Diets after Bariatric Surgery

Going on a Diet after Bariatric Surgery ?

Why would someone that has had Bariatric Surgery need to go on a diet?

For most surgery is the “last resort” and you wouldn’t need more diets to maintain your weight loss because you had surgery….right? Part of the answer to this question is addressing weight loss expectations after Bariatric Surgery. Has the patient followed their Surgeons plan? Is the patient consistent with prioritizing protein? What about carbohydrates and fiber intake? Then there’s the Dietary Fat discussion. With every Surgeon having a different plan sometimes it can get confusing real quick.

To Clarify a “Diet” is just you Nutrition methodology for fueling your body

Surgeons have been treating Obesity with surgery for a few decades now, there is much more data on post-op surgery patients. One common thing seen is regain, which can be scary for Bariatric Post op Patients. This is an aspect that many Surgeons and Dieticians do not fully explain to their patients. Not only do patients see regain , less than 5% of patients will lose enough weight to reach a BMI of 25 (consider the healthy range on the BMI chart).

The GOOD news is that we see 90% of patients lose over 50% of their excess body weight. Bariatric surgery continues to be the most effective treatment for the disease of obesity.

Nonetheless, there is a honeymoon year after bariatric surgery and when this phase of the journey begins to wear off, patients do wonder what else they could try to lose more weight or lose regain.

What do successful patients eat ?

Now we have research to help us with is studying the habits of patients who have maintained their weight loss for years after surgery. There are two studies that have great information on the subject.. One is the LABS-2 Post Operative Variables and Weight Change 3 Years after Bariatric Surgery. The other is a poster from a ASMBS meeting entitled Factors Distinguishing Weight Loss Success and Failure at 5 or more Years Post Surgery

These studies show overlap in habits reported by successful patients. To summarize some of them patients reported:

They focused on protein first

Ate set meal times (instead of grazing)

Kept follow up appointments

Schedule daily movement

Ate at home more than eating out

Ate mindfully

Attended support groups

Comparing diets after Bariatric Surgery

With keeping the research in mind and understanding that regain affects up to 98% of Bariatric Patients, we will now look into popular and mainstream diets. Some diets will conflict with bariatric surgery guidelines. Others can work with considerations in mind. My recommendation is to work with a Bariactive Nutrition Coach he or she will help you consider what is the best fit for your nutrition care after surgery. Different surgeries require different nutrition strategies and typically the 1200 calorie diet “for life” is simply not a good idea for Bariatric Patients. There is various factors to consider in decieding what the best “Diet” is for your lifestyle.

Here is a Summary of some popular diets

Keto - Recommends 80% of Calories from fat

Not a great idea as it is not consistent with prioritizing protein

We know most body fat stored comes from dietary fat intake

Not Bariatric specific

Intermittent Fasting – Specific & Scheduled eating and fasting times

Time restricted eating may not allow for adequate protein intake

Food volume per meal could be an issue for some patients

Not Bariatric specific

Noom – Categorizes food into Green , Yellow & Red

Some Green Food may be lower in protein

Some yellow foods may be quality protein

Colors may ultimately cause confusion to Bariatric Patients

Not Bariatric Specific

Weight Watchers – Uses a personalized point system. Assigns point values to food and provides a zero point food list

Learning a point system takes time

May be confusing

Not bariatric specific


Here at Bariatric Nutrition we recommend a “Diet” aka Meal Plan based on Macronutrient ratios customized for the individual. This can be customized for any stage of the Bariatric Journey. Our method always prioritizes protein and use carbohydrates and fats as variables depending on individual goals. The simple truth is adherence to a meal plan is highly dependent on individual preferences. There is no one plan that is going to work for everyone and that’s why BariActive Coaches work with clients to develop their own individual meal plan based on Macros & Activity data. Our goal at BariActive Nutrition is for our clients to be able to achieve their Health & Nutrition goals long term by educating them on nutrition fundamentals and teaching strategies for sustainable success.

Author: Jim Laur

Jim is a successful gastric sleeve patient (09-19-17) as well as a NASM Certified Nutrition Coach and Founder of Bariactive Nutrition .

Certified Nutrition Coaches are not medical professionals e.g. Registered Dietician or Physician therefore BariActive Nutrition Coaching Services are not regarded as medical advice. Coaching Services at BariActive Nutrition are a combination of accountability , evidence based nutrition education , and weight loss processes & strategies that are tailored to the individual that produce results for our clients. Please consult with your Doctor before making any changes to your Meal Plan including but not limited to : Caloric Intake, Macros, Food Volume, Vitamins & Supplements.

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