![\"Women](\"https://blog.baribuilder.com/content/images/2019/09/photo-1520877880798-5ee004e3f11e.jpg\")
For those who need to lose a large amount of weight, Onederland is an extraordinary milestone. For most of us, before we decided to have bariatric surgery, we spent several years looking at a scale number that begins with 2, 3, or even 4 or 5. Onederland refers to that fantastic moment when you step on a scale, and the first number is ONE, as in, 199 pounds! Of course, this is likely not your ultimate goal weight, but the idea of weighing under 200 pounds has been a dream for most of us, and it is a cause for celebration when you reach it. That is if you reach it.
You see, some of us never do get to celebrate that moment, because we never achieve it. We are lucky to live in a time where Gastric Bypass is a safe, viable option for those of us who need to lose a lot of weight. However, it is essential to realize that just having the surgery is the first step in a long journey, and even though you can't help but lose weight at the beginning, it is crucial to stay disciplined and put the effort in.
For some, it can be too easy to see the amount of weight that comes off in the beginning and think it will just continue to come off no matter what you do. This is what I thought, and as a result, I never did make it to Onederland, and in fact, ended up putting much of my lost weight back on.
Here are five mistakes I made that cost me my opportunity at reaching Onederland, and what you can do differently to avoid them.
As soon as you are cleared for physical activity, you need to get your body moving. If you are anything like me, moving was actually painful when you were at your heaviest, so physical activity is not exactly your favorite thing to do. Then when you come home from surgery, you are in pain, and just walking can be a sizeable physical chore for many of us.
You have to get these things out of your mind, though, and start moving.
Start by finding some activity that gets your body moving for at least 30 minutes per day. It's best if you find something you enjoy doing so that you are more likely to want to continue. Is there an activity you used to enjoy before you were heavy? Start there!
If not, something as simple as swimming or walking will do the trick. See if you can find a gym with a low-cost membership and make it a point to hit the treadmill and the pool!
And remember- at the beginning when the weight is coming off quickly is the best time to build these new healthier habits, not a time to sit back and enjoy the automatic weight loss!
![\"Cup](\"https://blog.baribuilder.com/content/images/2019/09/photo-1560192776-60a3bab7190d.jpg\")
Drinking plenty of water is one of the most natural and most important things we can do to ensure we are maximizing the benefits of our weight loss surgery. Water is an essential part of the healing process after surgery, and staying hydrated will also help with your weight loss because it helps the body work more efficiently overall.
There is another mistake you can make regarding water intake, however, and it can happen to those who are drinking plenty of water. Remember that you should not be drinking water during meals! Drinking water during meals will work to flush food out of your pouch and into your new digestive system, which can lead to overeating.
Sometimes the time intervals can vary so ask your doctor, but for the most part, you want to make sure to follow the 30/30 rule: do not drink any water for 30 minutes before or after your meal, in order to make sure you eat an appropriate amount.
Staying hydrated and not drinking during meals is an essential part of reaching Ondederland.
![\"Silverware](\"https://blog.baribuilder.com/content/images/2019/09/photo-1531928351158-2f736078e0a1.jpg\")
It's usually not too difficult to stick to your eating plan at first, both because we are excited to be improving ourselves, and because it's challenging to eat anything at all early on in the process. However, for many of us, we fantasize about some of the foods we used to eat, and if you're not careful, you will turn those fantasies into realities the moment you're able to.
I mentioned in a previous article that one question I hate answering from friends who are getting the surgery is \"Will I ever be able to eat pizza again?\" because it is a perfect example of this pitfall.
You may think that popcorn, chips, or crackers are relatively harmless, but items like these pack a large number of calories, and because they are so small you can potentially eat hundreds of extra calories in a sitting if you're not careful.
It's the same thing with grazing. Every time you hit up the fridge or the pantry for a snack, those are extra calories you are consuming. Munching throughout the day may seem harmless, but you have to realize that that is the OLD you finding a new way to overeat since your pouch won't let you do it in a single sitting anymore.
To stay on track for reaching Onederland, keep snacks out of the house, and stick to the diet plan your nutritionist gave you.
![\"Empty](\"https://blog.baribuilder.com/content/images/2019/09/photo-1566559531953-d8789d8fbb05.jpg\")
Carbonated drinks like soda can not only keep you from reaching Onederland, but they can be downright dangerous to your health!
Here are some ways that carbonated beverages put gastric bypass patients at risk:
In all honesty, carbonated beverages should be a thing of the past for gastric bypass patients. They have almost no positive nutritional value, and they likely played a large role in gaining your weight, to begin with.
As far as I'm concerned, carbonated beverages and Onederland do not go hand-in-hand.
![\"Bottles](\"https://blog.baribuilder.com/content/images/2019/09/photo-1546339166-72eaf6a67c3c-1.jpg\")
For many people, this Onederland mistake could have probably been combined with the \"carbonated beverages\" section, but for me, alcohol was a category all on its own.
First of all, there are nutritional issues with alcohol. As you probably already know, alcohol is full of calories while not containing any nutritional value whatsoever.
On top of that, alcohol reaches the bloodstream much faster, because most of the absorption of the alcohol occurs in the small intestines instead of the stomach as it does on a non-gastric bypass patient.
From a weight-loss and safety perspective, these are reason enough to avoid alcohol after weight-loss surgery.
But here's a more sobering fact, according to a recent study, \"People who undergo a gastric bypass procedure... are three times more likely than those in the general population to die of drug- or alcohol-related causes.\"
According to Dr. John Morton, Chief of Bariatric and Minimally Invasive Surgery at Yale School of Medicine:
\"The effect is purely physiological, not psychological... gastric bypass surgery removes 95% of the stomach. Alcohol receptors exist in the stomach and the liver, so by removing so much of the stomach, people lose the first pass at metabolizing alcohol.\"
For me, this meant drinking alcohol felt good, fast. I hadn't had this kind of instant gratification since I could overeat, and as soon as I felt it, I never looked back. I regret the day I first tried to drink alcohol after my surgery because it was the beginning of a years-long mistake that leads to addiction transfer and full-blown alcoholism.
As soon as I started drinking again, I stopped losing weight and eventually began gaining weight back. If I had to pick one reason why I never reached Onederland, this is it- alcohol.
Eventually, I would go on to gain about 65% of my weight back and even had to go to rehab to quit my alcohol dependence. This was a challenging time for my family and me, and it was completely avoidable.
And wouldn't you know it- as soon as I left rehab, the weight came peeling off again! Within four months of quitting alcohol, I lost 50% of the weight I had put back on, and I feel healthier than ever.
If you want to reach Onederland, stay away from alcohol. There are zero benefits and nothing but risks!
If there is one lesson I learned in all of this (besides staying away from alcohol), it's not to take Onederland for granted.
It's a big milestone for a reason; it takes work to get there. Simply having bariatric surgery is not enough. You have to stay dedicated to your new diet and lifestyle, and you have to make it part of your routine forever.
Hopefully, you can learn from my mistakes. I know I am, and I can't wait to write an article about actually reaching Onederland one day.
