Diet and behavior adjustments following bariatric surgery

This post was written by Jenna Walker, MS, RD, CD, bariatric coordinator, certified weight management educator, Parkview Weight Management & Bariatric Surgery.

After bariatric surgery, success is achieved by living a healthy lifestyle to ensure you reach your overall goals. These changes hinge on commitment, time and determination. It can be very difficult mentally and emotionally to change everything you have known for many years regarding your behaviors and food choices.

Building a foundation

It’s important to begin working on these modifications before a life-changing bariatric surgery procedure, which is why our patients typically go through a three to six-month education process preparing for the surgery. What you have to understand, is that bariatric surgery and the weight loss that follows, is a journey. It’s not a miracle solution that works overnight. We start discussing behavior and diet changes at the very first appointment.

These behavior changes 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 exercise makes you very aware of what you are doing daily to help make changes and notice your patterns. Multiple studies show that food journaling increases weight loss. This is an ideal habit to get into daily.
  • Establishing an exercise routine.  Movement is so important for weight loss. This includes multiple short walks a day or working up to taking longer walks. As weight loss continues, it’s easier to do more and more activity. Activity is very important for long term success and weight maintence.
  • Eating slowly at meals.  After surgery, it should take at least 20-30 minutes to eat 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 after surgery, they will get sick.
  • Eating protein first at each meal.  Protein is the most filling food. It 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 then a large plate with small portions. After surgery, your portions are going to be much, much smaller than the ones you ate before surgery. 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. After surgery, you’ll have to cut out all carbonation and high calorie drinks such as pop, carbonated water, juice, sports drinks, etc.  
  • Timed fluids.  After surgery, you cannot drink 30 minutes before, during or for 30 minutes after 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 bariatric surgery, especially at first, you won’t always feel hungry at meal times. It’s still important to eat! Eating regularly scheduled meals also helps you lose weight more quickly by regulating your metabolism. Many people think eating one meal per day increases your weight loss. This is not the case. Typically, by skipping meals, people tend to snack through the day more, which leads to taking in too many calories.
The post-surgery journey

After bariatric surgery, the stomach needs time to heal. You’ll be instructed to follow diet phases to get back to solid foods. This begins with a clear liquid diet, then full liquid, followed by soft/pureed 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 maximum you should eat long term is 1 cup per meal. It is important to try to stick to mostly protein, vegetables and fruit at meals. Bariatric surgery patients can get off track when grazing in between meals too much, snacking on carbohydrates and sugar.

Bariatric surgery is not an overnight decision, and is typically recommended for people who’ve tried to lose weight most of their lives. It’s a great tool to help with weight loss, but the surgery will not do it for you. It takes the combination of hard work, lifestyle changes and the procedure for success long term!


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