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Almost everyone needs protein supplements right after weight loss surgery. Protein shakes and powders give you the protein you need when you’re not allowed to eat solid foods. But which types should you choose? And should you keep using them when you’re eating solid foods and surgery is long behind you?
Protein for the Liquid Phase of the Post Weight Loss Surgery Diet Progression
After a day or two of sticking to clear liquids, you progress to a full liquid diet. You can be on this diet for a few days, if you’re a lap-band patient, or a couple of weeks, if you have the gastric sleeve or gastric bypass. Protein sources include the following. Non-fat milk, with 90 calories and 8 grams of protein per 8 ounces. Non-fat milk powder, with 100 calories and 10 grams of protein per ounce. Low-sugar protein powder, with 110 calories and 25 grams of protein per ounce. Low-sugar protein shakes, with 100 or more calories and 15 or more grams of protein per 8 ounces. Without supplementing your diet with protein shakes and powders, you’re not going to be able to hit your 60 to 80 grams of protein.
Protein Powders and Shakes in the Pureed Foods Phase
This phase is really a transition phase. You’re adding foods back into your diet, but aren’t yet ready to eat chewy, sticky, crunchy, or other solid foods. Protein foods include the following.
Non-fat cottage cheese, with 12 grams of protein per half-cup. Non-fat ricotta cheese, with 5 grams of protein per half-cup. Egg whites, with 4 grams of protein per extra-large white. Non-fat Greek or regular yogurt, with 8 to 14 grams of protein per container. During this phase, your surgeon will probably have you start to decrease your use of protein shakes and powders, but will probably recommend keeping them in your diet to help you get to 60 to 80 grams of protein per day. You might need one or two shakes a day, plus powder in foods such as oatmeal, yogurt, or pureed potatoes.
Be Wary of Protein Supplements in the Long-Term
Protein shakes and powders can be convenient, but they’re not your best bet for long-term weight loss. As you progress from pureed foods to semi-solid and then solid foods, your surgeon will probably recommend that you stop drinking shakes and focus instead on solid sources of protein.
They’re more substantial and satisfying than liquid shakes. They take longer to eat than drinking shakes. They’re easier to fit into a real-life eating plan. You won’t be “drinking your calories.” They have more natural nutrients than processed shakes and powders. Most weight loss surgery patients can get enough protein just by choosing one or two high-protein foods for each meal. You’ll get 60 to 80 grams with the following foods.
Breakfast: 2 scrambled egg whites with ½ light English muffin and some fruit. Lunch: ½ cup fat-free cottage cheese and a green salad with 3 ounces of canned light tuna. Dinner: 3 ounces of chicken breast and steamed spinach. Snack 1: 1 low-fat cheese stick. Snack 2: 1 6-ounce container of plain low-fat yogurt and ½ cup carrot sticks. When Protein Supplements Are Okay
Still, some weight loss surgery patients may still need protein shakes and powders in the long term. That’s often the case for vertical sleeve patients if your sleeve fills up too quickly to allow you to eat enough solid protein throughout the day. Talk to your surgeon to find out whether you should still use shakes and powders. Your surgeon might suggest that you include one or two protein shakes a day as snacks or mix protein powder into your yogurt, cereal or other foods.
Protein supplements can still come in handy even if you’re able to meet your protein requirements on your daily weight loss surgery diet. If your routine gets interrupted, you might come up short. Consider the protein you can miss if you need to change your regular plans for a meal or snack.
10 grams of protein if you run out the door without grabbing your yogurt in the morning. 22 grams of protein if you forget to pack your tuna for lunch. 26 grams of protein if you’re stuck in a meeting instead of cooking your chicken dinner at home. When you’re stuck in the car or too busy to plan ahead, protein shakes can be lifesavers. On vacation, you can take protein powder with you so you’re always sure to have a source when you need it. You could also try Unjury Protein’d Cheese Sauce on steamed vegetables for an extra 21 grams of protein.
Read the Nutrition Facts Panel to Find Protein Content
The Food and Drug Administration lets food manufacturers call a food “a good source of” protein if it has at least 5 grams of protein. If a serving has at least 10 grams of protein, a food can be labeled “high,” “rich in,” or “an excellent source of” protein. That doesn’t do you much good if you’re trying to find a shake or powder with at least 15 to 20 grams of protein per serving.
Don’t rely on a claim on the front of the label when you’re looking for a protein supplement. You could end up with a “high-protein” shake with only 10 grams of protein! Instead, check the nutrition facts panel to see how many grams of protein the food or shake has per serving.
Check the Label for Calories and Sugar
Protein shakes and powders can be high in calories and sugar. A bottle of Special K Protein has only 10 grams of protein, but 190 calories and 18 grams of sugar. A Pure Protein Frosty Chocolate Shake has 15 grams of protein, but 190 calories and 25 grams of sugar. A can of Boost High Protein drink has 15 grams of protein, 240 calories and 27 grams of sugars.
No matter which stage of your weight loss surgery diet you’re on, you can’t afford to eat too many calories or too much sugar. The only way to protect yourself is to read the labels.
Protein supplements can be great choices for boosting your intake to 60 to 80 grams a day. Shakes and powders can get you through the liquid and pureed foods stages of the post-surgery diet progression, and they can have a place in your diet even when you reach your long-term weight loss surgery diet plan. Just make sure not to overuse them if your surgeon is concerned, and to choose low-sugar options.

