Weight Loss Surgery Cookbook For Dummies®, 2nd Edition
Published by: John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030-5774, www.wiley.com
Copyright © 2017 by John Wiley & Sons, Inc., Hoboken, New Jersey
Published simultaneously in Canada
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Library of Congress Control Number: 2016956166
ISBN 978-1-119-28615-8 (pbk); ISBN 978-1-119-28617-2 (ebk); ISBN 978-1-119-28616-5 (ebk)
If you’re reading this, odds are you’ve made the very important decision to improve your health by having weight loss surgery. You most likely made this choice after years of struggling to live a healthier lifestyle by trying other methods to lose weight. You probably spent countless hours researching procedures on the Internet, reading books, interviewing doctors, talking to weight loss surgery patients, and speaking with other healthcare professionals, putting in the necessary time and effort to make sure this procedure was the right decision for you.
Your surgeon provides you with a tool — your surgery — to assist you in losing weight and leading a healthier life. Making that tool work is up to you, and a big component of your success will be your long-term eating plan.
Now is the time to use good nutrition to maximize not only your weight loss, but also your health, vitality, and renewed sense of well being. Weight Loss Surgery Cookbook For Dummies is an invaluable resource as you embark on this new chapter of your life — your weight loss journey — and we wish you all the success in the world.
This book is all about eating well after weight loss surgery. (If you’re looking for information on the types of surgery available, check out Weight Loss Surgery For Dummies.) At the beginning of this book we walk you through the four stages of your postsurgery diet and provide plenty of advice about living with and caring for your new pouch. Because life after weight loss surgery is an ongoing journey, we focus most of the book on what to do once you can eat “real food” again. We show you how to plan, shop for, and cook delicious and healthy meals that you and your family will love.
You receive cooking guidance from Chef David Fouts, who is known as the world’s premier culinary expert for weight loss surgery. And he is also a weight loss surgery patient, so you know the recipes and cooking advice come from someone who understands what gastric bypass patients go through. You find a compilation of imaginative, inventive recipes to suit every palate, specifically designed to meet the unique needs of people who have had weight loss surgery and people just wanting to eat healthier. So that you can stay informed of what you’re eating, each recipe lists the stage of the postsurgery diet it can safely be tried, the serving size, and the nutritional information. You can eat with confidence, knowing you’re eating healthfully, helping manage your weight, and maintaining your overall well being.
If you’re familiar with a For Dummies book (Weight Loss Surgery For Dummies, perhaps?), you know they’re divided into parts and chapters. The editors and authors designed this book in a nonlinear fashion so you can read it cover to cover or skip around to the areas that interest you the most. For those of you who are accustomed to the post-op lifestyle and handy in the kitchen, you may want to want to dig right in to Chef Dave’s delicious recipes (which have been tested by a professional recipe tester).
The following are a few conventions that you find in this book and that you should be aware of:
This symbol indicates a vegetarian recipe. Note that these recipes may still include eggs and dairy.In writing this book, we made the following assumptions about you:
As you read through the chapters of this book, you find the following friendly icons that are designed to draw your attention to different nuggets of information and useful tidbits:
Be sure to pay attention to the information next to this icon. This advice can help you make good choices, eliminate risks, and improve your skills in the kitchen.
When you see this icon, you’re sure to find good ideas that will help you along on your journey.
Pay close attention to this icon. It will help you avoid common pitfalls and mistakes.
In addition to the material in the print or e-book you’re reading right now, this product also comes with some access-anywhere goodies on the web. Check out the free Cheat Sheet for a quick guide to what to eat after weight loss surgery, info on portion sizes, and more. To get this Cheat Sheet, simply go to www.dummies.com and type Weight Loss Surgery Cookbook For Dummies Cheat Sheet in the Search box.
Weight Loss Surgery Cookbook For Dummies is written so you can start wherever you like. This may depend on where you are in your weight loss surgery journey and your skill set in the kitchen. If you are considering but haven’t had the surgery, you may want to read this book cover to cover in a linear fashion to gain a clear understanding of your post-op restrictions and lifestyle changes. If you have already had weight loss surgery and are beyond the transition phase to solid foods, you may want to start at Chapter 3.
If you’re a novice and want to learn how to prepare your kitchen, what tools you need, and what items to have on hand to cook like a pro, start with Chapter 5. If you’re an experienced cook and are looking to dig right in to some new and delicious recipes, feel free to start at Chapter 7.
Part 1
IN THIS PART …
Get step-by-step dietary guidelines for the transition from clear liquids to solid foods, starting with day one after surgery.
Find out about portion sizes, your new nutritional requirements, and the benefits of meal planning.
See what you need for a well-stocked fridge, freezer, and cupboards.
Get tips on caring for fresh and raw foods, cooking methods, choosing the right temperature, and measuring common ingredients.
Chapter 1
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.
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.
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.
