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So many people think that weight loss surgery is an easy fix.
As someone who has had surgery, I can fully share with everyone out there that believes this, that this “theory” is in fact false!
Many people think that weight loss surgery is an easy way out because it decreases the patient’s stomach size. However, what most people do not know is that a significant amount of people who have weight loss surgery (also called bariatric surgery), typically regain weight within the first five years after surgery.
Due to these drastically high statistics, it’s important to acknowledge that one of the biggest issues to address is behavioral change after weight loss surgery. Most individuals are guided by their bariatric surgeon’s office to follow a completely new diet following their surgical procedure.
However, this can be difficult, especially for some individuals who have not conquered their issues with food. Behavioral change after weight loss surgery is not just integral, it’s essential.
If someone is not going to change their behavior by following their post-operative diet or exercise plan, they can expect that either the weight will come off very slow, or not at all.
For any person who has watched the television show, “My 600 pound life”, there are individuals that sincerely struggle with this change.
Behavioral change after weight loss surgery comes in the form of changing one’s entire diet and including an exercise program. However, before that even happens, the patient goes through a series of dietary restrictions as part of the process in preparing them for the surgery itself.
The Post-Op Diet
Even before someone goes in for bariatric surgery, they have a team working with them that include the surgeon, dietician, and psychologist. Each individual is required to have a psychological evaluation. Additionally, each individual goes through a pre-operative diet phase to prep them for surgery, and then are given a post-operative diet. The post-operative diet is in phases because the surgery is done on the stomach, individuals will not be able to eat solid foods right away. This gives the stomach time to heal while also helping the individual gain nutritional value.
The post-operative diet plan occurs in stages:
Stage 1 – Clear Liquids (1-7 days immediately after surgery)
Water, fat-free milk, fat-free broth, sugar-free jello, etc.
Stage 2 – Pureed Foods and protein shakes (somewhere between 7-14 days after surgery)
Consisting of egg whites, non-fat cottage cheese, non-fat plain yogurt, protein shakes
Stage 3 – Soft Foods (gradual introduction, beginning 21 days post-operative, and lasting for 2-3 weeks)
Consisting of fish, lean turkey/chicken, non-fat cheese, cooked squash, green beans, carrots, bananas, avocados, and similar soft foods.
Stage 4 – The Return of Solid Foods (beginning approximately 6 weeks following the surgical procedure)
In this phase the patient can return to solid foods integrating them back into their life, one food at a time to ensure that the stomach can handle it.
The Long-Term Plan
Following surgery, it is highly recommended that bariatric post-op patients adopt a low-carbohydrate lifestyle. This is the point at which it is a lifestyle and not a diet.
As the newly formed stomach or “pouch” has been created to reduce food intake, it is sensitive to foods high in sugar, fat, and carbohydrates.
Dumping syndrome is a condition that occurs when overly sweet or fatty foods are consumed too quickly and can cause symptoms such as cramping, diarrhea, the cold sweats, nausea, vomiting, or even an increased heart rate. These symptoms typically wear off, however are a signal that the individual has eaten foods that are not good for the “pouch” and are being dumped from the stomach into the intestines quickly.
Therefore, bariatric post-op patients should avoid foods high in sugar, fat, and carbs.
Additionally, living a low-carb lifestyle helps post-bariatric patients lose weight more quickly and keep it off as the body metabolizes proteins different from carbohydrates.
Therefore, this is a behavioral diet change that everyone who has had weight loss surgery is required to maintain.
Lasting beyond the Honeymoon period
Most bariatric patients do well within the first 6-12 months after surgery. However, this is also dubbed the “honeymoon period” when they are adjusting to life after surgery and the new bariatric lifestyle.
However, following the first year post-operatively, things begin to shift within patients. The lure of the old foods and high-carbohydrate foods can be very tempting.
This is where most individuals struggle most with long-term behavioral change.
You might think that if someone kept up a diet for at least a year, they would be able to sustain it. However, everyone can do something for a short time, and the reason that people have surgery is to lose the weight and feel better.
Many don’t last longer than a year or so because the longing for the old foods creep in. With many holiday events, parties, and people bringing donuts into their company’s break room, people can be triggered by the lure of food.
This is why behavioral change is necessary after weight loss surgery.
In order to sustain long-term weight loss, people have to change their mindset and in turn their behaviors. Without long-term change, post-op patients can regain weight.
This happens when they “graze” or snack in between meals, or when eating foods on their preferred meal plan such as carbs, sweets, and foods high in fat.
