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What Sustainable Nutrition Habits Look Like after Bariatric Surgery

There is no one-size-fits-all diet after bariatric surgery. Lead dietitian Andrea Bookoff offers six habits to lead a healthy post-bariatric surgery lifestyle.

Bariatric surgery is recognized by experts as the most effective treatment for long-term weight loss. While it’s an excellent physical tool, it’s not a quick fix. Improving your life after surgery takes consistent lifestyle changes, including adjusting what you eat.

Bariatric surgery makes your stomach smaller to make you feel full faster, but it doesn’t guarantee your long-term success,” says  Andrea Bookoff, lead dietitian for Jefferson’s Comprehensive Weight Management program. “It’s important to put in the hard work of making sustainable lifestyle changes after bariatric surgery to ensure you reach your goals and make them stick.”

Specific diets vary from person to person after bariatric surgery, depending on lifestyle, work schedule, health concerns, medications and the type of surgery – but there are some commonalities to keep in mind. Here are six habits to strive for to lead a healthy post-bariatric surgery lifestyle.

1. Eat consistently throughout the day.

After bariatric surgery, your stomach won’t be able to handle large portions of food all at once. Instead of eating three meals per day, Bookoff recommends having five or six “mini meals” throughout the day.  “Be sure to consume enough to keep you satisfied and keep your energy levels up,” she says. “I suggest eating every three to four hours, but every person is different. Work with your registered dietitian so they can help tailor your eating habits to your lifestyle and needs.”

2. Focus on protein and whole foods.

Since you will need to restrict your portion sizes, it’s important to focus on getting the nutrients your body needs at each meal. “The post-bariatric diet should usually include some type of protein in every meal or snack,” says Bookoff. Try to choose whole foods to go along with your choice in protein, like veggies, healthy fats, fruits or starches, like potatoes or quinoa.

3. Eat what makes you feel good and avoid what doesn’t.

Some foods might be difficult to digest or may feel heavy in your stomach after bariatric surgery. “Steaks and red meat and foods high in fat and sugar — like fried foods, ice cream or candy — might not be well tolerated. They can even make you feel sick if you have too much,” says Bookoff. Many people also find that starchy foods — like bread, pasta and rice — tend to sit heavier after bariatric surgery.

Bookoff encourages patients to learn how their new stomach operates. “If something doesn’t make you feel well, it’s important to honor your body and adjust your habits accordingly,” she says. The only thing she always suggests avoiding after surgery is carbonated beverages, which can stretch out your stomach.

4. Make sure your goals are realistic and sustainable.

Bookoff emphasizes what can be gained from bariatric surgery, rather than how many pounds are lost.

“Focus on the non-scale victories you’d like to achieve, instead of a specific goal weight,” she says. “Do you want to get off a certain medication? Travel in an airplane without a seatbelt extender? Take a walk without feeling out of breath? These are all goals to work toward that don’t rely on the scale for success.” Assess what needs to happen in order to reach your goals, if you’d like to commit to what it takes to get you there and if those actions are realistic and sustainable.

5. Feel empowered, not restricted.

Changing your eating habits doesn’t have to be restrictive; Bookoff says her goal is to make sure her patients feel like they can eat whatever their family, friends and coworkers are eating.

“You should continue to celebrate at parties and go out to dinner with friends,” she says. “Don’t focus on calorie counting—it’s not a sustainable practice. The quality of foods you’re eating, portion sizes and how often you’re eating are all important factors in improving your quality of life, but the number on the scale doesn’t dictate your health.”

Bookoff believes the key to success after bariatric surgery centers on eating real food, listening to your body and making sustainable lifestyle choices—not living off of protein shakes.

6. Know the details of your specific surgery.

Different surgeries may require slightly different eating habits, explains Bookoff. “Some surgeries require more restriction in the long-term than others, but can be incredibly beneficial for people with chronic complications, such as severe acid reflux or a history of diabetes.”

For some people, this may not be feasible, making it harder to attain the quality of life you’re looking for. However, vertical sleeve gastrectomy and gastric bypass – two of the most common procedures offered at Jefferson – still allow you to enjoy many of the foods you are used to, just in moderation, adds Bookoff.

If you haven’t yet had bariatric surgery, your primary care provider, endocrinologist or bariatric surgeon can help you decide which surgery is right for you.

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