What’s Wrong with Away-from-Home?
There is nothing wrong with eating outside the home – unless you are average. That is because the average restaurant meal has more calories, more fat, and more sugar than the average home-cooked meal. You can reverse this, though, with some awareness.
Classic Breakfast Sandwiches
The classic breakfast sandwich or burrito can have eggs, cheese, and meat. From there, the sandwich can vary widely. An egg white McMuffin from McDonald’s, for example, has 260 calories, while a Croissan‘wich with bacon and sausage from Burger King has 620 calories. Skip the butter and any fried potatoes, such as hash browns or shredded potatoes, and choose:
Ham instead of bacon or sausage. An English muffin (or nothing) instead of a bagel, biscuit, croissant, or tortilla. Egg whites instead of whole eggs. Café Choices
Coffee shops and bakery-café’s offer all kinds of fresh, tantalizing, and absolutely off-limits foods. Hint: you do not need a cinnamon roll with 50 grams of sugar to start your day. Stay away from the breakfast pastries and breakfast sandwiches on bagels. Instead, you may be best off with an “a la carte”-style breakfast. Look for items such as:
Plain oatmeal or oatmeal with nuts as an add-in. Fruit cups or whole fruit. Low-fat cream cheese – you can spread it on half of a whole-grain bagel. Smart Suggestions
Starbucks offers some hot breakfast options for under 300 calories – their egg white bites have only 170 calories – and Dunkin Donuts offers some DD Smart Wake Up Wraps for 160 to 240 calories. By the way, a Bismark donut has 490 calories. Subway offers egg whites, ham, and reduced-calorie cheese on 3-inch subs, so you can avoid too much bread.
Lunch for Breakfast
You may not need to depend on the breakfast menu if the restaurant serves lunch early in the morning. If that is the case, you may be able to get grilled chicken, turkey breast, and cheese on a salad.
Bring Your Own
There is a chance that you may not realize how easy and quick it can be to bring your own breakfast from home and avoid restaurants altogether. We understand if you have exactly zero seconds to dedicate to making your breakfast in the morning before you leave home. You can stash it in the car or fridge the night before.
If you have access to hot water before you have breakfast, these options can work:
Protein Oatmeal with an apple or some walnuts. Protein Muffins in flavors such as Blueberry, Double Chocolate, and Maple Pumpkin. Protein Hot Chocolate with milk for extra calcium or protein. If you are going to eat in the car or have no microwave at work, you’ll need something ready-to-eat. Consider:
Protein Cereal in Honey Nut, Chocolate, or other favorite flavors. Oatmeal Raisin Protein Cookies. Fruit and cottage cheese or yogurt. A Protein Bar. You can have the best of both worlds: a meal as quick and easy as a fast food meal, with nutrition that fits into your meal plan like a home-cooked meal. Way to start the day right!

1. My weight does not determine my success nor worth.
“If you accept your personal best at everything else in life, why not weight?” – Yoni Freedhoff
Isn’t that SUCH a good quote?
Is your WLS team happy with your progress, but you aren’t? Why are you still pushing for and obsessing over those next 10 lbs? Reflect on why you feel that you must lose those extra pounds and what will happen if you don’t?
2. I acknowledge that a healthy lifestyle (i.e. eating healthy most of the time and moving my body often) is a part-time job. Some weeks it doesn’t feel like work, but often it does.
It is important to accept that doing well after WLS is not an accident. You have to make the time for your new habits.

3. I see meal planning, grocery shopping, and cooking as acts of self-care.
This mindset shift is HUGE. Embracing this shift requires practicing gratitude. For example, this means being able to acknowledge that although you may not enjoy cooking, you are thankful to have food to put on the table. Or, as another example, maybe you don’t enjoy meal planning, but you can acknowledge how much smoother getting organized on the weekend makes your week flow.
Try viewing these chores from a place of gratitude this week, and watch how much lighter they all of sudden feel.