Therefore, the mindset and behavioral training is essential for individuals to keep the weight off for good. The honeymoon period keeps people in check and on top of their game. Following this sweet-spot period, people can get very relaxed in their eating styles and not realize they’ve regained a few pounds. Overtime, this can add up to more than expected.
Key ways to long-term behavioral change
The best way for post-op patients to sustain their weight loss and to maintain behavioral change is through self-monitoring. Research has shown that self-monitoring behaviors help people stay on track.
Self-monitoring consists of logging or tracking one’ food intake and exercise. If someone is not working out daily, weekly, or at all, the records will show. Likewise, if someone is eating potatoes on a daily basis, the food tracker will show this as well.
When written down, it can be reviewed and reflected upon so that behaviors can be changed effectively. However, you cannot change something that you have no knowledge about. This is why behavioral change begin with awareness and tracking one’s eating and exercise behaviors.
Once someone tracks their meals and fitness routines they can effectively see what needs to change and begin to take action. Those who do not track, cannot begin to take action.
Some quick steps to behavioral change include keeping a food and fitness log, and setting a time weekly to reflect on the week’s events.
Then, revising a future week’s plan so that behavioral change can be made to reduce overeating or emotional eating, or eating between meals.
If someone is resistant to tracking their food, it could be that they are struggling with the realization or their behaviors, or simply do not want to face their struggles.
Avoidance happens when people do not want to change their behaviors yet also are frustrated with where they are at. Someone who is an avoidance might also be in a self-sabotaging state and may need to see a therapist or counselor to dig deeper on this in private sessions.
Change Happens Slowly – Give it Time
Behavioral change begins one step at a time, and occurs over time. Awareness is the key to change, and self-monitoring helps individuals see what they are doing well, and what needs to shift.
Beginning to track behaviors can help anyone see what needs to change, whether it be food or exercise.
Just because someone has had weight loss surgery does not mean they will lose the weight for good. It has been said that weight loss surgery is not brain surgery. The surgery happens on one’s stomach, and not on one’s brain or in one’s emotional state. Those that struggle with food may need to seek out a professional therapist or certified bariatric coach to help them get back on track in order so they can lose the weight and keep it off long term.
Weight loss surgery helps individuals to reduce their intake of food, and when paired with long-term behavioral change, it can be very successful. Individuals who are ready to take the next step and live their lives as thinner versions of themselves should note that the behavioral component requires more time and patience than the surgery itself.
It’s highly recommended that anyone having surgery have a strong support system as well as a plan of action for lifestyle change following their surgical procedure. While many people think it takes 28-30 days to create a habit, the long-term lifestyle change for bariatric patients may take much longer due to feelings and struggles with food and eating behaviors.
While success is definitely possible, it does take hard work and dedication on behalf of the patient to invest in themselves to ensure their long-term success by taking action toward their goals.
FOCUS ON HEALTH FIRST
When focusing on health first, this helps to shift one’s mindset around food. Previously it may have been about fulfilling an emotional need such as reflected in someone asking this question ‘what do I want to eat today?’ versus the new question which needs to be ‘what does my body need to function best today?’.
This is a key difference in a mindset shift that needs to occur following bariatric surgery in order for there to be long-term behavioral change. While food can and will still be a pleasurable experience, if someone focuses only on pleasure and ease, there may be more issues to overcome.
Fast-food is much different from healthy food fast. There are many healthy meals that can be whipped up quickly. However, the focus on health needs to be the biggest shift for making food fun so that people can make healthy meals quickly.
The old patterns of ‘fast’ can get in the way if the focus is not on health first. Therefore, by shifting one’s mindset around food to what is ‘pouch worthy’ or ‘stomach worthy’, this can help post-bariatric patients eat for their wellbeing, while seeking out tasty options.
Remember that having bariatric surgery is about lifestyle change, not dieting! This is why creativity is essential. Who said you can’t play with your food?
Of course you can!
There can be many ways to get creative with food. Now that we have the whole internet at our finger tips there are many things one can do to spice things up. Clearly, the focus is on bringing your imagination into this and you might be surprised, if you’ve had a fattening version, there is likely a “skinny” version available. When checking on blogs and sites, be sure to check the carbohydrate content and look for bariatric friendly options.
Looking on Pinterest or blogs can give people many ideas about how to stay low-carb and on plan all while trying out new recipes. There are many websites that can be found on Pinterest that help people get more creative with their food and eat healthier meals.
Think outside the box when it comes to creativity. While people think they can no longer eat pizza or breads, this may be true in the traditional sense, but once you get creative with your food, you’ll see you can eat just about anything once modified.
