How Can I Be Successful With Bariatric Surgery?

There are 9 main behavior changes that will help you be successful with Bariatric Surgery.

These changes should be started before surgery and will continue life-long.

1. Meal Timing & Frequency

• Do not skip meals.
• Eat 3 meals every day.
• Eat at schedule times.
• Eat breakfast within 2 hours of waking up.
• Meals should be 4-6 hours apart. 
• Snacks should be minimized. Have a snack if needed for blood sugar control, if needed for exercise, and if needed to meet your protein needs. 

2. Meal Size & How To Eat

• Take small bites.
• Eat slowly and mindfully.
• Stop eating and drinking when you feel full. 
• Eating past fullness can cause weight gain, stretching of the stomach, nausea and vomiting. 
• Avoid distractions when eating. 
• Before surgery the stomach can hold about 48 ounces. After surgery the stomach will hold between 1-8 ounces.
• After surgery you will start off eating 1-2 oz per meal. This will increase to about 8 oz (1 cup). 
• Use the "20-30 Rule": Chew food 20-30 times before swallowing. Meals should last 20-30 minutes. 
• Don't graze.
• Drink water in between meals.

3. Drink Enough Water / Fluids

• Dehydration is dangerous.
• Dehydration can cause constipation, poor nutrient absorption, headaches, weakness, electrolyte imbalance and stress on the kidneys. 
• Most people will need between 48-80 oz of water daily.
• You may not feel thirsty.
• Keep water with you. Keep sipping. 
• Water is the best option. 
• Artificial sweeteners are acceptable but may cause sweets cravings, constipation and decreased nutrient absorption. 
• Beverages must be low calorie, non carbonated, caffeine free.
• After surgery, do not drink liquids within 30-60 minutes after eating. Don't drink at meals. 

4. Consume Enough Protein 

• Protein is needed by every cell and tissue in the body.
• Protein is needed for healing, hair, skin, bones, nails, muscles, strength and fat loss.
• Protein keeps you full and reduces hunger. 
• Protein is a top priority after surgery. Eat protein first at meals. If you fill up on other foods you won't be able to eat enough protein.
• Most people will need 60-80 grams of protein. 

5. Vitamins and Minerals

• Vitamin and Mineral Supplements are needed post surgery.
• Weight loss surgeries make you consume less food, less calories and less vitamins and minerals.
• Weight loss surgeries put you at risk for developing nutrient deficiencies. These can be life threatening if not managed well. 
• Some weight loss procedures also decrease your nutrient absorption. 
• Labs should be checked at least yearly to monitor your nutrition status. 
• Routine supplements are needed.
• You may need different supplements based on your labs and other clinical needs. 
• Make sure you keep going to your doctors appointments and let all health care providers know that you have had a weight loss surgery. 

6. Fruit, Vegetables, Whole Grains

• These foods keep you alive, healthy, and full.
• Before surgery, try to have balanced meals that include protein, whole grains / complex carbohydrate foods along with fruits and vegetables.
• The volume of foods will be limited after surgery. 

7. Avoid Sweets and High Fat Foods

• After surgery, sweets and high fat foods can cause dumping syndrome and can limit your weight loss.
• Avoid sugar, honey, brown sugar, cake, ice cream, baked goods, candy, soda, juice, sports drinks, ginger ale.
• Avoid high fat foods: salami, pepperoni, bacon, sausage, chips, pork rinds, mayo, sour cream, cream cheese. Very small amounts of healthy fats may be included. 

8. Exercise

• Exercise helps with weight loss, strength, health and mood.
• Follow your doctors instructions for when and how to exercise.
• Try for 30 minutes of cardio / aerobic activity most days.
• Try for strength training 2/week. This helps you build and maintain muscle mass and may help improve your metabolism. 
• Don't forget to stretch. I recommend yoga once a week. 

Here are some ways to increase your activity:

• Take a 5 minute walk break when you feel stressed, bored or distracted.
• Park you car far from work and stores. 
• Take a family walk.
• Walk to work if possible
• Walk your children to school if possible.
• Do chores at home.
• Take an after dinner walk.
• Do online exercise programs.
• Find a walking partner. 
• Look in to gym memberships.
• Consider a pool membership. You might like lap swimming, pool exercises or water aerobics. 
• Use a smart watch to track your steps. 

9. Get Support

• Changing your lifestyle is tough. You need help, and help is available.
• There are local support groups that meet regularly.
• There are many online support groups available through social media.
• You are not required to continue in support groups post surgery, but this is highly recommended.
• Look in to your healthcare team: Surgeon, Primary Care, Therapist, Dietitian. There are specific requirements before surgery and less after surgery. However, you are highly encouraged to maintain regular and as-needed appointments after surgery.
• Do you have friends, family, and co-workers who can support you?

Final Thoughts

Losing weight with bariatric surgery requires a total lifestyle change.

You'll incorporate all of these things:

• Diet change.
• Exercise. 
• Increased nutrition knowledge.
  
• Positive motivation.
  
• Focusing on overall health.
  
• Self esteem and loving yourself.
  
• Realistic goals. 
  
• Behavior change. 
  
• A helpful support system.