Chapter 1

Fueling the New You: Ingredients for Success

IN THIS CHAPTER

Taking a look at your new healthy-eating plan

Setting up and preparing your kitchen for success

In order to make the most of your surgery, you need to change your lifestyle after you have your procedure. This doesn't have to be a chore - in fact, when you see how good you feel when you give your body all the nutrients it needs, you'll want to continue doing it.

Establishing new eating and exercise habits is an essential part of achieving and maintaining a healthier weight. Each patient is expected to change the foods eaten, the amount of food eaten, and how that food is eaten, in order to provide the body with the nutrition it needs and to promote weight loss. These dietary changes and nutritional guidelines are meant to be followed for the rest of your life.

In this chapter and throughout this book, we start at the beginning, from your first day at the hospital, through your transition to solid foods, to sticking with a healthy eating plan for life. We outline portion sizes and general guidelines to assist in making your transition as easy as possible.

A weight loss surgery lifestyle includes planning and preparing small, high-protein meals, chewing every bite thoroughly, exercising, keeping a diet and exercise diary, and more. Your bariatric team will provide nutrition and fitness guidance and help you develop plans that will work best for you.

When it comes to food, different people have different tastes and schedules. Listen to your body and your surgeon's directions, and call your bariatric team if you have a question about your specific situation.

Are you frightened of the kitchen? The amazing thing about cooking is that you can make it as easy or difficult as you want. We show you how to organize your kitchen like a pro and guide you through the shopping aisles. (Here's a hint - buy foods that are healthy, convenient, and good.) You find out the best way to prepare and cook your meals. We also assist you in understanding nutrition and your food intake so that you can maintain your weight long after surgery. We think you'll find you have more energy and just feel better in general.

Understanding the Bariatric Surgery Diet

The diet after weight loss surgery gradually progresses from liquids to purées to solid foods. Because the size of your stomach is effectively reduced to about the size of 1 cup or less, your meals are smaller. You have to eat more frequently throughout the day, and you need to make sure you chew your food slowly and thoroughly, so it doesn't become stuck and so it's properly digested. You need more time to eat than you used to, but you'll notice you feel fuller with less food. You eat and absorb fewer nutrients than you did before surgery, so to prevent deficiencies, you need to commit to a regimen of vitamin supplements for the rest of your life.

After surgery, your pouch is swollen and your diet has to progress gradually from clear liquids to solid food to prevent discomfort and the premature stretching of your pouch. This is done in the four main stages described as follows. In Chapter 2 we cover each stage in greater detail, including specific foods, daily menus, and helpful tips.

• Stage 1, Clear Liquids: This stage starts the day after surgery and includes any liquids you can see through - excluding alcohol.
• Stage 2, Full Liquids: When you're able to tolerate clear fluids and have your surgeon's blessing, you get to add full liquids to your eating plan. These are identified as foods that are liquid or semiliquid at room temperature.
• Stage 3, Smooth Foods: These foods are mixed in a blender until they're very soft and smooth in consistency. This stage is also known as puréed foods.
• Stage 4, Soft Foods: In this final stage before regular eating, you add solid but soft foods.

Specific dietary guidelines vary for each procedure and each patient. What we discuss are some of the general dietary changes weight loss surgery patients can expect after weight loss surgery.

Making Healthy Choices

By understanding a little about nutrition and applying what you know, you will feel healthier, look better, and have more energy.

Getting what you need in smaller portions

A typical meal in a bariatric surgery diet includes protein-rich foods such as lean meat, eggs, and lowfat dairy products as well as starches and whole grains, fruits, and vegetables. Eating protein helps you feel fuller longer. You'll be able to eat a variety of foods - in smaller portions, of course. Check out Chapter 3 for details on portion sizes.

Since you are only eating small portions of food, choosing foods that are healthy is very important. Nutrient-rich foods deliver the most nutrition for the least amount of calories. To find nutrient-rich foods you need to check out the food labels to find out what a portion of the food is and how many calories and which nutrients are in a portion.

Drinking enough water at the right time

Water is important because it flushes toxins from your liver and kidneys, regulates body temperature, and reduces the risk of many cancers. It also helps with digestion, lubricates your joints, allows you to use glycogen in your muscles, which provides you with energy, and helps eliminate hunger by taking up space in your pouch.

Prior to surgery you received a great deal of water from the foods you ate. After surgery you don't have the same capacity to eat, which is why many post-op patients are prone to dehydration.

You need to ensure you're drinking enough water. However, you also need to avoid eating and drinking at the same time because your new pouch is too small to allow both liquid and solid foods.

Checking out eating guidelines

After you make the transition to solid foods, follow these dietary guidelines:

• Plan your meals.
• Eat three meals a day.
• Start each meal with a protein source.
• Chew, chew, chew each bite.
• Don't overeat - stop before you feel full.
• Drink between each meal, not with your meals.
• Don't eat in front of the TV, in the car, or while you're reading.
• Keep healthy foods available and get tempting unhealthy foods out of the house.
• If you're going to a party, offer to bring a healthy food item to ensure you'll have something there you can eat.
• Pay attention to the taste of your food.
• Try not to eat late in the day.
• Use a food diary to keep track of what and when you eat and how you feel.

Finding out what foods your new pouch will tolerate after surgery is a matter of trial and error. Dumping syndrome, a common condition for gastric bypass surgery patients, occurs after you eat foods that are high in sugar, fat, or sometimes dairy, or high-calorie liquids. It can cause nausea, diarrhea, light headedness, cold sweats, abdominal cramping, weakness, and a fast heartbeat. (We talk more about dumping syndrome in Chapter 2.) Many people who experience dumping find it good incentive to avoid the foods that triggered the reaction for a while.

Keeping a food diary

A food diary is a useful tool not only when you're losing weight but also when you're trying to maintain your weight. A diary helps you be aware of what you're eating and whether you're veering from your healthy eating plan. Diaries can also help you to increase your awareness of why you're eating. If you write down any emotions you feel when you think you're hungry, you may discover that the feeling is something else - maybe thirst, fatigue, or stress.

Check out Chapter 3 for more information on how a food diary can help you achieve and maintain your weight loss goals.

Organizing and Readying Your Kitchen

Before starting on your cooking adventure, make sure you have your kitchen in order. Nothing is more frustrating than starting a recipe and being unable to find your favorite cookware or utensils or realizing you don't have the necessary ingredients on hand.

The first step to getting organized is to assess what you have, edit down to what you really need, and arrange it in an efficient setup, the primary goal of which should be accessibility. In Chapter 5 we help you organize your kitchen, stock your cupboards, and introduce you to essential equipment. By laying this groundwork you can make your cooking experience more efficient and enjoyable, which will help you stay on track with healthy meal preparation.

Planning to Eat Well

By taking the time to plan meals ahead of time, you're more likely to stick with your eating plan, stay within your budget, and find ways to use up what you already have on hand.

To take out all of the guesswork and free up time every day, take a little time one day a week and plan your meals for the week. You can extract a grocery list from your menu choices and do the week's shopping in one trip, which prevents frantic dashes to the grocery store for a forgotten ingredient. Cooking will be more enjoyable because you're more prepared.

Smart shopping is the name of the game. This means purchasing foods that are healthy, convenient, and good. Here are some smart shopping tips:...