4. I move my body because it feels good and helps me to re-charge. I don’t exercise to control my weight.
If you are exercising solely for the purpose of controlling your weight, it is only a matter of time before you burn yourself out.
Moving your body should come from a place of self-care. The activities that you choose should be enjoyable and energizing. They shouldn’t feel forced.

5. I am not on a diet. I eat foods that I enjoy. I practice moderation and flexible eating to the best of my ability.
All foods fit.
If you feel restricted, if you’re counting your calories daily, if you’re always hungry, or if you often feel guilty or ashamed about your food choices, you are going to burn yourself out!
If you have dieted for most of your life, you likely have a lot of baggage in this department to work through. For many of our patients, it takes years to work through this mindset shift, so don’t be too hard on yourself.

So, how many of these mindset shifts have you fully embraced? Which ones are still a struggle? Where do you feel stuck?
Try posting these 5 mindset shifts up in your office or home to keep them top of mind as you go about your day. Envision and journal about what it would feel like and look like to embrace all of them.
Click HERE for a FREE printable of these 5 mindset shifts!
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If you need help working through these shifts, speak with your WLS dietitian or psychologist.
Wishing you all much happiness in your WLS journey!
– Monica & Lisa

Why Does It Matter?
There is an expression that goes, “Shoot for the stars and you’ll hit the moon.” The idea is that if you set your sights high but fall short, you will still achieve something great. The theory may sound good, but it may neglect to consider reality.
The truth is that for many of us, another saying is truer: “Success breeds success.” That is, when you hit one goal, you are motivated to keep working towards your next one. You build momentum as you hit goal after goal, and those goals then act like stepping stones to those proverbial stars.
The Trap of “Too Much, Too Fast”
There is a common tendency overshoot when it comes to weight loss goals. These are some reasons why.
We want to lose weight so badly that we think only of the dream goal.
Most of us tend to think of ourselves as above average – so we set our weight loss goals at higher than average.
We set deadlines that are too short because we are so focused on getting there that we forget to recognize how wonderful the journey is.
We set our goals based on what someone else lost.
Classic Failure: “All or Nothing”
One of the surest ways to set yourself up for failure is to set your weight loss goal to be too many pounds within too little time. It is comparable to the “all-or-nothing” mentality that so often comes with dieting: you are doing fine until you eat a cookie, and then you figure that the day is wasted, so you might as well finish the bag of cookies, skip your workout, and order pizza and breadsticks for dinner.
The same mentality after weight loss surgery can get you into the same trouble. If you aim for an unrealistic 20 or 30 lb. in your first month and instead hit a respectable 5 to 10 lb., the “disappointment” can discourage you so you do not try as hard.
Realistic Weight Loss
The amount of weight you can realistically expect to lose depends on your procedure, how much you have to lose, and your own drive and other individual characteristics. An average gastric bypass or sleeve patient might lose about 50% of excess weight. For example, Someone who is 5’4” tall and weighs 245 lb. has about 100 lb. of “excess” body weight and might set a goal to lose about 50 lb.
Another way to look at it is to take a rough estimate of average weight loss with your procedure for your surgeon’s patients. You might use that number as the basis for your own weight loss goal. You could also look at your final goal – say, 100 lb. down – and divide that by 1 to 2 years – in this case, a seemingly modest 1 to 2 lb. per week.
Setting Realistic Goals
For weight loss or any other goal, you can follow certain guidelines for realistic goal-setting. Set your goal to:
Include a realistic amount of weight loss.
Leave yourself enough time to achieve that amount.
Include interim goals that you can celebrate and use as motivation.
Provide for rewards as you progress, so you stay motivated.
Allow enough time for plateaus and setbacks. They will come.
Keep It in Perspective
Strange but true…weight loss is only one of many reasons to get weight loss surgery and follow a healthier lifestyle. What about…?
Gaining energy?
Getting healthier?
Feeling more confident?
Participating in more of life?
Along with setting weight loss goals, you can set other goals for healthy eating, working out, and trying new things. You will always have something to chase after and you will be able to see more progress every day.