","url":"https://blog.baribuilder.com/onederland/","uuid":"5ce94afe-cab1-41ce-a218-0ccd8517e06d","page":null,"codeinjection_foot":null,"codeinjection_head":null,"codeinjection_styles":null,"comment_id":"5d8b92de76cbe8003728f9a3"}},{"node":{"id":"Ghost__Post__5d8a257e73194700384b58f0","title":"Bariatric Surgery and Alcohol: Can You Imbibe After Surgery?","slug":"bariatric-surgery-and-alcohol","featured":false,"feature_image":"https://blog.baribuilder.com/content/images/2019/09/allie-smith-5PGrknK2juc-unsplash.jpg","excerpt":"Is it possible to safely include alcohol after bariatric surgery? Yes, but with a few guidelines and precautions. While moderate drinking may be included in a healthy lifestyle, there are some things to consider when it comes to consuming alcohol after bariatric surgery.","custom_excerpt":"Is it possible to safely include alcohol after bariatric surgery? Yes, but with a few guidelines and precautions. While moderate drinking may be included in a healthy lifestyle, there are some things to consider when it comes to consuming alcohol after bariatric surgery.","created_at_pretty":"24 September, 2019","published_at_pretty":"06 October, 2019","updated_at_pretty":"09 February, 2021","created_at":"2019-09-24T10:17:34.000-04:00","published_at":"2019-10-06T08:00:00.000-04:00","updated_at":"2021-02-09T11:52:33.000-05:00","meta_title":"Bariatric Surgery and Alcohol: Can You Imbibe After Surgery? ","meta_description":"Is it possible to safely include alcohol into a healthy diet after bariatric surgery? Yes, but with a few guidelines and precautions.","og_description":null,"og_image":null,"og_title":null,"twitter_description":null,"twitter_image":null,"twitter_title":null,"authors":[{"name":"Morgyn Clair, MS, RDN","slug":"morgyn","bio":"Morgyn is an RD specializing in weight management and surgical weight loss. She has a master's in clinical nutrition and dietetics, and currently works as a clinical dietitian in a physician’s office.","profile_image":"https://blog.baribuilder.com/content/images/2019/10/morgyn.png","twitter":null,"facebook":null,"website":null},{"name":"Gintas Antanavicius, MD, FACS, FASMBS","slug":"gintas","bio":"Dr. G is a co-founder of BariBuilder. A US-based expert surgeon with over 10 years of bariatric experience, he regularly publishes research in medical journals like SOARD, Obesity Surgery, etc.","profile_image":"https://blog.baribuilder.com/content/images/2018/11/drgheadshot.png","twitter":null,"facebook":null,"website":null}],"primary_author":{"name":"Morgyn Clair, MS, RDN","slug":"morgyn","bio":"Morgyn is an RD specializing in weight management and surgical weight loss. She has a master's in clinical nutrition and dietetics, and currently works as a clinical dietitian in a physician’s office.","profile_image":"https://blog.baribuilder.com/content/images/2019/10/morgyn.png","twitter":null,"facebook":null,"website":null},"primary_tag":{"name":"WLS","slug":"wls","description":"Articles about weight loss surgery","feature_image":"https://blog.baribuilder.com/content/images/2020/04/blue-tape-measuring-on-clear-glass-square-weighing-scale-53404.jpg","meta_description":null,"meta_title":null,"visibility":"public"},"tags":[{"name":"WLS","slug":"wls","description":"Articles about weight loss surgery","feature_image":"https://blog.baribuilder.com/content/images/2020/04/blue-tape-measuring-on-clear-glass-square-weighing-scale-53404.jpg","meta_description":null,"meta_title":null,"visibility":"public"},{"name":"Alcohol","slug":"alcohol","description":"Articles about alcohol and weight loss surgery","feature_image":"https://blog.baribuilder.com/content/images/2020/04/kelsey-knight-udj2tD3WKsY-unsplash.jpg","meta_description":null,"meta_title":null,"visibility":"public"}],"plaintext":"The short answer is yes, but with a few guidelines and precautions. Bariatric\nsurgery is a tool to assist patients with weight management by controlling\nhunger and the amount of food the stomach can hold, but it is ultimately up to\nthe individual to make healthy choices and lifestyle changes. \n\nAlcohol is involved in nearly every social event in our culture, from weddings\nand parties to funerals and professional events. While moderate drinking may be\nincluded in a healthy lifestyle, there are some things to consider when it comes\nto consuming alcohol\n[https://blog.baribuilder.com/bariatric-surgery-and-alcohol/blog/gastric-sleeve-and-alcohol/],\nespecially after bariatric surgery.\n\nDrinking heavily puts people at risk for many adverse health consequences\n[https://pubs.niaaa.nih.gov/publications/aa72/aa72.htm], whether they have\nundergone bariatric surgery or not; but those who have had bariatric surgery are\nat a greater risk than others for developing complications.\n\nAlcohol Metabolism\nAlcohol is not absorbed by the body\n[https://www.bgsu.edu/recwell/wellness-connection/alcohol-education/alcohol-metabolism.html] \nin the same way that food is. A small amount is absorbed by the tongue and\nlining of the mouth. The rest travels to the tissues of the stomach. Although\nsome alcohol is metabolized by the stomach, most travels to the small intestine\nand then to the bloodstream, where it is circulated all around the body. Alcohol\nenters all body tissues except for bone and fat. Finally, alcohol is delivered\nto the liver for the last step in metabolism.\n\nAlcohol absorption into the bloodstream is primarily regulated by the rate that\nalcohol empties into the intestines from the stomach.\n\nAlcohol is part of social norms when celebrating. Provide sparkling grape juice\nor alcohol-free options for those abstaining.Altered Metabolism\nResearch shows that blood alcohol levels increase quicker and faster due to\naltered metabolism after bariatric surgery. Because of reduced stomach capacity\nin both the sleeve and bypass procedures, bariatric surgery results in alcohol\nmoving much more quickly from the stomach into the small intestines, and\ntherefore increasing blood alcohol concentration much faster. \n\nAdditionally, there are fewer enzymes [http://www.sado.org/Articles/Article/134] \navailable in the stomach for alcohol processing, allowing larger amounts of\nalcohol to pass into the bloodstream.\n\nExcess Calories\nAlcoholic beverages can be high in calories but provide minimal nutrition; this\nconcept is what is referred to as “empty calories\n[https://www.rethinkingdrinking.niaaa.nih.gov/tools/calculators/calorie-calculator.aspx]\n.” Drinking alcohol can work against your weight loss goal. For example, wine\ncontains twice the calories per ounce than regular soda does. Alcohol may also\nlower your inhibitions, leading to poor food choices or feelings of increased\nappetite.\n\nAlthough straight liquor helps you avoid highly sweetened mixers, you may feel\nthe effects much more quickly.Addiction Transfer\nThere are other considerations when it comes to bariatric surgery and alcohol.\nAddiction transfer, also referred to as cross addiction\n[https://www.obesityaction.org/community/news/bariatric-surgery/transfer-addiction-following-bariatric-surgery/]\n, occurs when individuals trade one harmful, compulsive behavior for another. In\nbariatric surgery, some individuals are at risk of trading compulsive or binge\neating [https://www.neverbingeagain.com/stop-binge-eating/] for compulsive or\nbinge drinking\n[https://www.eatingdisorderhope.com/binge-drinking-and-binge-eating-disorder-what-are-the-connections]\n.\n\nBecause food can no longer be a source of comfort, distraction or reward,\nindividuals may turn to alcohol as a coping mechanism. For those dealing with an\nactive addiction before surgery, treatment is essential. Those who have\nstruggled with addiction in the past are encouraged to continue treatment and\nrefrain from alcohol use.\n\nSeek help if you feel you may be using alcohol as a coping mechanism. Your\nbariatric team, primary care physician and support group can all be sources of\ninformation.Bariatric Surgery and Alcohol: Guidelines\nAlcohol consumption is generally not recommended directly following bariatric\nsurgery\n[https://blog.baribuilder.com/bariatric-surgery-and-alcohol/blog/eating-one-week-after-gastric-sleeve/]\n. However, over time, patients may choose to re-introduce alcohol. Substance use\nfollowing bariatric surgery can significantly impact your physical health. The\ngoal is to use alcohol responsibly\n[https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2012/july/can-you-drink-alcohol-after-weight-loss-surgery] \nwithout compromising your commitment to a healthy lifestyle.\n\nAvoid alcohol for the first 6-12 months after surgery. Specific bariatric\nprograms may have different guidelines; always follow your program's\nrecommendations.\n\n * When reintroducing alcohol after surgery, avoid carbonation and highly\n sweetened mixers.\n * Remember that after surgery alcohol will affect you differently. You may feel\n the effects sooner, more intensely, and you may be at risk for low blood\n sugar.\n * If you find yourself drinking regularly to cope with emotions or stress, seek\n help.\n * Keep your bariatric team and primary care physician informed of your decision\n to use alcohol.\n\nWhen used appropriately, alcohol can be a healthy part of celebrations and\nsocial gatherings.","html":"The short answer is yes, but with a few guidelines and precautions. Bariatric surgery is a tool to assist patients with weight management by controlling hunger and the amount of food the stomach can hold, but it is ultimately up to the individual to make healthy choices and lifestyle changes.
