Alabama Bariatrics & Minimally Invasive Surgery

Bariatric Diet Orbera Gastric Band Sleeve Gastrectomy Gastric Bypass

W. Jay Suggs, MD, FACS, FASMBS
Madison, Huntsville, and Decatur
Phone: (256) 274-4523
Fax: (256) 203-8791

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The Farm Fresh Diet

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 ~A common sense, no-nonsense approach to eating healthy and healthy living. Eat the way our grandparents and great-grandparents did.  Sometimes, the old ways are the best ways.~

The hardest part of a diet is sticking to it. This diet plan seeks to be a reasonable eating plan consistent with lifestyle changes for long-term success with weight control, whether you’ve had bariatric surgery, an Orbera intragastric balloon, taken diet medications, or no interventions at all. In the long run, I never so no to anything. Moderation is the key, as well as identifying your diet struggles and addictions. Have a problem with carbs, fast food, or alcohol? Then, those are areas you’ll need help with avoiding or moderating. Having someone hold you accountable, or avoiding places that promote your eating of those things is important. For bariatric and non-bariatric patients, the principles for keeping the weight off is the same.

What this diet is:

  • Lifestyle change
  • Common sense
  • Something that you can stick to
  • Delicious and satisfying

What this diet is not:

  • Faddish
  • Demanding of organic, gluten free, grain free, or vegan eating
  • Impossible to do long-term
  • Expensive
  • Radical

Keys to Diet Success:

  • Must be realistic and achievable
  • Reasonable, do-able lifestyle changes
  • Have a daily eating plan
  • Exercise regularly and intensely
  • Improved health and fitness is more important than a number
  • Maintain the weight and level of fitness that you worked so hard to achieve

Why the Farm Fresh Diet?

Obesity, irritable bowel syndrome, chronic headaches, and fibromyalgia barely existed 3 generations ago.  So, what has changed?  How did our grandparents and great-grandparents eat and live?  If you are fortunate enough like me to still have living grandparents, and to have known great-grandparents (and even great-great grandparents), you may have some insight into this question.

Have you ever looked in the mirror at your teeth?  We’re built with canines for tearing meat, incisors for chomping vegetables, and molars for grinding grain.  We’re designed to be omnivores.  We’re not intended to eat just meat, or just vegetables, or avoid grains like some diets recommend.  Our own mouths are telling us what we’re supposed to eat.  And our tummies are telling us not to eat all the processed foods and simple carbs and sugars that are a mainstay of the post-modern American diet, or diaita Americana as I call it.

Historically, hunter-gathers including Native Americans ate meat, fish, nuts, fruits, and vegetables.  Some later cultivated grains such as corn and wheat.  They grew potatoes and other hardy crops. Mummified Neanderthals have been exhumed with berries, meat, and grains found in their stomachs.  Archaeological evidence, as well as ancient writings such as the Bible, give us insight into how our ancestors ate.  And it did not include potato chips and drive-thru’s.  Bread and meat and dairy have always been part almost every culture in the world.

Many of my great-grandparents were American farmers:  Gillilands, Robinsons, Sidenstrickers, Robinsons, Carmichaels, and Pullens.  There was not a hint of obesity in any of them.  My great-great grandmother “big mama” only weighed 98 pounds and lived to be 98 years old!  Around the turn of the century and before the war, my grandparents worked hard and enjoyed the fruits of their labors.  They ate well, including meat, vegetables, bread, dairy, corn, and other grains.  What they did not have was all of the fast-food, prepackaged processed foods, and refined sugar that we consume today.

My grandparents came to age during the Great Depression.  Food was often hard to come by.  At that time, they did not have much meat.  But they did eat a lot of beans, cabbage, corn, and grains.  They had no processed food, and very little canned foods (although my grandmothers often did the canning themselves).  Fruits were a special treat, rarer than desserts are for us now.  They did not eat out, did not eat fast food, and did not snack.  They walked most everywhere.  Riding in a car was a luxury.  The kids worked in the fields while on summer break from school.  There was no TV, no internet, and no video games to turn them into coach potatoes.