Take note of the research.
Studies have already shown the potential for people to give in to obesity due to its classification as a disease. In one study, overweight individuals who read a story about obesity being genetic ate more cookies than a group of individuals who read a different story. In another study, overweight individuals who read an article explaining that obesity is a disease ordered and ate more calories from a menu at lunch than a control group.
Distinguish “disease” from “doom.”
A drawback of labeling obesity as a disease is the tendency to feel doomed or to feel like a victim. That could lead you to stop trying to be healthy, but that mindset is ridiculous. That would be like giving up using sunscreen simply because skin cancer is technically a “disease,” or skipping the measles vaccine because measles is a “disease.”
Genes and the environment interact to affect your health.
You do not need to succumb to obesity simply because it is a “disease.” A disease means that something it wrong; it does not mean that you cannot do anything about it. Even if you suspect that you do have obesity gene or two, your own choices still affect your weight.
Consider identical twins with a genetic predisposition to obesity. If one twin eats 3,000 calories a day from pizza, ice cream, and beer, she will end up weighing more and being less healthy than the other twin, if she eats 1,500 calories a day from vegetables, whole grains, and lean proteins.
Rather than feeling sorry for yourself because of your genes, make the most of what you have. Any effort you put in will yield benefits.
Pull your weight (so to speak) in the doctor’s office.
Doctors may have general guidelines for treating obesity patients, but that does not make them experts. You have the right to the best possible treatment, which means you have the responsibility of helping your doctor along as needed. Let her know if the plan she suggests is not going to work for you, and tell her what you really need. She should be grateful to hear from you, since the concept and practice of treating obesity rather than ignoring may be new to her.
In addition, demand the compassionate and respectful care you deserve. If your doctor or anyone in the office is rude to you or treats you without respect, speak up. You might consider being polite the first time; they may not even know they are demeaning.
Obesity is a disease, but it is one you can influence with your healthy behaviors and your decision about weight loss surgery. Let yourself feel better knowing that it is a disease, but do not let that be an excuse to play the victim. You can fight obesity successfully!

Who cares what obesity is?
You might wonder whether it matters whether obesity is a “disease” or not, especially if doctors have not managed to help you lose weight, except, possibly, your bariatric surgeon. But, the name actually does make a difference.
It gives obesity and obesity treatment more attention. It can help remove the stigma surrounding obesity. It gives doctors a mandate to treat you. It could lead to increased medical insurance coverage for obesity treatment, from diet programs to bariatric surgery. Here is why obesity is a “disease.”
Obesity meets a definition of disease comprising three criteria:
"an impairment of the normal functioning of some aspect of the body;" (changes in organ function, for example) "characteristic signs and symptoms" (excess body weight, for example) "harm or morbidity” (obesity-related complications, such as diabetes and arthritis, for example) The American Medical Association, the American Heart Association, the American College of Cardiology, and The Obesity Society are among the respected organizations who agree that obesity is a disease.
Obesity is not only a disease but an epidemic based on the number of people it affects. It affects 35% of American adults, not including the other 30% who are overweight and at risk for obesity. Nearly one out of five children are obese.
Healthcare providers can take charge.
One point of calling obesity a disease is to allow and even require, healthcare providers to treat it. No longer should they simply tell you to lose weight, or, worse, ignore the “condition” in the first place. Instead, they should provide care for obesity, including developing treatment plans and following up with you to discuss progress.
Now there is a roadmap.
Now that obesity treatment is in the realm of medical professionals, there needs to be a standard approach to treating it. The American Heart Association, along with the American College of Cardiology and The Obesity Society, have published clear guidelines for treating obesity.
Identify at-risk patients and patients with obesity using BMI, and monitor them at each appointment. Enroll patients with BMI of 30 or over in a medically-supervised weight loss program (note: this is not the same as your doctor telling you to eat less and lose weight on your own!) Keep weight loss surgery in mind for patients with extreme obesity and an obesity-related condition). Weight loss surgery is a recognized treatment for obesity.
The third prong of the roadmap is especially important if you are considering weight loss surgery. The recommendation to consider it when treating high-risk patients has a few effects.
It reduces stigma, from primary care physicians and your other regular doctors, surrounding WLS. It increases the number of patients who may have WLS covered by insurance. It encourages patients and professionals alike to learn about WLS. No longer is weight loss surgery considered to be an extreme or fringe approach. The ASMBS states that experts who agree that bariatric surgery has a role in obesity treatment also include the American Association of Clinical Endocrinologists, the American Diabetes Association, Centers for Medicare & Medicaid Services (CMS), and the National Institutes of Health (NIH).
Further progress is needed.
There is still much to be done in the medical arena. Healthcare professionals aside from bariatric specialists are often still in the dark about recognizing obesity and treating it. Worse, many still have stigma or bias against overweight patients, and still, engage in patient-blaming.
Obesity almost certainly has genetic components along with lifestyle factors. While it may be a disease, it is also a disease that you can work to treat. Now that it has officially been recognized as a disease, let us hope that patients and healthcare professionals can work hand-in-hand, each doing their part to fight obesity.