buzzly36

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.
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.

How much hummus can you load onto a chip, cracker or pita wedge?
If hummus is healthy, is it a freebie food after surgery?
Bariatric Dietitian Elizabeth Anderson helps clear the air.


“But Elizabeth, hummus is supposed to be good for you.”
My post gastric sleeve client sat across from me in the office, confused and frustrated.
“Are you telling me I can’t eat hummus?”
As a bariatric dietitian, I’ll tell you what I told him, “You can eat hummus…. cautiously.”
Here’s the deal with hummus. Hummus is a savory and delicious, bean-based condiment or dip.
Yes, it’s full of good-for-you monounsaturated fat but at 50 calories per 2 tablespoons—the good times add up FAST.
Every two bites mean 50 calories.
4 bites = 100 calories.
You get the idea.
If you’re not paying a whole lot of attention to your snacking --you can easily be in pain and overloaded with calories in no time.
The hummus example is just one in a long line of misconceptions that set dieters back but can be downright dangerous for weight loss surgery patients.
I’ve picked 5 of these misunderstood dieting tricks and in the next five days I’ll clear the air.
Tomorrow check out the first myth: missed meals = missed calories.

Once you choose your surgeon, you should be confident that you’re in good hands. Still, your surgeon is only partly responsible for your weight loss surgery success. YOU have the greatest share of responsibility. Here’s what you can do before surgery to make surgery safer, make recovery easier, and lose weight faster – and it’s not just sitting back and waiting for your surgery date to arrive!


Pre-Op Diet
The pre-op diet has a few purposes. The critical one is to shrink your liver so it’s not blocking your surgeon’s view of your insides during surgery. That makes your operation easier and safer.
The pre-op diet also helps you lose weight. That may be surprising since you’re expecting to start your weight loss after surgery, but it’s actually a good idea to start losing weight beforehand. In fact, the more you lose before surgery, the safer surgery will be, and the better you’ll feel afterwards.
Different surgeons suggest different pre-op diets. The diet has about 1,000 calories. It could depend on lean proteins and other nutrient-rich foods, or it could be a liquid diet with protein shakes. Or, it could be a combination of the two, with each day including two protein shakes as meal replacements plus one meal with vegetables and protein.
The pre-op diet can last from a few days to several weeks or even months. In general, the longer you’re on it, the better. You’ll lose more weight, shrink your liver more, and gain confidence that you’ll be able to continue a strict eating program long-term after surgery.
Get in Shape
Why exercise before surgery? One reason is that, like with a good diet, it can make surgery safer. In this case, it’s because exercising can strengthen your heart, lungs, and blood vessels. Of course, exercise also burns calories and can help you lose a little extra weight before surgery.
Another reason to get in shape before surgery is because it will make recovery easier. Many weight loss surgery patients find that walking around the house and then the neighborhood is their best tool for fighting post-op pain. If you’re used to being active before surgery, you’ll have an easier time walking after surgery.
You don’t need to go crazy on your pre-op exercise regimen. If you’re not used to exercising, start small. As long as your doctor approves you to be active, just find a few minutes each day to walk at a comfortable pace.
Clean and Stock the Kitchen
Fact: you can’t eat food that’s not there.
So, clean out your kitchen. Get rid of sugary desserts, starchy snacks, and fatty meats and cheeses. Anything you know you shouldn’t be eating shouldn’t be in your kitchen. Get rid of it before surgery because for weeks after surgery, you won’t be physically able to carry out heavy trash bags filled with forbidden foods.
Once your kitchen is cleaned out, stock it up! At least get the protein shakes and powders you’ll need for weeks or more after surgery. Consider getting some flavored water in case you’re unable to tolerate water post-op. You can also stock up on non-perishable staples, such as canned chicken and tuna, frozen fruit and vegetables, and instant oatmeal packets.
Take Your Nutritional Supplements
You know you’ll be taking nutritional supplements post-op. If you have the sleeve or bypass, you’ll be taking them for life. With the band, you’ll need supplements for months, years, or life. Did you know you shouldn’t wait until after surgery to start taking your supplements?
At a minimum, take a multivitamin beginning when you start your pre-op diet. Even if you’re eating a balanced diet, the supplement helps make sure your body has the nutrients it needs to heal your surgery wound. Also, it’s an insurance policy so that if you have trouble eating and swallowing supplements for a few weeks after surgery, your body will still have a good store of nutrients in reserve.
Practice Your Healthy Eating Habits
Consider the pre-op period practice for the post-op diet. That includes eating slowly, measuring portions, and choosing nutrient-dense instead of processed, high-calorie foods. Also consider making exercise a habit now, so it’s easier to get back to it after surgery.
You cannot guarantee an easy surgery, but you can certainly do a few things to improve your chances. Use these tips to take control of your pre-op prep as soon as you’re ready to lose weight and get healthy!

