5 Behaviors Bariatric RDs Recommend Avoiding

Article By: Rachel Ignomirello, MS, RDN, CSOWM, LDN

Rachel Ignomirello is a Bariatric Dietitian and Board-Certified Specialist in Obesity and Weight Management.

After many years as a bariatric dietitian, I’ve seen the good, the bad, and the ugly when it comes to patients’ journeys. Slips are a very normal part of the bariatric journey, but there are certain behaviors that patients should try their hardest to steer clear of for long-term success. Here are five behaviors this dietitian recommends avoiding:

Not listening to your surgical team.

We want your surgery and efforts to be as successful as possible. That is why preoperative education and lifestyle preparation is key. Your team is going to help prepare you with evidence-based guidelines, so it’s imperative to follow those guidelines. If a patient only listens to half the surgical team’s advice, I find that they’re only half as successful. Patients should also be cautious with online advice. It breaks my heart when I spend so much time with a patient on their education only for them to find bad advice elsewhere. When in doubt, consult your surgical team. After you’re done reading this great blog entry, you’ll even notice this blurb: “BariMelts provides general recommendations, not to be construed as medical advice. Please consult your doctor.” After surgery, postoperative follow-up is especially important. Patients who regularly keep their follow-up visits lose more weight than those who stop coming.

Taking an old vitamin.

After bariatric surgery, patients are unable to meet normal nutrient requirements due to their new, small stomach and absorption changes. Because of this, it is absolutely necessary for patients to take their bariatric vitamins. Otherwise, vitamin and mineral deficiencies will occur. No matter how patients feel, no matter how their labs look, no matter how far out they are from surgery, vitamins are a FOREVER commitment. There can be serious deficiencies if patients are not taking appropriate vitamins. This is why I recommend vitamins made specifically for bariatric patients. Patients should avoid taking regular, over-the-counter vitamins.

Eating whatever in small amounts

Some patients make the mistake of thinking they can eat whatever they want after bariatric surgery and still lose weight. Right after surgery, it may seem like this is true. However, the honeymoon phase does not last forever. Furthermore, serious gastrointestinal (GI) complications can occur if guidelines are not followed. There are certain foods and drinks that should be avoided or especially limited to reduce empty calories or GI issues: soda, sweets and desserts, chips, alcohol, and greasy/fried foods.


 Grazing is the habit of eating small amounts of food throughout the day without purpose and without portioning. This is one of the main weight regain reasons I see. It’s so easy to consume extra, mindless calories when you aren’t careful. Avoid it by sticking to your meal plan and making sure snacks are intentional. Limit mealtime or else you may end up stretching out a meal and nibbling more than you need. A lot of grazing happens because of boredom hunger, so reflect on what type of hunger you are experiencing: head hunger or physical hunger.

Drinking with meals

 Drinking while eating can cause food to flush out too quickly from the small bariatric stomach pouch. This may result in larger portions, more hunger between meals, and dumping syndrome. Mealtime drinking can be normal prior to surgery and is often one of the hardest behaviors to change. Remember: patients can drink right up until that first bite. That will help with thirst. Take small bites, avoid dry food, and stay busy for 30 minutes after the meal is finished. It becomes easier over time.

Surgery requires a lot of changes, and they do not happen overnight. As patients learn to adapt to healthy behaviors, mistakes do happen. However, it’s important to identify them early on and avoid repeating them. Learning from slips is key to staying on track to this new, amazing lifestyle!

BariMelts provides general recommendations, not to be construed as medical advice. Please consult your doctor.

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