Old photographs tell the story the fitness of my grandparents and great-grandparents.  In their youth, they had slim waistlines.  But I remember them not as trim and lithe, but as pleasantly plump.  After World War II, processed foods, modern cuisine, and the automobile began to have its impact on them as well as their children.  Obesity began to run rampant.  The jogging craze of my youth somehow missed my grandparents, parents, aunts, and uncles.

The Farm Fresh Diet

Phase I – Induction

This is the hardest part of the diet, and will require will power and attentiveness to the details of the diet.  If it’s too tough, it’s ok to end the induction phase early.  But, if you can stick to it, it will really jumpstart your weight loss.  Men should expect to lose 5 pounds in the 1st week of the Induction Phase, and women should lose around 5 lbs in the first 2 weeks.  Weight loss will definitely slow down after that.

This diet is not a calorie counting type of diet, but based on the types of food in your diet, avoiding problematic foods, and maximizing weight loss with exercise.  Accountability, and getting back on track when you fail, are essential features.

In this phase, we’ll eliminate certain foods.  It’s important to eliminate all refined sugar.  Pretty quickly, you’ll find out if you have a sugar addiction.  Likewise, you may have an addiction to simple carbs like potato and corn based processed snack foods.  After coming off simple carbs and sugars, your blood sugar may transiently drop.  You may feel awful and be experiencing a non-bariatric version of the dumping syndrome, but avoid the temptation to treat your symptoms with more carbs or sugar.  That will just keep you in this vicious cycle.  I have found that a little caffeine may ameliorate some of those symptoms.

Optional:  liquid protein diet for 1-2 weeks.  Basically, one would substitute a protein drink for a meal.  Do at least 2 meals a day this way, and all 3 if you have the will power.  Otherwise, one meal could be a healthy meal of solid food which still fits the Phase I criteria.  You can make the protein shake yourself, from a powder, or drink it pre-prepared.  Come to the office to determine which protein shake may work best for you or go to our Recipes page and check out some delicious smoothies to try!

In the Induction Phase, you must eliminate bread, potatoes, pasta, and rice.  Even whole grain bread and pasta, and brown rice are out.  Carbs are okay, just not these during the Induction Phase.  A good substitute for these food staples are grains like quinoa and barley, and “riced” or “mashed” cauliflower.  However, be careful of adding too much butter or oils.  Try adding a variety of spices including garlic and salt to make these substitutes tastier.

You must also eliminate all snack foods and desserts.  Yes, I know that’s hard to do, but in 2 to 3 days after you kick the sugar addiction, you will be pleasantly surprised that you could do it.  Since your intake of fresh fruits and veggies is unlimited, snack on fruits, veggies, and a small amount of nuts such as almonds and cashews instead.  Be careful; the calories in nuts can really add up quickly.  And no peanuts are allowed (they are actually legumes).

Although this is not a low-fat diet per se, choose leaner cuts of meat, and use added fats and oils sparingly.  Eggs are also ok, and actually good for you, but use only egg whites during the Induction Phase of the Farm Fresh Diet.  Skim milk is rather nutritious and filling and can be used to make a satisfying shake or smoothie.  However, no cheese is allowed in the phase.

It’s important that you do not eat out during this phase.  In fact, it’s probably best to avoid any travel during the Induction Phase because you’ll probably lose control of your diet while on the road.  Have you ever thought about bringing your lunch to work or school?  A novel idea in modern times, but try it. 

There are two more rather austere aspects to the Induction Phase of the diet:  No alcohol and no sweets.  However, contrary to other popular diets, caffeine is not off limits.  The possible negative effects it may have on your weight loss are rather minor, and really not well substantiated.  And, what’s better for you as a treat…a little espresso or cup of coffee with artificial sweetener and skim milk, or a donut?  If a fully caffeinated diet soda is what it takes to get you through the afternoon till your healthy supper, then go for it.

