Why Breakfast Matters for Weight Loss, Weight Regain, and CravingsAugust 3, 2020
Breakfast Matters for Weight Loss
Initial weight loss after bariatric surgery begins to slow sometime around 12 – 18 months following surgery. Patients that may have slowly picked up any of their bad eating habits again may not have seen any negative effects during the first year, but this is the time that the impact of the old habits may begin to show. One of the old habits might be skipping breakfast. I'll discuss why breakfast matters for weight loss, weight regain, and food cravings.
Weight Regain and Staying On Track
A few years after bariatric surgery, some patients will even find that they begin to regain some of the weight they have lost after surgery. This is not uncommon, in fact, research shows that between 25 to 35 percent of patients who undergo bariatric surgery regain some of the weight they have lost . Obesity is considered a chronic disease, and a person can “relapse” into habits that lead to regaining.
What are some steps to staying on track? Taking a good look at how much you are eating is a great place to start. That means not only the volume of food, but the calories, and what makes up those calories (protein, carbohydrates, fats, etc).
Tracking all your meals to get the full picture of everything that you are eating helps keep you accountable, and good to have if you want to review your meals with a nutritionist. The first focus should be to take a look at what you are eating for breakfast each day – what is on your plate? This is the first step in learning why breakfast matters for weight loss.
Breakfast, originally hailed as “the most important meal as the day” by C.W. Post as a marketing campaign for cereal against his rival Will Kellogg in 1944, which included many health claims including that it could cure everything from malaria to appendicitis .
Lucky for us, there has been some research about breakfast options and how they impact us over the last 50+years (and some other ways to treat malaria and appendicitis). Breakfast can indeed be the most important meal, as it can impact food intake for the remainder of the day.
But what is equally important is what you eat for breakfast especially the makeup of the macronutrients. Macronutrients are types of food that are required in large amounts in the diet like a protein, carbohydrate, or fat.
Breakfast Matters for Weight Loss With Protein, Not Carbs
A meal made up of mostly carbohydrates, like cereal, muffins, bagels, or toast will be digested by the body and turned into glucose (sugar) which enters the blood stream almost immediately. The body can easily use carbohydrates for energy.
Even though the stomach feels full and the body feels energized, the satisfying feeling does not last. Blood sugar rises quickly, but the spike in blood sugar is followed by a fall shortly thereafter. This fall in blood sugar, also known as the “crash” causes hunger, sleepiness, and cravings for more sugar.
Carbohydrate digestion starts in the mouth, and then the food is passed quickly through the stomach (this quick emptying is what can cause dumping syndrome after certain types of bariatric surgery).
As carbohydrates pass through the stomach, often described as “sliding” through, they do not give the feeling of fullness (satiety) that protein would give.
Because carbohydrates move through the stomach quickly there is room for more food sooner. This process is what allows for “grazing” where bariatric patients eat small amounts continually throughout the day. Protein is digested at a much slower rate because it takes longer to digest, helping maintain the feeling of fullness, and also helps you eat less throughout the day .
The thermal effect of food (how much energy is burned digesting, absorbing, and disposing the food that was eaten) is also much higher in protein. 20-30% of the calories of the protein meal will be used just to help digest it (carbs only use 5-10% of their calories) ! What this means is that it takes more calories, energy (and time!) to digest a meal that has more protein.
Studies have proven that high protein breakfasts increase feelings of fullness and decrease levels of hunger hormones in the body [5, 6]. Subjects in the studies with the best results had 30g of protein at breakfast – this might be tough after bariatric surgery! Try and split it up between your breakfast and your morning snack, but choose high protein options. Some choices are 4 oz of greek yogurt (~10g protein), 4 oz of cottage cheese (~8g protein), 2 eggs (~14g protein) or bariatric friendly overnight oats (~22g protein).
Protein goals are always a big focus post-bariatric surgery and sometimes those goals are met by supplementing with protein shakes. While it is okay to have a shake at breakfast, try to consider some food to meet your breakfast protein goals as well.
