Food After Bariatric Surgery

Re-Think the Way You Think of Food After Bariatric Surgery

August 1, 2018

Ask anyone who knows me and they will tell you these two things define me: racing cars and being a passionate dietitian. Most would think these two things have nothing to do with each other.

Food Is The Fuel For Your Body

You can’t drive a car without gas, and you cannot run your body without food.

I often use the example of food being the fuel for your body. The most astonishing thing my patients have to learn is that, even after bariatric surgery, you still need food in order to lose weight. Once you understand this concept, you can begin to change your relationship with food, no longer thinking it is the enemy to your successful weight loss. Instead, you begin to realize its importance in your journey to a healthy life.

Your metabolism is the way your body converts what you consume to energy, which powers your body every day. It is an incredibly complicated series of systems and pathways which took me an entire year in college to learn.

So let’s keep it simple. Every time you eat something, it is processed from its starting form all the way down to the individual nutrients that it contains. We tend to think of mainly the macronutrients: fat, carbohydrate, and protein. Anyone who has ever gone on a diet, and certainly people who have tried numerous diets, can tell you that they all start with eliminating one of these nutrients. This is both the problem and solution to weight loss.

By eliminating a category, you almost unavoidably eliminate some calories daily. Calorie deficit is how we lose weight. It’s as simple as that. But the problem with these diets is that our bodies require all three of these macronutrients so a person cannot sustain a diet that eliminates one of them. The person inevitably goes back to eating the eliminated food and gains weight back. Let’s use this as our jumping off point for discussing food as a fuel source, not the enemy.

A History Of Chronic Dieting

All of the patients I have counseled over the years have one thing in common: a history of chronic dieting. Therefore, their first question is always “what kind of diet will I be on before and after surgery.” This question is always tough for me to answer because, in truth, I don’t want to put my patients on a “diet”; I want to change their lifestyle and relationship with food.

So the best answer I have come up with is “well, we do require a liquid diet in the weeks before surgery, and after surgery, you have to slowly progress back to eating solid food while your body is healing. But after that, it is really up to you to make the choices you know will keep you healthy.” In reality, yes, I do teach my patients that they need to prioritize protein and minimize carbohydrates. The reasoning behind putting protein first is simple: if we do not take in enough protein on a daily basis, our bodies will begin to break down our muscle mass in order to obtain protein which in turn will lead to malnutrition.

While carbohydrates are important as a quick source of fuel in our body, they don’t really sustain us.

I think my patients generally understand this teaching the best when I tell them this simple truth: our bodies are made to first use carbohydrates as an energy source, then protein and lastly fat. So basically, the last thing our bodies want to do is burn our stored energy (fat), but this is the goal of every patient sitting in front of me.

Start Seeing Food As Fuel

So I give you the tools to get your body to this point. It is a combination of calorie deficit and making sure your body has access to enough protein daily to avoid muscle breakdown. This is where we start seeing food as fuel. I am actually counseling my patients to eat. Yes, I want them eating certain things, but still, they must eat in order to lose weight. My most successful patients are those who don’t overly restrict their diet, but instead always make sure they meet their daily protein goal, hydration goal, and exercise goal.

It isn’t about avoiding food, it’s about choosing what food you are going to use to fuel your body.

All food has calories. This is just fact. Usually, when wanting to lose weight, we are highly focused on calories. But hopefully, you are now thinking not just of total calories, but what those calories are made up of (macronutrients). If I tell you that you need to eat 1200 calories or less per day in order to lose weight, how are you going to decide where those 1200 calories come from? Some people will want to save all of those up to eat at their fancy dinner out on date night. Others load up half of those daily calories when getting their morning coffee beverage at Starbucks. And others meticulously track and calculate through the day. But what is the right way?

Enter The Bariatric Registered Dietitian

Enter the bariatric Registered Dietitian to save the day. Every person will have different needs and goals, so I can’t just put it out here as “do this and you’ll lose weight.” But when I set up goals for a patient, my process is the following.

First, I need to determine their overall calorie needs. In our practice, we do this through REE (Resting Energy Expenditure) testing. This test gives us an estimation of how many calories you need per day, just to stay alive (yes, we burn calories through breathing, heart rate, etc.).

Once I have this number, I set your daily calorie goal below this (at least 300-500 calories below which will allow you to lose about 1 pound per week). Now that I have your daily calorie goal, it’s time to talk about those pesky macronutrients again. I always start with protein. Most of my patients need about 1 gram of protein per kilogram of body weight. After that, I divide the remaining calories between carbohydrate and fat grams. Then it is up to the patient to track their intake.

If they consistently meet their restricted calorie goal, they lose weight. However, if they aren’t meeting their daily protein goal and instead more of their calories are coming from fat and carbohydrate, they will also be losing muscle mass which leads to the person feeling weak and also looking more “sickly” as opposed to healthy. And there it is!

This is why we must think of food as fueling our bodies. It is simply not enough just to restrict ourselves of calories, but instead, we must understand how these specific calories and nutrients are functioning in our bodies.

Yes, I want my patients to eat foods that contain all the macronutrients, but it must be done in the right proportions. We see food as the enemy when we are consuming too much of it, or simply too much of the wrong macronutrients.

Food After Bariatric Surgery Summary

So now it is up to you. Reading this article may have given you motivation or simply put more questions in your head. Whatever the case, I encourage you to seek out a qualified medical professional (such as a Registered Dietitian or bariatric surgeon) to help get your own personal goals set up.

I hope if nothing else that reading this article has taught you that food is a necessary part of our lives, regardless of our goals related to our weight, and should never be our enemy. Food is an intricate part of our lives and how it functions in our bodies is amazing, but we must use it correctly with healthy habits to truly fuel us.

ABOUT THE AUTHOR

Danielle Houston RDN, LD is a Registered Dietitian Nutritionist and Licensed Dietitian at New You Bariatric Center who has been specializing in weight loss (bariatric) surgery for the past 3 years. She graduated with a BS in Dietetics from the University of Arizona in 2008 and is currently the Practice Manager (and dietitian) at New You Bariatrics in Irving Texas.

Read more articles by Danielle!