Losing and keeping the pounds off after weight-loss surgery largely depends not just on eating less, but upon eating the right foods, with the right nutrition, in the optimum amounts. But finding the foods you can, and moreover want to eat, and making the transition from your ‘old life’ to a healthy new one, can be challenging. Even if you know a great deal about nutrition, putting this into practise is hard.
From the early post-op days on Fluids and Soft Foods, moving onto what I call ‘Food for Life’, it is important to practise ‘mindful eating’, making sure that you eat right with every bite. Ironically, this can often be easier in the early ‘honeymoon’ stage after surgery, when you might not have any real appetite or hunger for food, than the later stages, although there can be the danger of not eating or drinking enough. During this time you can maximise your weight-loss results by eating right and exercising regularly.
Protein will be your greatest priority during this time and it is fair to say will always be. Most patients are told to aim for 70g per day to facilitate good healing.
Carbohydrates come next, and although these vary by surgical procedure as well as medical issues (like diabetes), 130g per day is often what is quoted in bariatric surgery scientific literature. The aim here is to ingest many of these as complex ones, found in plant-based foods, rather than as simple sugars. This figure may sound overwhelming and most likely won’t happen in the first few months after surgery, but it is certainly something to aim for at least 6-9 months post-op. Gastric bypass patients will also have to watch sugars for fear of ‘dumping syndrome’…I rarely have a dish with more than 7-10g sugar per hit to reduce this risk.
Fats, often labelled the bad guys, also have a place but vary enormously according to procedure, and the mantra here is to steer clear of too many saturated fats, keeping the level down to under 3-5g fat per 100g. Add to that advice about eating ‘5 a day’; keeping up the fibre; hydrating well with at least 2 litres/81/2 cups of water; not forgetting the daily taking of multi-vitamins, calcium and other supplements; and you have a regime that can be more than a little testing.
It has been my challenge as a food and cookery writer to develop recipes for all these stages of post-op eating, taking some of the guess-work out of cooking on a daily basis. The recipes, on this website and in my books ‘Return to Slender’ and ‘Return to Slender … 2nd Helpings’ have all been devised and tested to not only work (a minimum requirement!) but to also adhere to these nutritional guidelines and to be deliciously tasty too.
Some are very simple and will not test even the most basic or inexperienced cook and others will offer ideas for those who like to entertain. All have been considered carefully in terms of cost, seasonality and cuisine so offer the virtues of variety. They also have been devised to suit the needs and appetites of everyone so that mealtimes can be a pleasant experience with family and friends. They have been classified with a traffic-light coded system as suitable for the Red/Fluids Stage; the Amber/Soft Foods Stage; and finally the Green/Eating for Life Stage, to guide a patient on the journey of eating well again.
People’s tolerances vary greatly; so while these recipes may be recommended as being appropriate for a specific stage, only the patient will know for sure when they can best be tolerated. Each recipe also has a nutritional analysis breakdown so that you can keep a check on the calories, protein, carbohydrates and fat. Used in conjunction with a food tracker you can see how your levels are working out over a day and week.
Recipes are however one thing and general eating is another. I would still advocate that patients become avid, if not fanatical, back of pack or label readers. Understand and be aware that food manufacturers add sugar, salt and fat to foods to make them taste better. Check out the best nutritional options – take a little extra time in the supermarket to find them; speak to other bariatrics on websites and forums for advice; and pass on anything you find that is good at support groups for everyone to benefit.
What have I learnt since my own surgery? Well, that I have a new regime to follow. I have forgotten about dieting and the old destructive starve and binge ways of old. I now have a diet but I’m not on a diet. This took some time to get right. I followed the 3 stages of eating after surgery in a relaxed way…there doesn’t have to be a race to the tape, indeed there isn’t a finishing line! I considered myself to be weaning rather like a baby and realised that some days some things suited, other days they didn’t. But I always did retry and, as a result, my diet has great variety.
I have learnt to practise ‘mindful’ eating…trying to eat only when hungry, not when bored, sad or angry. I eat slowly and savour every mouthful and I chew, chew and then chew some more. I have quite easily slipped into a healthy 3 meals and 2 snacks (if required) regime. I also sit at the table to eat with a knife and fork without distractions. No more sitting on the sofa with a packet of something or other, watching TV, and then wondering who ate all the goodies a little while later!
I have also adhered to the advice given to me by my dietician about not grazing, and to ease up as time has gone by with sloppy/slider foods that won’t help me feel full for long. And, (this has come as a surprise) I have started to move much more. I have found the best exercise for me is the one that I will do. So I walk, dance, swim and occasionally hit the gym.
Some of my tips for success include cooking for 1 to serve 2. If I didn’t then my husband would eat 11/2 portions and be sitting on the gainers bench well away from me on the losers. I also use a smaller side or salad plate for myself so that portion control is more manageable. I use a bariatric portion plate to help with this so that I not only get the food choice right but also the correct proportions for a bariatric.
I also eat slowly following the 20:20:20 rule using my bariatric cutlery.
When on the road or away from home I also use my bariatric bento box to keep food perfectly portioned and also in good condition and safe. It’s ideal for when options away from home can be limited or non bariatric-friendly.
I also plan for emergencies by having bariatric-friendly food in the freezer and a couple of snacks in the boot of my car should I get caught up in traffic or be running very late. In restaurants (which I visit at least twice a week) I tend to order 2 starters instead of a starter and main course/entrée and am not shy about ordering off a children’s menu or asking for a ‘doggy bag’ to take home something I can’t finish. I often ‘upcycle’ these leftovers into something quite different.
On this website and in my books I have covered all the basics for success. Problems usually occur when we lose sight of these and veer off course. The result is weight gain or a long-term stall (I stress the long-term because stalls and plateaus do occur but it’s when they are persistent they need addressing). So what are the basics to follow and get back to when all is not well? Here are my top 10 which are covered in more detail if you search and scroll around the site:
MY TOP 10 BACK TO BASICS
- Follow the 20:20:20 rule (need a reminder of this? see here)
- Hydrate well – but remember don’t drink with meals
- Eat your protein first and ensure it fills half of your plate (use a bariatric portion plate to ensure this). Check your portion size isn’t too large and that the proportions are correct
- Take your vitamins and supplements every day and check your blood annually
- Move more! Introduce exercise or activity into your day, but do something you enjoy
- Don’t graze! Have 3 main meals and 2 additional high protein small snacks if necessary daily
- Don’t rule out food groups or stigmatise certain foods. If you experience intolerance try cooking in a more bariatric-friendly way – all foods should be enjoyed
- Practise ‘mindful’ eating – use a knife and fork, sit at a table and without distraction
- Look for support from your bariatric team, a local or online group and when things get tough a professional
However, the best advice I can give has been left until the end, 10. LEARN TO COOK – that way you can control your food intake, know just what you are eating and still have a good, healthy relationship with food. This doesn’t mean being a slave to the kitchen, there are lots of healthy convenient foods out there to make life easier, just try to avoid the unhealthy ready-made and processed junk ones. Ensure however that you measure foods and ingredients carefully so that the portion size is correct – our bariatric portion, cook and serve cups can be invaluable help with this.
Remember, it is not just about eating less, although you will undoubtedly have a smaller plateful than your non weight-loss surgery counterpart, but about nourishing yourself with inspiring dishes to ensure success, long-term.