How to do Keto Diet after Bariatric Surgery?

Medically Reviewed by Katelyn J. Mock, US-Registered Dietician (R.D.)

A research study by Nicholas J Krilanovich[1] Benefits of ketogenic diets” Nicholas J Krilanovich, The American Journal of Clinical Nutrition, Volume 85, Issue 1, January 2007, Pages 238-239, Published:01 January 2007
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 in the American Journal of Nutrition states that reducing carbohydrates and switching over to a fat-rich ketogenic diet allows for drastically cutting down calories without feeling rapaciously hungry.

Logically, consumption of more fat would mean elevated cholesterol levels; however, there are numerous research studies[2]Hussein M. Dashti, Naji S. Al-Zaid, Thazhumpal C. Mathew, Mahdi Al-Mousawi, Hussain Talib, Sami K. Asfar and Abdulla I. Behbahani. Long-term effects of the ketogenic diet in obese subjects with high cholesterol level. Molecular and Cellular Biochemistry 286: 1–9, 2006. DOI: 10.1007/s11010-005-9001-x
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pointing out that the logic-defying ketogenic diet results in reduced bad cholesterol (LDL) levels and elevated good cholesterol (HDL) levels.

This is achieved by forcing your carb-deprived body to convert fat into fatty acids and ketones and utilize them for energy. So carbs get replaced with fat as the primary source of energy for the body. In other words, your body is practically running on (read burning) fat.

How Ketogenic diet works - infographic

The Ketogenic Cheat Sheet

To Keto or Not to Keto after Weight Loss Surgery?

With all the buzz around it, you have to modify your approach to the ketogenic diet in case you have had weight loss surgery. The basic premise of keto – high fat-low carb – has to marry the high protein-low carb bariatric philosophy. And the result – a low carb, high fat, higher protein diet suiting your altered stomach and digestive system. Do keep in mind that the Keto Diet may not be for everyone.

A ketogenic diet has many benefits, some of which are:

  • Low Carbs = Lower Appetite
  • More Weight Loss
  • Loss of Pesky Belly Fat
  • Lowered Blood Triglycerides
  • More Good Cholesterol
  • Less Bad Cholesterol
  • Improvement in Type 2 Diabetes
  • Reduced Blood Pressure Levels

Keto Diet Benefits - Infographic

Typical Bariatric-Friendly Keto Meals

Here are some sample ketogenic menus suitable for those who’ve had bariatric surgery:

*Adapted from St Louis, Betty Wedman. “Appendix 1 – Ketogenic  (Low Carbohydrate ) Diet.” Bariatric Surgery Patients: A Nutritional Guide. CRC, 2017.

What to Look Out for?

  • Not more than one teaspoon butter/ghee per meal
  • No full-fat whole milk
  • No heavy cream
  • No cream cheese, including the low-fat variety
  • No skinny lattes
  • No eating till you feel stuffed or till the point you are uncomfortable

MBS

Video: Milk Alternatives for Bariatric Patients

Some Keto-Friendly Swaps

  • Zoodles (made of zucchini using a spiralizer) instead of pasta or noodles
  • Cauliflower pearls instead of rice
  • Low-fat cheese in place of cheddar cheese
  • Unsweetened tea or coffee instead of the non-fat milk variety laden with artificial sweeteners

The Pre-Op Keto Bonus

Some research studies are pointing at the positive effects of a ketogenic diet on pre-operative bariatric patients. According to Frida Leonetti and colleagues[3] Frida Leonetti, Fabio Cesare Campanile, Federica Coccia, Danila Capoccia, Laura Alessandroni, Alessandro Puzziello, Ilenia Coluzzi, Gianfranco Silecchia. Very Low Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet. Obesity Surgery > Issue 1/2015
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, low carb-ketogenic diet results in a reduction of body mass index (BMI), waist circumference and neck circumference, and even decreased diabetic medication after following a pre-operative ketogenic dietary regimen.

We want to reiterate that bariatric surgery is no magic pill. The onus of its success is primarily on you – the eating habits and commitment to lifestyle changes. A modified keto diet can be a great way to eat well while feeling sated at the same time.

Just make sure you consult your bariatric surgeon as well as the nutritionist before you take the plunge, as they will rightfully help with the modifications to suit your new stomach and digestive system. Go Keto!

References

1)”Benefits of ketogenic diets”Nicholas J KrilanovichThe American Journal of Clinical Nutrition, Volume 85, Issue 1, January 2007, Pages 238-239, Published:01 January 2007

2) Hussein M. Dashti, Naji S. Al-Zaid, Thazhumpal C. Mathew, Mahdi Al-Mousawi, Hussain Talib, Sami K. Asfar and Abdulla I. Behbahani. “Long-term effects of ketogenic diet in obese subjects with high cholesterol level.” Molecular and Cellular Biochemistry 286: 1–9, 2006. DOI: 10.1007/s11010-005-9001-x

3) Frida Leonetti, Fabio Cesare Campanile, Federica Coccia, Danila Capoccia, Laura Alessandroni, Alessandro Puzziello, Ilenia Coluzzi, Gianfranco Silecchia. “Very Low Carbohydrate Ketogenic Diet Before Bariatric Surgery: Prospective Evaluation of a Sequential Diet. Obesity Surgery” > Issue 1/2015

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3 Comments

    1. Hi Shannon, I would not take the Keto Flux diet pills. They are mostly a scam and the main “electrolyte” in these types of supplements is usually sodium, aka salt.

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