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Proper Portion Post Bariatric Surgery? – Bariatric Edition

What does a proper portion look like after bariatric surgery?

This is not a cookie cutter answer because it will depend on what kind of bariatric surgery was performed and how far along our client is.  It also depends a lot on the kinds of foods that the person is consuming after their weight loss surgery.  
If you are recently post op, you will experience a lot of post surgery inflammation which takes a few weeks to come down.  When your new tummy is healed, you will be able to eat a larger amount of food even though you will still feel a lot of restriction with a small amount of food.
If you find yourself being able to consume more food after a few months, does this mean that you have stretched out your stomach?
The size of the bariatric pouch will vary from person to person but it is important to limit your meals and snacks to about three to six ounces for each meal or snack.  If you set this boundary, you will still be able to consume sufficient protein while getting a caloric restriction.
You may find that you can eat more than three to six ounces of food and this sometimes depends on the types of foods that you are choosing to consume.  You see, soft foods  are always going to feel better on the stomach over hard foods and real textures.  
Let’s compare cottage cheese to chicken breast.  You may be able to eat an entire six ounces of cottage cheese but you will have a hard time to eat more than three ounces of chicken breast.  This is because the texture of the chicken breast is more dense and it will fill up the bariatric pouch more quickly, making you feel full and satisfied.
I believe that portion control is something all bariatric patients need to practice with each meal and snack.  Portion out the amount of food on a plate or in a bowl and pay attention when you eat the portion.  Think about how it makes you feel and understand how your restriction is working.  
Portion control becomes very important when you choose to consume foods such as refined, processed and easy to digest carbohydrates.  An example of a processed carb would be things like chips, cookies, crackers, pretzels, popcorn.
To make portion control easier and more friendly, eat off of smaller plates and use smaller utensils.  You can measure out your foods instead of eating them directly from the box or bags.   You can measure your food with a measuring cup or with measuring spoons.
Here are some general guidelines to follow after your bariatric surgery:
  • Always speak to your bariatric nutritionist in order to ensure you are meeting your macronutrient requirements.
  • Each meal or snack should not exceed three to six ounces at one sitting.
  • You should aim to have 1/2 of your meal consisting of protein such as chicken, fish, eggs.
  • Almost half of your meal should consist of vegetables such as green salad, broccoli, cauliflower.
  • You can take an optional bite or two of carbohydrate which are high in fiber such as quinoa, legumes or other such vegetables like turnips.
How should my breakdown of my macronutrients (protein, fat and carbohydrates) look like after my bariatric surgery?
There is no perfect way to answer because there are times when our macronutrients are going to be based on our medical conditions or our current health status.  There are times when we need to consider your activity level or age and gender.  
It is best to seek assistance with your specialized bariatric nutritionist but here are a few general guidelines that post bariatric clients can follow:
  • Aim for 800 to 1200 calories each day while you are actively losing weight.
  • Aim for 60 to 80 grams a day of protein.
  • Aim for a lower carbohydrate intake but eat your high fiber vegetables. Eat less than half of the number of grams of carbohydrates than you do for your protein. For example, if you eat 60 grams of protein, aim to eat less than 60 grams of carbohydrates.  
  • Aim for 20 grams of fat per day, preferably unsaturated fat.
Here is an example of a post surgery bariatric breakfast, lunch and dinner menu with snacks included.  This is not for the first month after surgery but it is building up over time.
  • Breakfast: 1 scrambled egg with 2 tbsp of onions and pepper with a small slice of avocado.
  • Lunch: 3 ounces of salmon with 4 brussel sprouts and 1 tbs of olive oil for veggie roasting.
  • Dinner: 2 meatballs with 1/3 cup zucchini noodles and marinara sauce with 1 tbsp parmesan cheese.
  • Optional Snacks: 6 ounces greek yogurt, raw veggies for dipping, 1/4 apple, 1 tbsp peanut butter.
Is it a good idea to eat bariatric snacks?
If you are able to eat six ounces of food at one sitting, you are not going to have to eat snacks.  Once you are able to reach your protein target, you do not need to consume snacks to increase that number.  However, if you find yourself truly hungry and you have water first to ensure that you are not just thirsty, then go ahead and have a high protein snack to satisfy you until your next meal.
Overall, always practice portion control.  Don’t forget to consume protein first before eating carbohydrates.  You can eat carbs but ensure that your carbs are always the kind that are high in fiber.  These are your complex carbohydrates.  Be aware of the types of foods you are eating and try not to be distracted when you are eating.  Focus on your food and try to stick to foods that are whole, live, fresh and good quality.
Join me this last week in the IF challenge / the last week in Fasting February is to Intermittent Fast for 19 hours and our eating window is for 5 hours.
Let’s discuss “proper bariatric portion control” on my FB LIVE 3pm EST on Friday, February 22nd. Why do we want to control our portions and do we need to?

About the Author: Sheri Burke is a Registered Holistic Nutritionist and Bariatric Surgery Coordinator at International Patient Facilitators in Tijuana and Cancun, Mexico. She has worked with bariatric surgery clients for over 10 years and especially enjoys providing nutritional guidance to pre and post bariatric clients.  In her free time, she enjoys spending time with her husband and two teens and cooking up a nutritional storm in the kitchen.

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