Each Monday I sit down and find a topic that I believe will be useful to the weight loss surgery community.  I search for ideas that I believe will educate clients and help them to navigate the waters post-bariatric surgery.  This week I want to bring to you some ideas of what to prioritize after surgery and what “not to do” after surgery.  It’s just a gentle reminder of how to reach our goals, both short and long term.

Let’s start with the importance of protein. In order to heal faster and prevent muscle loss, it’s important to consume sufficient protein.  Protein shakes are fine in the beginning but I like to see people transition pretty quickly to whole, live, fresh, natural food.  Instead of reaching for a protein shake for breakfast, prepare some scrambled eggs.  Instead of having a shake for lunch, prepare a chicken salad at home with an olive oil vinaigrette.  It’s better for your health and your wallet.

Make sure to stay hydrated.  A lot of my clients don’t feel hungry or thirsty post surgery so I make sure to stress the importance of H20.  You need to drink a minimum of 8 glasses of water per day and when you are very newly operated, it can be difficult.  I want you to be very focused on how much water you are drinking.  Keep track of it and put an app on your phone which reminds you to drink up.

Nutrient deficiencies can occur in post-bariatric surgery clients.  Let’s try to prevent them before they occur.  Please take your bariatric vitamins.  I believe that food comes first and supplements are like a good insurance policy.  You cannot supplement your way out of a bad diet but we can add to our good diet by taking high-quality bariatric vitamins. 

Keeping a log or a journal after surgery is a really good way to get to know your new anatomy.  It can help you figure out food sensitivities and understand better what works and what doesn’t work for you.  You can go back to the early days and see what you were eating when the pounds were falling off.  You can also track your exercise,  water intake, your feelings, and your sleep schedule.  It gets you to slow down and spend a few moments with yourself.  

All of my clients have the advantage that they are able to communicate with me whenever they feel the need.  I am an RHN, registered holistic nutritionist, who specializes in post-bariatric nutrition.  If you have a nutritionist or a dietician included in your weight loss surgery plan, use them.  Stay close to them.  Reach out to them and let them know any concerns that you have.  Share your food log with them.  Make regular appointments with them.  They are an important part of your journey and they can help you to reach your weight loss goals through good nutritional habits.  

Now let’s move to the next section which is what NOT to do as a post-bariatric client.

Don’t speed through your post-op guidelines.  What I mean to say is that I don’t want you going from soups to stews overnight.  There is a progression that needs to be respected in order to allow sufficient time for your newly operated stomach to heal.  You will get to the stage where you can eat everything but don’t rush it.  Time passes quickly and you will get there before you know it.  In the beginning, go slowly, and follow your guidelines.  Your tummy will thank you for it.

Don’t allow old habits to creep back into your new healthy lifestyle.  You have worked so hard to have your surgery and to lose weight.  If you go back to those habits of drinking your calories or eating refined and processed carbohydrates (slider foods), you are setting yourself up for a weight re-gain.  Try to incorporate your new healthy habits in a way where they become your lifestyle.  You are in this for the long haul and those french fries are not worth the damage they can cause if you begin to eat them again on a regular basis.

Don’t compare yourself to others who have had weight loss surgery.  We are all at a different starting point, different age, different gender, different metabolism.  This is your personal journey and if your scale is moving in the right direction, you are winning.  Don’t be looking over your shoulder at others who are losing weight at a different rate.  

Bariatric surgery isn’t a race and there is no finish line.  It is a lifelong journey to improved health markers.  Enjoy the trip.  If you’ve had a few bad days, get back on track again.  Sit down and make a plan. You have a new opportunity each and every day.  Grab a hold of it.

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We are all aware that bariatric surgery is not just a “get it done and be done” situation. It is a lifelong commitment to healthier habits. It is a journey to wellness and understanding ourselves better.

But, sometimes we just want to believe that the surgery is going to fix all of our problems.  I wish it would but it isn’t going to.  It will give you the kickstart you need to start losing weight and possibly to even get to your goal weight but what happens then?  Is it over?  Do we just never have to worry about our health or about weight gain ever again?

Let’s look at the timeline. How long is it from the time you make the decision to have bariatric surgery until your actual surgery.  Many of you who have worked with me as your patient coordinator will say that you had surgery anywhere from two weeks to six months after we first made contact.  A lot will depend on your personal timeline, family events, work, and your financial situation.

We all have our pre. op date in our mind and we anxiously get physically, mentally and emotionally prepared for our “start date”.  The journey begins and from there we are deep into the actual pre. op diet, surgery and post surgery progression stages.  The weight is coming off, we are recovering and we are feeling stronger and happier each day.

The “pink cloud” is that very special place where no matter what we do, we lose weight.  What a rollercoaster of emotions!  Finally, we are seeing results and it is all worth it.  The honeymoon doesn’t last forever. It lasts until the first weight loss stall occurs and we panic because the scale stops moving and we are only a 1/4 of the way to our goal.

