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Many diet plans tell us it's all about the calories. But is that true after weight loss surgery?
Can you really keep eating everything you love just limit the portions?
Bariatric Dietitian Elizabeth Anderson provides her take on this question in the final installment of her dangerous diet tips series.


Imagine me, 16 years old at the neighbor’s pool, feeling pretty sassy in my new one piece bathing suit with the buttons down each side.
My grandmother’s friend edges up to the side of the pool and motions me over conspiratorially.
“Elizabeth, I see you’ve lost some weight, tell me, what’s your secret?”
“It’s easy, just eat 1000 calories a day. You can eat whatever you want just don't go over 1000."
Ladies and gentlemen, why did I ever pay for a nutrition degree when I clearly had all the information at age 16????
Clearly, I jest.
1000 calories of hot dogs, English muffins, fat free Cookies and pancakes does not a diet make—let alone a healthy weight loss plan.
But it’s soooo tempting to follow this advice. It’s simple, clear cut and junk food is totally fine--as long as you keep the total consumption under the specified number of calories.
Some WLS patients have taken the bait—especially after they stop losing weight.
Not surprisingly, there are some problems with this type of plan.
1. 1000 calories of potato chips isn’t nutritious but it fits the criteria.
2. If you don’t have enough Protein you’ll be compromising your weight loss—regardless of calories.
3. Individual calorie needs depend on sex, age and activity level to name a few. One size does not fit all.
There’s a better way. Stop counting calories. Don’t let a number determine how much you’re going to eat today. Rely instead on your surgical tool and natural hunger.
This can be scary—flying without a net. The temptation to use total calories as a guide is real. But ignore it. You are ready for something else, something more effective and natural.
Here’s how to start:
1. Eat three bariatric-sized meals and two portioned Snacks each day.
2. Sit down to eat, eliminate distractions: TV, computer, magazines or books.< /p>
3. Pay attention to the deliciousness of the food. Savor it.
4. Try to take at least 15 minutes to finish a meal, 30 is better.
5. When you are full, stop eating. Notice if there is still food on the plate. If there is, does that make you uneasy? There are a lot of members in the Clean Plate Club. Cancelling your membership IS possible, but first you have to realize you are a member.
It isn’t easy shaking old diet thinking and behaviors—the first step is realizing you are following them. With some self-compassion and support, you can find your way back to healthy and sustainable weight management.

If you’re putting off your weight loss surgery (WLS) because you’re worried about Hair loss, you’re not alone! And if you were surprised when you suddenly started to lose your hair a few months post-op, you’re not the first WLS patient to be caught off guard.


Here are a few facts on hair loss after weight loss surgery.
It’s actually a condition called “telogen effluvium,” which happens when more of your hair is in the resting stage than the growth stage, so you end up losing hair faster than it grows.
Telogen effluvium – and hair loss - can be triggered by stressful events like WLS and the WLS diet.
It’s more common after gastric bypass and gastric sleeve surgeries than after the lap-band.
Hair loss is most severe around 3 to 6 months post-op.

It’s hard to predict who will lose their hair and who won’t after WLS. Also, there’s no fail-proof protection against hair loss. But there are a lot of promising strategies that work for some WLS patients that may work for you. The best part about them is that they’re also good for weight loss.
Protein: 65 or More Grams Daily
Protein is the foundation of your post-op WLS diet. It’s a nutrient that lets your surgery wounds heal. It also helps you maintain lean muscle mass as you lose weight. And when you get enough of it, it can help reduce hair loss.
Lap-band patients need at least 65 grams of Protein each day. Sleeve and bypass patients need 80 to 100 or more grams per day. Go lean with sources like tofu, chicken breast, tuna, egg whites, and non-fat yogurt and cottage cheese. If you can’t hit your needs with food, go for low-sugar protein shakes, protein powders, and protein bars.
Water: Not an Afterthought
Fluids aren’t always top on your mind when you’re worrying about your weight loss diet, but maybe they should be. When you choose calorie-free ones, they can help reduce hunger and lose more weight. Plus, Water prevents dehydration and symptoms like headaches and fatigue. It also promotes healing and lets your body function - and that’s good news for your hair.
Aim for at least 64 ounces per day of calorie-free fluids, such as water, flavored waters, diet sports drinks, and broth/bouillon. Feel free to go for more, though!
Biotin and Silica: Ask Your Surgeon
Biotin and silica are essential nutrients. You can usually get enough of them from diet alone, but WLS changes that. Some people swear that Biotin and silica supplements can reduce hair loss, but the science doesn’t yet support that. Talk to your doctor before taking these supplements. Biotin is usually safe even in high doses, but too much silica can be a problem.
Essential Fatty Acids: Fats Are Good!
Fats are high-calorie, and they make many foods off limits: think fried foods, creamy foods, and fatty meats. But some fats are good, and they’re the ones that you’re most likely to be deficient in after WLS. The possible results? Scaly skin and…hair loss.
You don’t need huge amounts of fats to stay healthy. You could see a difference just by getting a little more omega-3 fat in your diet. Once you’re into the mushies/pureed foods stage, you can get omega-3’s from pureed boneless salmon and canned tuna. Later, you can add walnuts and flaxseeds. If you’re not eating these foods, you might want to ask your doctor about a fish oil supplement.
The Extras
Why does hair fall out? Stress! So let’s see…what stresses have you already put on your body? There’s the stress of surgery; the stress of starving your body at least, that’s what your body thinks when you drop down to 1,000 calories a day; the stress of changing your entire lifestyle and possibly your relationships.
When you think about all the stress in life, it’s a wonder anyone has any hair left at all! So when possible, try to reduce stress however you can.
Get enough sleep.< br> Take time for yourself.
Exercise daily.
Laugh it off…whatever “it” is, it’s probably not worth losing your hair over!

