BARIATRIC EATING (AND COOKERY) IT’S NOT JUST ABOUT EATING LESS | Doctor Neil Floch

BARIATRIC EATING (AND COOKERY) IT’S NOT JUST ABOUT EATING LESS


and a warm welcome from me. I am delighted to be part of this new community.

My name is Carol Bowen Ball and I am not only a Bariatric Cook, but also a WLS Patient (I had a bypass over 10 years ago). Since then I have made it my mission to pass on good eating advice and recipes for post-op life. I have learned a good few things in the interim period. I would like to pass these on to you, beginning with a general overview and some of the things I have learned, plus an update on what to do about possible lock-down regain that may have occurred in the last few weeks

osing and keeping the pounds off after weight-loss surgery largely depends not just on eating less, but upon eating the right foods, with the right nutrition, in the optimum amounts. But finding the foods you can, and moreover want to eat, and making the transition from your ‘old life’ to a healthy new one, can be challenging. Even if you know a great deal about nutrition, putting this into practice is hard.

rom the early post-op days on Fluids and Soft Foods, moving onto what I call ‘Food for Life’, it is important to practise ‘mindful eating’, making sure that you eat right with every bite.

ronically, this can often be easier in the early ‘honeymoon’ stage after surgery, when you might not have any real appetite or hunger for food, than the later stages, although there can be the danger of not eating or drinking enough. During this time you can maximize your weight-loss results by eating right and exercising regularly.

rotein will be your greatest priority during this time and it is fair to say will always be. Most patients are told to aim for 70g per day to facilitate good healing. Check with what the recommendations are from your team.

arbohydrates come next, and although these vary by surgical procedure as well as medical issues (like diabetes), 130g per day is often what is quoted in bariatric surgery scientific literature. The aim here is to ingest many of these as complex ones, found in plant-based foods, rather than as simple sugars. This figure may sound overwhelming and most likely won’t happen in the first few months after surgery, but it is certainly something to aim for at least 6-9 months post-op. Gastric bypass patients will also have to watch sugars for fear of ‘dumping syndrome’. I personally rarely have a dish with more than 7-10g total sugar per hit to reduce this risk.

ats, often and mistakenly labelled the ‘bad guys’, also have a place but vary enormously according to procedure, and the mantra here is to steer clear of too many saturated fats, keeping the level down to under 3-5g fat per 100g.

dd to that advice about eating ‘5 a day’; keeping up the fibre; hydrating well with at least 2 litres of water (but not just before or just after eating); not forgetting the daily taking of multi- vitamins, calcium and other supplements; and you have a regime that can be more than a little testing.

t has been my challenge as a food and cookery writer to develop recipes for all these stages of post-op eating, taking some of the guess-work out of cooking on a daily basis. The recipes, on my website, www.bariatric cookery.com and in my first 2 books ‘Return to Slender…after weight-loss surgery’ and ‘Return 2 Slender…Second Helpings’, and more recently ‘The Bariatric Bible’ have all been devised and tested to not only work (a minimum requirement!) but to also adhere to these nutritional guidelines and to be deliciously tasty too.

ome are very simple and will not test even the most basic or inexperienced cook and others will offer ideas for those who like to entertain. All have been considered carefully in terms of cost, seasonality and cuisine so offer the virtues of variety. They also have been devised to suit the needs and appetites of everyone so that mealtimes can be a pleasant experience with family and friends.

hey have been classified with a traffic- light coded system as suitable for the Red/Fluids Stage; the Amber/Soft Foods Stage; and finally the Green/Eating for Life Stage, to guide a patient on the journey of eating well again. People’s tolerances vary greatly; so while these recipes may be recommended as being appropriate for a specific stage, only the patient will know for sure when they can best be tolerated.

ach recipe also has a nutritional analysis breakdown so that you can keep a check on the calories, protein, carbohydrates, sugar, and fat. Used in conjunction with a food tracker you can see how your levels are working out over a day and week.

ecipes are however one thing and general eating is another. I would still advocate that patients become avid, if not fanatical, back of pack or label readers. Understand and be aware that food manufacturers add sugar, salt and fat to foods to make them taste better. Check out the best nutritional options – take a little extra time in the supermarket to find them; speak to other bariatrics on websites and forums for advice; and pass on anything you find that is good at support groups for everyone to benefit.

hat have I learned since my own surgery? Well, that I have a new regime to follow. I have forgotten about dieting and the old destructive starve and binge ways of old. I now have a diet, but I’m not on a diet. This took some time to get right. I followed the 3 stages of eating after surgery in a relatively relaxed (not overly stringent) way – there doesn’t have to be a race to the tape, indeed there isn’t a finishing line! I considered myself to be weaning rather like a baby and realized that some days some things suited, other days they didn’t. But I always did retry and, as a result, my diet has great variety.

 have learned to practice ‘mindful’ eating, trying to eat only when hungry, not when bored, sad, or angry. I eat slowly and savor every mouthful and I chew, chew, and then chew some more. I have quite easily slipped into a healthy 3 meals and 2 snacks (if required) regimen. I also sit at the table to eat with a knife and fork without distractions. No more sitting on the sofa with a packet of something or other, watching TV, and then wondering who ate all the goodies a little while later!

 have also adhered to the advice given to me by my dietician about not grazing, and to ease up as time has gone by with sloppy/slider foods that won’t help me feel full for long. And, (this has come as a surprise) I have started to move much more. I have found the best exercise for me is the one that I will do. So, I walk, dance, swim and occasionally hit the gym.

ome of my tips for success include cooking for 1 to serve 2. If I didn’t then my husband would eat 11/2 portions and be sitting on the gainers bench well away from me on the losers. I also use a smaller side or salad plate for myself so that portion control is more manageable. I use a bariatric portion plate and bariatric cutlery to help with this so that I not only get the food choice right but also the correct proportions for a bariatric patient.

 load it up with half the plate comprising of protein and then a quarter for complex carbs, and the remaining quarter for vegetables, fruit or salad. My cutlery helps me to pace my eating too so that I get the ideal ‘bite-size’ and I don’t eat too fast!

 plan for emergencies by having bariatric- friendly food in the freezer and a couple of snacks in the boot/trunk of my car should I get caught up in traffic or be running very late. In restaurants (which I visited at least twice a week until isolation and lock-down started, but I hope to return to when advisable) I tend to order 2 starters instead of a starter and main course/entrée and am not shy about ordering off a children’s menu or asking for a ‘doggy bag’ to take home something I can’t finish. I often ‘upcycle’ or re-purpose these leftovers into something quite different from the original.

owever, the best advice I can give has been left until the end, LEARN TO COOK – that way you can control your food intake, know just what you are eating and still have a good, healthy relationship with food. This doesn’t mean being a slave to the kitchen, there are lots of healthy convenient foods out there to make life easier, just try to avoid the unhealthy ready-made and processed junk ones.

 

emember, it is not just about eating less, although you will undoubtedly have a smaller plateful than your non weight-loss surgery counterpart, but about nourishing yourself with inspiring dishes to ensure success, long-term.

’ve presented a recipe in this magazine that has been specifically developed for bariatric patients for the green (or ‘eating for life’ stage post-op), indeed it has been to popular it has been chosen for the cover of ‘The Bariatric Bible’ book. I hope that you will try it but also visit www.bariatriccookery. com to check out more information and advice as well as find many more recipes.

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