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Have you gotten off track and lost your "Bariatric Brain"? Maybe it's time to start thinking like a bariatric patient again!


Let’s face it - after bariatric surgery, life is not the same. Your diet will change, your body will change, and in many cases, your attitude will change. For many of us, however, a point in time comes when we find ourselves in a different state. In some respect, we almost forget that we’ve had bariatric surgery.
After our initial phases of being on liquids, soft and chopped foods, and transitioning into full solids, we spend some time reveling in our ability to eat a ton less and to be able to only eat certain foods. For the first 6-12 months, we are in a “honeymoon phase” of sorts - we’re losing weight easily, we have the assurance that we just CAN’T eat certain things such as rice, bread, pasta, etc., and we’re in a certain mindset that I’ve dubbed the “Bariatric Brain”. For some of us, that mindset remains because we are never able to eat certain things without them getting stuck or without experiencing dumping syndrome. For others, that mindset all but disappears when we discover that we can eat certain foods without sliming or them getting stuck, or that other foods no longer send us to the bathroom for an hour.
From my own experience, the downfall out of the “Bariatric Brain” began 6 months after my surgery. I was told my my nutritionist that I was allowed to have carbonation from that point on. I was a little confused, as all of the other people I knew with the sleeve had been told they could never have it again, but my addiction to diet soda was stronger than my common sense. From that point on, I learned I could also eat bread (8 months), pasta (10 months) and rice (14 months). From there, it was no-holds barred.
Something else that happens with the sleeve that they don’t tell you is that at a certain point - your stomach capacity will increase after a time. This is because for a few months, it’s swollen to a point that you can only hold about ½ a cup of food at one time. After the first year, and it is completely healed, that capacity increases to about a cup. For someone that’s not expecting that, it can be a little confusing. For a food addict, it can be exciting and tempting. At that point, you are no longer bound by restrictions.
When this happens, some people begin to forget about their surgery. They begin to get back into a different mindset. One of “oh, I can eat this!” instead of, “Nope - gotta leave that off”. When this happens, the diet shifts to one of fast food, sugar, carbs, soft drinks, and alcohol (not every food in every case, mind you). It is that moment when the tool that we so greatly loved and admired begins to fail us. Or, rather, WE begin to fail our TOOL.
When this happens, it’s time to return to the mindset we were in during the first year. It’s time to think like a bariatric patient again.
This is no easy feat, after all, we’ve returned to our addiction - FOOD.
But at the same time, in the case of most other addictions - drugs, alcohol, nicotine, etc. - there is almost always a backslide. A heroine addict may sneak out of rehab for that one more fix, an AA leader might get depressed one night and get insanely drunk, someone trying to quit smoking might sneak a puff or two at a rock concert. These instances are normal and, some believe, even a healthy part of the healing from addiction. If this is acceptable in these cases, why is it not acceptable in the weight loss world?
When this happens, take a step back. Look at yourself from the outside in. It’s important here to remind yourself that getting off track is NORMAL and OK. Although not everyone has done it, many MANY people have - and some of those people have the most successful weight loss stories on the Bariatric Pal forum.
With that in mind, how does one go back to the “Bariatric Brain”?
Go Back To Basics
Remember what started the weight loss to begin with? Protein, water, walking? Get back to it! Make sure you’re getting AT LEAST 60g of protein a day (even better is 80-90g!). Make sure you’re getting AT LEAST 64oz of water a day, and make sure you’re getting some kind of activity for AT LEAST 15 minutes a day (30-45 minutes is better).
Return To Liquids?
Some people return to a liquid diet for a few days (no more than 3). They feel that this helps “reset” their system and returns their mindset back to where it should be. One way of doing this is through the “5-Day Pouch Test” (designed for RnY or Gastric Band patients) in which you return to liquids for a few days then gradually return to solid foods.
For those that have the sleeve or the duodenal switch, the pouch test might not work for you as it’s not designed for that kind of surgery. That being said, if you feel the need, you can also return to liquids for a few days.
Return To Support Groups
Support groups are the #1 key to a successful weight loss surgery, regardless of your surgery or your stage. If you are a year or more out, consider returning to a support group. Hearing what the people in the early stages are having issues with, and helping them work through those issues can, in fact, help you work through yours.
Read, and Educate Yourself
Consider finding books, articles, cookbooks, and magazines on bariatric surgery. Do research on one aspect that really interests you. Immerse yourself in it again like you did in the beginning!
Remember Your Motivation
What was your reason for having Bariatric Surgery to begin with? Your health? Your family? Your looks? Looking at what you wanted from your surgery and where you are now might help you to refocus.
In The End Remember …
What you are going through right now is okay, and completely normal. Thousands of people are going through exactly the same thing you are. You are not alone!
Remember that if you’re REALLY struggling, you can always find help. Talk you your nutritionist or dietician, seek mentorship in a support group, or find a good counselor that has experience with food addiction and bariatric patients. And ALWAYS remember - YOU CAN DO THIS!!!

