Imagine the relief of not having to worry about overeating as this holiday
season approaches. Imagine what it would be like to feel full and satisfied
after a few bites of delicious and nutritious food. Imagine if you knew how to
prioritize the order in which you eat your food to feel and stay well. And
finally, imagine that while your food should be tasty and familiar, the focus of
eating is no longer on the quantity, but the quality of what you consume.
If you are a post-op bariatric patient, you no longer have to imagine. Your
holiday wish to enjoy small tastes of wonderful food can come true as you
reflect, with thanks, on your decision to take special care of yourself from
this year forward.
While holiday food choices are important, the manner in which you eat your
food can determine the success or failure of a special meal as well as your long-
term post-op outcome. At Holiday time, you must embrace those behavioral
commitments that were introduced pre-operatively and that you implement year
round. Eating behaviors that predict a successful surgery outcome include:
• Eat three meals/day; Skipping meals or banking calories in anticipation of a
large holiday meal are not appropriate post-op behaviors for any bariatric
• Allot no more than 30 minutes/meal or end your meal at the very first sign of
fullness, which ever occurs first.
• Eat your protein (turkey, fish, eggs, meatball, chicken, roast beef, duck,
etc.) first at every meal. Eat veggies or fruit second and save small tastes of
starches for last. Exceptions would be mixed meals like stews, chili, lasagna,
etc. where protein veggies and starches may be mixed together in each bite. (Be
careful as mixed meals may not allow you to meet your daily protein goal if carb
to protein ratio is high.)
• Unless you have a protein shake as a meal replacement, drink all beverages
between meals. Lap Band (LB) and Gastric Sleeve patients should wait 30 minutes
after a meal and Gastric Bypass (GB) patients should wait 45 minutes after a
meal before drinking anything. this is to prevent discomfort, rapid emptying and
eventual pouch stretching. All sugar-based and carbonated beverages should be
avoided. Caffeinated beverages should be taken in moderation with adequate
hydrating beverages to counter the potential dehydrating effects of caffeine.
Aside from an occasional sip or two, (non-carbonated/non-sugary) alcoholic
beverages should be reserved for very special occasions.
• As a rule, bariatric patients should avoid picking & grazing. Both eating
behaviors have been linked to disappointing long-term post-op results based on
excess calorie intake over the course of a day. On holidays, the rules may be
stretched a bit but you want to be able to enjoy your holiday meal. When
appetizers are offered, be very mindful as to what you select. A few small
tastes of favorite items with a break before the main meal is encouraged to
prevent an “angry” pouch. If grazing is difficult to resist, sip on a beverage
up until 30(45) minutes before the meal or ask to help out with serving, setting
the table, etc.
• It is emotionally preferable for post-op bariatric patients to view their new
way of eating as a healthy lifestyle choice as opposed to another restrictive
diet. That said, when fat, sugar & salt can be reduced in your family’s
traditional holiday recipes, without a significant taste alteration, they
should be. If leftovers are always an anxiety provoking issue, reduce the amount
you cook to match your crowd size.
• If family & friends are aware of your post-op status, celebrate your own
personal triumphs by using a beautiful & special small plate, bowl or even wine
glass (for a celebratory sip or two) at your place. You deserve it!
• To make a creamy but lower calorie mashed (sweet) potato, yam or vegetable
puree, substitute buttermilk, low sodium broth, Greek or low-fat sour cream for
some of the butter typically used.
• Dabble in the squash family. Butternut, acorn, delicata, etc. have a mild &
nutty sweetness and almost half the carbs of potato. They can be roasted,
steamed, microwaved or baked and can be sweetened with a bit of (sugar-free)
maple syrup or brown sugar (substitute) as desired.
• Keep food flavorful & moist with your favorite fresh/dry herbs, spices and
thoughtful amounts of fat & condiments. Unadorned dry food (particularly lean
protein like turkey breast) does not typically go down well. A small bit of
seedless cranberry sauce, gravy, etc. might seem indulgent but will usually help
the protein go down with ease.
• As much as you might love pasta dishes like mac & cheese, lasagna or other
very high fat/high carb “combination foods” that may appear on your table, they
don’t love your pouch. Too many patients have ruined their holiday meals with
one or two tastes of something that ends up landing like a lead balloon. If you
must, pack up a very small amount of “casserole” to taste with your next day’s
lunch but remember your pouch size before overindulging in fat laden starches.
• Dishes made with ground nuts, eggs or other protein-containing
foods may be a good option as opposed to high carbohydrate food choices.
• If a bit of sweet will complete your holiday meal try poaching fruit in light
juices or sugar-free jelly, baking apples with sugar-free maple syrup or apple
juice or making low-sugar fresh fruit crisps. Recipes for sugar-free mousse,
custard, etc. can all be found by googling sugar-free desserts.
Note that eating your dessert directly after your meal is preferable to waiting
until your pouch empties and having a large portion later on. (Always use the
restrictive nature of your procedure to your advantage.)
For your safety, please note that while the above information can be generalized
to most bariatric patients (RYGB, LB and GS) you must individualize it to your
own procedure and post-op stage, particular tastes, tolerances, medical
conditions and weight goals. GB patients can tolerate sugar less well than other
bariatric patients and should use sugar-free alternatives like Stevia/Truvia,
splenda or Equal for baking or sweetening dishes whenever possible. Sodium
intake should be adjusted to particular taste and blood pressure history. since
all fats (butter, oil, bacon cream, cheese, etc.) promote a feeling of fullness
and slow down digestion, hidden or excess sources at your holiday can cause
immediate discomfort and regret. Fluids and good hydration must not be
forgotten during the holidays and some yummy warm beverages like herbal tea and sugar-free cocoa may reappear.
This information will help you enjoy a mindful, healthy and delicious holiday