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Bariatric Surgery – What to Eat When the “Honeymoon” Wears off

by Sarah Muntel, RD

Fall 2012

The first few months after bariatric (weight-loss) surgery, can seem easy. Patients have limited hunger, eat very small volumes of food, and struggle to get all their food in daily. During this period, it seems as if the weight is just falling off of you. Many people refer to this first year after surgery as the “honeymoon period.” Unfortunately, the “honeymoon” doesn’t last forever.

Things are different as you reach the one-year mark. Typically, as patients near their one-year anniversary, hunger returns a bit, food volumes increase and it can be more of a struggle for people to stay on track.

Your diet is very important throughout your journey, but some argue it is even more important as you reach the one-year mark. Following your bariatric diet in the long-term is crucial to having lifelong success. Here are a few tips to keep you going as you approach the one-year mark.

Tips to Keep You Going

Eat solid food.

This is a lesson you learn at pre-op class, but it is even more important now than it was early on in your journey. Runny and crunchy foods slip right through your pouch and leave you feeling hungry more quickly, which allows you to eat a greater volume. New post-op patients tend to eat softer foods. They are easy to eat and go down so easily and that can become a habit. If you don’t start eating solid food, you’ll notice a big change in the amount of food you eat and your hunger level.

A protein supplement may not be the best breakfast for someone one-year post-op because it is a liquid and does not satisfy you. Instead, eat solid food like a scrambled egg and cheese.

Limit your carbs.

We focus on protein at the beginning of your program. As you advance your diet, you may start adding more carbohydrates. Carbohydrates are to be added in moderation. Be very careful with this. Some patients add in a whole grain cereal at breakfast, whole grain pasta at lunch and brown rice for dinner. These are all acceptable choices, but not if you have them in the same day!

Some patients find the more carbohydrates they eat, the more they crave. As they begin to add more carbohydrates, they want to eat more and more. For the patients we see in our clinic, we put them on a very low carbohydrate diet to get their diet under control. They typically find their cravings go down and they are not as hungry. As they gain more control, small amounts of carbohydrates can be added back into their meal plan.

Protein, protein, protein

Protein is and always will be the center of your meals. At this point, you should be getting most of your protein needs (60-80g per day for most) met by eating three protein-based meals. Eating three to four ounces of good solid protein at each meal is a good way to meet your protein needs and keep you full for a longer period of time. Some people want to add in a protein supplement. Most people do not need a supplement because they are meeting their protein needs with the food they eat. Adding a protein shake at this point only adds extra calories because your needs have been met. A common misconception is that if you want to lose more weight, add a protein shake!

Limit your snacks.

If you snack, make good choices. I recommend three meals per day. Snacking in between meals typically leads to handfuls of carb-based foods (like crackers, cereal or chips). In a perfect world, this works. In our crazy busy lives, it doesn’t. If you are going longer than five hours between meals, think about having a snack. Keep your snacks protein-based (a cheese stick, cup of yogurt or an apple with peanut butter are all good choices) and keep snack foods out of the house. This will keep you full and prevent you from overeating at your next meal.

Journal your foods.

This one makes everyone cringe. Every dietitian out there asks patients to do it. The reason why is because it works! When you write your foods down, you are mindful of what you’re eating. It is so easy to grab a couple bites of a snack at work, bites of your child’s dinner and a cookie at a social event. These are all things you would never remember you ate if you weren’t actively writing them down. Anytime you are struggling, start a journal and you will quickly find what you need to improve.

Plan your meals.

Planning is everything after bariatric surgery. When you are newly post-op, you plan your meals, supplements, vitamins and fluid. As your diet advances and you are able to eat a greater variety of food, it is easy to begin eating on the run and not planning ahead for meals. If you don’t plan ahead, you can begin grabbing high calorie foods that will slow down your weight-loss.

Recently, I spoke with a man who had been fixing his lunch in the morning and having scrambled eggs. He got out of the habit and began running through a fast food restaurant every morning and getting a breakfast sandwich. He couldn’t figure out why his weight-loss had slowed. Eventually, he realized it was because he was not eating his planned breakfast and was choosing a breakfast that was around 250 calories extra and he was having it every day!

Get your fluids.

You should always strive for 64 ounces of fluid per day. This can be a struggle when people are newly post-op, but as you approach the one-year mark, most people do not have trouble with it at all. The problem I see is beverages with calories making a comeback. Adding in beverages with calories can slow your weight-loss quite a bit. Stick to calorie-free, non-carbonated, non-caffeinated beverages for your best choice.

As you read through these tips, realize that you won’t be perfect. No one is perfect. You do need to make sure that you don’t start deviating too far from the rules. If you start slipping a little, get right back on track. You will find the more you follow the rules, the more successful you’ll be!

About the Author:
Sarah Muntel, RD, is a registered dietitian with IU Health Bariatric & Medical Weight-loss. She has worked in bariatrics for the past 12 years and enjoys helping people get to a healthy weight so they can improve their health, feel better about themselves and become more active.

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