It's hard to stay hydrated during the cold winter months. These tips will help you get your liquids in and stay warm!


It’s no secret that hydration for a WLS patient is key. We’re told from the very beginning to “sip sip sip” our water, after all. But during the winter, it can be hard to get our liquids in. Let’s face it, it’s cold out there and we really don’t want to drink water all the time!
Although water is the very best way to stay hydrated, during the winter months there are other, warmer, ways to get our liquids in. Here are a few tips that will keep you cozy and hydrated at the same time!
1. Warm broth. Weather it be chicken, beef, or veggie, broth is delicious, warming, and comforting. If you make homemade bone broth, it can be very nourishing as well!
2. Hot Apple Cider. You can make your own or buy it pre-packaged. Watch the sugar content, however, especially if you have issues with dumping. To make your own, put some of your favorite no-sugar-added or sugar free (100% juice) apple juice in a saucepan or crock pot. Add some spices such as cinnamon, nutmeg, orange peel or ginger. Allow it to warm slowly and enjoy!
3. Hot tea. Herbal or black, hot tea is a great way to get warm and to get our daily liquid requirements. Try a nice cup of earl gray with a twist of lemon and a little honey. Some wonderful herbal tea blends that we love are orange spice and peppermint.
Like we said, straight water is best for hydration, but during the winter months sometimes you just have something to warm you up from the inside out!

Colleen, You are a talented writer. I enjoy each and every one of your articles....... Love that sense of humor you have. I try to live my life not too seriously, so I can relate in many ways to you and your wacky self........ I probably would have been personally praying that somebody had poured the rest of their Starbucks on top of it to SEAL THE DEAL of not getting it out of the trash can. On a personal note, I don't like FUDGE !

Loved the reading, and made me chuckle. I'm sure we will all have times where we will go through the similar. You had me wondering "will she, no not in the middle of the airport, but wait it should be right on top, and who would know if she walks away with it, and opens some where else. So does she? Ah, she didn't, good for her." Lol. Thanks!

Umm, fudge! It had been a crazy busy week. Away from home for 10 days, facilitating two training courses and speaking at an Obesity Summit, I was tired and ready to go home. Though I have a pretty good routine when I travel and stay focused on my good Success Habits, I was tempted


Umm, fudge! It had been a crazy busy week. Away from home for 10 days, facilitating two training courses and speaking at an Obesity Summit, I was tired and ready to go home. Though I have a pretty good routine when I travel and stay focused on my good Success Habits, I was tempted beyond my ability to resist, to buy a piece of fudge. Umm, I love fudge and of course the walnuts added the all important “protein.” I had kept up with my exercise and make good food choices all week, so I felt justified in splurging a bit.
As it always does, the first bite was heavenly! Smooth and creamy. So good. I relished that first bite, waited a bit and then another, and yet another. Enough! I thought. I’m good. Now I am going to mindfully throw the rest away. A difficult thing to do knowing how much I paid for it and due to all of the starving people in the world. But I knew it had to go. With Michael Jordan flair, I strutted by the trash can and slam dunked it. There! Good for me. I would have high-fived the guy next to me, but he gave me a funny look so I decided I would just celebrate privately.
Boarding for my flight began and victoriously, I marched onto the plane. Safe from “too much” fudge. An hour passed by still on the tarmac, waiting for a mechanical repair. Finally, the captain announced that we would need to deplane and board another flight. By that time I had missed my connecting flight in Denver so I knew enough to get off the plane and get quickly in line for re-booking.
As I waited patiently in line, I don’t know why, but the thought of my left over fudge so close by started to haunt me. Though I am embarrassed to admit it, here is the conversation in my head. “This situation is beyond stressful and surely another piece of fudge would calm my nerves.” Honestly, you are not thinking of getting the fudge out of that trash bin over there are you?” Well, it is still good, it was wrapped up and in the bag.” Really?” What will people think of you digging in the trash?” “It will be right on top. Easy and there are not too many people over there, I can be quick!” Come on, seriously, you are better than this. You don’t eat food from the trash! Well I guess you are right! Thank goodness.”
Whew! That was close. It shouldn’t have even crossed my mind but it did. Why, I wonder? What is this problem I have with food? I was pleased that my good voice over ruled my temptress voice but I would have preferred not to have had that conversation at all! Perhaps you can relate?
Sometimes I find myself focusing on how unfair it is that I struggle with such unhealthy food relationships. But then, I am both relieved and proud that I have been able to win many of these battles. And every time I do – the “you can do it, you are better than that” voice gets stronger and stronger. For those of you who have heard my other crazy food stories, you’ll know how important it is when I say, I don’t eat M & M’s off the floor, whipped cream with my fingers, OR fudge from the trash! Yeah!