There are two really good ways to keep yourself accountable to your weight loss and healthy lifestyle goals.  One, keep a food diary.  Yes, you really need to write down everything you eat, as well as the amount, and the time of day that you eat it.  You’ll also later need to add a notation about whether you were really hungry or not when you ate it, and was your hunger satisfied.  And look for patterns of when your hunger recurs, or if you experience symptoms of the dumping syndrome.  In medical science, we put great emphasis on collecting data.  But, you must also analyze the data if you want to improve outcomes.  The same applies to improving your weight and lifestyle.

The second really good way is to find a weight loss and/or exercise partner to not only encourage you, but also to understand your struggles yet hold you accountable to continuing to meet your goals.  Some people do better with a coach, for example a personal trainer or nutritionist, to hold them accountable rather than a partner. For bariatric patients, these partners can be found at your local support group.  Also, church members and your neighbors may fit the bill.  Avoid family members, however, as they can often be overly critical and sometimes sabotage you.

Another important facet of the Farm Fresh Diet is exercise. Exercising will synergize with your dietary changes to improve your weight, health, and fitness.  Exercise recommendations are listed in a separate tab, but in general, one needs to exercise 3 to 4 times per week at a time of the day when you have the most energy.  This may be first thing in the morning for you, or after work.  Some people are able to go to the gym during their lunch break.  You need to get your heart rate up and sweat.  It should be somewhat strenuous and tiring.  For weight loss, it’s important to do aerobic types of exercise such as walking, running, cycling, and rowing.  Do not do weight lifting in this phase.  Note that your weight may not change as much as you would expect, but your waist size will decrease as you build muscle with aerobic exercise.  It would not be uncommon to put on 10 pounds in muscle, yet lose even more in fat, as your strength and endurance increase.

Standing for long periods of time and lots of walking at work don’t count toward exercise.  Although you may be tired after doing it, you’d be surprised at how little calories those activities actually burn.

Keep a log of your exercise as well. If you run or walk, there are lots of apps for smart phones that will keep track of your mileage, time, and even calories burned.  You can share the data with your friends to keep you motivated and celebrate your successes.

Phase II – the Diet

You may not have enjoyed the first phase of the Farm Fresh Diet, but you can celebrate your successful completion of it and your awesome weight loss!  Now comes the really exciting and satisfying part of the diet, Phase II in which you’ll discover healthy and delicious foods that result in weight loss and feeling better.  You’ll also continue to feel better about yourself as you continue to meet your goals and improve health and fitness.  And, if you fall off the wagon, there's still hope. You can get back on and continue to meet your goals.

The length of time you are on this phase of the diet depends on your weight loss goal.  Remember, you need to be realistic about how much weight you can expect to drop.  Long term maintenance of your weight and improved health is more important than hitting the lowest weight possible.  A reasonable goal would be to lose 1 pound per week.

Phase II  the Diet1To maximize your success, make a commitment to learn to cook.  Not only is eating something that you produced yourself rewarding, it cheaper and healthier than the equivalent pre-made or restaurant food.  If done right, it’s also tastier.  And, it’s great fun for the whole family!

At this time, you can add back whole grain breads and whole wheat pasta.  A small amount of potatoes is okay, but consider potato substitutes as listed in the next section. You can add back some alcohol in moderation, but no more than 2 servings per week (a serving is 12 oz. for beer and 4 oz. for wine).  Choose light beer over regular beer, and keep in mind that craft beers may have substantially more calories.

You can have an indulgence such as pizza (but not the whole pizza!) or a burger once per week, but remember that too much indulging will subvert your dieting efforts.  You may have dessert once per week.  However, 2 pieces of dark chocolate per day is also allowed.  Make sure it is not milk chocolate and does not contains added nuts.   This, of course, excludes candy bars. Dried fruits are very high in calories, so avoid those as well except as a special indulgence rather than chocolate.

