Lifestyle changes are critical to achieving sustainable weight loss with bariatric surgery. Each person is different in terms of what works for them however developing positive habits certainly increases the likelihood of long-term success. Tools for estimating precise energy requirements have not yet been validated in a population of patients following bariatric surgery. This is why all guidelines are general, and it is important to keep close contact with your dietitian, to ensure that your nutritional needs are being met.
Recently a team of researchers has developed a visual model of lifestyle goals after surgery for patients who have had bariatric surgery. Figure 1 below shows the recently developed nutritional pyramid for patients following bariatric surgery.
What do you think?
Figure 1: Nutritional pyramid for patients who have undergone bariatric surgery.
We think this is an excellent visual representation of what patients should aim for. Like anything however, it is important to remember that these guidelines are general and not intended to replace individual advice from your surgeon or doctor.
Below is a summary of the recommendations included in each section of the pyramid
Don’t forget everyday
This section focuses on the importance of physical activity, ensuring you drink adequate fluids and taking your daily supplements. The pyramid lists calcium + vitamin D, iron, multivitamin and vitamin B12 as the required supplements. Not all patients need to take all these. Your dietitian will recommend the supplements that you need to take on an individual basis.
These sections focus on sources of protein including lean meat, fish, eggs, tofu, legumes, and dairy. As we recommend also, these foods should be the first part of your meal. Next up are low starch vegetables and fruit. Low starch vegetables should be the next things on your plate. Fruit is a great snack option as your appetite increases a few months down the track.
The serving sizes provided next to both the protein choices and vegetables/fruit are guides only. In fact these are quite generous compared to what we usually see and we do not expect you to eat this much. Portion sizes in the beginning will only be a few tablespoons, making such servings unachievable. The best thing you can do throughout the whole journey is listen to your body and eat accordingly. In the beginning if you feel full after 2 tablespoons that is fine. A few months later you may eat a bit more before feeling full and that is fine too. Your own individual hunger and satiety cues are the most important guide you have!
This is where all carbohydrate-containing foods belong. Think potato, corn, pumpkin, bread, rice, pasta, cereals etc. This is the food group we want to limit as much as possible. The serving size indicated on the pyramid is again just a guide. Some patients are fine with no carbohydrate at all, others may have small amounts once they are a few months down the track. Your dietitian will give you personalised advice regarding this so have a chat to them if you have any queries.
Try to Avoid Intake
At the top of the pyramid is processed foods which are high in saturated fat and refined sugar, alcohol and soft drinks. These are the foods and drinks we really want to limit as much as possible, as they provide a lot of calories for very minimal nutrition. A little bit here and there is okay as moderation is very important too. Again have a chat to your dietitian about this to strike a balance that works for you!
And that’s it! What do you think? Do you find visuals helpful? Has anyone already come across this pyramid?
It is a great visual to refer to, as long as you keep in mind that not all elements may apply to you, and it is best to always consult your surgeon or dietitian for personal advice. That’s what we are here for and happy to help any time!
- Moize, V, Pi-Sunyer, Mochari H, Vidal J. Nutritional Pyramid for Post-Gastric Bypass Patients. Obes Surg. 2010 Aug;20(8):1133-41. doi: 10.1007/s11695-010-0160-9.