Alcohol is involved in nearly every social event in our culture, from weddings and parties to funerals and professional events. While moderate drinking may be included in a healthy lifestyle, there are some things to consider when it comes to consuming alcohol, especially after bariatric surgery.
Drinking heavily puts people at risk for many adverse health consequences, whether they have undergone bariatric surgery or not; but those who have had bariatric surgery are at a greater risk than others for developing complications.
Alcohol is not absorbed by the body in the same way that food is. A small amount is absorbed by the tongue and lining of the mouth. The rest travels to the tissues of the stomach. Although some alcohol is metabolized by the stomach, most travels to the small intestine and then to the bloodstream, where it is circulated all around the body. Alcohol enters all body tissues except for bone and fat. Finally, alcohol is delivered to the liver for the last step in metabolism.
Alcohol absorption into the bloodstream is primarily regulated by the rate that alcohol empties into the intestines from the stomach.
![\"social](\"https://blog.baribuilder.com/content/images/2019/09/social-drinking.jpg\")
Research shows that blood alcohol levels increase quicker and faster due to altered metabolism after bariatric surgery. Because of reduced stomach capacity in both the sleeve and bypass procedures, bariatric surgery results in alcohol moving much more quickly from the stomach into the small intestines, and therefore increasing blood alcohol concentration much faster.
Additionally, there are fewer enzymes available in the stomach for alcohol processing, allowing larger amounts of alcohol to pass into the bloodstream.
Alcoholic beverages can be high in calories but provide minimal nutrition; this concept is what is referred to as “empty calories.” Drinking alcohol can work against your weight loss goal. For example, wine contains twice the calories per ounce than regular soda does. Alcohol may also lower your inhibitions, leading to poor food choices or feelings of increased appetite.
![\"liquor\"](\"https://blog.baribuilder.com/content/images/2019/09/liquor.jpg\")
There are other considerations when it comes to bariatric surgery and alcohol. Addiction transfer, also referred to as cross addiction, occurs when individuals trade one harmful, compulsive behavior for another. In bariatric surgery, some individuals are at risk of trading compulsive or binge eating for compulsive or binge drinking.
Because food can no longer be a source of comfort, distraction or reward, individuals may turn to alcohol as a coping mechanism. For those dealing with an active addiction before surgery, treatment is essential. Those who have struggled with addiction in the past are encouraged to continue treatment and refrain from alcohol use.
![\"alcohol](\"https://blog.baribuilder.com/content/images/2019/09/alcohol-addiction.jpg\")
Alcohol consumption is generally not recommended directly following bariatric surgery. However, over time, patients may choose to re-introduce alcohol. Substance use following bariatric surgery can significantly impact your physical health. The goal is to use alcohol responsibly without compromising your commitment to a healthy lifestyle.
Avoid alcohol for the first 6-12 months after surgery. Specific bariatric programs may have different guidelines; always follow your program's recommendations.
![\"celebration\"](\"https://blog.baribuilder.com/content/images/2019/09/scott-warman-rrYF1RfotSM-unsplash.jpg\")
You carefully considered the benefits and drawbacks of bariatric surgery, went through the initial medical evaluation, made changes to your diet, and are finally ready for surgery... almost. Your surgery team tells you that you must follow a liquid diet for 2 weeks prior to surgery. This liquid diet before bariatric surgery will continue after surgery as well.
What is this liquid diet all about and how can you follow it? In this article, we will explore the concept of following such a diet before surgery and provide tips on how to be successful with it.
The purpose of a liquid diet before bariatric surgery is not simply to place another roadblock in front of you; instead, it’s to make sure the surgery goes as smoothly as possible. Typically, this liquid diet is done for about 2 weeks just before the date of surgery. The diet accomplishes three main goals:
A liquid diet will usually be needed before and after surgery, but this can include a variety of foods.
The most popular bariatric surgeries: the roux-en-y gastric bypass and the gastric sleeve procedure, can help people lose about 60-80% of their excess weight. Most of this weight loss occurs in the first year after surgery through a combination of factors that generally include reducing stomach size, appetite, and absorption of nutrients.
A liquid diet is generally very low in calories, about 800-1000 calories per day, which can help you lose about 4-5 pounds before surgery. This initial weight loss is easier to keep off after surgery as you will get used to eating a much smaller amount of food.
The liver is a large organ located right above the stomach that is in charge of processing nutrients and breaking down toxins.
The pre-surgery liquid diet is designed to be low in not just calories, but also fats and sugars. Since the liver is not as active in processing these nutrients, it will temporarily shrink in size. In addition, fat accumulates directly on the liver itself (this results in fatty liver disease over time). Reducing calories on a very low-calorie diet, such as the liquid diet prior to bariatric surgery , will help to reduce this liver fat.
Reducing the size of the liver is important because it allows better access to the stomach during surgery. This means that the surgery is safer, quicker, and easier for the surgeon.
![\"Diagram](\"https://blog.baribuilder.com/content/images/2019/08/diagram-1.png\")
Another benefit of the pre-surgery liquid diet is to get used to following a liquid diet as it will also become necessary after surgery. Typically, you will need to slowly advance from a clear liquid diet composed mostly of broths, water, and sugar-free juice and gelatin to a full liquid diet that is similar to the pre-surgery diet. Making sure you have beverages on-hand and have experimented with what fluids you prefer will make this transition much smoother.
A proper pre-surgery liquid diet is typically between 800-1000 calories, 70-120 of protein, low in simple sugars and fat. The exact diet composition may vary depending on which facility you have the surgery at, some facilities prefer a strict liquid-only diet while others will allow small snacks or meals. Your nutrition needs also vary and your medical team will give you individualized recommendations.
Because the diet consists of a very small amount of food, it is important to get enough protein; and in a liquid diet, this is best accomplished through the use of protein shakes. The key with protein shakes is to choose a variety that has about 15 or more grams of protein and less than 5 grams of sugar per serving. Many products can fit this mold. A protein shake that is too low in protein will not be able to meet protein needs without going over in calories or sugar.
A variety of other liquids are acceptable, including strained soups and hot cereal. Focus on low sugar and low-fat choices and make sure to stay hydrated with water and sugar-free beverages. Aim for at least 64oz of fluids.
Finally, a multivitamin is recommended to make sure you are covering all your nutrient bases. A chewable multivitamin is often used after surgery, and it is a good idea to try these out prior to surgery.
![\"Protein](\"https://blog.baribuilder.com/content/images/2019/08/drink.jpg\")
![\"Oatmeal\"](\"https://blog.baribuilder.com/content/images/2019/08/bowl.jpg\")
Breakfast
Lunch
Dinner
Snack
Nutrition information: 800 calories, 100g protein
![\"Lemon](\"https://blog.baribuilder.com/content/images/2019/08/water-lemon.jpg\")
Between pre and post-surgery requirements, you will need to follow a liquid diet for 4 weeks or more. This will take some getting used to, but the following tips can help:
1. Read the nutrition facts label. The nutrition labels will help you estimate the total calories of your liquid diet and ensure you are meeting your protein needs, while avoiding too much sugar.
