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Maximizing Weight Loss After Bariatric Surgery

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Question: I’m not happy with what my expected goal weight would be. How do I maximize the weight loss after bariatric surgery?

Our US-RD says (video transcription):

Remember that the expected weight loss after surgery is just an average. Obviously eating a variety of healthy foods and being active are the key to maximizing effects of surgery. However, in my personal experience most patients have a very good understanding of the food and exercise component. It is in other, more personal areas where they struggle.

Recognizing areas that have been difficult for you to change in the past with in regards to eating healthy and exercise before surgery and continuing to work on those areas after surgery is a great way to try and maximize the effects of surgery. It is important to remember that surgery is just one tool to help you get healthy.

  • Start by focusing on eating healthy and managing “bad habits” (habits like eating on the run, or in front of the television, or waiting too long between meals/snacks, or not planning ahead, etc). Pick 1-2 areas where you know you work and focus on making those changes initially.
  • Think about personal issues that have made following a diet and getting healthy in the past difficult. Examples of this may be that you didn’t have support from your family, or maybe you have struggled with emotional eating. These are areas that are not fixed by surgery and ALMOST ALWAYS come up again and again if you avoid working on them.

Bad Habits to Avoid After Weight Loss Surgery

Guide to Eating for Successful Outcomes

Check out this video in which the nutritionist talks about the challenges of eating right after weight loss surgery and how to overcome them:

“Hi! So, I wanted to take some time today to talk about the diet progression after bariatric surgery and what it looks like and hopefully to give you a visual as to how you can prepare yourself and your mind for that big change in what you’re eating and the portions that you’re eating.

  • I always really like to think about the first 6 to 12 weeks as if you are an infant, i.e. advancing to the solid foods for the first time.
  • So, kind of if you give the pre-op diet and the first 2 days after the surgery when you are on clear liquids or maybe a couple of full liquids, as you wean on a formula as a baby, right? But you are just basically on a liquid and from there you start to advance into purees, right.
  • So, when you think about a baby, the first time that they eat, they don’t have a peanut butter jelly and whole apple, right? They start off with something like a pureed vegetable, fruit, rice cereal or yogurt. So, very soft, basically liquid consistency and that’s exactly what you want to do the first time you have something solid again after surgery.

Pureed Diet Options

So, you want to do:

  • Strained cream soup
  • Diluted yogurt
  • Applesauce
  • Pureed fruits or vegetables

A protein drink is common too. So, go for something very liquidy, very simple, easy to tolerate and then from there you can advance to softer foods about a month if you’re doing the sleeve.

For bypass it can be a little bit earlier and that’s because you don’t have as long a suture line as in a gastric sleeve because they remove three quarters of your stomach. There is a very long suture line and you really have to let that heal.

Not Everything You can Tolerate is Good for You

I have heard people say, “I can tolerate French fries” – it’s true I heard someone say that – or regular meat loaf or whatever, just because you can tolerate it, it doesn’t mean to be a good thing at this point as you really want to let that suture line heal.

Eating A Few Weeks After Bariatric Surgery

Advancing to Soft Foods

From purees you can advance to more soft foods. I would like to think of crock pot meals. Very, very tender, moist – you just need a fork to cut through the meat or potato, no-knives-required kind of diet. if you think about a baby, that’s also what they advance to. It may be some diced bananas, cubed cheese, very, very simple soft, tender foods.

Invest in Baby Spoons and Forks

  • You can also think about getting some baby spoons and forks. I think these are some very cheap investment.
  • If you have anyone in your family that has a baby, maybe you can ask just to borrow a couple for a month or so because these not only train your mind as far as how much you can have and it will also train your hands to grab just a small amount because that is all that can fit in your fork or your spoon.
  • As opposed to using your normal silverware, it can be very hard to keep that dime-sized bite in your mind or getting a half teaspoon size out of what you should be having per bite. So, my plug for the baby spoons, forks, etc.

Dime as a Guide for Bite Size

  • You can also put a dime on the table that is about the size of something that you want to eat.
  • So, if we think about a banana you don’t want to slice it into halves and have that one whole piece.
  • You want to cut that into two or three maybe four pieces depending on how big it is.
  • So, once again just think of your stomach as that of a baby.
  • Ask yourself – will you give this to your eight-month-old? If you wouldn’t then you don’t want to have it for those first few weeks either. Or you want to cut it up or cook it up a little bit more. Or make it softer.

Whatever it is for that food. So, let me know if you have any questions. I hope this is helpful for those who are just a few weeks post-op. or those of you who are getting ready for surgery in the next couple of months.”

Updated on January 3, 2019

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