With determination, and follow through, the scale begins to move again, only this time it is a bit slower.  It is no longer showing us the losses of a pound a day. Some days it moves and other days it doesn’t.  Our weight loss is slowing down and we are seeing losses of 1 to 2 lbs each week now.  As long as it is moving in the right direction, we are still happy and on track.

What happens when it is a year after surgery and the scale stops moving – whether we are at our goal weight or not.  How is our diet? Are we still strictly adhering to our post-operative bariatric guidelines?  Are we happy at our current weight and are we ready for maintenance?

As you can see from the above scenario, the bariatric journey doesn’t just stop after one year.  It changes, but it continues.  This is why I always talk about the lifelong journey that we need to commit to.  There will be good months and there will be bad months but if we never want to go back to our pre-surgery weight, we need to be vigilant and to learn to break old bad habits and create new and healthy ones.  We are in this for the long haul.

There are a few things which I see very successful bariatric clients do.  I want to share these with you.  I think we can all learn from them and possibly add these ideas to our new and healthy lifestyle.  It is a constant learning experience. 

I want you to weigh yourself on a regular basis.  If you ignore the scale, you could be in for a surprise.  I want you to know your current weight and give yourself a five pound buffer.  If you gain 5, then it’s not great but if you go above those 5, you need to have a serious look at your diet and make some changes.  It is much easier losing five pounds, over fifty pounds.  Take the easier road and stay on top of the scale.

Eat real food and avoid the processed and refined stuff.  That crunchy, yummy, easy to eat, processed stuff is considered “slider foods”.  They are easy to eat and easy for your tummy to digest but this is the fastest way to have a re-gain.  The foods which are not so easy to eat, like meat, chicken, and seafood, are the ones which will keep you fuller for longer periods of time.  Eating real food will also not raise blood sugars and insulin levels like the processed foods will.  When blood sugars are high and insulin levels are high, it is very difficult to lose weight and you will more than likely have a weight loss surgery stall or a re-gain.  

When you have a bariatric set-back, just keep on moving forward.  This is not the time to let one little set-back keep you from reaching your goals.  Don’t allow a small problem to balloon into a big issue.  Jump back on the horse.  If you have a bad food day (or 3), tomorrow is a new day.  Make a meal plan.  Do a meal prep.  Get organized and get right back on track.  Don’t beat yourself up.  Life happens sometimes.  Just roll with it and admit to the flaw and then get ready for your next healthy meal.  

Practice mindful eating.  Really sit down and take the time to enjoy your meals.  Think about the flavor, colors and textures.  Take the time to chew your food properly.  Listen to your fullness signals.  Put your fork down between bites.  Turn off the television and put your phone away.  Sometimes we are so busy when we are eating that we actually forget that we ate.  The pleasure was robbed from us.  Try to break this habit and replace it with mindfulness.  It will help us a great deal to appreciate our food.

Make a food log once a month.  In the beginning you will get into the habit of logging your meals and snacks but once you are accustomed to your new eating habits, a lot of us tend to let this go.   Try to take the time each month to make a 4 day food log.  This will enable you to see the quantities and types of foods you are consuming.  Once we see it all laid out on paper, it takes on a new meaning.  Sometimes we believe that we are not eating anything that is not a part of a perfect post op diet but when we add it up, it shows us a different story.  This is a great way to be accountable to ourselves.

Meal prep – yes you really need to do this.  Failing to plan is planning to fail.  If you don’t have time to sit down and do a real food prep, make sure to take the time to plan your meals for one or two days in advance.  Being hungry is the worst time to make food decisions.  I personally plan my meals from Monday morning until Friday afternoon, and then I give myself some space for Friday evening and Saturday to eat something different and off my plan.  Sunday is a healthy day whether I plan it or not but Monday to Friday, I know what I am doing as far as my food plan goes.  I am not going to be at a stop light with 7 fast food places glaring at me.  Nope, I am not doing it.   Now, you don’t have to follow my schedule.  But find a schedule that works for you.  Trust me, when you take control of this part, it falls into place and you won’t know what to do without your food planning and prepping.

Last but not least – exercise.  There are a lot more pointers I could give to help you to remain successful after your bariatric surgery but one of the main tips is this one.  You need to make exercise a regular part of your life.  Not just for your physical health and to maintain your weight loss goals, but also for your mental health.  When I say exercise, I don’t mean going to a gym or taking an exercise class (unless that is your thing).  Exercise can be so much more.  It can be taking a brisk walk, taking a dance class, riding your bike, gardening, deep cleaning your home.  Move more.  Stay active.  If you cannot walk for an hour, because you don’t have time, then walk for 20 minutes.  Just make sure to do what you enjoy because if you enjoy it,  you will continue doing it.