Whilst it is not the most pleasant topic, bowel motions, or lack thereof, are something we are regularly asked about following weight loss surgery.


We often have people tell us they are constipated at their first post-surgery appointment. It is important however to realise that constipation and slower bowels are two very different things - it’s not how often you go, it is how you go! After surgery, particularly during the recovery stages, the amount of food you eat is far less than pre-surgery. With less food comes less waste, so it is likely you will use your bowels less. As long as you are not uncomfortable, this is not a problem. If your motions are less frequent, hard, dry and you need to strain to pass them, then you are likely constipated.
The ‘key ingredients’ to help manage periods of constipation are:

Fibre – this helps to bulk and soften bowel motions and move them through the intestine
Fluid – fibre absorbs fluid, so if you increase fibre without ensuring your fluid intake is adequate it can make constipation worse.

During the weight loss surgery recovery phases of the fluid and smooth puree diets, it can be a significant challenge to obtain enough fibre and fluid and for many this results in constipation.
Boosting Your Fibre Intake
During the fluid phase:

Blitz rolled oats and chia seeds in your food processor to form the texture of flour and add to smoothies and shakes. Don’t forget to add plenty of fresh fruit as well.
Add plenty of vegetables to soups. Chop up your favourites and blitz in your food processor. Make sure you blend them enough that they could pass through a straw. Onion, carrot and celery work well to boost both the fibre and flavour of almost any soup.
Add legumes or lentils into soups to boost both protein and fibre. Once blended they help make soups creamy and will help keep you feeling satisfied. Chickpeas, bean mixes and lentils all work well.

During the smooth puree phase:

Introduce porridge or Weetbix® with plenty of low fat milk at breakfast. Sprinkle with crushed seeds and/or try topping with some pureed fruit.
Add plenty of vegetables and legumes or lentils into stews and casseroles. Remember to blend into a smooth consistency (much like the texture of smooth mashed potato).

During the soft diet phase:

Naturally soft fruits such as banana, mango, ripe pears and peaches can be reintroduced.
Well cooked vegetables that are soft enough to cut with a fork can also be enjoyed.

Longer term:
Remember to focus on wholemeal and wholegrain bread and cereal products.
Include fresh fruits and vegetables daily. Include skins where you can , just chew them well.
Include some regular exercise.

It is important in all dietary phases to focus on your fluid intake – remember to sip, sip, sip and aim for 1.5L of fluid daily.
For detailed information on where to find fibre in foods speak to your dietitian or check out the section on fibre in Your Complete Guide to Nutrition for Weight Loss Surgery.
Need Extra Help?
If you are constipated at any stage, you may find a fibre supplement useful. A soluble fibre supplement such as Benefiber® or Metamucil Fibresure® can help. These products are colourless and tasteless, hence can be dissolved in a range of fluids. They are best taken regularly, with plenty of fluid. They are not likely to be effective taken if you take a random dose once constipation is established.
The following recipe for prune, bran and apple mix can be a useful addition to your diet to improve your bowels. Try adding 1 tablespoon to your breakfast, or with some yoghurt for a high fibre, high protein snack.
Prune Bran Apple Mix
75g All-bran®
250g Apple Puree or apples, pureed
75g prunes, pureed
50ml orange juice
Blend together adding more juice if required. Freeze in ice cube trays and defrost 1 cube at a time as needed.
If constipation persists, discuss this with your surgical team or GP. Please seek medical advice before commencing laxatives.