The weight loss surgery journey is easier for some than for others. That’s true not only mentally, but physically as well. Some patients are confident as they get the surgery, follow their prescribed diets, and lose weight until they approach their goal weights.
But most have doubts at some point. Those doubts can be strong especially in the first few weeks after surgery.


I see this lack of confidence time and time again in the forums. Weeks or a month after surgery, gastric sleeve, gastric bypass, lap-band, and other Weight Loss Surgery (WLS) patients start to wonder whether Weight Loss Surgery was the right choice. Most often, they are disappointing in the number of pounds they have lost, and they wonder, “Am I going to be the Weight Loss Surgery patient who fails?”
I can say this with confidence: If you follow the Weight Loss Surgery diet, you’ll lose weight.
“I’m Not Losing Weight Fast Enough!”
That’s a common post on BariatricPal. The poster is usually a week or a few weeks post-op, and worries their weight loss isn’t fast enough. They think their “slow” rate of weight loss means Weight Loss Surgery didn’t “work” for them. They think they will never be able to lose significant amounts of weight, since WLS was a last-ditch effort to lose weight and get healthy after years of dieting didn’t work.
But in most cases, these fears just aren’t true. Don’t misunderstand me. I’m not saying these fears are unreasonable. I understand them perfectly. I, and probably every Weight Loss Surgery patient, wondered whether it would work for me. And the answer for me, and for everyone who followed their Weight Loss Surgery diet, was “YES!”
The Perfect Storm for Frustration
So why the panic? I like to think of the first few weeks or even months after weight loss surgery as a perfect storm for generating doubts. It’s a time when the following are true.
You realize you have made a decision that led to a change to your body that is irreversible (in the case of sleeve gastrectomy) or meant to be permanent (in the case of the gastric bypass), or
You realize a lifetime commitment to changing your eating habits and lifestyle is a pretty big deal.
You have not eaten solid foods for weeks, or even more if you had a liquid diet for long before surgery, and it’s getting you down.
You are struggling in your daily life as you try to make time for exercise or you find your family members continue to eat junk food in front of you.

All that is enough to get anyone down before you even start thinking about the reason you got the surgery in the first place – to lose weight! If you doubt you’re losing weight “fast enough”, you might start wondering if you made the wrong decision when you got Weight Loss Surgery – and that’s a depressing thought.
Crunching the Numbers
Almost without fail, the BariatricPal member who posts about disappointing early weight loss is losing weight quite quickly. The only person who is disappointed in this number, typically, is the member him or herself. I’ve seen members post with concerns about losing “only” 20 pounds in the first month, or “only” 10 pounds in the first week. Guess what. That’s great!
Think about it. A general round number for great first-year weight loss after Weight Loss Surgery is 100 pounds. That’s an average of 2 pounds a week, or 8 pounds a month. If you lost 20 lbs in your first month, you’re doing fantastic! To hit 100 pounds in your first year, you won’t even lose a pound every three days! So don’t worry if the scale doesn’t plummet every single day. If you’re eating right, you’ll lose weight.
Try to keep yourself motivated by keeping it all in perspective. Another motivating thought is to consider how long it took you to gain the extra weight. 5 years? 10 years? Your whole life? And now you have a chance to lose it within 1 or 2 or 5 years? That’s a pretty good bargain, right?
Recovery Now for Weight Loss Later
Now, I know you’ve prepared for Weight Loss Surgery for a long time, and you’re eager to lose weight. But really, you’re not quite ready to focus on weight loss if you’re still recovering from surgery. It’s far more important to heal properly. That’ll help you lose weight faster later and avoid complications that’ll set you back, not to mention cause possibly serious health problems.
So, no matter how frustrated you are, stay positive, and focus on following your surgeon and nutritionist’s instructions to the letter. Continue to eat a liquid diet and then pureed foods without cheating and sneaking in solid foods. Use this time to establish a pattern for your long-term success. Learn to measure your food, and to set aside time for food prep and for exercise.
Weight loss surgery is a lifetime adventure, and that realization can really hit hard in the early days and weeks post-op. You can get through this tough period by focusing on one day at a time and not worrying about your rate of weight loss. Measure your success not by the scale number, but by how well you stick to your plan.

I think this is one of my greatest weaknesses failing to plan. This article is a great wake up call.

Excellent article. I really do find I do best when I pre-plan. When traveling I already have in mind what I can get and where so that I stay on plan.