2. Space out meals and snacks. Eating everything at one time will make it harder to manage hunger throughout the day and will cause stomach problems after surgery.
3. Avoid restaurants. Very few things on the menu will be acceptable choices and it will only make it more difficult to stay on the diet.
4. Stick to a grocery list. It is much easier to have self-control once per week at the grocery store then to try to avoid tempting foods all week.
5. Focus on the big picture. Remember the reason you are choosing to undergo surgery and that liquid diets are ultimately temporary.
![\"Woman](\"https://blog.baribuilder.com/content/images/2019/08/shopping.jpg\")
Many surgeons require a special pre-op liquid diet before bariatric surgery that lasts about 2 weeks. The purpose of this diet is to start losing weight, get used to liquid diets, and reduce liver size. These factors ultimately help to ensure the best surgery outcome.
","url":"https://blog.baribuilder.com/liquid-diet-before-gastric-bypass-surgery/","uuid":"8d968678-1711-4718-ad64-8b149aefab56","page":null,"codeinjection_foot":null,"codeinjection_head":null,"codeinjection_styles":null,"comment_id":"5d69bddb85ff7e003711ea14"}},{"node":{"id":"Ghost__Post__5d62d14b4d8dc70037b95cb4","title":"Eating Out: Tips for Finding Bariatric Friendly Restaurants","slug":"bariatric-friendly-restaurants-eating-out","featured":false,"feature_image":"https://blog.baribuilder.com/content/images/2019/08/night-out-family.jpg","excerpt":"Let’s talk about finding bariatric friendly restaurants and some alternatives. There are many ways to do this effectively - we just need to keep some considerations in mind as we do it.","custom_excerpt":"Let’s talk about finding bariatric friendly restaurants and some alternatives. There are many ways to do this effectively - we just need to keep some considerations in mind as we do it.","created_at_pretty":"25 August, 2019","published_at_pretty":"28 August, 2019","updated_at_pretty":"01 March, 2020","created_at":"2019-08-25T14:19:55.000-04:00","published_at":"2019-08-28T08:00:00.000-04:00","updated_at":"2020-03-01T00:58:39.000-05:00","meta_title":"Eating Out: Tips for Finding Bariatric Friendly Restaurants","meta_description":"There are many ways to find bariatric friendly restaurants and some alternatives effectively. We just need to keep some considerations in mind as we do it.","og_description":null,"og_image":null,"og_title":null,"twitter_description":null,"twitter_image":null,"twitter_title":null,"authors":[{"name":"Jose Grimaldo","slug":"jose","bio":"Jose Grimaldo, Jr. is a former high school teacher turned freelance writer who had gastric bypass surgery in 2014. He loves sharing his experiences - positive and negative - with BariBuilder readers.","profile_image":"https://blog.baribuilder.com/content/images/2019/08/jose.jpg","twitter":null,"facebook":null,"website":null}],"primary_author":{"name":"Jose Grimaldo","slug":"jose","bio":"Jose Grimaldo, Jr. is a former high school teacher turned freelance writer who had gastric bypass surgery in 2014. He loves sharing his experiences - positive and negative - with BariBuilder readers.","profile_image":"https://blog.baribuilder.com/content/images/2019/08/jose.jpg","twitter":null,"facebook":null,"website":null},"primary_tag":{"name":"WLS","slug":"wls","description":"Articles about weight loss surgery","feature_image":"https://blog.baribuilder.com/content/images/2020/04/blue-tape-measuring-on-clear-glass-square-weighing-scale-53404.jpg","meta_description":null,"meta_title":null,"visibility":"public"},"tags":[{"name":"WLS","slug":"wls","description":"Articles about weight loss surgery","feature_image":"https://blog.baribuilder.com/content/images/2020/04/blue-tape-measuring-on-clear-glass-square-weighing-scale-53404.jpg","meta_description":null,"meta_title":null,"visibility":"public"},{"name":"Diet","slug":"diet","description":"Articles about diet and weight loss surgery","feature_image":"https://blog.baribuilder.com/content/images/2020/04/anna-pelzer-IGfIGP5ONV0-unsplash.jpg","meta_description":null,"meta_title":null,"visibility":"public"}],"plaintext":"It's not easy to change the habits we've become accustomed to over the course of\na lifetime. And for those of us who have had or are considering bariatric\nsurgery, it's especially not easy when it comes to our eating habits.\n\nIn fact, some experts say it could take as much as 8 months\n[https://www.sciencealert.com/how-long-it-takes-to-break-a-habit-according-to-science] \nto replace a bad habit with a good one. This is why gradual change is so\nimportant. There are dozens of small ways you can change your habits when eating\nout, so it's not necessary to swear off going out to eat just because you've had\nbariatric surgery.\n\nLet’s talk about finding bariatric friendly restaurants and some alternatives.\nThere are many ways to do this effectively - we just need to keep some\nconsiderations in mind as we do it.\n\nRemember that we are going for gradual change here; eating out after bariatric\nsurgery should NOT be a priority. So while these tips may take a while to become\nhabit, it is imperative that you follow them every time for the sake of your\npouch and your weight-loss success.\n\nFast Food\nVegetable pizza makes a great fast food item.I almost didn't even want to put\nthis section in here, because fast food is one of the main things that got me\ninto trouble over the years, and I'm sure it hasn't helped in your case either.\nHowever, life does happen, and eventually we're going to have to be able to face\nwhatever it throws at us. If you do find yourself needing to eat fast food, make\nsure you are doing it in a mindful and deliberate way.\n\nHere are a few tips to get you through a trip to a fast-food restaurant:\n\n * Choose grilled chicken over hamburgers. If it only comes in a sandwich, ask\n for it without the bun or remove it yourself.\n * Instead of french fries or onion rings, try to choose sides like mashed\n potatoes, corn on the cob, or baked beans.\n * Hit the salad bar if you can! Order a broiled chicken salad and throw some\n fresh vegetables over it from the salad bar. Make sure you are using only a\n small amount of low-fat dressing.\n * Top a baked potato with cottage cheese and vegetables.\n\nRestaurant Tips\nI realize it can often be a bit more expensive, but if you have to eat out then\nI recommend you go to a restaurant to do so. When it comes to bariatric friendly\nrestaurants, what you order is more important than where you go. there are\nbariatric-friendly items on almost any menu, you just have to find them and\noccasionally you might have to get a little creative.\n\n\nHigh protein is not so bad, is it!Here are a few ways to set yourself up for\nsuccess:\n\n * Go in with a plan. Look at the menu online and decide what you will eat\n before you even get there.\n * Start your meal with a bowl of vegetable soup. This can help prevent\n overeating during the meal.\n * It's okay to ask how foods are prepared. Take it a step further and ask for\n your food to be prepared without high-fat ingredients such as butter, cream,\n cheese, or oil.\n * You can never go wrong ordering meat, poultry, or fish. Order it broiled,\n baked, grilled, steamed, or poached.\n * Always remove the skin from chicken.\n\nThere's one very important thing I want to mention and it's this-- absolutely NO\nALCOHOL! The risk is too great. One study shows that people who undergo\nRoux-en-Y gastric bypass surgery could be as much as 3 times as likely to die\nof\nalcohol-related causes\n[https://www.webmd.com/mental-health/addiction/news/20190620/drug_alcohol_deaths_soar_after_weight-loss_surgery#1]\n. The risk may not be quite as high for gastric sleeve\n[https://blog.baribuilder.com/blog/gastric-sleeve-and-alcohol/] recipients, but the overall\nrisk of alcohol use disorder still exists.\n\nA Word of Caution\nExpect mixed emotions the first time you go out to eat following your bariatric\nsurgery. You'll undoubtedly feel self-conscious, and to be frank - it's a bit of\na bummer when you can't get the foods you used to love to eat. Ordering off the\nkids' menu and explaining why can sometimes be embarrassing, but just remember\nthat these are the things we have to deal with now that we are getting\nhealthier.