After you've lost all your excess weight and are in the maintenance phase of WLS life -- either newly or several years down the road -- what's the best eating path for you to follow?

There are at least three major schools of thought about how to eat during WLS maintenance, with hybrids of these approaches. Each approach has enthusiastic boosters and rabid opponents among WLS patients. Each approach is espoused by some WLS surgeons, nutritionists, psychologists, bloggers, coaches, and those who sell WLS products.

(1) Abstinence Approach: WLS patients should abstain forever from specific foods, especially those that contain sugar, processed carbs or alcohol. Proponents of the abstinence approach to maintenance offer advice to WLS patients like this:

"Bread is empty calories and a waste of valuable pouch space." At http://www.bariatriceating.com/2016/02/can-versus-difference/

"Say no to alcohol." At http://www.bariatricpal.com/topic/364081-bariatric-realities-%E2%80%93-medical-professionals%E2%80%99-guidelines-about-alcohol-use-wls/?hl=%20stapleton

(2) No Dieting Approach: Some WLS patients report that they have maintained their weight losses by eating in moderation all foods that appeal to them. "I didn't have WLS to be on a diet the rest of my life" is a refrain often heard from this group. The major tool in this approach to WLS maintenance is portion control.

(3) Mindful Moderation Approach: This approach has a foot in both the abstinence and non-dieting camps. Those who follow this approach select their foods based primarily on nutritional content, but indulge occasionally in the kinds of "treats" eschewed by abstainers. They endeavor to observe their feelings and behaviors around food choices and use this information to inform future choices.

Recognizing that all WLS patients are not alike -- we vary considerably with regard to our surgery types, complications, physical and mental health challenges, emotional resources, basal metabolic rates, degree of family support, access to therapy/counseling, macronutrient tracking (with an app or mentally), physical exercise (intensity and frequency), etc. -- which maintenance approach works best for you?

EDIT: Or if you know of other approaches to successful maintenance you think work well, please describe them here.

Of possible interest to those who are now in maintenance is this BP post about a five-year study of sleeve maintenance performance.

"Benefits of Sleeve Gastrectomy Wane at 5 Years"

At http://www.bariatricpal.com/topic/349472-benefits-of-sleeve-gastrectomy-wane-at-5-years/#entry3933756

This study's findings mean, to me, that my choice of maintenance model(s) matters considerably!

I have seen this study before. It mostly seems to talk about diabetes.

In one of my pre opt sessions, I asked the nut about failure.

For what it's worth, she said it was generally caused by grazing on bad foods. Eating small amounts of bad food continuously all day long.

As I think about model 2 above, it seems that it could lead to this sort of failure. Imagine eating a snickers bar every 45 minutes?

Face it, we all got here by eating too much of the wrong thing, even though our brains told us not too.

If we "pretty much eat what we want", how long will it be before we start eating more often and allowing our palette (rather than our brain) decide what we eat?

Not in maintenance yet, but #3 would definitely be the best "fit" for me. I don't trust myself enough for #2, and I think #1 would be hard to sustain long term (at least for me....)

I follow #1 with a little wiggle room here and there. Still weighing and logging, which makes me accountable.

While this isn't for everyone, it's worked well for me. At the moment I'm within 1 pound of my lowest weight.

Another aspect of maintenance that's very helpful is continuing to come to a support group such as Bariatric Pal or Facebook. It keeps me mindful of what needs to be done to succeed and inspires me!

I'm of the number 3 mode. I'm mindful shopping.... I cannot have super tempting (for me) food here and not last very long fighting it.

I don't want the struggle that I had for years....

This is the new normal for years. And I try to not set myself up for failure.

Not saying I'm 100% successful..... Just really most of the time and I am content with that

I'm so sad when I read about unsupportive family members bringing home or cooking tempting foods. I have to say I pretty much control the food in my home. I do the grocery shopping, meal planning and cooking. Having this control has really helped me avoid my trigger foods.

#3 on a day to day basis...no tracking, mindful of my protein and water intake, abstain from nothing but indulge in moderation. However, I tend to leap with both feet firm in the #2 camp over holidays and when on vacation. But afterwards my tummy usually hurts so bad from all the sugar and alcohol, I'm more than happy to return to the #3 camp.

Until I can be 100% positive that I can be #3 I'm going to be in the #1 category. I know it probably seems a little strict but I know that I don't have a lot of willpower around food currently so I have to abstain as much as possible. I'd like to be #3 eventually and know that I can eat healthy with special occasions sometimes but like I said, willpower. I'll get there one day.

Good topic! I think I fall most closely into the third category. I definitely follow portion control as in the second category, but probably pay too much attention to my diet to say I’m a non-dieter.

I don’t forbid myself specific foods, as in the first category, but I do often think that certain high-calorie, unhealthy foods are a waste of space, so it’s better to choose healthier ones to fill up my pouch.

I do try to go for healthy foods first. If I am not hungry enough to eat something healthy, like a salad, I don’t let my head tell me I’m starving and need that ice cream. But, if I’ve wanted ice cream for a while and the desire doesn’t pass, I’ll plan for it and have it – in moderation, and with a lot of attention so I get full pleasure!

I am definitely number 3 and have even read a few books on the topic and gone to classes at my doctor's office. Even with all that, I feel like a baby learning to walk. I fall down a lot. But it's a process and I'm trying to undo years of bad thinking and habits. I definitely feel that number 3 is the hardest path to follow but will lead to permanent change.

"I tell myself I absolutely can't have something is the second I start desperately craving it. I do MUCH better lying to myself and saying, "oh you can have that tomorrow or next week". Most of the time I never end up having it, but if I do, then I can move on and be content.

I do this all the time when I am craving something not on my plan. I say, if you really want it, you can have it tomorrow and most times, I don't want it. It's what works for me (most of the time)!

Edited April 12, 201610 yr by Lorie77

I'm a #3. I am mindful of how I fuel my body. I indulge occasionally. When I indulge. I increase my exercise to get back in range.

I tried being a two and stress gained 20 pounds. Went back to being a three and am back to goal with 6 more pounds to lose to get back to my all time low.

At least I caught it before I needed new pants!!

I think I started off as #2 and that worked for me for a long time. I never was able to eat in moderation before WLS. All of a sudden I knew what that was and it was amazing!! I could take just a bite of cheesecake and be satisfied. As I get further out from surgery, I realize that I can eat more and my portions are bigger. So I'm trying to be more like #3 - make healthier choices with occasional treats.

Dieting doesn't work for me - which is why I never could lose before WLS. My brain immediately rebels against the "I cannot have that" rule. And through my therapist I realized I was categorizing food as good or bad. So I would beat myself up mentally each time I "failed" by eating something "bad" and then thow in the towel because I was bad too. There are no bad foods - yes, some foods have no nutritional value or are unhealthy. But eaten once in a while, won't really hurt me. I still want to enjoy food so having that treat makes me feel like I'm not depriving myself. And knowing that I'm allowed to have it, means that I'm not going to feel guilty and feel like a faliure if I decide to eat it. That is a vicious cycle that got me to the weight I was before.

I am not quite there yet, but my plan is to use calorie restriction whenever there is a '5' in front of my weight and mindfulness if my weight starts with a '4'. So over 50kg restrict, below 50kg be mindful.

No idea if this will actually work, but I have lost this weight so many times before and put it all back on that I plan to watch the scales like a hawk.