Tag: <span>Diet</span>

There’s a common perception amongst some people that having weight loss surgery is somehow the easy option or a cheat. However it’s definitely not the easy way out. It involves a lot of hard work and a lifetime commitment.


Part of the problem is that people often misunderstand what weight loss surgery is. They sometime think of it as a type of cosmetic surgery, a bit like liposuction, where an obese person will go in for an operation – have huge amounts of fat taken out – and wake up a few hours later 50kg lighter!

That’s definitely not the case.

The surgery itself doesn’t reduce a patient’s weight at all. It reduces the size of a person’s stomach, often to about the size of a golf ball, and also reduces the absorption of nutrients from food. So it’s not the surgery that reduces someone’s weight, but a very restricted diet they must follow after surgery.

So it’s not a quick fix. It’s a lengthy and difficult process that can take a year or more for someone to lose their excess weight.


There’s also a lot of social stigma attached to weight loss surgery. Some people have the opinion that if a overweight person just stopped eating so much and exercised a bit more they wouldn’t need to have surgery. They see overweight people as lacking sufficient character or willpower to lose weight on their own.

They don’t comprehend the struggles that overweight people have gone through, over many years, with managing their weight and with yo-yo dieting. They don’t see the psychological and emotional issues around overeating, and they don’t have to live with the shame attached with being an overweight person.

This fear of negative reactions or being judged forces a lot of bariatric patients to keep their surgery secret. And this secrecy only adds to the stigma, because people don’t hear about others having weight loss surgery.

Then there’s also all the lurid headlines we see in the press where they will ‘out’ a celebrity as having bariatric surgery, and pick apart all kinds of private details about their weight management struggles and personal life.


The surgery itself is not particularly dangerous – no more dangerous than having a gallbladder operation. It’s mostly done laparoscopically by making 5 small incisions at the top of the belly. However, it’s still invasive surgery, done under a general anaesthetic, requiring a couple of nights in hospital, and is very painful to recover from.

The wounds take a number of weeks to heal and are painful. Patients are also put on a very restrictive diet to stop potential damage to their new stomachs – normally liquids only for a few days, and after that blended/pureed food (think: baby food).

People also need a number of weeks off work to recover.

Hard work

The surgery itself is only the start of a hard journey. The smaller stomach is a tool that can be used to help lose weight. It will make people feel full a lot quicker, and will reduce the amount of nutrients that are absorbed from food. However the restricted diet is the hard work.

People that have had bariatric surgery typically can only eat a starter-sized portion of food at each meal. However they must also try to consume as much protein as possible, and avoid carbs and sugar as much as possible as they will make them sick. And because of the reduced absorption they will need to take multivitamins and other supplements for the rest of their lives.

And just think of all the social occasions that are linked to food: meals out with friends or colleagues, weddings, family gatherings, birthday parties, Christmas, and other celebrations. Someone who has had weight loss surgery will not be able to eat the same amount of food like everyone else. They will only manage a small portion. There are no ‘cheat days’ where they can pig out on a huge pizza and ice cream.

There’s also the social awkwardness of trying to order a starter while everyone else has main courses. Or having to deal with the questions from waiting staff when more than half the food goes uneaten on the plate. Or from well-meaning relatives that get insulted when you turn down their food.


As with any surgery, there’s always the risk that something might go wrong. It’s possible that the new stomach might leak, or there will be internal bleeding. Other complications may present themselves months or even years after, and necessitate additional revision or corrective surgery.

It’s also possible that over time the new stomach pouch might stretch, which reduces it’s effectiveness at helping to manage weight.

There’s also the unaddressed psychological and emotional issues that led to someone overeating in the past. Without food to act as a comfort these issues will need to be addressed, which might be difficult.

So, all in all, when you consider all of this, weight loss surgery is definitely not the easy option. It’s a lot of hard work, and a lifetime commitment.

Surgery Weight

Whenever I’m planning any meal, it seems that my first thought is how much protein it contains. It’s become a bit of an obsession for me.

I’m conscious that I should by trying to have 60-80 grams of protein a day. And with small meal portions that’s actually quite difficult to achieve.

The bowl of porridge for breakfast, made with protein milk and added powdered skimmed milk, only gives my 19 gram of protein. The reduced fat paté and crackers at lunch only gives me 10 grams. Then a dinner of lasagne and salad gives me another 18 grams. And I end the day only having 47 grams, and I’m short of my 60-80 gram target.

I can help increase my protein intake by having snacks between meals, but if I do that then I can’t eat as much in my main meals. Or I could have protein drinks, but I’m not a fan of milky drinks.

So I’ve bought myself some protein bars, which are small enough not to fill me up, but will also give me 15 grams of protein each. And just maybe it’s enough to stop me obsessing about the amount of protein in each meal!

Diet Surgery

I was curious to find out the average weight loss for gastric bypass patients, so that I could reality-check my expectations.