\n\nDon't ruin this for yourself!There's also the risk of going overboard the first\ntime you go out. Please don't do this to yourself. Your pouch can't handle it,\nand if you're lucky enough to have avoided dumping syndrome\n[https://blog.baribuilder.com/blog/gastric-bypass-dumping-syndrome/] thus far, the last thing\nyou want to do is tie that awful experience to your first time going out\npost-op.\n\nAlso, remember that you are on a strict eating plan\n[https://www.mayoclinic.org/tests-procedures/gastric-bypass-surgery/in-depth/gastric-bypass-diet/art-20048472]\n. There is a reason for that, and it doesn't go out the window just because you\nare going out for the night. The idea is to learn to adapt your meal out to that\neating plan, not the other way around.\n\nA few reminders:\n\n * You need to drink at least 64 oz of water a day to avoid dehydration, but not\n during meals. Remember to employ the 30/30 rule- no water 30 minutes before\n or after your meal!\n * Eat slowly to avoid dumping syndrome. Eating out for the first time is\n exciting, but let's make it a happy memory.\n * Eat lean, protein-rich foods and avoid anything high in fats and sugar.\n * Avoid alcohol.\n\nSo Where Should You Go?\nAs I mentioned before, where you go is not nearly as important as what you eat.\nRemember, you shouldn't be making a habit out of eating out, so on those rare\noccasions that you do, go where you want. Just remember to have a plan and order\nthoughtfully.\n\nFamily Restaurants\nThe thing about family restaurants is that they often have a large menu, which\ncould cause you trouble if you are not prepared. The good news is that with all\nthose choices, there's bound to be a healthy one or two! In general, a salad\nwith some kind of protein or another is a good choice. \n\nTry to keep it simple if you can, and get something like this:\n\n * Vegetable and grilled chicken kabobs\n * Low-sodium vegetable soup\n * Broiled or grilled fish\n\nIf you're stuck, try Applebee's. their kids' menu has an excellent grilled\nchicken alfredo, or you can get a 4oz. steak off the kids' menu as well!\n\nAsian Food\nTime to get the chopsticks out!Asian food was one of my first post-op cravings,\nand the good news is that it's fairly easy to make a healthy choice! First of\nall, it's important to know what to avoid. Noodle dishes like lo mein and pad\nthai are a no-go. And you definitely want to steer clear of fried or battered\nmeat, like sweet and sour pork or General Tsao's chicken.\n\nSo what's left? Any kind of steamed chicken or vegetables is always a great\noption. However, you probably want Asian for some flavor, so look to some hot\nand sour soup and seafood, or some grilled shrimp or chicken skewers.\n\nHere are a few more good choices:\n\n * Chicken, fish, or tofu stir-fried with veggies- no soy sauce though.\n * Chicken tandoori\n * Steamed dumplings\n * Sushi or sashimi\n\nAs always, go in with a plan.\n\nItalian Food/Pizza\n\"Will I ever get to eat pizza again?\" I cringe whenever my friends who have had\nthe surgery ask me this, because I want to say, \"Yes, but that shouldn't be a\npriority right now!\"\n\nBut this post assumes you've been doing everything right, and you've EARNED this\ntrip out. So let's enjoy it! Obviously, like anything else, the best answer is\nto have it with veggies. A slice or two of thin crust with vegetable toppings\nshould do the trick.\n\nIf you're going for something other than pizza, I commend you; you're stronger\nthan I am! Here are a few other choices to satisfy your taste for Italian:\n\n * Pasta primavera (pasta with tomato sauce or sauteed vegetables)\n * Tortellini in tomato sauce\n * Minestrone soup\n\nBut who am I kidding - enjoy the pizza!\n\nMexican Food\nCareful with the Mexican food!Making good bariatric decisions at a Mexican\nrestaurant can be a bit more challenging, but it's not impossible. The trick is\nto avoid the high-carb, starchy sides in favor of veggies or lean protein like\nshrimp, salmon, pork loin, chicken breast, or flank steak.\n\nThe other thing about Mexican food is that some people's pouches are sensitive\nto it. We all know Mexican food already has a reputation to begin with, and it's\nnot like bariatric surgery will make that any less true. So whatever you try,\ntry a small amount first and see how your system reacts.\n\nTry some of these ideas:\n\n * Chicken or whole-bean soft taco- no sour cream, cheese or guac\n * Chicken or fish fajita\n * Arroz con pollo\n * Steamed corn tortillas\n\nTip: Chipotle is a great choice for post-op Mexican food. You are in control of\nwhat goes in your bowl and one bowl can last you 3-4 meals. Here's a great\noption: black beans, no rice, chicken, lettuce, pico, medium salsa, and cheese.\nIt's loaded with protein and it's yummy!\n\nDon't Make it a Habit\nHopefully, if you follow this guide, you'll be able to enjoy a night out to eat\nwithout suffering any ill-effects. There's a catch-22 with this though, and we\nfoodies are particularly vulnerable to it. If all goes well, then you'll have\nenjoyed a delicious meal out with friends or family, felt great afterward, and\nprobably brought home leftovers.\n\nIf this is how it goes for you, then great! But don't make it a habit.\n\nBariatric surgery is a serious thing, and you should never forget that it's a\nlifelong commitment. Excess is what got us here, and it will be our downfall if\nwe're not careful.\n\nBut as long as you keep that in mind, feel free to enjoy!","html":"It's not easy to change the habits we've become accustomed to over the course of a lifetime. And for those of us who have had or are considering bariatric surgery, it's especially not easy when it comes to our eating habits.
In fact, some experts say it could take as much as 8 months to replace a bad habit with a good one. This is why gradual change is so important. There are dozens of small ways you can change your habits when eating out, so it's not necessary to swear off going out to eat just because you've had bariatric surgery.
Let’s talk about finding bariatric friendly restaurants and some alternatives. There are many ways to do this effectively - we just need to keep some considerations in mind as we do it.
Remember that we are going for gradual change here; eating out after bariatric surgery should NOT be a priority. So while these tips may take a while to become habit, it is imperative that you follow them every time for the sake of your pouch and your weight-loss success.
![\"Vegetable](\"https://blog.baribuilder.com/content/images/2019/08/vegetable-pizza-1.jpg\")
I almost didn't even want to put this section in here, because fast food is one of the main things that got me into trouble over the years, and I'm sure it hasn't helped in your case either. However, life does happen, and eventually we're going to have to be able to face whatever it throws at us. If you do find yourself needing to eat fast food, make sure you are doing it in a mindful and deliberate way.
Here are a few tips to get you through a trip to a fast-food restaurant:
I realize it can often be a bit more expensive, but if you have to eat out then I recommend you go to a restaurant to do so. When it comes to bariatric friendly restaurants, what you order is more important than where you go. there are bariatric-friendly items on almost any menu, you just have to find them and occasionally you might have to get a little creative.
![\"Steak\"](\"https://blog.baribuilder.com/content/images/2019/08/high-protein-1.jpg\")
Here are a few ways to set yourself up for success:
There's one very important thing I want to mention and it's this-- absolutely NO ALCOHOL! The risk is too great. One study shows that people who undergo Roux-en-Y gastric bypass surgery could be as much as 3 times as likely to die of alcohol-related causes. The risk may not be quite as high for gastric sleeve recipients, but the overall risk of alcohol use disorder still exists.
Expect mixed emotions the first time you go out to eat following your bariatric surgery. You'll undoubtedly feel self-conscious, and to be frank - it's a bit of a bummer when you can't get the foods you used to love to eat. Ordering off the kids' menu and explaining why can sometimes be embarrassing, but just remember that these are the things we have to deal with now that we are getting healthier.
