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bariatric diet

Your Bariatric Diet After Surgery

What We Can Learn From Farmers

Millions of Americans suffer from obesity, and the condition can cause countless challenges both on and off the scale. While there are ways to temporarily lose weight and keep it off, the only scientifically-proven way to fight obesity for life is through weight loss surgery. If you have made the choice to get bariatric surgery, you are not alone. Nearly 600,000 people undergo weight loss surgery annually, and most people report a decline in health-related conditions and report overall higher quality of life following their procedures. The biggest challenge, however, comes after the surgery. Knowing what to eat after bariatric surgery is critical to maintaining a healthy weight for life.

The Diet and Exercise Trap

When most people start thinking about losing weight, the first thought is, “I’ll just join the gym!” While exercise is a vital part of an overall healthy lifestyle, exercise is only part of the equation. Some would argue that it is the smallest part. When most people embark on an exercise routine, they fail to take into account the relationship between food intake, exercise and weight loss. Here’s a simple equation to illustrate the formula:

Calories in is greater than calories out= weight gain

Calories out is greater than calories in= weight loss

Without getting into an overly technical explanation of total daily energy expenditure, let us give you a clearer picture of why exercise alone isn’t enough. The equation seems simple enough, doesn’t it? Here’s where it gets tricky. (1)

The average 200 pound, 40 year old, 5’5″ woman needs about 1,894 calories a day to survive. Now most people would think this meant that she would need to burn nearly 1,900 calories at the gym to lose any weight. That would be quite a few hours on the treadmill! What this number actually means is that 1,894 is the amount of calories her body burns just to keep her alive. If she sat in a chair and stared at the wall all day, she would still burn those calories.

Let’s say the same woman takes in 3,000 calories a day, more than 1,000 than she actually needs. This is where the weight gain happens. In order to lose weight, she would simply have to take in fewer than 1,895 calories daily. Since each pound of fat equals 3,500 calories, simply cutting out 500 calories a day would mean she would lose one pound a week. Cutting 1,000 calories a day would mean she would lose two pounds a week or nearly 100 pounds in a year. (In theory, but since she only weighs 200 pounds, that’s not likely. The body would slow down her loss after a while.)

She can achieve this deficit of 500 calories a day with a combination of diet and exercise. She can cut out butter on her breakfast bagel and save 250 calories, and work out for one hour at the gym and save the other 250, for example.

Sounds simple, right? Well, not quite.

Challenges to the Diet and Exercise Formula

If simply eating a dry bagel and going to the gym were all that were needed to lose weight, everyone would be doing it, right? There are, however, some challenges that make weight loss difficult for most people. Portion control is the biggest one. Americans, unfortunately, have been socialized to eat portions that are far larger than what the body requires. If you go to most fast food restaurants and order a cheeseburger, what you get is a huge burger that contains about half a day’s calories. Add to it fries and a drink and you have a diet disaster.

There are fast food restaurants that sell tiny burgers that we refer to as “sliders.” We love these places as well, but it is typical for a person to eat about five or six of those. The correct portion size would be one of those sliders.

Because we are accustomed to eating so much more than we need, the whole idea of exercise at the gym is futile if we then eat five times as much food as we need. This obstacle is removed with bariatric surgery. Patients who have undergone the gastric sleeve or gastric bypass simply are unable to eat a massive cheeseburger, eight sliders or a dozen chicken wings. They enjoy built-in portion control, making weight loss easier for them. With portion control no longer a factor, learning what to eat is the next critical piece of the weight loss puzzle.

The Gastric Bypass Diet: It’s About What You Eat

In Dr. Jay Suggs’ book, The Farmhouse Diet, a Common-sense, No-nonsense Approach to Healthy Living and Healthy Eating,” he encourages people to eat the way our grandparents did, before obesity was an epidemic and eating became such a complicated affair. Farmers ate for sustenance, using foods that were seasonally found on the farm to provide healthy and balanced fuel for their work. Farmers worked for hours in the fields, sometimes burning thousands of calories a day.

The average farmer walked about 10-12 miles daily in the course of their work, and their food was used as fuel. Farmers lead active lifestyles by design—there was no driving to pick up a prepared meal. Everything was cooked fresh using the freshest ingredients, making obesity all but unheard of.


Protein are the building blocks of the muscles, and enjoying a diet high in protein will help boost your weight loss and keep obesity at bay. Patients should strive for 60-80 grams of protein per day, and this can be found in the form of nuts, beans, eggs, red meat, lean chicken breast and certain fish. Protein is critical for preserving muscle mass which also helps to keep your weight under control. In addition, it is critical for healthy hair, skin and teeth, and by getting enough protein, you can avoid the thinning hair that many post-bariatric patients complain about. (2)

On the farm, the family ate fresh eggs, beef, chicken and yogurt. Working all day to plow fields, tend to animals and lift hay bales kept their muscles strong. While most of us don’t work on farms, we can enjoy a high-protein diet along with regular exercise to manage our weight loss post-surgery.


Incorporating vegetables into your diet is one of the best ways to stave off weight gain and to maintain a healthy weight post-surgery. Aim for 4-6 servings of vegetables each day, focusing on leafy greens and cruciferous vegetables like broccoli, Brussels sprouts, cauliflower, cabbage and bok choy. (3)

Consider a leafy green salad at breakfast, add a side of coleslaw with low-fat mayonnaise to your lunch, try roasting broccoli with dried parmesan cheese for dinner. The key is to add something green to every meal to ensure you are getting your daily allowance of vegetables.

Since farmers grew a lot of vegetables, their diets were heavy on them. Cabbage soup, boiled greens and raw vegetables were staples in their diets.


One of the most overlooked parts of the bariatric diet is hydration, namely water. Bariatric patients are encouraged to drink about 8-10 eight-ounce glasses of water a day, which can seem pretty daunting at first. Post-surgery patients are cautioned to cut their caffeine intake, avoid drinking during meals and steer clear of alcohol, which is high in calories. In addition, drinking water helps to fill your stomach and stave off hunger longer.

Many post-surgery patients find that keeping a large bottle on their desk at work and periodically filling it throughout the day is one of the most effective ways to get in enough water each day.

Our farmers certainly had to drink a lot of water to keep hydrated when working in the fields all day, so following their lead will help you to enjoy long-term weight loss.

How to Eat After Surgery

After surgery, it is important to change the way you eat in addition to what you eat. First, eat slowly, chewing your food thoroughly before taking another bite. Try to aim for 4-6 small meals per day instead of three large ones. (4)

Stop eating as soon as you are full. Some patients will continue eating until they become physically ill. Learning to eat with your new stomach is a challenge, and it is easy to slip back into old eating patterns. Making a rule to only eat at a table will help you to be more mindful of your eating and reduce the likelihood of weight gain.

Remember our farmers? They didn’t snack all day. They typically ate their food and continued to move their bodies throughout the day until the next meal.

Eating after weight loss surgery can be challeging. By following lessons from The Farmhouse Diet we can adopt new, healthy habits that will help keep the weight off for good.

At Alabama Bariatrics, we have a team of nutritionists who can help develop an eating plan that works for your life. We have worked with patients of every age and background, and our caring staff will treat you with the dignity and respect you deserve and motivate you in your journey toward a transformed and healthy new life. Contact us for a free consultation today.