not a “one and done” surgery. Our patients need lifelong follow-up and commitment to the program for success. That will not happen unless a patient feels a sense of belonging.

I started by creating an email list that includes every patient I see, and even those who came through our program before I started working here. I created a monthly newsletter to send out to more than 500 patients. I am sure that will continue to grow.

My newsletter includes my monthly blog, as well as a recipe of the month, information about support groups or any upcoming classes, pictures from recent events, and an introduction of upcoming events [such as] the Walk from Obesity on May 18. I also include a story “spotlight” from a successful patient with their before and after pictures. I am always sure to send reminders for support groups and classes to maintain patient participation. I also participate in a closed Facebook group on a daily basis.

I developed a mentor program, which allows our successful patients to guide our new patients just starting their journey. I hold training meetings for our new mentors and monitor the program. I host the support group program and run the Back on Track program, which includes a supermarket tour and cooking class. All the above provides a feeling of belongingness and a sense of community!

Rob Borkowski is a PBN staff writer. Email him at