Taking good care of yourself after WLS can help prevent hair loss, but not always. Still, you can take heart in the fact that it probably won’t last for more than a few months. And at the other end of those few months, you’ll be down several pounds. Isn’t a little hair loss worth it if the payback is to be healthy?

I have lost 28 lbs so far some days 30 lbs....I have my 5th fill on Wednesday. I'm still struggling but getting better restriction with each fill. everyone is doing fabulous....

Excellent!
In my hospital days, I asked one of our plastic surgeons how long following a weight loss someone ought to wait before considering plastics. He said that after about a year, someone would have benefited as much as they could from their skin's own elasticity. He also said that sometimes someone with a significant weight loss has some up and down as they settle into maintenance.
So I'm thinking that's what I'll do, wait til a year after goal. I know for sure I want a boob lift, heck, I need one NOW.

So I am starting to believe they are a myth! I have been on dating sites and most women have dogs or don't like cats. WTH? where are all the single cat ladies that I always heard so much about? I'm a single cat guy so it's obvious that a single cat lady is my match. haha

It's been very easy for me.
The surgeon did a great job.....the medical care at the hospital was excellent and the simultaneous hernia repair wasn't so bad.
Each step of the healing and way of eating has had unique challenges but they've gone very smoothly.
I have zero complaints and zero fears about the future.
The liquid diet pre-post op (6weeks for me) was very instrumental in my establishing a new way of interacting with food. If needed in the future, I'll jump back on that liquid diet in a skinny minute !!!!
I've really gained confidence now as I've resumed grilling and cooking again for the family and have no problems with temptations.....not interested in carbohydrate heavy food. I'll cook it for others, but I have no desire for it.
meats and some Fiber filled carbs with occasional cheeses or nuts are my staples......along with on occasional Quest bar or shake.
I do admit to weighing frequently. I'm not recommending that folks do that......I'm just stupid that way......I've got to see that number every day. I don't let slight upward fluctuations freak me out.....but they do motivate me to stay on point.
The absolute singular regret I have is not doing this years ago.

Big tip: Water is your friend!

Yes, I found it is much easier than I anticipated.
I had an awesome surgeon, great support, and an very uneventful recovery.
I have found the post-op program simple (not necessarily "easy") and straightforward.
I also had the benefit of years of therapy and recovery and working on food issues that I believe has played a huge part in helping me through this process.
I have come a long way and have a long way to go, but I am more hopeful and optimistic than I have been in years.

Hi there....I am 2 years post op and the hardest part for me in the beginning was not being able to eat my emotions away. I don't know about your story but just remember to eat slow and chew really good so you don't have any complications

@jhammer2 It's a slippery slope, so just say "No" to cheat days! Instead, find alternatives to the foods you want to "cheat" with and you'll have a Win/Win situation. Here's one example ... I love pizza and life without it just seemed like it would be dreadful. Instead, I searched and researched and found a recipe that I tweaked to my own taste and voila - I get to eat pizza! It's bariatric friendly of course (the crust is made out of ground chicken breast) but it tastes super delicious. I now but the 3 lb. container of Perdue ground chicken breast so I can make 19 individual crusts at one time. They freeze beautifully and then I can have pizza within minutes. The cost, breaks down to about 60 cents per crust. I have other recipes for quiche, cheese cracker crisps, pudding and frozen yogurt bars. Let me know if you'd like any of them and I'll gladly share.

I used to run hot. Now I run cold. I wear socks to bed, I wear layers under my clothes. I have a space-heater under my desk at work.
Sure don't miss in insulation though!!