A Very “Bari” Holiday Season
Did you know that December is probably THE busiest, highest volume month of the year for bariatric surgery (or probably any elective procedure)? This is because many patients have already met their out-of-pocket max for the year and are very anxious to schedule surgery by December 31st.
It can be stressful to undergo surgery during an already crazy time of the year for most of us - juggling work deadlines, social engagements, kids at home from school, decorating, gift shopping, and so on. The other element is navigating social encounters around food, which can be a tricky situation for both recent and late post-op patients.
These are some common questions I am asked about regarding bariatric holiday issues:
What do I eat so that I don’t make myself sick, or fall off the wagon?
If you’re still on a liquid diet, you really can’t have any traditional dishes like turkey, ham, or anything solid. You’re sipping on fluids, so try an herbed broth, strained cream of mushroom soup, cinnamon or peppermint herbal tea, or steamed milk with pumpkin spice to enjoy the flavors of the season.
If you’re beyond liquids and are now on soft foods, then you have way more options. First, any meat has to be pretty tender like meatballs or juicy chopped turkey with light gravy. Only cooked vegetables are allowed so think pureed butternut squash soup, well-cooked carrots or green beans, or wilted garlicky spinach. Be careful with starches like mashed potatoes, stuffing, or rolls because these swell in your pouch and may cause intense discomfort. You’re also highly susceptible to dumping syndrome, so have caution with sweetened punches, hot cocoa, and any desserts.
If you’re at least several months after surgery and on regular textures, then liquid calories, portions, grazing, and sweets are the main temptations. Choose a tasty zero calorie drink (like cranberry and orange infused water) and sip it when you aren’t eating which helps “water load” your pouch. Stick with a small appetizer plate throughout the night. Survey ALL options on the table before selecting what you really want to eat - please make protein one of those! Try to position yourself several feet away from where food is laid out so that it’s harder to graze on nuts, cheese, chips, etc. Although some patients completely avoid concentrated sweets, others manage sugar well by making it an intentional and mindful choice.
How do I deal with the constant questions about why I am not eating much or comments (positive or negative) about my changing body size?
One patient who just had surgery, later told me that she would put food on her plate, cut it up, and move it around with her fork. She was participating in the social aspect of eating without actually eating, and that worked for her. Depending on your comfort level with disclosing your surgery status to others, sometimes being open about it will invite support and admiration for your decision. By contrast, I also had a patient who never let anyone know he had bariatric surgery other than his wife. He told everyone else that he was working with medical professionals on a weight loss plan and left it at that.
When comments start to focus uncomfortably on your physique, I’ve heard some patients redirect the conversation by explaining how good they FEEL and how much more they can DO with their bodies since losing weight. It’s not anyone else’s place to judge whether THEY think you’ve “lost too much weight” either. One of my patients was persuaded by his relatives that he had gotten too skinny so he allowed more laxity in his eating choices, leading to significant weight re-gain.
What if I gain weight after the holidays?
If you’ve had more salty foods during the holidays, your body retains water which affects weight. Increase your fluid intake and eat more potassium rich foods like dark green leafy vegetables, tomatoes, and mushrooms.
If carbs got out of control over the holidays, then consider “resetting” the pouch by following a condensed version of the post-op diet stages that lasts only 5-7 days. All sweets, sugary drinks, and starches are off the table for the week. The outcome after a pouch reset is to remind yourself of that sensation of fullness again. You become better “tuned in” with your body on when to stop so you’re back in control again.
Days 1 to 3: high protein liquid diet (shakes, yogurt, soup)
Day 4: pureed diet (eggs, smoothies with protein)
Day 5-6: soft diet (fish, ground meat, cooked veggies)
Day 7: regular diet (dense, solid meat and crunchy fresh vegetables)
Re-establish a regular exercise routine if that was affected by holiday distractions. Whatever you choose, have fun and take a buddy with you if possible!