I have this goal in my head that I’d like to get down to 105 kg, which for a man of my height would take my BMI below 30, and make me officially ‘Overweight’ rather than ‘Obese’. Some might say that I should be aiming for a more ambitious goal, and try and get my BMI down below 25 into the ‘Normal’ weight category. However I wanted my goal to be achievable and realistic.

I found a blog article about how much weight you lose in a month, and I decided to use the information in it to check out if my 105 kg goal is realistic, not ambitious enough, or too ambitious.

The article talks about calculating my Ideal Body Weight, and working from there. And according to their chart, my Ideal Body Weight is 171 lbs or 77.6 kg.

From there I need to calculate my Excess Body Weight, which is the amount of weight I am above my Ideal Body Weight. In my case, on the day of my surgery my Excess Body Weight was 86.1 kg.

Expected excess body weight loss

Different bariatric procedures seem to have different results in terms of the amount of the Excess Body Weight that will be lost:

  • Roux-en-Y Gastric Bypass : 70% of excess body weight will be lost
  • Vertical Sleeve Gastrectomy: 60% of excess body weight will be lost

So with my Excess Body Weight of 86.1 kg, and an expected loss of 70%, then my expected loss is 60.3 kg, and my expected final body weight is 103.4 kg.

As such, my personal goal of 105 kg actually seems about right.

Expected first month weight loss

The article also says that gastric bypass surgery patients generally lose about 17% of their excess weight in the first month.

For me, 17% of my excess body weight is 14.6 kg. But in the first month I lost 10.9 kg, which is just under 13% of my excess weight.

However this 17% goal is based upon a US bariatric post-op diet that seems to be a lot more restrictive than the one I’m on. It has patients on liquids for 2 weeks, pureed food for another 2 weeks, and then soft food for another 12 weeks. Whereas my bariatric team had me on liquids for only 1 day after surgery, then pureed foods for the rest of that week, and soft foods for the next 5 weeks.

So I guess I’ve probably been consuming more calories in my first month than a typical person following the US diet. So I’m not going to worry about not hitting this 17% target.

Surgery Weight

This is one of the top questions that weight loss surgery patients ask, but it’s also one of the hardest ones to answer, because every bariatric team and dietician will have their own variation on this. And some people may need to follow a diet plan that is specifically tailored to their needs.

However, having said that, I thought I’d write down a few guidelines that seem to apply in most cases:

  • Portion size for each meal should be 85 – 170 grams of food. This is avoid stretching out the new stomach pouch. With this size of portion, people might need to have upto 6 meals a day. Some people might be able to eat slightly bigger portions, so might get by on 3 meals a day.
  • Calorie intake should be around 800-1200 calories per day. This is during the weight-loss phase.
  • Protein intake should be around 60-80 grams a day. This is to help guard against muscle loss, and help with feeling fuller and less hungry between meals.
  • Carbohydrate intake should be as low as possible. Some people suggest that the carbohydrate weight should be lower than the protein weight, but that can lead to a fairly restrictive diet.
  • Fat intake should be a minimum of 20 grams a day. This should be mostly unsaturated fats.

The main thing is to keep an eye on portion size. It’s actually really hard to judge the right size of a meal, so it might be worth using some scales or measuring spoons or cups. Also choose side plates to limit the amount of food on the plate.

Aim to have at least 50% of the plate as protein, and try to eat as many fruits and vegetables as possible. It’s OK to have a small amount of carbs as well, but these should be limited as they often high in calories but don’t provide much nutrition.

Order of eating

When eating a meal, it’s best to try and eat the different food types on the place in the following order:

  1. Protein
  2. Vegetables
  3. Carbohydrates (Potatoes, Rice, Pasta)

The order is important, as we want to consume the most important food types first, in case we get full and need to stop eating. We start eating the protein first, to feel fuller and protect our muscles. We eat the vegetables second, to get all the healthy vitamins and minerals. We then have the carbs last of all, that is if we’re not feeling full.

Tracking calories, protein, carbs, and fat

The easiest way to find out how many calories, protein, carbs and fat a food has is to check the packaging that the food arrived in. Some restaurants also publish the nutritional information on their menus.

Another way is to use a food tracking app like MyFitnessPal (or other similar apps) that have a huge database of foods and their related nutritional information. I like to use the barcode scanner to help find the correct product quickly and easily. The reports also let me know if I’m hitting my goals.

Diet Surgery

It’s six weeks since my gastric bypass surgery, and I was back in hospital today as an out-patient to have a follow-up consultation with my surgeon.

I was delighted to report that I had lost nearly 14 kg since surgery – just over 2 stones. The surgeon said that at the 6-week mark they would ideally be looking for about an 8% loss in weight, and I was more or less bang on target.

We talked about the medications and supplements I was on, and about the fact that my bloods would be checked in a few weeks before my next hospital appointment with the dietician in December. And we also talked about the vitamin B12 injection that I have to get soon.

I asked about my low levels of energy, and also about feeling cold, and she said that both of these were perfectly normal side effects of losing weight, and would rectify themselves over time.