When I had RNY October 28th, 2014. I was expecting to lose a little weight but I was sure I would be an underachiever in this journey. I had always underperformed in all my diets. In my mind, it followed that it was going to be the most likely scenario with bariatric surgery. There is a range of weight loss and of course I would be a slow loser. Not true at all. I have lost 99 lbs in 8 months. I have been successful beyond my dreams. I would have been over the moon with half that amount.
The difference, I am not hungry all the time. Now my hunger is manageable and I have (literally) enough time to make good choices about what I eat.

You’re considering weight loss surgery, you’ve scheduled it, or you’ve already gotten it. Are you going to be successful with it?
Historically speaking, the answer is “No.” Maybe that’s not what you wanted to hear, but it’s true. Just take a look at your past. You haven´t been able to lose weight and keep it off. It you had, you wouldn’t be looking at Weight Loss Surgery.
But that’s no matter. Your past does not need to determine your future. Replace old habits and attitudes and look forward instead of back. That’s how you will be able to get the results you want instead of the disappointments you used to get.
In this first article of the two-part series, we’ll take a look at some of the problems from the past that could stand in your way. Part 2 of the series will have a few more.


Problem: Childhood Habits
No joke. It’s hard to shake off the behaviors you learned while growing up. Maybe your family traditions were something like making pancakes and sausage on Saturday mornings, ordering pizza on Wednesday nights, and watching Sunday afternoon football while eating the usual unhealthy snacks. Maybe your “habits” were actually lack of habits – maybe you didn’t grow up walking to school or playing outdoors every day.
Do you see yourself clinging to the old traditions, whether or not purposefully? Give yourself permission to let go of the old ones, and maybe even create some new ones. You don’t need to plop down in front of the TV after dinner just because you always have. Maybe you could take a walk. You don’t need to meet your parents at a favorite Italian restaurant every week. Maybe you could meet for coffee. Or, you could meet at the Italian restaurant, but change your usual order of spaghetti and meatballs to a salad.
It’s time to stop letting your childhood dominate your current life and health. And here’s food for thought: if you’re old enough to get weight loss surgery, you’re old enough to make your own traditions.
Problem: Mistaking “Food” for “Love”
This can be one of the biggest obstacles for weight loss surgery patients because it can lead to conflict between them and their families. Maybe it’s the Jewish or Italian mother who guilts you into eating, the Asian culture that requires you to clean your plate, the Latin American family that solves problems at the dinner table, or the African American community known for soul food.
Which of these or other food-centric cultures you were raised in doesn’t matter; the point is somehow food got confused with showing love. Somehow, eating for reasons other than hunger – for celebration, comfort, courtesy, expression of love – became cultural norms.
Your personal history may be weighing you down if you are eating to make other people happy. This won’t work for you. It can stall weight loss and continue to make you feel dependent on others. Instead, make the decision now to eat for yourself – to nourish yourself, to fuel yourself, to be able to enjoy life. There are many ways to give and receive love besides eating food that is literally killing you slowly.
Problem: Devaluing Yourself
You wake up before dawn to clean the house. Then you get the rest of the family up and ready, and make, serve, and clean up from breakfast. You drop the kids off at school on the way to work, then pick them up on your way home. You help them with homework, make and eat dinner, and put the kids to bed. After a few minutes with your spouse, you hit the sack yourself. The day is over, and you haven’t had one second to yourself.
Sound familiar? If this – or something like it – has been your life for years, you’re setting yourself up for weight loss underachievement because you’re undervaluing yourself. Where’s the you time in this day? You deserve it, and it's up’to you to take it. It’s not something you should feel guilty about, but if you do, consider this: doing your best for yourself puts you in the position to do your best for others, too.
Problem: Hanging with the Wrong People
It’s true. The people you hang out with affect your weight just as much as your genes do. If your friends are obese, they may be setting you up for much bigger struggle than necessary against obesity. That’s because you are likely to make the same choices they make. You sit on the couch with them and order unhealthy dishes with them. In contrast, skinny friends may influence you to eat healthier and be more active.
If you notice your friends dragging you down, feel free to say something. You can politely ask to get together to shoot hoops instead of drink beer. Catch up at the park or over coffee, not over nachos. Collect and test healthy recipes instead of decadent desserts. Changing those age-old habits may not be that hard.
If your friends refuse to change their activities and you still want to spend time with them, you can. Just be aware of how their choices can affect yours, and make sure it doesn’t happen.
Do any of the above sound familiar? If they do, think about how you can avoid making the same mistakes this time around. Some of the smallest changes in attitudes can lead to big changes in results. Stay tuned for Part 2 of the series for more!