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.
Related Articles:
Ready, Get Set, Lose Weight!
8 Foods To Avoid After Bariatric Surgery
How A Bento Box Can Help Your Bariatric Diet
Can You Stretch Your Pouch?
5 Ways To Avoid Weight Gain After Bariatric Surgery
Bariatric New Year Resolutions!
5 Steps To Move Out Of A Weight-Loss Plateau
A Day In My Bariatric Pouch
Worried About Weight Regain?
No More Excuses!
6 Ways To Bullet-Proof Your WLS Success & Speed-Up Weight Loss
10 Tips For Success After WLS
Tom Greenfield says
Thank you Carol, great advice & information. I am 4 yrs post op, (RNY by-pass) & I am finding it difficult to focus on healthy eating at the moment.
For me life style is the problem, often eating on my own it is easier to ‘bung-in’ a ready meal in the microwave. I have tried to adapt some of your brilliant recipes from ‘Return to Slender’ but sometimes run out of ideas & take the easy, ‘chicken ding’ type meals for one 🙁
Perhaps I need to go to a bariatric cookery school?
Thanks again for your continuing help, many of us rely on your support!
Tom x
Carol Ball says
Hi Tom, how lovely to hear from you and many thanks for the kind message and support – it means a great deal. Healthy eating at this time of year is especially tough in the UK – the weather seemingly defeats us by making everyday shopping tough; new fresh produce at a decent price is thin on the ground; and after all the holiday festivities our enthusiasm flags too. That said, I think it’s cooking for one a great deal of the time that is your non-motivator. Hard to raise the spirits to cook a few tablespoons of food isn’t it? My way around this is to freeze a good many of the extra portions of main meal dishes that I cook for the rest of the family so that I have something to hand when I’m solo dining. I have a freezer well stocked with portions of soup, chilli, mini shepherd’s pies, curries and roasted vegetables that often just need a quick zap in the microwave to serve. With a few frozen peas or handful of salad they make a meal that seems as fresh and satisfying as when it was first made. It doesn’t take long to build up a store – what for some might be too little to store and save is perfect for a bariatric patient – means the dog doesn’t like it here since no leftovers reach his bowl! Otherwise I go to the supermarket and grab a few things from the deli or salad bar – I can buy as little as I want – a single slice of ham, a chicken thigh, a small pot of ready-chopped vegetables that make a brilliant basis for a stir-fry … you get the idea. I rarely opt for a ready meal because many are protein light and carb/sugar/fat heavy but the M & S ‘Fuller for Longer’ range are great in an emergency. I know they are pricey but one meal is for me two bariatric portions (one to eat now and one for later or for the freezer) so cost effective as an occasional purchase. You have however given me some food for thought and I can see the need for some single portion main meal recipes – so I am going to make this a topic for one of my next newsletters – look out for them! Thanks for the message and do keep in touch. C x
Carol davies says
I am in a similar situation to Tom, wishing there was a Bariatric Cookery School but I find your books very helpful. However I would also appreciate more recipes for single main meals.
Happy New Year Carol and thanks for everything.
CAROL says
Hi Carol, Happy New Year to you too and many thanks for the kind comments. I have noted your request for some more recipes to serve 1 and will get onto them straight away! As for a cookery school then we might have to wait longer although I have thought about a couple of special day events that could include some cooking sessions – maybe it will happen in 2016. C x
Gulay says
I am a newby here and have learnt so much. I thank everyone for all I am learning. What I would love is a learn to cook channel or subscription of some kind and actually watch videos on not only cooking but also meal preps/freezer meals for the week to minimise risk of ready packed meals. A video channel more so for those that live on the other side of the world that cannot attend day sessions etc… I follow the recipes in the books but still does not turn out as expected… Not really a good cook I suppose 🙁
Thanks
CAROL says
I’m looking at a series of videos for cooking post-surgery but it’s still in its infancy. Luckily I have a new addition to the family with a ‘son-in-law-to-be’ who is a camera man and film maker so perhaps this will happen sooner rather than later. I’ll announce as soon as we have something together – so many others have asked for this Gulay so I recognise the need and urgency. C x
Linda says
Hi from Australia.
I have only recently (last week) had the balloon placement as part of my kickstart to a new me.
Thankfully no side effects at all, apart from inability to sleep…. Hence I find myself on internet looking for information and came across this site.
WOW…. Thank you so much …. I have picked up so many wonderful ideas such as the 20 20 20 rule, (and written them down).
I know how to cook (usually without a recipe) but the way point 10. Is written made me more mindful of how I previously cooked. I had never really thought about being in ‘control’ of my food intake by measuring, I always knew what I was cooking and eating but now realise I had no idea about ‘control’. For example: in a healthy vegetable pasta meal I without thinking… Just add that ‘bit extra’ cream or cheese… Thanks for informing me of healthier choices I can make just by measurement.
Great site and will be added to my home screen for (possibly constant) future reference as I proceed from liquid puree mush back to real food.
Many Many thanks. LK
CAROL says
Hello and welcome Linda! Glad everything has gone well for you so far – the balloon can be tricky for some so it’s great that you’re finding things are working well, although a pity about the sleep (I’m sure that will settle). As you’ve doubtless found with your surfing on the site there are a good many ‘rules’ to follow and some handy bits of advice gleaned from countless post-ops to make bariatric eating and lifestyle easier as time goes on. Adopt them as much as you can in the early days and make them your routine and you’ll be repaid umpteen times with a successful outcome. It’s hard after years of veering away from healthy eating and some destructive behaviours to get back on track and embrace a new healthier way of eating with some special regime to follow after wls but doable. I hope you’ll find more and more as time goes on to entice your appetite (small as it might be) and also to gain control in an effective way. My own life has changed beyond recognition in the last 61/2 years and all for the better – I hope you find your ‘nirvana’ too. Do keep in touch and let me know how things go and if there is anything I can help with then you know where I am! C x
LaShall says
Carol, thank you for all that you do! I am three 1/2 yrs out and I have not just fallen off the wagon, I fell off and got run over. I didn’t know about the 20:20:20 rule, although I practice all but sitting at the table, hubby and I love eating in front of the tv. This post has given me hope that I can reach my weight loss goals and enjoy doing it. I can’t wait to get my bariatric plate, container and measuring bowls, I’m truly truly excited to lose my regained weight along with the rest of the weight. So, once again, thank you Carol, you are a blessing for making this journey a bit easier! be blessed.
CAROL says
Thank you for such kind words. I am certain with your positive attitude and renewed enthusiasm you’ll lose that regain and any other surplus. The products will help but do check out the recipes and advice too. Let me know how things go and keep in touch. C x
Debnie says
I just found you online. I had sleeve 3 days ago and I’ve always loved to cook. My style of cooking was yummy but not healthy. I was afraid I would not be able to cook anymore. I will be picking up your cook book for ideas on healthy eating. I’m at the stage now where I’m wondering if I made a huge mistake. Generally not feeling well. This web site gives me hope.
CAROL says
Ah Debnie, I don’t think there is a post-op patient out there who doesn’t wonder if they have done the right thing just days out of surgery. Everything seems strange and thought of a life without the usual foods and routines is quite bewildering. But please believe me when I say it gets better, easier and more pleasant each and every day from now on. That’s not to say there won’t be some peaks and troughs but if you stick with the plan and regime you’ll enjoy weight loss and huge health benefits for years to come. I can also promise great food – it’s not about what you can’t have but what you can – and there’s lots of variety, great food to cook and many dishes to enjoy. I hope you’ll enjoy browsing the website for advice and recipes and if I can help further then you know where I am. Good luck! C x