Generally she seemed delighted by my progress, and that I could start to progress onto a more normal diet. I don’t need to restrict myself to soft foods any more, and can start to introduce new things into my diet and see how I can tollerate them.

My Story Surgery

With weight loss surgery, a lot of emphasis is put on the physical changes that happen to the body, and what toll the surgery may take on someone’s physical health. However often the emotional health of someone getting surgery is ignored.

Having bariatric surgery often means a huge change to a person’s life. Quite apart from the physical toll of the surgery itself and the recovery, there are substantial changes to a person’s diet and their relationship with food. Before and after surgery, what we can eat will change substantially, and that can be very hard for people to come to terms with.

Many obese people use food as an emotional crutch. It’s used as a reward, or as a means of consolation. We might over-eat in response to a whole range of emotions such as stress, sorrow, grief, happiness, pain, and so on. And we will often over-eat to try and suppress or drown out those emotions.

The act of getting bariatric surgery is very often only the start of the journey in dealing with a food addiction. It’s a tool to help us press the reset button for our overeating. But with it comes a whole range of emotional issues that need addressing.

Isolation and loneliness

A lot of people might feel reluctant about telling others that they’re having weight loss surgery. They might feel that people might judge them negatively for not being able to manage their weight without resorting to surgery, and maybe even feel ashamed.

Others might be open about their surgery, but still come across strange reactions from those they tell, maybe because of a lack of knowledge about weight management issues, or a lack of empathy to understand their past struggle with weight.

All this can lead to feelings of loneliness and isolation. It can feel like nobody else really understands why you’re having weight loss surgery, and what effect it might have on you. Some might not have anyone to talk to about it, and that can make the bariatric journey feel quite lonely.

Mourning the loss of food

After bariatric surgery, gone are the days when we can enjoy a hearty meal. Gone are the days when we can binge eat a whole tub of ice cream. Gone are the days when we can enjoy the same portion sizes that we’ve enjoyed in the past.

Eating after weight loss surgery means that portion sizes are significantly smaller, and the types of foods we can eat are also restricted. We have to avoid sugar or else face the horrible effects of dumping syndrome. And to get the best weight loss results our diet needs to change to be protein-rich, and also low in fat and carbohydrates. And some of the tastiest foods we enjoy are pumped full of sugar, fat and carbs!

And so, when coming to the realisation that we can no longer enjoy the foods we used to eat, we often go through a period of grief and mourning for those foods. And that period of mourning is tough – especially if those foods played a big part in our old diet.

Emotional trauma of the operation

When recovering from any operation, we tend to concentrate on the physical recovery. We talk about how well the wounds are healing, or how bad the pain is, or whether there are any complications.

What we don’t always call out is that having an operation – any operation – can cause emotional trauma. This might have been ignored or suppressed on the run up to surgery, as we concentrate on our pre-surgery diet and focus on the big day itself. And it might only be after surgery when we get home that the emotional toil catches up with us.

And it’s important to recognise that it takes time to get over this trauma. A body might physically recover quite quickly, but it might take longer to process through the emotions – such as anxiety and worry – from the surgery.

Lack of support from friends and family

Many friends and family struggle to understand the weight-loss journey, unless they themselves struggle with their weight. They don’t understand that the surgery itself is only the beginning of the journey. They might worry about the risks of the surgery itself, but once you are over that, their concern might quickly slip away.

Unless they have taken the time to educate themselves about the bariatric journey the probably can’t empathise with the ongoing weight loss journey that follows after surgery. And at social events in the future they might not fully understand they you can’t eat and drink in the same way as before.

There are some cases where friends and family – and even partners – trying to sabotage someone getting weight loss surgery. On a purely selfish level they might not want their loved ones to lose a lot of weight, because it has the possibility to change the dynamics of the relationships.

Positive changes that can help emotional health

While it’s important to acknowledge the challenges to our emotional health, and take the time to heal, there are also some ways in which we can all make positive changes to make the road to emotional recovery a little easier:

  • Find support elsewhere. If the people around don’t understand the bariatric journey then support can be found elsewhere. Some hospitals have their own bariatric support groups, and there are a couple of good online forums with people that can offer help and advice. And hopefully by connecting with others getting weight loss surgery, it can help to feel less isolated.
  • Get outside and exercise. Even if it’s just a short 10-minute walk at the start, getting outside for some fresh air and exercise will help with the production of endorphins – which help relieve stress and pain.
  • Find new hobbies and activities. After losing some weight it can often mean that people have more energy and are physically able to do more. This might be an ideal time to take up new hobbies and channel that new-found energy into something interesting.
  • Organise social activities that don’t involve food or drink. Sometimes people are a bit lazy when planning social occasions, and suggest meals out or going to the pub for a drink – activities that bariatric people might feel excluded from. So instead why not be proactive and suggest alternate activities for getting together with people – such as a walk, or a dance class, or a trip to the cinema or theatre.

Does this match your experience? Do you have some advice that might help? Do you have any experience with emotional health that you’re happy to share? Then please leave a comment below:

Sickness Surgery