By understanding a little about nutrition and applying what you know, you will feel healthier, look better, and have more energy.
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.
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.
After you make the transition to solid foods, follow these dietary guidelines:
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.
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.
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.
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:
Fresh fruits, vegetables, and raw meats are always better than processed, but “safety first” is the rule.
It’s upsetting to think about, but the foods you eat to stay healthy can make you sick. Fortunately, you can do many things to protect yourself and your family from foodborne illness. At the grocery store, avoid cans that are bulging and jars that have cracks or loose lids. At home, follow these tips from the Food and Drug Administration:
Check out Chapter 6 for more tips and tricks to ensure all your meals are safe to eat.
Chapter 2
IN THIS CHAPTER
Treating your pouch well
Following your surgeon’s and dietitian’s guidelines for eating safely
Getting familiar with the four stages of your postsurgery diet
Chances are, before your surgery you got a lot of information from your doctor about what to expect afterwards. You probably also sat in your surgeon’s office with a registered dietitian who painstakingly explained the diet you have to follow for the few weeks following surgery until you’re able to eat “real” food again. The facts, guidelines, and warnings probably made perfect sense at the time, until you left the office and it all suddenly became very overwhelming. Don’t feel bad — you’re not alone!
Be reassured, your period of healing and adjustment will come to an end and you will be able to eat regular food again. You need to be conscientious of what you eat and the portion sizes, but having weight loss surgery certainly doesn’t mean that life as you knew it has come to an end. You’ll be able to go to a restaurant and have a lovely meal with friends. You just may want to split an entrée or take some home!
In this chapter we explain what to expect from your new pouch and some of the new sensations and symptoms you may experience. We show you what you can eat in the days and weeks after your weight loss surgery, and walk you through each of the four initial stages of foods. We also clue you in on food preparation tips and provide some sample menus to get you started in the right direction.
Here are a few things to remember as you recover:
Your pouch is about the size of an egg and holds one to two ounces. You know how gently you have to handle an egg? Well, the pouch also requires special care, which begins in the hospital and continues throughout your life.
After surgery, the pouch is swollen for anywhere from a week or so (if you had sleeve gastrectomy, also known as gastric sleeve) to a few weeks (if you had adjustable gastric banding [AGB]) to a few months (if you had Roux-en-Y gastric bypass [RYGB], also called simply gastric bypass [GBP], or biliopancreatic diversion with or without duodenal switch [BPD/DS]). This in itself makes it difficult to eat much food at all. As time goes on, you’re able to eat more. Some hunger is normal, so you may also want to eat more. At this point, it can be helpful to use smaller plates and utensils so it looks as if you’re eating more and to help guide you in taking small bites. Forming good eating habits now (this means watching portion sizes) is important so you don’t return to old eating habits and stretch the pouch.
Foods may taste a little different after surgery, especially if you had gastric bypass. If it tastes metallic, which is common, you can use plastic forks and spoons to minimize the taste. Cold foods tend to have less aroma, so eating chilled foods may also help unusual tastes. This side effect usually passes with time.
Keep in mind that no matter how closely you follow your surgeon’s instructions, you are probably going to experience side effects at some time. By following instructions closely, however, you can minimize the frequency and severity of the symptoms. The following sections describe common side effects you may experience and how to deal with them. Keep in mind that in addition to increased severity of these side effects, not following your surgeon’s instructions can result in not achieving your weight loss goals, nutritional deficiencies, decreased energy, and just not feeling well.
Common complaints after surgery are nausea and vomiting. If you feel pressure or fullness in the center of your abdomen, stop eating! Nausea and vomiting may occur during the first few months after surgery as you get used to your new pouch.
If you experience nausea and vomiting, chances are you have done one (or more) of the following:
Vomiting is more than simply a nuisance and discomfort. Unresolved vomiting can lead to complications such as:
If you experience nausea and vomiting, stop eating until it passes. If you have any question about whether your symptoms are normal, or you cannot keep water down, consult your surgeon immediately.
Surgery itself can affect your digestive system, but the lifestyle changes that come with a pouch can also cause you to experience irregularities. The following sections provide tips to help you get back on track.
Don’t assume that any sudden change in bowel habits is a result of your surgery. If the symptoms (diarrhea or constipation) don’t subside with treatment, see your surgeon to rule out other causes.
Constipation is a common complaint after surgery. Right after surgery you’re sore and that’s probably the last thing you want to think about, but it happens. Usually it means you need to drink more fluids — the more, the better.
Immediately after surgery, you may be constipated due to the effect of the anesthesia or pain medication, which slows bowel function. Keep sipping fluids and move around as much as possible to move things along.
If you experience constipation later, it’s most likely due to insufficient fluid intake. Some supplements, like calcium and iron, can also contribute to constipation. Don’t stop taking your supplements, just keep drinking!
