The Important Nutrient You Should Include After Bariatric Surgery

Article By: Whittany Gibson, RDN

Whittany is a Registered Dietitian Nutritionist who specializes in bariatric nutrition counseling, providing education and support prior to and following weight loss surgery.

So, you’ve done the hard work of going through bariatric surgery, and you are crushing your basic nutrition goals. You’re losing weight as expected, meeting your protein goals like a champ, and staying well hydrated. But things are moving slow in one particular area...the bathroom. Constipation can be a real pain after surgery, quite literally. In my experience as a bariatric dietitian, this tends to be the chief complaint at most of my patients’ four week post-op appointment. If you are preparing for bariatric surgery, or if this currently sounds like something you are experiencing, this article is a must read.

Constipation can occur for various reasons following bariatric surgery. Some patients have difficulty with consuming fluids while others may find their iron-containing bariatric multivitamin to be binding. In most cases, however, it could likely be your protein choices that are the culprit. Variation in your protein choices can be key.

Following weight loss surgery, it is vital to consume adequate protein. Protein helps to support healing, supports a healthy metabolism by feeding the muscle and burning fat, promotes healthy hair, skin, and nails, and contributes to one’s overall nutrition status. Protein also keeps us feeling full and satisfied, helping to reduce cravings. Considering the amount of protein they offer per serving size, it is easy to lean toward a higher intake of animal-based foods such as meat, poultry, fish, and animal byproducts like dairy, eggs and whey-based protein supplements. These foods are excellent sources of complete protein but can also contribute to constipation as these foods are void of fiber and are slower to digest. So, why am I bringing up fiber?

Fiber is a carbohydrate that is indigestible, helps to bulk stool and eliminate waste from the body. It can also help to control hunger and blood sugar levels. Fiber is found in most plant- based foods, some containing higher amounts than others. Examples of fiber rich foods include fruits, vegetables, beans and legumes, nuts, seeds, and whole grains. The intake of these food groups can be quite low following surgery, especially in the first few months. This is due to the small size of the stomach, not allowing much more other than your protein choice.

The daily recommendation for fiber intake for women and men under 50 years old is 25g and 38g, respectively. Over the age of fifty the recommendation is slightly lower at 21g for woman and 30g for men. Here are three tips on how to increase fiber while continuing to meet your protein goals:

1) Try plant-based protein supplements. There are various plant-based protein powders that taste great and are the perfect addition to smoothies. There are countless flavor options that cater to most preferences. Most powders are a blend of plant-based proteins, such as pea protein, brown rice, or soy. By combining different plants, this ensures a complete amino acid profile. Most of these supplements offer prebiotics and probiotics that are great for promoting beneficial bacteria in the gut. You should aim for at least 3g fiber per serving. Not ready to make your own smoothies or protein shakes? You can try ready to drink protein shakes that are plant-based. Remember to check the grams of protein on the label, aiming for more than 3g fiber per serving or bottle. If you’d like to stick to whey-based protein shakes, aim for one that will provide the equivalent amount of fiber.

2) Optimize on smoothies. Smoothies are a wonderful way to pack substantial nutrition into an easily digestible drink. They are blended so there is not much work for your stomach to do, and they can be made easily into a complete meal serving as a meal replacement. Fiber sources added to a smoothie can include fruits, frozen veggies, avocado, ground flax seed, hemp seed or hemp seed powder, chia seeds, and nut butters.

3) Incorporate convenient plant-based snacks into your day. There are many varieties of plant-based, protein rich snacks. Look for snacks like roasted edamame, nut mixes, roasted beans and lentils. These will all offer a significant amount of protein, quality carbohydrates that will include a good amount of fiber, and healthy fats.

Pro tip: To optimize on fiber intake, make sure you are drinking adequate fluids to help move things along. Remember, fiber needs fluid. Aim for at least 64oz of water or clear fluids per day, more if you are active and live in more temperate climates.

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

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