Now that you’ve kicked your sugar addiction, and no longer desire sugary drinks, be sure to drink plenty of water.  People who formerly did not like the taste of water will now be refreshed by a cold drink of water.

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Breakfast should consist of eggs, lean proteins, yogurt, and fresh fruits rather than the traditional diaita Americana breakfast of sugary cereals and pastries.  Whole grain cereals are okay, but may not be optimal for weight loss.  Use skim milk.  If you are having a hard time finding palatable selections for breakfast, or if you're short on time, consider simply drinking a protein shake or smoothie for breakfast.  I often drink 12 oz. of V-8 juice for breakfast.

Limit eating out to 1 lunch and 1 supper per week.  And don’t go to a buffet.  Bring your lunch to work or school.  Emphasize cooking at home.  Also, fried foods, processed foods, packaged food, and snack foods are still off limits.  This includes french fries, chips, crackers, etc.

Increase the amount of grains and fresh vegetables in your diet.  Frozen, and even canned, vegetables are acceptable.  However, vegetables from a Chinese restaurant, or incorporated into a casserole such as green bean casserole, is not much different from eating a pizza.

Eat fish or seafood at least 2 to 3 times per week.

Don’t add sauces.  They can add a tremendous amount of calories and simple sugars.  Add herbs and seasonings as well as a little butter or olive olive.  Use only light salad dressings.  No creamy dressings.  Oil based dressings are better.  All salad dressings should be used in moderation.  Toss the dressing into the salad well.  If the dressing pools at the bottom of your bowl, you’ve used too much dressing.

The list of substitutes, the cooking tips, and the eat/don’t eat lists below will help you make healthier choices, yet also create delicious foods.

Be a smart consumer and dieter.  Foods that may be advertised as healthy, may actually be nothing of the sort.  For example, don’t get fooled into thinking that wheat bread is healthy.  It’s just processed flower.  Look for stone-ground whole wheat instead.  “Healthy” chips such as lentil chips may have potato starch listed as the first ingredient, with less than 10 percent made from lentils! Look at the first ingredient on the package.  Is it flour or sugar or potato starch?  Don’t eat it.

Exercise remains a critical component of weight loss and fitness, as in Phase I.  You should continue to increase the amount of time you exercise and the degree of difficulty, such as running longer and faster.  It becomes easier and more enjoyable as as your weight drops and your cardiovascular stamina improves. 

Continue you accountability with a diet and exercise partner or support group or a “coach”.  Diet and exercise logs will continue to be useful for meeting your goals.  And weigh yourself 2 to 3 times per week. Don’t forget that if you periodically fail, all hope is not lost.  You can get back up again.

The Farmer's Plate:

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Phase III – Your New Lifestyle

You did it! You reached your weight loss and fitness goals. Now is the phase when you will maintain your weight and level of fitness.  This phase, your new lifestyle, is the rest of your life.  So, make sure that your goals and new diet habits are realistic.

Nothing is off limits per se, regardless of the calorie count.  As long as the food is fresh, or cooked with limited amounts of added fat and sugar, you can eat it.  Beware of canned and prepackaged fruits and veggies, added sugar, and vegetables cooked in a restaurant as they usually have a lot of added fat and even sugar.

Weigh frequently, 2-3 times per week, at the same time of day and with the same amount of clothes on.  Do it before you exercise, or after, but be consistent so that you will get a true picture of your weight.  It’s not uncommon to lose a couple of pounds during an intense aerobic work out.  Weighing weekly is probably not enough to keep yourself accountable, but weighing every day is probably counterproductive. 

Continue to use the Farm Fresh Plate.  Continue to use healthy substitutes.  Have a daily eating plan, such as not eating any sweets until after supper, or avoiding juices at breakfast, or not going back for seconds, or never eating fried foods at lunch.  Yes, it may sound a bit obsessive-compulsive to plan what you will eat every day a week in advance, but this will keep you from carelessly and insidiously packing on the pounds.

