The hardest part of any weight loss program is keeping it off. For thousands of people each year, bariatric surgery is a way to lose weight, reduce the risk of developing further health concerns and improve the overall quality of their lives.
While eating smaller portions has been proven to be effective for these patients, the success of this process is largely dependent on behavior modification. With the emphasis on behaviors, patients are encouraged to eat breakfast, lunch, dinner, and to minimize snacking during the initial months after surgery. This is the time to train“ both the mind and body to adapt new patterns.>
Bariatric programs and protocols vary, but the commonality amongst them is to have patients designate a time for eating and to supplement their intake with protein shakes and non-caloric beverages between meals. Since they are now feeling physically satisfied with small nutrient-dense meals, the goal is to have their minds“ adapt to a new style of eating and break old habits.>
Grazing can be equated with mindless eating, which signifies that their food choices lack nutritional value.
People who suffer from obesity often report erratic eating habits prior to surgery, which includes grazing throughout the day and night. Many people often report that they do not eat at designated times, and instead grab, pick, and nibble frequently and constantly during the course of a day.
The Difference Between a Snack and Grazing
The distinct difference between a snack and grazing“ is that snacks can be part of a healthy meal plan.>
Dietitians encourage people to eat smaller more frequent meals to bolster metabolism and to avoid the overeating that results from long lapses between meals. With this type of a plan, people can anticipate a mid-morning, mid-afternoon, and an evening snack if they work that into their meal plan. While this is a good practice because it allows for accountability, grazing can be defined as perpetual and constant eating and this pattern lacks structure.
People who graze are usually grabbing for what is convenient and readily available, and these calories are not factored in to their daily allowance because there is no plan.
It becomes more difficult to track intake and account for all the calories consumed. There are so many snack foods on the market today, which does attribute to this growing obesity problem. While manufacturers attract people with food labels that read fat-free, no sugar added and gluten-free this does not mean that they are calorie free or have any nutritional value. These snack foods generally provide empty calories and often are not satisfying.
In addition, eating mindlessly often occurs when people are in the midst of another activity. It could be during work hours, cooking, doing activities with their kids or even watching television. Since these activities require attention, people are more likely to overeat and be less cognitive in their actions.
Another habit that often plagues people who are overweight is this idea that they can starve themselves and reduce their caloric intake by not eating at all. Their day usually starts out with minimal a minimal intake, like a cup of coffee, and results in grazing later on in the day. Ultimately they too will end up eating more than they anticipated and neither deprivation nor grazing will facilitate weight loss.
Eat Slowly During the Honeymoon Phase
After bariatric surgery, patients often report that they feel full after a few spoonfuls of food. They may even be inclined to skip meals. The initial weeks and months after surgery can be referred to as the honeymoon“ phase>. As euphoric as they may feel with minimal intake, it is important to make mealtime a scheduled activity.
While eating slowly is imperative to ease digestion, it is also important to give yourself sufficient time to finish the meal. The recommendation is to allow oneself approximately 30 minutes to finish. This does not mean they should force themselves to finish everything on the plate, but they may need to take a breather during that time. When meals are a scheduled activity and the focus is simply on eating, the mind is better able to register when the body is full. If everyone approached mealtime in this manner, it would prevent people from taking second helpings and cleaning the plate.
Patients may take a few bites and see no problem with going back to the same meal over the course of a few hours but they are then setting the precedence for grazing later on.
Bariatric patients after surgery now have a small tank to fill and should think of meals as their fuel. The objective is to fill the tank and sustain good energy levels and to avoid feeling hungry throughout the day. I often tell them they will now be eating what their body needs and not what their mind wants.
Grazing can be detrimental to their long-term goals and can result in weight gain. By filling the tank with 1-2 ounces of food they will feel depleted in a short while. This will stimulate a craving to refuel and fill the tank again. Since grazing never allows for the tank to be on full this creates a cycle of perpetual eating all day long. Over time this will hinder their progress and result in weight gain. If they are not designating the 30 minutes to eat or perhaps not planning meals then their program lack structure.
These patients usually complain that they are always hungry and never have that feeling of satiety. Further conversations with them will reveal that they were eating three regularly scheduled meals after surgery, drinking protein shakes to supplement their intake, and not drinking and eating at the same time. These habits must become the new normal because if they revert back to old habits they will either plateau or regain the weight.
Plan Meals and Snacks and Eat at Scheduled Times
To prevent this problem it is important to plan meals and snacks and eat at scheduled times. Packing a snack gives people something to look forward to during the day and can provide essential nutrients too. When you are eating at regular intervals you are less inclined to think about food throughout the day. It helps to have a plan that can be adjusted based on your schedule, travel plans, and social engagements. Take a look at both routine and lifestyle and have some portable on the go options to make things easier.
Prepackaged food does not have to mean processed as the latter is made with sugar, salt, and preservatives. Since we live in a convenience world it is possible to buy bags of cut up fruit, individual servings of peanut butter and small four ounce containers of cottage cheese, yogurt and hummus just to name a few.
The best recommendation is to avoid foods that stimulate cravings and perhaps trigger bad habits. Instead, find an alternative healthy food option with a similar texture. For example, many people like crunchy foods and can find satisfaction in eating some carrots or apple slices. Another very important practice is to keep foods out of sight and out of mind. Bringing foods into the home or office is often just a recipe for disaster.
The objective is to leave very little to chance and to avoid impulse purchases. If a patient is struggling with choosing appropriate food options or managing emotional overeating and behavior modification it is always a good idea to seek help from their bariatric team. These are the people who will provide guidance and support and help patients reach their long-term goals.
ABOUT THE AUTHOR
Shara“ lazar rd> has spent many years counseling patients with varied health concerns including renal failure, hypertension and diabetes. It was those experiences that lead her on a path to help people reduce the risk of developing these health concerns and improving the quality of their lives. She joined New York Bariatric Group with eight years of bariatric nutrition expertise and is also extremely passionate about fitness. She will help you to integrate both nutrition and exercise in to your life with a practical approach and continuous support.