Modifying your food is essential after bariatric surgery so that you can get the highest nutritional impact for your new stomach. This process clearly is about getting creative because you want to enjoy your food without experiencing deprivation, which is totally possible!
DON’T GET STUCK ON SPECIFICS
Many people after bariatric surgery tend to get stuck on very specific things such as no bread, no rice, no pasta, etc. These are typical requirements because foods high in carbohydrates typically get stored as fat if not burned by the body. This is why bariatric patients are put on a low-carbohydrate diet following surgery. The goal is to maximize weight loss while also feeling full and satisfied.
Foods high in carbohydrates are typically a ‘no-no’ but that doesn’t mean you cannot still get creative with these recipes. There are tons of recipes available that change the ingredients of dishes such as stuffing, rice, and other seasonal favorites that help people stay on their plan all while enjoying delicious foods.
Instead of regular stuffing, try cauliflower stuffing.
Instead of bread, look for low-carb tortillas or low-carb flat breads. There are also cauliflower crust pizzas and cheese or chicken crust pizzas that can be just as tantalizing.
Instead of regular rice, there are other paleo friendly foods such as cauliflower fried rice, etc.
Instead of fried chicken wings, you can make baked buffalo tenders.
Instead of pasta, there are zucchini noodles, known as ‘zoodles’. Lasagna can even be made with thin sliced zucchini instead of the pasta, or without a noodle at all and is called a ‘ricotta bake’.
Instead of sandwiches, take out the protein filled interior and eat it with a fork and knife.
One of my favorite recipes to make is a philly cheesesteak skillet (sans-bread). It’s filling and delicious. It has all the fixings of a philly cheesesteak, but is low in carbohydrates.
There are so many more options as well. Having fun with food is something that can help every bariatric patient be successful after surgery because while there is a shift in the types of foods, there are so many modifications available that it can be fun to try new things.
This is why being creative and opening one’s mind to food options is essential for the post-bariatric patient. Anything the mind can conceive in low-carb, can and probably will be created!
Get your forks ready!
OPEN YOUR MIND TO NEW OPTIONS
When it comes to living the bariatric lifestyle after having weight loss surgery, it’s important to remember to keep an open mind regarding food choices. When checking out various food options, keeping an open mind is essential. This is a new way of life and so thinking outside the box and keeping options open can make life so much easier.
This is also a time to explore with new foods or making foods in a new way. There are many options and recipes available that teach people how to eat healthier while keeping the carbohydrates down.
Just about any food that someone made or ate prior to surgery can be reproduced in a ‘bari-friendly’ way or in a low-carbohydrate option as noted above, so don’t turn your nose up just yet. Give yourself an opportunity to try the bari-friendly version. Many of my clients rave about ricotta bakes and zoodles.
This is a great opportunity to enjoy your food and often most people don’t even miss the heavy carb loaded recipes!
Even burgers can be made without the bun. Instead of French fries, steamed veggies are a good option for keeping the crunch without all the added fat.
Be open to trying new things at least once so you can test out new foods. Check them out and see if you like them. If you do not, at least you know you won’t be making that dish again.
(Give it a TWO-FORKS up if it is good, and a TW0-FORKS down if you’ll never make it again!)
However, if you do like it, then you will be able to add that recipe to your approved ‘bari-friendly’ and tasty food list so that you can make it over and over.
Having a list of options will help you stay on top of nutritious food choices and will help you stay away from trigger foods.
PLANNING IS THE BEST WAY TO MAKE IT HAPPEN
When changing your lifestyle, meal planning is essential. This is how you can make food fun. Prior to surgery many people ended up going through the drive through to get food which is both healthy and cost concerning.
Having a meal plan can help people to stay on track with both their weight and their budget.
However, shifting one’s mindset around the time commitment is important. Yes, cooking will take more time and more planning, yet in the long-run the reward for this time investment is priceless.
Eating a fast-food lifestyle is what packed the weight on to begin with and taking the time to prepare your food will help both your health and the health of your family as well.
The modified versions help people use the ‘bari-friendly’ options to keep food healthy, fun, and tasty.
Each week take out a sheet of paper and spend 20-30 minutes planning out your meals for the week.
Look at your favorite websites or type in “bari-friendly” or “bariatric” or “WLS” keywords into Pinterest.
MAKE YOUR FOOD WORK FOR YOU
Having foods that are both delicious and nutritious are important. Foods that you can make at home that are both cost effective and quick are also vital. When creating your meal plans, focus on these four areas to feel fully satisfied.
● Quick to make
● Cost Effective
Being on top of your food plans and ensuring that your food fits into these categories can make food fun after bariatric surgery!