We all want to be successful in our weight loss endeavors, and bariatric surgery is an excellent tool to help make that happen. However, bariatric surgery is just that – a tool.
Unfortunately, it is not a silver bullet to help you lose all the weight you need without working hard. To that end, changing your diet and improving your exercise habits are critical to ensuring that you lose weight safely and rapidly, and maintain that weight loss over the long term.
When a patient is more than six months post-surgery, they tend to start taking greater responsibility for their diet and exercise routine. In other words, the convenient postoperative packet we provide is less prescriptive than it was during the first six months. As a result, many patients worry that they may be veering off track with their diet.
So, let’s find out how to determine if you’re on the proper diet.
The diet shouldn’t feel like a diet
This sounds like a strange concept for someone who may have been used to overeating or constantly dieting; however, the long-term postoperative bariatric diet is not meant to be a diet. A diet, after all, is in and of itself a temporary phenomenon. Instead, this is a lifestyle change. This is a new direction in eating habits that involves consuming an appropriate number of calories for your weight and lifestyle.
There’s no exact number that applies to every patient, and there is no “best diet” out there. If you are more active, you’ll require more calories. Similarly, as you lose weight, you will need fewer. The key here is to remind yourself that this is the new reality and to work hard to find foods that taste good but also fit within the bounds of your dietary restrictions after surgery. Evidence shows that the most effective diet is the one that you can keep doing over a long period of time.
One of the greatest advantages of bariatric surgery is that there are very few absolute restrictions on the foods you can enjoy. That said, we strongly recommend limiting added sugars, highly refined carbohydrates, and ultra-processed foods. Diets consistently lower in sodium, added sugars, and ultra-processed ingredients have proven very effective for our patients. Research also supports that minimizing these components not only improves overall health but also enhances the success of any weight loss program, making results more sustainable over the long term.
You can indulge in small treats here and there, albeit not the way you used to. If your favorite dessert is being served on a holiday, take a small slice and enjoy it. Remember that this should not be a daily treat, but a once-in-a-long-while indulgence. On the flip side, if doing it here and there causes you to crave more and more sweets, it may be better if you choose not to eat them at all or find healthier replacement options.
Dieting should be easy and repeatable
One of the problems with dieting, over time, is the human tendency to go to extremes. If you are transitioning into a new diet, whether it’s keto, Mediterranean, or otherwise, it serves you best to ease into it slowly, so it doesn’t feel like a huge life change.
The problem with going to extremes is that one slip-up can quickly set you back to where you started: frustrated, upset, and tempted to give up on what could otherwise have been a successful diet. Because of this, it’s also essential to consult a professional before beginning any new eating plan. Your nutritionist, dietitian, bariatric nurse, or surgeon can guide you toward diets that have worked well for their patients and, based on your personal preferences, may be best suited for your circumstances.
It’s important to remember that there is no one-size-fits-all diet. What works for one person may be completely counterproductive for another. The key is to experiment, stay patient, and make informed choices that support long-term success.
For many patients, weighing foods is a helpful strategy to ensure portion sizes are correct. Soon enough, your body will be so accustomed to the new portion sizes that you won’t need to use the scale to determine how much you should be eating.
Eating out, though, may still require some diligence, as you really don’t have any control over how the kitchen prepares the food, even if you do mention your dietary requirements. A little caveat worth mentioning is ordering from the kids’ menu. While that can seem like a great option proportionately, it still may not be the healthiest. It’s better to ask for a to-go box or ask your server to split the entire entree before they even bring it to your table.
Your diet should be relatively easy to follow, but what exactly does that mean? Just like your exercise program, the best diet is the one that you can stick to. If you hate every moment of being on that diet, it is most definitely not the right one for you. Similarly, if you dislike your workout routine, you’re likely to become frustrated and lose motivation, eventually quitting and forfeiting all the fantastic gains you’ve made. Once again, there is no perfect diet for every patient – know that it’s hard work, but that you can also make it enjoyable.
Make no bones about it – diet and calorie restriction will not be easy at the beginning. You might experience headaches, cravings, and more. This is all very normal, and you do have to push through with willpower to get past it. However, over the long term, your diet should start becoming second nature to you – it should not feel like you are making an unreasonable sacrifice to keep the weight off. If you continue to struggle or just need assistance, you can always talk to your provider about meal options and/or obtain a referral to a registered dietician.
Bonus tip: The amount of weight you lose each week can help you determine whether your diet is adequate.
Over the first six months after bariatric surgery, you will be losing a significant amount of weight, and you will feel like the pounds are just melting off. You may even be alarmed at how much weight you lose and wonder if it will ever slow down. How much you lose at first depends on what type of bariatric surgery you had. For example, a patient who had a duodenal switch will lose a lot more weight than somebody who had a gastric sleeve.
Eventually, you will reach plateaus. Some of those plateaus you will bust through and continue to lose weight in the future.
From about six months onwards, aim for one to two pounds of weight loss per week, resulting in a total of four to eight pounds of weight loss per month. If that doesn’t feel like a lot, bear in mind that by the end of the year, if you have followed this strategy, you’ll have lost between 50 and 100 pounds. No small feat! (Again, based on the type of surgery and surgeon recommendations, this could look different for everyone.)
How you lose the weight matters
If you’re finding that you’re gaining weight rapidly and then losing it once again very rapidly by starving yourself, you know that you’re not on the proper diet. Similarly, if you have reached your goal weight and are yo-yoing, you may be doing the wrong thing. Stress eating and stress starving are signs that it’s time to see your surgeon and advanced practitioner. They can provide many resources for you with possible pharmacological interventions.
Should you supplement with GLP-1s?
GLP-1 medications can be an effective tool for patients to maintain weight loss after reaching their goals or to get back on track if they start regaining weight following bariatric surgery. However, they should not be considered a long-term alternative to diet and exercise for maintaining or losing weight.
Unfortunately, these drugs can get very expensive, and we also know that they only work for as long as they are taken. To that end, speak with your SAMPA bariatric surgeon to better understand your postoperative needs and whether a GLP-1 medication can help you achieve and maintain your goals in the long run.
Just be mindful that a combination of a proper diet and vigorous exercise will not only make you feel better physically and mentally, but also help you maintain the weight you want.
The bottom line
Remember that when it comes to weight loss, everything should be in moderation. This is a journey, and oftentimes people will have ups and downs during the process. If you’re experiencing extreme weight fluctuations or must make significant lifestyle changes to maintain your weight, it’s important to address any potential longer-term issues or concerns by consulting a qualified professional, such as those at SAMPA or your current weight loss care provider.