![\"Caution](\"https://blog.baribuilder.com/content/images/2019/08/dont-ruin-this.jpg\")
There's also the risk of going overboard the first time you go out. Please don't do this to yourself. Your pouch can't handle it, and if you're lucky enough to have avoided dumping syndrome thus far, the last thing you want to do is tie that awful experience to your first time going out post-op.
Also, remember that you are on a strict eating plan. There is a reason for that, and it doesn't go out the window just because you are going out for the night. The idea is to learn to adapt your meal out to that eating plan, not the other way around.
A few reminders:
As I mentioned before, where you go is not nearly as important as what you eat. Remember, you shouldn't be making a habit out of eating out, so on those rare occasions that you do, go where you want. Just remember to have a plan and order thoughtfully.
The thing about family restaurants is that they often have a large menu, which could cause you trouble if you are not prepared. The good news is that with all those choices, there's bound to be a healthy one or two! In general, a salad with some kind of protein or another is a good choice.
Try to keep it simple if you can, and get something like this:
If you're stuck, try Applebee's. their kids' menu has an excellent grilled chicken alfredo, or you can get a 4oz. steak off the kids' menu as well!
![\"Chopsticks\"](\"https://blog.baribuilder.com/content/images/2019/08/chopsticks.jpg\")
Asian food was one of my first post-op cravings, and the good news is that it's fairly easy to make a healthy choice! First of all, it's important to know what to avoid. Noodle dishes like lo mein and pad thai are a no-go. And you definitely want to steer clear of fried or battered meat, like sweet and sour pork or General Tsao's chicken.
So what's left? Any kind of steamed chicken or vegetables is always a great option. However, you probably want Asian for some flavor, so look to some hot and sour soup and seafood, or some grilled shrimp or chicken skewers.
Here are a few more good choices:
As always, go in with a plan.
\"Will I ever get to eat pizza again?\" I cringe whenever my friends who have had the surgery ask me this, because I want to say, \"Yes, but that shouldn't be a priority right now!\"
But this post assumes you've been doing everything right, and you've EARNED this trip out. So let's enjoy it! Obviously, like anything else, the best answer is to have it with veggies. A slice or two of thin crust with vegetable toppings should do the trick.
If you're going for something other than pizza, I commend you; you're stronger than I am! Here are a few other choices to satisfy your taste for Italian:
But who am I kidding - enjoy the pizza!
![\"Tacos\"](\"https://blog.baribuilder.com/content/images/2019/08/mexican-food.jpg\")
Making good bariatric decisions at a Mexican restaurant can be a bit more challenging, but it's not impossible. The trick is to avoid the high-carb, starchy sides in favor of veggies or lean protein like shrimp, salmon, pork loin, chicken breast, or flank steak.
The other thing about Mexican food is that some people's pouches are sensitive to it. We all know Mexican food already has a reputation to begin with, and it's not like bariatric surgery will make that any less true. So whatever you try, try a small amount first and see how your system reacts.
Try some of these ideas:
Tip: Chipotle is a great choice for post-op Mexican food. You are in control of what goes in your bowl and one bowl can last you 3-4 meals. Here's a great option: black beans, no rice, chicken, lettuce, pico, medium salsa, and cheese. It's loaded with protein and it's yummy!
Hopefully, if you follow this guide, you'll be able to enjoy a night out to eat without suffering any ill-effects. There's a catch-22 with this though, and we foodies are particularly vulnerable to it. If all goes well, then you'll have enjoyed a delicious meal out with friends or family, felt great afterward, and probably brought home leftovers.
If this is how it goes for you, then great! But don't make it a habit.
Bariatric surgery is a serious thing, and you should never forget that it's a lifelong commitment. Excess is what got us here, and it will be our downfall if we're not careful.
But as long as you keep that in mind, feel free to enjoy!
Having bariatric surgery is a major event in one’s life and involves making many lifestyle changes. Besides having to gain approval from your insurance and healing after surgery, you’ll also need to change your diet. Bariatric surgery and popcorn is a common question we’ll dig into in this article.
Before surgery, you may have to go on a pre-op diet to lose some weight to help reduce your liver size for a safer surgery. Then, after surgery, you will have to eat smaller portions, take smaller bite sizes, and chew more per bite. This will help you avoid getting too full and putting pressure on your newly modified stomach pouch.
In addition to this, you may have to avoid certain foods to limit any digestive complications. Read below to learn if popcorn is a food that you can enjoy or should avoid after bariatric surgery.
![\"Surgeon](\"https://blog.baribuilder.com/content/images/2019/08/surgery.jpg\")
There are several types of bariatric surgery that can assist individuals in losing weight. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), the most common bariatric surgeries include (1):
All bariatric surgeries hold promise to improve, prevent or cure type 2 diabetes as well as other chronic conditions such as heart disease, high blood pressure, sleep apnea, and stroke (2). Also, research shows that gastric bypass surgery is known to significantly reduce symptoms of gastroesophageal reflux disease (GERD).
The eating regimen you follow post-op will depend on what surgery you had done. Some variations of progression will exist with different bariatric centers, but the principals of advancing your diet are the same.
In the first week after gastric bypass surgery, you will be on a clear liquid diet. This will be for a few days before moving on to a full liquid diet (3). Then, once you tolerate full liquids, you will consume pureed foods for a few weeks before transitioning to soft foods. You can begin to consume solid foods after about eight weeks post-surgery in most cases.
When it comes to gastric sleeve surgery, it’s like the gastric bypass in that you are on a clear liquid diet for the first week (4). During this time, you must avoid caffeine, sugary drinks, and carbonated drinks. Then, you can start a full liquid diet. Finally, you can have a pureed diet around the third week post-op. You will then transition to soft foods before you start on solid foods again.
The post-op diet for the duodenal switch is similar to the phases of the gastric bypass and gastric sleeve surgery (5). The post-op diet for gastric banding surgery is a little bit different. After this surgery, you will eat liquid and pureed food for about two to three weeks (6). Then, you will slowly start to eat soft foods and solid foods.
![\"French](\"https://blog.baribuilder.com/content/images/2019/08/fried-foods.jpeg\")
No matter what bariatric surgery you have done, there are some common foods and drinks you should avoid, including (3,4,5,6):
![\"Bread\"](\"https://blog.baribuilder.com/content/images/2019/08/bread.jpg\")
In addition to such foods, you should also avoid alcohol for the first six months after surgery (6). This is because alcohol contains a lot of calories and little to no nutrients. Also, since you will be eating less food, alcohol can absorb into the bloodstream faster (7). In turn, it can affect you more even drinking one drink.
![\"Bowl](\"https://blog.baribuilder.com/content/images/2019/08/popcorn-1.jpeg\")
Popcorn is a common snack food that people enjoy on a standard healthy lifestyle. It’s high in fiber, contains protein, and is low in fat and sugar when unseasoned (8). It’s only when you add toppings that popcorn may become unhealthy. Therefore, after bariatric surgery, people may wonder if they can enjoy healthy, crunchy snacks like popcorn.
Unfortunately, popcorn is off-limits after bariatric surgery for several reasons. Popcorn tends to expand in your stomach, making you feel fuller (9,10). This can cause great discomfort in some people.
Although it contains fiber, popcorn is still a higher carbohydrate food that you should limit. It contains about 5 net carbohydrates and 1 gram of fiber per cup (11). And since it’s a lighter texture food, it can be easy to consume a lot in one sitting. Therefore, be sure that even if you are able to tolerate popcorn, stick to just a few cups a day.
![\"Bowl](\"https://blog.baribuilder.com/content/images/2019/08/hummus.jpg\")
Since popcorn is off-limits after bariatric surgery, that doesn’t mean snacks are out of the picture. Use the tips below to find delicious snacks that are safe to eat after bariatric surgery.
