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Key changes for success after bariatric surgery

Last Modified: January 14, 2021

Family Medicine

Bariatric Surgery

This post was written by Jenna Walker, MS, RDN, LD, bariatric coordinator, PPG – Weight Management and Bariatric Surgery.

Following bariatric surgery, a patient has to make changes that demand commitment, time and determination. It can be very difficult mentally and emotionally to change everything you have known for years, with your behaviors and food choices.

It’s important to work on these modifications before a life-changing bariatric surgery procedure. Patients typically go through a three-to-six-month education process to prepare for the surgery. What patients have to understand, is that bariatric surgery and the weight loss that follows, is a journey that won’t happen overnight. Behavior and diet changes are something that we discuss at the very first appointment with our patients.

Changes to behavior following surgery, include:

Keeping a food log daily.  Writing down what you eat, how much you eat, what you drink, how much you drink and how much you exercised makes you very aware of what you are doing daily to help make changes and notice your patterns. Multiple studies show, food journaling increases weight loss. This is an ideal habit to get into daily.

Establishing an exercise routine.  When establishing goals for weight loss and exercise, it’s important to focus on just moving more than you are or were prior to surgery. This includes multiple short walks a day and working up to taking longer walks. As weight loss continues, it’s easier to do more and more activity, which is essential for long-term success and weight maintenance.

Eating slowly at meals.  After surgery, it should take at least 20-30 minutes to consume a meal. This includes chewing each bite 20-25 times before swallowing. If a bariatric surgery patient eats too quickly or does not chew well enough, they will get sick.

Eating protein first at each meal.  This is key for success. Protein is the most filling food. Protein also plays a vital role in building and maintaining body structures, including muscles, etc. Protein from food should be a main focus at each meal after surgery. Protein supplements are required after surgery for a period of time as well.

Using smaller plates and bowls to help control portions.  A smaller plate full of food will look more satisfying than a large plate with small portions. After surgery, portions are much, much smaller than a person can eat normally. Initially, a post-surgery patient can only eat ¼ cup per meal.

Aiming for at least 64 oz. of fluid per day.  Water is always the best choice. Patients have to cut out all carbonation and high-calorie drinks such as pop, carbonated water, juice, sports drinks, etc.  

Adjusting drinks schedule/routine.  Patients cannot drink 30 minutes before, during or 30 minutes after their meals. By avoiding fluids during, before and after meals, it ensures that the stomach will be completely empty so you can take in the recommended amount of food. Following bariatric surgery, the portions will be small, so this is important. Another reason eating and drinking together is not recommended, is because when you eat and drink at the same time, you can liquefy your food in your stomach. When your food is a liquid consistency, you are able to eat a larger volume, which leads to a higher calorie amount at your meals.

Eat three meals per day.  After surgery, especially at first, bariatric surgery patients don’t always feel hungry at mealtimes. It’s still important to eat! Eating regularly scheduled meals also helps accelerate weight loss by regulating your metabolism. Many people think eating one meal per day increases weight loss, but that’s not the case. Typically, by skipping meals, people tend to snack through the day more, which leads to taking in too many calories. 

Other key adjustments

After bariatric surgery, the stomach needs time to heal. Patients are instructed to follow diet phases to get back to solid foods, including a clear liquid diet, full liquid, soft/pureed diet and then back to solid foods. It takes approximately five weeks to get back to solid foods.

Food portions after bariatric surgery slowly increase over the first year. The max a person should eat long term is 1 cup per meal. It’s important to try to stick to mostly protein, vegetables and fruit at meals. Bariatric surgery patients can get into “trouble” when grazing in between meals too much, snacking on carbohydrates and sugar.

Bariatric surgery is not an overnight decision and typically fits for someone who has been trying to lose weight most of their life. It’s a great tool to help with weight loss, but the surgery will not do it for you. Hard work, lifestyle changes and the procedure combined can result in a healthier, happier life.


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