Calorie Counting

Calorie Counting: 5 Mistakes to Avoid When Tracking After WLS

February 19, 2018

Weight loss surgery depends mostly on restriction. Many patients rely on restriction without having a proper nutrition plan, or have a very a strict caloric controlled plan but end up sacrificing flavor or not enjoying their meals.

Let's get into what the so-called Calories actually are. A calorie is a measure of energy, not a measure of nutrition. Technically speaking, a dietary calorie is defined as the amount of energy required to raise the temperature of 1 kilogram of water by 1 degree Celsius.

The body’s energy currency is based on this calorie. We expend calories by thinking, walking, eating, sleeping, every activity your body performs requires calories. We intake calories, by eating and drinking, every meal has calories, the difference relies on the caloric density of foods.

Foods are packed with varying calories:

  • 1 gram of fat stores 9 calories
  • 1 gram of protein has 4 calories
  • 1 gram of carbohydrates has 4 calories
  • Alcohol is packed with 7 calories per gran without any nutritional value.

In reference to weight control, calories matter only as a mathematical equation. If your intake exceeds the expenditure, you will gain weight, and vice-versa if you burn more calories than you intake you will lose weight.  Sounds simple but metabolism plays a very important role in the balance of body weight, and then we add the nutritional value and the thermic effect of food. So, actually, calories are just a simple number in a very large equation to keep weight down.

Calorie Counting: 5 Mistakes to Avoid When Tracking After WLS

1st Mistake to Avoid: Don’t rely only on the number of calories in a food choice. Remember, calories are just a number of energy. There are more things than calories involving your metabolism. Don’t eat just because you think you will burn some number of calories. The main goal is to focus on your nutrition and to have a proper protein intake; the surgery will take care of the quantity and some of the absorption.

Make sure to keep your intake balanced on nutrition than just a number of calories.

2nd Mistake to Avoid:  What many people do not know is that if a company packs less food than what it says on the label, they get penalized, so it is very common that if the label says 100 grams, for example, the company will pack 110 grams to be on the safe side and avoid penalties. This means you will intake extra calories that you aren't including in your tracking. Be sure to take this into consideration when adding calories to prepackaged foods.

Having a blind trust in the food labels on packaged foods. We count calories based on the nutritional information on the label that a product contains.

3rd Mistake to Avoid:  Don't fall into the mindset that exercise will allow you to eat all the calories that you want. Many patients will base their meals in relation to the calories they will be burning with a certain activity. The "calorie burning numbers" are estimates based on a segment of the population, they are not specific to you. How many calories you will burn with a specific activity will again depending on your metabolism, hormones, intensity and many factors that we cannot measure on a single patient easily.

If exercise is a constant in your life and you can rely on a daily workout to burn calories, we recommend using a BPM calculator or sports watch to keep your burning rate more exact.

4th Mistake to Avoid:  Make sure that you consider the thermic effect of food (TEF). Not all the calories are created equal, so it is important that you take into account the thermic effect of food. To digest food we burn calories, some foods require more work from our body to break them down in our digestive system so these foods are said to have a higher thermic effect. Examples are protein and high fiber vegetables.

The more processed your meal is, your body will require less effort to break it down so you burn fewer calories during digestion. Try to skip high-calorie liquids, starches, sugary food, high-fat foods. If you need to use some of these ingredients, try to mix them with vegetables or fiber so this will increase the work on the intestine hence you will burn more calories just by eating.

5th Mistake to Avoid:  Stay aware that alcohol is high in empty calories. The first rule in regards to alcohol is to avoid it right after weight loss surgery, given that it affects scaring tissue and the healing process. Alcohol is irritating to the stomach and to the anastomosis, it can promote reflux and strictures, and it’s very easy that you can transfer an addiction from food to alcohol so we recommend you avoid it at least the first year after your surgery.

Alcoholic beverages have more calories per gram than carbs and protein. We call them empty calories because they don’t count as nutritional calories, the body does not use alcohol as a nutrient.

Every gram of alcohol is loaded with 7 calories, in addition to the calories that the liquid has from carbs. For example, a glass of wine can have 12.5% alcohol per 100 ml, this means that every 200 ml (approximately 6.7 ounces) is loaded with 25 grams of alcohol multiplied by 7 calories is a total of 175 calories just from the alcohol intake, plus the carbs! A mixed drink can have anywhere from 300 calories up to a 1000 calories per drink. If you drink 2 times a week and have 3 drinks, you can add 2000-4000 calories every week. Some weight loss surgery patients avoid eating to be able to keep drinking, so for those patients, the alcohol adds malnutrition to the equation.

If You Choose to Only Count Calories

  • Keep yourself aware of the big picture of nutrition.
  • Don’t sacrifice quality or the joy of having a normal small meal just to become a calorie counting machine.
  • Know the nutritional info on your meals instead of just the calories.
  • Set your goals on a number of calories for the day and stick to a 20% up or down.
  • Calories will help you to keep track of your daily balance, but the importance is in how you have those calories, having more protein, more vegetables, more fruit, good healthy choices.
  • Do not eat all your daily calories in one meal, and try to have 5 meals spread out through the day.
  • Eating 65% of your total calories before 4:00 p.m. will boost your metabolism.
  • Avoid carb calories at night to help you to avoid turning carbs into fat.


Dr. Edgar Campos is a clinical bariatric doctor and nutritionist with over 10 years of experience with pre-op and post-op bariatric patients. He also supports patients with non-surgical options for weight loss such as the balloon procedure and nutritional guidance. Dr. Campos  practices medicine at Mexicali Bariatric Center as the medical advisor and bariatric doctor.  He is an 8-year post-op gastric sleeve patient himself.

Read more articles from Dr. Edgar Campos!