Like everyone else at the Lubbock, Texas, holiday dinner, Kristy Owens fills up her plate. But halfway through the turkey and trimmings, she’s done. She’s “completely full” and can’t eat another bite. Owens, 40 — who was on the verge of diabetes eight years ago — skips dessert. “If something even looks sweet, I’m completely turned away by it,” she says. Food tastes saltier now, and she doesn’t have much use for the salt shaker anymore. In 2006, Owens had weight-loss surgery, and like others who’ve had the procedure, she’s found the experience of eating changes in many ways.
Smaller Meals
Your stomach is smaller after weight-loss surgery and simply can’t hold as much food as it used to. So the challenge is maintaining good nutrition while eating less. Shannon Owens, a dietitian (and Kristy’s sister), works with patients at The Advanced Bariatric Surgery Center in Lubbock. Once fully recovered, patients are encouraged to eat every two to three hours as part of their permanent routine. While the exact amount of food depends on the type of surgery, Owens says the range is from one to two cups of food at a time. “They’re eating six times [a day] so they’ll definitely have no problem getting adequate calories and protein with this food,” she says.
Protein First
Protein malnutrition is the big concern, especially during early recovery. Patients are strongly encouraged to eat mostly protein foods, such as lean meats and low-fat dairy or eggs, says Owens, who teaches a course on bariatric surgery and nutrition at Texas Tech University. Protein shakes are helpful, she says, although not mandatory. “Sometimes it can help if people can sprinkle protein powder in their milk or in their yogurt just to get a little bit more protein, right at the beginning.” Down the road, she says, people can eat bigger portions and add more balance to their diet, by incorporating more fruits, vegetables, breads and grains.
Kristy Owens says in addition to protein supplements, she’s also been told to take extra calcium and vitamin B. Different centers may recommend additional supplements, like vitamin D.
Taste Change
Salty, sweet, sour and bitter — taste perception may differ between obese and non-obese people. In a recent study using taste strips, “obese patients had a lower taste perception than the non-obese, and that was pretty much across the board, regardless of type of taste,” says lead author John Morton, president of the American Society for Metabolic and Bariatric Surgery. Morton suggests that by learning taste appreciation, instead of getting satisfaction from the sheer volume of food, people could make up for it through taste, or the way food looks and smells. And paradoxically, the longer people take to eat, the less food they consume.
Taste perception can change after weight-loss surgery, the study also found. Patients “became more sensitized to salt — that was the big difference,” says Morton, who is also an associate professor of surgery and director of bariatric surgery in the School of Medicine at Stanford University.
Owens says it’s likely that 80 percent or more of patients experience some type of taste change. Sugars may become “sickeningly sweet,” for example. She’s had several patients who disliked tuna before the surgery but enjoyed it after. “A lot of people crave pickles after,” she says. “So we tell them, put pickle relish in your tuna salad [but] just don’t eat pickles.”
Sugar and Fats: Body Talks Back
Most patients are able to tolerate sugar, Shannon Owens says, with the exception of those who had the Roux-en-Y gastric bypass procedure. Gastric bypass involves creating a pouch within the stomach to make it smaller, and bypassing part of the small intestine to reduce the amount of calories absorbed. These patients will be “super sensitive” to sugar, she says. A different procedure, the duodenal switch, leaves patients really sensitive to fats. These foods can lead to nausea and vomiting, or diarrhea — otherwise known as dumping syndrome.
Owens put together a cookbook, “Extraordinary Taste: A Festive Guide For Life After Weight Loss Surgery,” to help patients who once loved chicken-fried steak and mashed potatoes come up with new ways to enjoy food. She previously learned that “when you change fat and sugar in recipes, they do not turn out OK.” She says people really enjoy her chili recipe, among others, and all are “lean protein, healthy fats and high fiber.”
Alcohol Issues
It’s not a question of no more alcohol, ever, for most patients, Owens says. However, research is looking at whether food addiction can be transferred to something else — like drinking — after weight-loss surgery, she notes. Her group strongly discourages alcohol for the first year after surgery, when those at risk for addiction are most vulnerable. People may feel the effects of alcohol after just a few sips, she adds. Wine is one of the best choices for those who do drink, she says, because unlike beer, it isn’t carbonated.
Carbonation No-No
Carbonated beverages, Morton says, including beer, Champagne and soft drinks, “are a problem.” Carbonation actually stretches the stomach. To illustrate, he says, “If you’ve ever drank a Coke pretty quickly with a normal-size stomach, you have the sensation that you need to burp. So imagine it’s considerably smaller.” Morton doesn’t advocate any type of soft drink, not even Diet Coke. Not just because it’s carbonated, but “there’s also the sense that your body is not fooled by the ‘diet’ part of it and will try to make up for it in other ways by eating more.”
For her part, Kristy Owens admits to the occasional lapse with a Diet Dr Pepper. However, her sister Shannon says, “Every center is different, but we don’t recommend carbonation, ever.” That’s another tough restriction, she admits. “But I’ve never had a patient go, ‘Man, this surgery was not worth it because I want my soda.’ They’re like, ‘Oh my gosh, I feel so much better. I’m no longer diabetic, and it’s definitely worth it.'”
Mindful Eating
Of course, eating isn’t just about bubbles in a soft drink or sugar in a cookie — there’s the emotional side. Owens notes that patients at the Lubbock center see a psychologist to ease the adjustment. Morton says his center, like others, educates patients to help guide their expectations. “Your relationship to food does change, but I think it changes for the better,” he says. “It doesn’t mean saying goodbye to eating; it means saying hello to eating right.”
Kristy Owens says while she can no longer do things like watch TV and snack, she “so much loves being able to wear a size that’s not in the double digits into the 20s.” She says the exchange is well worth it, including exercising more and relating to food in a healthier way.
More from U.S. News
Exercising After You’ve Gone Under (the Knife, That Is)
10 Changes in Surgery in 25 Years
What’s Eating Like After Weight-Loss Surgery? originally appeared on usnews.com
