Ten Bariatric Rules to Live By

This article was written for Bariatric Choice by Sharon Howard, R.D.

These are habits that should be well established during your first six months after surgery. If you want to maintain the weight loss you have achieved, you must continue following these basic rules of bariatric surgery.

1. Have 3-4 small balanced meals a day. If you struggle with meeting your protein goals, enjoy a protein shake between meals to increase your protein and fluids. Be sure the protein shake in low calorie.
2. Eat slowly, chewing food well. Be mindful of your fullness and stop.
3. Get adequate liquid intake of 48 -64 oz a day.
4. No liquids with solids—wait 30 minutes before and after meals to drink. Sip in between.
5. Avoid caffeine, carbonation, and alcohol. A smaller stomach is susceptible to gastritis and ulcer formation. The alcohol can cause liver damage.
6. Get at least 70 grams of protein a day. Put preference on protein at a meal by eating half of your protein portion first.
7. Avoid sugar and sugar sweetened foods. Sugar give you excess, empty calories. If you had the gastric by-pass, you may get dumping symptoms.
8. Don’t go back to SLIDER foods. Crackers, chips, ice cream, candy and other easy to mindless nibble high carbohydrate high fat foods are off the list—forever.
9. Stay with your vitamin regimen. Your digestive system has been permanently altered, and some nutritional deficiencies can develop.

• Multivitamin: With your limited intake, you are at risk of missing certain nutrients over time. A balanced multivitamin will cover the essentials, almost. You may be allowed to swallow whole vitamin pills, but if you like the chewables, its more likely they are dissolved in your smaller stomach and intestines .

You need Calcium Citrate in addition to the multivitamin (or an all-in-one). Citrate is absorbed without stomach acid, so it is more available. 1200 mg in 2-600 mg doses. Your bone health is important.

B-12: The alterations to your digestive system may have changed your ability to absorb vitamin B-12. So, a sublingual B-12 500 mcg daily is recommended. Be sure to have lab work to check B-12 yearly. You could also opt to get B-12 shots. A B-12 deficiency can cause irreversible nerve damage.

Vitamin D: Although your multivitamin supplies Vitamin D and or your calcium tablets, you still may be deficient. Your doctor needs to check your blood levels and can prescribe extra doses.

Iron: You will need to check your iron status, and may be prescribed iron supplementation.

• Take Calcium and Iron (as well as multi-vitamins) 4 hours apart. The iron and calcium bind together and become unavailable to your body.

10. If and when you change primary doctors, be sure he is aware of your bariatric surgery and performs bariatric blood studies yearly.