While most of us knew all about the physical side of Weight Loss Surgery, many people have no idea about the emotional ride they're about to face. This article discusses all aspects of the "emotional roller coaster" from the moment you first decide on having bariatric surgery all the way up to the maintenance phase of your weight loss. It's a wild ride baby!


When was the last time you were on a roller coaster? If you’re like me, it’s been a while. In fact, the last time I was on a roller coaster I was 310 lbs and could barely fit into the seat. The restraint almost didn't go around my tummy. I was squeezed in like Cinderella’s step-sister’s foot must have tried to squeeze into that tiny shoe. Yep. I was Drizella’s foot and the coaster seat was the glass slipper. I’m sure it was a comical, if not sad and pathetic site, for those around me. It was embarrassing to me, to say the very least. But I laughed it off and went on, as I tended to do.
That roller coaster was a wild ride. It had huge climbs, steep drops, loop-de-loops, sharp turns, and at one point it feels like you’re lying on your side. Honestly, it’s a wonder I stayed in the coaster even with the restraint!! The end of the ride was abrupt - it felt like my insides were coming out of my mouth when it stopped short back at the beginning of the track. When it was over, I felt accomplished, in a way. I’d survived that coaster ride, wild and uncomfortable as it was.
Many people don’t realize that life before, during, and after weight loss surgery becomes a roller-coaster ride of it’s own. It has the huge climbs of elation and joy and excitement, the steep drops into anxiety and depression, and the loop-de-loops, sharp turns, and lying on your side moments of uncertainty, worry, and fear. Here are some of the emotional dealings that will occur before, during, and after surgery that you might not know.
1. Pre-Surgery Elation. This happens when you are finally approved for surgery. It’s going to be a reality! You are going to get a brand new lease on life! The period of life where you are having to go through diet after diet is finally coming to an end! You might tell everyone you know or you might decide to keep your secret to yourself. Regardless, you are excited and ready to go!
2. Pre-Surgery Blues. This is when you realize that you are going to have to say good-bye to one of your best friends ... Food. You come to the realization that there are some favorites that you are just not going to be able to eat anymore. Depression sets in slightly, and you might even go on a food bender - similar to what an addict might do. At this point you might even question your decision to go through surgery.
3. Day of Surgery. You’re going to be going through a myriad of emotions during this time. You’ll feel excitement, anxiety, apprehension, and impatience all at the same time. You’ll be worried because, after all, it is a major surgery you’re about to go through. But at the same time, you’ll be excited at what’s about to happen. When you wake up from anesthesia, you might be scared, especially if you’re having a rough transition out of anesthesia. You might be a little confused, wondering where you are. When your body settles down a bit and you remember where you are and what just happened, you might feel a little concerned. "Did everything go okay?" "Is this going to work?" "Did I just make the biggest mistake in my life?" On the other hand, you might wake up beautifully, singing the praises of your surgeon and his/her team, excited to begin your new life. These feelings and emotions will likely cycle throughout the day as you’re getting used to the idea of what just happened and your body relaxes and comes out of shock from surgery.
4. Going Home. When you’re finally released to go home, you’ll either be excited or scared. Thoughts might rush your brain like “will I be able to do this on my own?” and anxiety might set in again. You might, again, question your decision to undergo surgery, especially once the monotony of the liquid diet phases set in. The first few days might be easy, and the next might be excruciating. You’ll be in some discomfort because of incisions and if the surgeon inflated your abdomen with gas prior to surgery (commonly done in laparoscopic surgeries), and this might heighten your doubts and anxieties. You might begin to worry about issues such as leaks, slippage, or staples coming loose.
5.The first few months. You will be going through a mourning period at some point, and for some that occurs during the first few months after surgery. You no longer are able to lean on food for emotional support, so you might feel sad. You might even go through a type of “withdraw” from food, similar to what an addict might be going through their first few days in rehab. You’ll be able to eat more some days than others, and that will lead you to worry if your surgery is working or if there’s something wrong. Some days you’ll be jealous of watching everyone around you eat foods that you once loved. Others, you’ll be glad you can’t/don’t eat those things anymore. By the time you've finished all of your phases and are on to real food, you’ll be relieved and excited, and likely worried and anxious as well. Whereas before, you were relying on liquids for sustenance, now you’re on your own and have to rely on figuring your food choices out for yourself.