I hope you enjoyed reading some of my suggestions and I want you to always remain successful after your bariatric surgery.  If you haven’t reached your goals yet, don’t give up.  Today is a new day and tomorrow we can all do better.

I salute you on your journey to health and wellness.

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Shout out to all the coffee drinkers out there.  We all have one thing in common – we love ourselves a cup of hot, steaming Java in the morning.  How do you feel about your coffee?  Do you drink it happily, enjoying each sip or do you drunk it begrudgingly?  Do you savor the flavor or do you drink it in order to jolt some alertness into your body?

This can change over the years.  Did you know that?  Our tastes can change and all of a sudden that thing that we felt was the best tasting thing can start to taste different or strange.  

Post-bariatric clients deal with this very often and with a lot of different foods and drinks.  I often get calls where the client is describing how their once favorite flavor of crystal light now tastes too sweet and too chemically.  This is a very common occurrence.  

I personally have been having this same issue with coffee.  I have to ask myself “do you really want that cup of coffee or are you drinking it out of plain habit”?  If I was to be honest with my readers and with myself, I would say that 9 out of 10 times, I do not even enjoy my coffee anymore.  I don’t know what has happened but I kind of force myself to drink it because it is a habit and I believe that this is just what we are supposed to do in the mornings. 

When discussing coffee with our post bariatric clients, I often tell them to go ahead and continue drinking their one cup of coffee in the morning IF they want to.  If the habit of drinking coffee doesn’t bother you, then you do not have to give it up.  If it is just a cup of plain black coffee, even better.  If you have just a splash of cream and stevia, that’s fine.  We have to strike a balance but, if we are talking about morning lattes and cappuccinos, then we need to make some important changes.

When I think about coffee, I think about the stuff that I brew in my kitchen.  I am not thinking about the drive-thru coffee or the specialty coffee shops that prepare ginormous cups of steaming sugar, milk, cream, flavorings and coffee beans.  That is not coffee.  That is a dessert for breakfast.

We need to enter those fancy coffee shops with our eyes wide open.  In my 12 years working with bariatric clients, I have seen people entering and then exiting coffee shops, extremely overweight and probably battling serious health issues but they are carrying a syrup-laden latte.  Maybe we all want to believe that coffee is good for us, I mean read all the articles that tout the great benefits of drinking coffee.  It’s not the coffee that worries me, it’s what we are adding to our coffee that scares me.  We need to compare some of those coffees to the amount of sugar that a big gulp soda contains.  So many of our clients tell me that they will never drink soda again but, they continue to drink these sugar-laden lattes.  

Also, portion control, this just doesn’t seem to be a worry when we order a small or medium designer coffee.  These coffees are BIG – really BIG.  We all know that it only takes a couple of hundred additional or “extra” calories each day and that can add up to a lot of added lbs by the end of the year.  Who finds it easy to order a beautiful, fancy coffee and not order the gorgeous piece of lemon cake or blueberry designer muffin that is calling our name?  The two go hand in hand.  

Now let’s chat about the actual coffee or caffeine that we are drinking.  There is a team that insists that coffee is brilliant and how it is good for us.  They talk about how it increases our mental alertness and now it can even protect us against certain diseases such as type 2 diabetes.  

There is another team that tells us that coffee increases anxiety and tremors.  Our body has a “stress response” when we drink coffee and when our bodies are stressed, we release the hormone cortisol.  Cortisol inhibits weight loss plus the additional stress also reduces sleep and sleep quality.  Do we not struggle sufficiently with sleep issues already without coffee? 

There are so many other studies which cite the pros and cons of coffee.  I decided long ago not to choose one specific side.  I agree with some of the pros and with some of the cons and I ask you to decide for yourself if coffee is something that is good or bad for you at this specific stage in your life.

Remember, the maximum caffeine intake we should have is approximately 400mg each day.  If you order a large coffee, you will be at that limit already.

I tried to quit drinking coffee a few times.  I successfully stopped about a year ago for a period of 4 months.  It was terrific and my energy levels were so much better.  Sure, there was a learning curve and I missed my coffee for the first few weeks.  I tried to replace it with all sorts of things and I never found that magic replacement so I just stopped trying to replace it.   Of course, I became comfortable and one day I had a cup of coffee and it slowly snuck back into my life.  My one cup of coffee in the morning started up again.  Problem is, that one cup of coffee has now turned to two cups of coffee and sometimes I think about having an afternoon coffee.  I mean, where does it end?

Last week I decided to have my coffee with no cream and no stevia.  If I was going to drink coffee, it needed to be black.  That didn’t last very long.  3 days later, here I am, drinking TEA.  I don’t like black coffee and I don’t think I ever will.  What’s a girl to do?  For now, I will have my tea and see if I can break that coffee habit AGAIN.  

A fellow nutritionist once said to me, “if you cannot drink your coffee black, that means you are not addicted to coffee, it means you are addicted to the cream and sugar”.  You know what, those words stuck with me and I think she is right.  

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