Another reason for constipation is lack of fiber, which can happen easily when your intake of fruits and veggies is restricted. If you’re in Stage 2 of the eating plan, be sure you’re drinking 48 to 64 ounces of fluid a day. In Stage 3 you can try soft cooked fruits and vegetables. In Stage 4 you’re free to try fresh fruits and vegetables. Later, high-fiber cereals are a really good option.
Suppositories, stool softeners, fiber supplements, and enemas can also help, but talk to your surgeon about the problem first and find out what she advises.
Just remember, if you add fiber to your diet, you need to add more water, too. And don’t forget to get up and move around! Exercise (even just walking) can often get things going.
On the other end of the spectrum is another common complaint: loose stools, or what we typically call diarrhea. If you have diarrhea or are having more than four or five bowel movements a day, call your surgeon. And be sure to drink plenty of water, because you can become dehydrated quickly.
You’re more likely to experience diarrhea if you have had GBP or BPD/DS than if you have had AGB. Diarrhea is often due to the following causes:
Your surgeon may prescribe medication or probiotics to treat the diarrhea. Probiotics are supplements that can be used to change or improve the natural bacterial balance of intestinal tract.
If you remember one thing from the pre-op information you received from the dietitian, it’s probably how important fluids are. Fluids are necessary for almost every bodily process as well as fighting off fatigue — not to mention helping your metabolism to encourage weight loss. We recommend you get 48 to 64 ounces of fluid a day. Because you can’t drink very much at one time, this means you need to have something with you at all times so you can be sipping.
A really good way to gauge if you’re getting enough fluids is by the color of your urine. If it’s pale yellow or clear, good job! If it’s gold, drink more.
In addition to dark urine, other signs of dehydration include
Water is certainly the best thing to drink. If you don’t like the taste of water, try adding some lemon or lime juice or a sugar-free flavoring packet. Try to stay away from fruit juice because it can lead to dumping syndrome, which is discussed later in this section. Juice can also sabotage weight loss because it contains a lot of sugar and calories. If you must drink fruit juice, limit yourself to about four ounces a day and dilute it 50/50 with water.
If you love coffee, tea, or carbonated beverages, you’re going to have to make some changes. The caffeine in coffee, tea, and colas can be dehydrating, and it will be challenging enough to stay hydrated as it is. Go for decaffeinated tea or coffee, and don’t add calorie-laden cream and sugar. A little skim milk and artificial sweetener should be fine. Carbonated beverages are not recommended because they can distend your pouch and lead to uncomfortable gas and bloating.
Just a word about alcohol — don’t. Like the drinks mentioned earlier, alcohol is a diuretic, meaning it has a dehydrating effect on your body. You may also metabolize alcohol differently than you did before surgery. Always check with your surgeon before introducing alcohol into your diet.
Sip fluids slowly and don’t use straws. Drinking too quickly can lead to nausea and a feeling of fullness and even vomiting. Straws can introduce air into your pouch and lead to gas and bloating. (Chewing gum does the same thing.)
Dumping syndrome is a miserable condition that may happen to those of you who have gastric bypass surgery. Symptoms can range from mild to severe and may include
Dumping syndrome occurs after you eat foods that are high in sugar, fat, or sometimes dairy, or consume high-calorie liquids. These kinds of foods travel quickly through your pouch and are “dumped” into your small intestine. Doctors believe this triggers a series of hormonal responses that cause you to experience symptoms, sometimes right after eating and sometimes hours later.
Dumping syndrome can last from ten minutes to four hours depending on what and how much you have eaten. Unfortunately, time is the only cure; you can’t take anything to get rid of it. The best suggestion is just to go to bed and ride it out.
Some people may experience less dumping syndrome as time passes. For others, it may be a chronic condition.
If you had GBP, your surgeon can give you recommendations about how much added sugar (as opposed to natural sugar in fruit and dairy) you can safely eat at one time. The following additional guidelines may also help you avoid dumping syndrome:
Most people who experience dumping find it good incentive to follow these guidelines for a while. If these measures don’t help you, let your surgeon and dietitian know.
Anyone who has had weight loss surgery has some experience with food intolerances. Unfortunately, there’s no rhyme or reason for who has what intolerances. For some people it’s dairy, for some it’s beef, for some it’s applesauce. You may suddenly be nauseated by something you have eaten all your life. The following foods are commonly not tolerated well:
A food intolerance is not a food allergy. It happens when your pouch is not ready to accept a new consistency or is irritated by the offending food. The most mysterious part of food intolerances is that they often subside — a week or two later you may be able to eat problem foods again. If you discover an intolerance, wait a while and try it again. However, some people find that certain intolerances are more or less permanent.
After surgery, reintroduce yourself to foods one at a time so you may be able to identify what doesn’t sit well. Also, when introducing a new food, eat a very small amount of it. The best way to avoid intolerances is to take it slow and stick to the phases of your diet as instructed by your dietician.