6. The losing phase. From the moment you leave the hospital until you reach your goal you are considered to be in the losing phase of surgery. For the purposes of this article, we’re going to call the losing phase the time period from month 3 (about the time you transition into full solids) to the point where you reach your goal. There will be many frustrations, joys, and concerns in the months ahead. Some days you’ll forget everything you were taught about nutrition and make yourself sick on something you shouldn't have eaten. Other days you’ll be 100% on track. You’ll have moments of pride and joy, and moments of shame and weakness. You’ll revel in finding out you can eat something as simple as asparagus and despair over not being able to eat rice pilaf. You’ll finally reach your “groove” point sometime during month four or five, and things begin to go well. You’ll reach a stall or two (or five ...) and wonder if you’re doing something wrong or if you've messed up your new tummy. You’ll marvel over losing 10 lbs in one week. You’ll wonder why you only lost 2 lbs the next week. When your loss starts to slow down, you’ll worry that you’re not exercising enough, that you’re eating too much or too little, or worry that your surgery is beginning to fail. You’ll relax more when you are consistently losing, even if it has gone down to 1-2 lbs a week.
7. The maintenance phase. When you reach your goal weight, you will have reached what is called “maintenance”. This is the final stage that you will likely be in for the rest of your life. Here, you will change your diet slightly in order to not lose or gain any more weight. You will get frustrated a time or two - especially the first time you gain a few pounds. You will marvel at what you've lost, but are concerned with the way your body looks now. You will have loose skin, which may cause body image issues. If you’re single, you might notice more possible suitors paying more attention to you. You might fall from one addiction (food) into another (sex). You might also be tempted into other addictive substances or habits such as alcohol, cigarettes, shopping, or pornography. Alternatively, you may look back at your loss, as meaningful and inspirational. You might revel in the way your life has changed and be happier than you have ever been and be ready to branch out and help others succeed in their bariatric surgery journeys.
Tips on Riding the Roller Coaster
Knowing that these emotions are possible doesn't mean they will happen for everyone, and doesn't mean you can’t get through them. The following tips will help you stay on the road to success and prevent you from falling off the wagon and into an abyss of self-doubt and depression:
1. Support. This is the number one most important thing for WLS patients. Even more important than food is support. Support can be found at home, through friends and family, in a hospital or surgery center support group, or even online forums such as Bariatric Pal.
2. Stick to the plan. As tempting as it might be to veer off and eat something you’re not supposed to, stick with your doctor or nutritionist’s eating plan as closely as possible. This will ensure that you continue to lose steadily, decrease the length and amount of stalls you’ll experience, and will speed up the healing process.
3. Vitamins. It sounds very cliche, but remember to take your vitamins! Focus on Iron and B Complex vitamins especially.A vitamin deficiency can result in depression, physical weakness, and poor sleep habits.
4. Speaking of sleep ... Make sure you’re getting plenty of it! At least 8 hours a day for an adult! Lack of sleep can lead to fatigue, weight gain, and (you guessed it!) depression!
5. Remember that “this too shall pass” ... These stages of emotional turmoil certainly won’t last forever. You’ll get over them as quickly as they overcame you. And keep in mind that each stage after surgery only lasts a short time in the grand scheme of things. Most eating phases last, at most, a month. After which you’re on to the next phase.
6. Keep a plan handy. Know that you will likely feel some unpleasant emotions or feelings and plan for them. Know what you’re going to do when you get upset, depressed, feel head hunger, or even feel physical pain from surgery. Have a list of friends to call at the drop of a hat, have a bottle of water ready to sip on at all times, or have your doctor’s phone number on speed dial. Know that these feelings will likely happen at some point in time, and be ready to deal with them when they do.
7. Remember that everything you’re going through is completely normal and OKAY. It’s important and helpful to know that everyone goes through a stall at some point. Everyone has pain during the first couple of weeks after surgery. Everyone eats something they shouldn't at some point. Whatever it is you’re going through - someone else has likely gone through it!
8. Finally, DON’T GIVE UP! Remember that this is a journey. As the old saying goes, “It’s a marathon, not a sprint.” There will be ups and downs on this wild roller-coaster ride. There will be twists and turns and loop-de-loops and there will be many moments when you feel like you’re laying over on your side. But, in the end, it will all be worth it. Your health, your life, and YOU ARE WORTH IT!!