Solid food increases the extent of fullness and reduction in appetite . That’s because just the process of chewing sends messages to the brain that signal fullness! Increasing the number of chews per bite will further increase the release of those hormones. . If you do supplement with a protein shake, whey protein has been reported as providing slightly more fullness than others, but soy, pea, gelatin and others all gave similar results .
Better Food Choices and Control Cravings
The bottom line – starting the day with a high protein meal keeps you full throughout the day and will make it easier to make better choices throughout the day. This tiny adjustment can make a difference and help control hunger cravings.
Bariatric surgery is a tool to lose weight, and after the initial weight loss, it is important to maintain healthy eating habits to keep the weight off. Following up with a nutritionist or your bariatric surgeon also are important as well. Studies have shown that increased follow up has been associated with better weight loss results after bariatric surgery . These strategies are important for all patients whether they want to maintain or work on their weight loss.
- Felsenreich DM, Langer FB, Kefurt R, et al. Weight loss, weight regain, and conversions to Roux-en-Y gastric bypass: 10-year results of laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(9):1655–1662. doi:10.1016/j.soard.2016.02.021
- Bratskeir K. Why Breakfast Isn't the Most Important Meal of the Day. LIVESTRONG.COM. https://www.livestrong.com/article/13721066-breakfast-most-important-meal/. Published September 9, 2019. Accessed February 24, 2020.
- Martens EA, Lemmens SG, Westerterp-Plantenga MS. Protein leverage affects energy intake of high-protein diets in humans. Am J Clin Nutr. 2013;97(1):86–93. doi:10.3945/ajcn.112.046540
- Gibson MJ, Dawson JA, Wijayatunga NN, et al. A randomized cross-over trial to determine the effect of a protein vs. carbohydrate preload on energy balance in ad libitum settings. Nutr J. 2019;18(1):69. Published 2019 Nov 9. doi:10.1186/s12937-019-0497-4
- Leidy HJ, Clifton PM, Astrup A, et al. The role of protein in weight loss and maintenance. Am J Clin Nutr. 2015;101(6):1320S–1329S. doi:10.3945/ajcn.114.084038
- Lemmens SG, Martens EA, Born JM, Martens MJ, Westerterp-Plantenga MS. Staggered meal consumption facilitates appetite control without affecting postprandial energy intake. J Nutr. 2011;141(3):482–488. doi:10.3945/jn.110.133264
- Gwin JA, Leidy HJ. A Review of the Evidence Surrounding the Effects of Breakfast Consumption on Mechanisms of Weight Management. Adv Nutr. 2018;9(6):717–725. doi:10.1093/advances/nmy047
- Miquel-Kergoat S, Azais-Braesco V, Burton-Freeman B, Hetherington MM. Effects of chewing on appetite, food intake, and gut hormones: A systematic review and meta-analysis. Physiol Behav. 2015;151:88–96. doi:10.1016/j.physbeh.2015.07.017
- Westerterp-Plantenga MS, Lemmens SG, Westerterp KR. Dietary protein - its role in satiety, energetics, weight loss, and health. Br J Nutr. 2012;108 Suppl 2:S105–S112. doi:10.1017/S0007114512002589
- Spaniolas, K., Kasten, K. R., Celio, A., Burruss, M. B., & Pories, W. J. (2016). Postoperative Follow-up After Bariatric Surgery: Effect on Weight Loss. Obesity Surgery, 26(4), 900-903.
ABOUT THE AUTHORErica Amianda, P.A.-C is a Lead Physician Assistant & Manager with the Bariatric Program at Hackensack University Medical Center. She has a Master's in Healthcare Administration & a demonstrated history of working in the hospital & health care industry. She has multiple years of clinical & administrative leadership experience with a strong interest in quality improvement. From Erica, "I’m a Bariatric PA passionate about obesity & being a PA!"