As you can tolerate more solid foods, you can add in some other raw produce to snacks. This includes produce like baby carrots, bell pepper, or pears, for example.
Popcorn is a delicious snack that is naturally low-calorie and a good fiber source for a healthy diet. However, after bariatric surgery, your body will digest foods a bit differently. You may not tolerate higher fiber foods as well after surgery. Not to mention that carbohydrate-containing foods like bread, pasta, and popcorn expand in the stomach. This can lead to pain and discomfort after bariatric surgery.
Luckily, there are plenty of other snack options, even crunchy ones, that are safe to eat after bariatric surgery. If you still feel you aren’t tolerating a lot of food choices after surgery, be sure to speak with your medical team. After surgery, they will be the ones that will be able to help you through any medical issues and/or answer any questions.
Bariatric surgery continues to be a tool to help those who are struggling with obesity. Living with excessive weight can take a toll on the body, including damages to vital organs like the liver. Regardless of the surgery choice, it is important to understand the importance of being in “optimal” shape prior to the procedure. The time between the first consultation with the surgeon and surgery day should be used to help prepare the body and mind with the vast changes that will occur post-surgery. This includes the concept of a “liver shrinking diet” before surgery.
Prior to surgery, patients will need to follow a pre-operative diet, also known as a liver shrinking diet, generally between seven to fourteen days. Bariatric patients will often have an enlarged liver due their excessive weight and poor diet such as foods high in fat and sugar contents.
![\"X](\"https://blog.baribuilder.com/content/images/2019/07/burger-donuts-no.png\")
By carefully monitoring the patient on a very low calorie diet (VLCD), this will help shrink the liver, as some studies have shown, to minimize risks related to the surgery. Following a restrictive diet with low carbohydrate and fat intake, will help achieve weight loss by forcing the body to use up its stored fat. Our liver and stomach are very close to each other. Since the nature of weight loss surgery is altering the stomach and possibly the intestines, a smaller liver will help the surgeon have easier access to the stomach and minimize any complications.
![\"Digestive](\"https://blog.baribuilder.com/content/images/2019/07/Liver-2.png\")
As mentioned earlier, this liver shrinking diet will slightly vary depending on the patient’s situation as far as duration and foods allowed on the diet. Every practice will have a different approach. Some will only allow liquids, primarily meal replacement protein shakes and calorie-free liquids, while others will include protein shakes, appropriate solid foods, and calorie-free liquids.
Despite the differences, the ultimate goal is to lose weight so try not to compare with other patients as each plan is individualized.
Whether it is a seven day or two-week pre-operative liver shrinking diet, the first few days will be the most challenging phase. You will be hungry and probably irritable so be prepared. To make this temporary journey less difficult, follow these guidelines to better prepare for this diet:
Protein supplements will be an integral source of energy during the pre-operative diet. When choosing a protein shake, there are few things to look for before purchasing. It is recommended to sample at least a few products to see what you like and dislike. Shop around to see where you will get the best price since you will need a large quantity. Studying and comparing the nutrition facts will be useful. The following is a guideline when choosing a protein supplement:
| List of Frequently Used Meal Replacement Protein Shakes | \n|
|---|---|
| Ensure® Max Protein Ensure® High Protein Premier Protein® Slim Fast® Advanced Nutrition Muscle Milk® Genuine Protein Shake Muscle Milk Light® Protein Shake | \n GNC Total Lean® Lean Shake 25 GNC Total Lean® Lean Shake Burn GNC Total Lean® Lean Shake Green (plant based) | \n
Patients will be given a pre-operative diet prior to surgery. As mentioned before, each practice will have specific guidelines. However, the overall message is the same. You will be reducing the overall consumption of starchy carbohydrate and fatty foods. Instead, the emphasis will be on lean protein and non-starchy carbohydrate choices including appropriate protein supplements.
Patients will need to avoid caloric beverages such as alcohol, juice, soda, and sweet tea as this will also promote weight loss. Below are lists with recommendations for each major food groups as it will help you make better choices.
Protein can be found in various forms including animal-based and plant-based foods. As you prepare for bariatric surgery, it is recommended to find ways to minimize overall fat intake. Thus, choosing leaner choices is preferable. This list below offers some options.
\n| What is considered one serving of protein? | \n
|---|
| 5 to 6 oz of skim of low-fat yogurt (preferably the “light” version due to its lower sugar content and “Greek” version due to its higher protein content) 1 oz low-fat cheese 1 cup skim or low fat cottage cheese 3 oz tuna packed in water 3 oz of baked, broiled, or grilled lean protein ((skinless chicken breast, beef, pork, fish, tofu, shrimp) – do NOT fry 1 egg (limit to one daily) 1/2 cup cooked beans | \n
Carbohydrate covers a spectrum of a variety of foods. However, the type of carbohydrate that is most concerning is the refined type, commonly referred as the “starchy” carbohydrate, such as pasta, bread, rice, and wraps, as they often dominate the daily diet. To successfully lose the necessary weight and shrink the liver, these types of foods need to be consumed very minimally. If possible, choosing a whole grain, high fiber version is better as it provides more beneficial nutrients.
\n| What is considered one serving of starchy carbohydrate? | \n
|---|
| 1 slice of bread OR 2 slices of light bread 1/2 cup of cooked cereal, pasta, or rice 1 cup ready to eat cereal | \n
Fruits and vegetables are natural sources of vitamins and minerals. However, this does not mean we can eat endless amounts of them. Some will have more carbohydrate contents than others, especially fruits and starchy vegetables (ie. potato, corn, carrots). During the liver shrinking diet, it is important to limit fruit intake to 1 serving daily while eating 2 servings of non-starchy vegetables due to its low-calorie content. When preparing vegetables, avoid cooking with fat. Instead, consider steaming, roasting and using lemon juice to add flavor.
![\"Blackberry](\"https://blog.baribuilder.com/content/images/2019/07/blackberries-salad.jpg\")
| What is considered one serving of fruit? | \n
|---|
| 1 “fist-sized” fruit (apple, peaches, nectarine, orange) 1/2 large banana or 1 small banana (6 inches) 1 cup whole grapes 1 cup of whole berries (strawberries, blueberries, blackberries, or raspberries) 1 cup cubed watermelon 1/2 cup dried fruit 1/4 cup 100% fruit juice* | \n
| What is considered one serving of vegetables? | \n
|---|
| 1 cup of raw OR 1/2 cup of cooked leafy green vegetables 1/2 zucchini or squash 1/2 cup broccoli or cauliflower 1/2 bell pepper 1/2 cup sliced cucumbers 1 cup chopped celery 1/2 cup cherry tomato | \n
As a general rule, everyone should be adequately hydrated. However, it is important to know what we are consuming through our fluid intake. Many will be surprised to see how much sugar is consumed just from our beverages. The list below includes suggestions and recommendations with fluid intake.
![\"Water](\"https://blog.baribuilder.com/content/images/2019/07/water.jpg\")
The pre-operative diet will range between 1000 to 1200 calories - significantly less than what most patients consume daily. It is going to be challenging due to the restrictive nature. With help from staff and personal persistence, it is possible. This portion of the journey is usually a good indication of how successful the overall weight loss journey will be after the surgery. Below are two samples of 1000 calorie dies. Do not hesitate to ask your medical team for help if you have concerns.