Eat:

  • Meat
  • Dairy:  eggs, butter (in moderation), milk, yogurt, etc
  • Fresh fruits and veggies
  • Whole grain breads and pasta
  • Potatoes (in moderation)
  • Grains such as quinoa, barley, and millet
  • Beans and lentils
  • Soups with clear broth
  • Fish and seafood
  • Sautéed foods, particularly in extra virgin olive oil

Don’t Eat:

  • All non-fat
  • High fat
  • Processed foods
  • Canned fruit
  • Too much starch
  • Only protein or meat instead of vegetables
  • Creamy soups
  • Fried foods
  • Fast food

You may eat some processed and snack foods in this phase, but do it in moderation.  Alcohol, desserts, and other indulgences should also be in moderation.  Be careful of what you eat on vacation or during the holidays, or be prepared to lose that extra 5 pounds when it’s over!

Cooking Tips:

Can you boil water?  Then you can cook!

Add

  • Spices and seasonings
  • Salt
  • Oil, especially olive oil
  • Butter (sparingly)
  • Milk
  • Garlic and onions
  • Veggies

Don't Add

  • Too much salt
  • Too much oil
  • Margarine
  • Coconut milk
  • Sauces from a can or jar

Grilling Tips:

  • Go low fat (add bacon to the lowest fat ground beef for some extra flavor in your burger).
  • Use lean beef, pork, and chicken.   
  • For better flavor, don’t grill previously frozen meats.
  • It’s not that hard to grill fish and shrimp.
  • Grill vegetables and fruits.

Set a standard for yourself as to how often you will eat out at a restaurant, and what kind of foods you will allow yourself. You may want to continue to limit eating out to once or twice per week, unless you are traveling or have a business lunch.   Set limits, like indulging in either an appetizer or dessert, but not both.  Limit yourself to one serving of alcohol, and order not more than one side item.  Select a fish or seafood option 1 out of 3 times eating out.  If you eat pizza or a burger, make sure you also order a salad instead of having fries or more pizza.

Stay committed to cooking and eating at home.  Family meals are the cornerstone of the traditional American family. You should teach your new healthy lifestyle to others, including your spouse and children.  Your family can potentially be the best support system for your new healthy lifestyle, but they have to understand it, and buy in to it.

Have a plan in the event of recidivism and weight regain.  Go back to Phase II or even Phase I.  But whatever you do, don’t give up.  You can get the weight back off.  It’s not hopeless. You are not a failure.

Exercise is very important not only for losing weight, but also keeping it off.  Make a goal, for example, of working out 3 hours per week in a gym or running 15 miles per week or walking 3 miles per day.  At first, it will be very difficult, exhausting, and even demoralizing when starting a new program.  But don’t feel like a failure.  Keep at it, and you’ll be surprised what you can do. See separate exercise tab.


Basic Food Prep Techniques:

  • Keep it simple.
  • Use veggies in unexpected places, like adding carrots to spaghetti sauce.
  • Make healthy substitutions, like sliced jicama with hummus or guacamole rather than pita or chips; or sweet potatoes and other root vegetables for potatoes; or mashed cauliflower for mashed potatoes; or grains such as quinoa, barley, and kasha for potatoes, rice, or pasta.
  • Make whole grain substitutions in foods such as pasta and breads.
  • Add spices rather than excessive butter, cream, and sugar.
  • Use herbs, and even vegetables, from your own garden.  It always seems to taste better and be more satisfying if you grew it yourself.
  • After cooking in a pan, drain out the grease.
  • Avoid the cream or sauces in making soups.  Add ground cashews or almonds to make it creamy
  • Steam, bake, or grill instead of frying.
  • To maximize flavor, don’t overcook meats or veggies.  Otherwise, you may have to add some sauce to make it palatable. Have fun!