![\"Egg](\"https://blog.baribuilder.com/content/images/2019/07/egg-avocado-toast-1.jpg\")
| \n | Sample A | \nSample B | \n
|---|---|---|
| Breakfast | \n Protein shake | \n1 egg 1/4 avocado 1 slice of light whole grain bread | \n
| Snack | \n6 oz Greek yogurt | \nProtein shake | \n
| Lunch | \nProtein shake Handful of cut up raw non-starchy vegetables (cucumber, bell peppers) | \n 3 oz lean protein 2 handful of green salad 2 tablespoons of light dressing | \n
| Snack | \n1 serving of fruit | \n1 light string cheese or 1 oz low fat cheese | \n
| Dinner | \n3 oz lean protein Handful of raw non-starchy vegetable or 1/2 cup of cooked non-starchy vegetable 1/2 cup cooked quinoa or brown rice | \n 3 oz lean protein 1 light whole grain wrap 1 serving of fruit | \n
| Snack | \nProtein shake | \nProtein shake | \n
45% of bariatric patients are deficient in iron.
56% of bariatric patients are deficient in folate.
A staggering 60-80% of bariatric patients are deficient in vitamin D.
The list goes on [1]. Weight loss surgery (WLS) patients are no strangers to nutritional challenges - even before they’ve had surgery. Most patients present with some array of deficiencies, and getting the surgery adds another layer of nutritional complexity to post-op life.
And it’s not simply a matter of forcing down a mouthful of pills every day. Excess consumption to the point of toxicity is a real concern. Financial difficulties can make even the most diligent patients fall off the wagon.
Plus, we’re all human: pill forms, flavors, pill counts, and other factors have an undeniable effect on patients’ ability to stay consistent.
Regardless of surgery type – whether it is a gastric sleeve, gastric bypass or duodenal switch operation – patients need vitamin and mineral supplementation.
All of these operations impair nutrient absorption to various degrees. This impairment results in weight loss, but also comes with other undesirable effects: namely, reduced vitamin and mineral absorption.
If supplementation is ignored, severe deficiencies may develop. For example, a vitamin A deficiency can cause blindness in severe cases. A vitamin K deficiency can result in bleeding gums and easy bruising. Lack of vitamin B12 might mean anemia, irritability, forgetfulness and dementia. Vitamin D and calcium deficiencies mean osteoporosis, and so on.
The American Society for Metabolic and Bariatric Surgery (ASMBS) has published generalized guidelines for micronutrient supplementation after surgery [1, 2]. These guidelines are exactly that: guidelines for medical professionals. They do not sufficiently represent the medical needs of an individual patient.
In fact, one of the paper’s principal conclusions is that “it is the responsibility of the registered dietitian nutritionist and WLS program to determine individual variations as they relate to patient nutritional care.”
Despite this need to “determine individual variations” - in other words, take personalized regimens - it is all too common to see patients taking a “one size fits all” approach. This usually happens when patients purchase high-dosage “bariatric” branded pills that claim to “meet or exceed ASMBS guidelines.” They then mistakenly believe that fulfilling these baseline guidelines is all that they need.
A patient who strictly attempts to “meet or exceed the ASMBS guidelines” for the entirety of his or her post-op life by adopting the “one size fits all” approach is making the following assumptions:
These assumptions are particularly dangerous if a patient does not reassess his or her requirements on a regular basis by getting bloodwork and doing annual follow-up meetings.
Looking solely at the first assumption is a major cause for concern. The reality is that most patients start with different blood levels of vitamins prior to surgery. Many levels might be on the low end of “normal,” and many are outright deficient:
All of these differences are mainly due to individual food consumption habits, different levels of exposure to the sun, and other various activities with which people engage daily.
Because the starting point varies for so many patients, it is impossible to consistently address vitamin supplementation needs with a “one size fits all” approach.
When a patient’s vitamin level drifts down below the normal range - or he/she was, like many patients, deficient to start with - he or she will typically compensate by adding additional vitamin products to their regimen.
After several rounds of this process over the years, it can become impossible - or at least extremely complicated - to add up total dosage levels from all the different brands and products with nontrivial ingredient lists.
Unaware of total intake, a patient is liable to end up with toxic dosages of individual vitamins. The resulting adverse health effects can be almost as bad as deficiencies: too much vitamin A in pregnant women can be teratogenic, too much B6 can result in neuropathy, and so on.
Furthermore, being merely aware of aggregate dosages is still not enough. If the patient takes a one-size-fits-all pill and suddenly his or her blood level of vitamin B12 skyrockets to an excessively high level, most professionals would suggest decreasing the B12 dosage. But how should a patient accomplish this in practice? We cannot simply remove vitamin B12 from the pill.
![](\"https://blog.baribuilder.com/content/images/2018/11/uniquepic-1.png\")
Fortunately for everyone: the vitamin products that solve this problem already exist.
If patients browse Amazon.com for vitamin products, they’ll find hundreds of thousands - maybe millions - to choose from.
Each product has some combination of the ingredients that fulfill some percentage of a bariatric patient’s individual requirements. When patients add together Product A + Product B + Product C, they will get exactly what they need as individuals. The possibilities for product combinations are infinite.
When patients look at the entire vitamin market to fulfill their needs, they cease to be tied to specific, bariatric-branded products that “meet or exceed ASMBS guidelines.” After all, the “ASMBS guidelines” those products quote are in fact a range of possibilities, intended only for an average patient who needs only maintenance supplementation.
For some patients who fit that “average” description, a $70/month, pill-minimizing, great flavor option from Bariatric Advantage is the best choice.
Other more financially-conscious patients can find a $20/month, pill-heavy option coming from a combination of brands like Centrum and Kirkland.
Still others can find a balance. Maybe they don’t need any iron or B6, so there’s a good-tasting $40 combination of lesser-known brands that will suit them both financially and medically.
This regimen personalization is certainly possible for a patient to do via manual process: go on Amazon, search around, read Supplement Facts labels, convert units, and compare standardized prices.
But we know that sifting through this mass of commercial product information isn’t an easy task. We’ve built a web application that makes the searching and calculating easy: BariBuilder Shop (shop.baribuilder.com).
Please note that shop.baribuilder.com development is on hold. If you think this is a useful product, shoot us an email with that feedback at feedback@baribuilder.com - it'd be helpful to know that we should put our focus back into it!
A patient can enter his or her ingredient goals and sit back as the software does all those calculations to surface the best choices for them. By the time they’re doing check-out, they’ll have in front of them a regimen that is both cost-effective and matches their medical needs exactly.
1.\tParrott J, Frank L, Rabena R, Craggs-Dino L, Isom KA, Greiman L. American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the Surgical Weight Loss Patient 2016 Update: Micronutrients. Surg Obes Relat Dis. 2017 May;13(5):727-741. doi: 10.1016/j.soard.2016.12.018.
2. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, Heinberg LJ, Kushner R, Adams TD, Shikora S, Dixon JB, Brethauer S; American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013 Mar;21 Suppl 1:S1-27. doi: 10.1002/oby.20461.
3. Buffington CK, Walker B, Cowan GS, et al. Vitamin D deficiency in the morbidly obese. Obes Surg 1993;3:421– 4.
4. Ybarra J, Sanchez-Hernandez J, Vich I, et al. Unchanged hypovitaminosis D and secondary hyperparathyroidism in morbid obesity after bariatric surgery. Obes Surg 2005;15:330 –5.
5. Madan AK, Orth WS, Tichansky DS, Ternovits CA. Vitamin and trace mineral levels after laparoscopic gastric bypass. Obes Surg 2006;16:603– 6.
6. Carrodeguas L, Kaidar-Person O, Szomstein S, Antozzi P. Preoperative thiamin deficiency in the obese population undergoing laparoscopic bariatric surgery. Surg Obes Relat Dis 2005;1:517–22.
7. Flancbaum L, Belsley S, Drake V, et al. Preoperative nutritional status of patients undergoing Roux-en-Y gastric bypass for morbid obesity. J Gastrointest Surg 2006;10:1033–7.
8. Boylan LM, Sugerman HJ, Driskell JA. Vitamin E, vitamin B-6, vitamin B-12, and folate status of gastric bypass surgery patients. J Am Diet Assoc 1988;88:579 – 85.
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