Do Small Frequent Meals Still Apply After Weight Loss Surgery?

Six meals a day? Three meals a day? Which is it?

By now you’ve heard the recommendation to eat small but frequent meals. Five meals a day? Six meals a day? Every few hours?

What about after weight-loss surgery? Should you still be eating all the time if you aren’t hungry? How do you lose weight if you’re eating all the time?

Every program differs

While every bariatric program and every dietitian will differ in their recommendations on a good post-op eating program, here are my personal thoughts that are not meant to replace your dietitians or doctors recommendations. Think of this as merely a conversation about what I find beneficial in the lives of my post-op patients.

Prior to surgery eating more frequent meals is beneficial. It definitely has it’s place. I personally have not had surgery but have kept off 40+ pounds by eating 5 times per day. Breakfast, snack, lunch, snack and dinner. However….

Weight Loss Surgery Changes things

After the initial stages of healing, liquid and soft food diets, I ultimately encourage my patients to stick with three meals per day. What about the small, frequent meal thing?

There are two big reasons why I don’t see as much success with frequent eating after surgery:

Getting in enough water is not only very important for hydration after surgery, it’s also the best appetite suppressant there is! If a patient is eating every few hours after surgery, the first thing I would be concerned of is water.

Hitting fluid goals every day (64 to 96 ounces) keep weight loss moving, keeps energy up and appetites down. In my practice, I recommend 3 meals a day and focusing on water intake in between meals.

The reason small frequent meals is so helpful prior to surgery is for hunger control and metabolism. Weight loss surgery is a tool that helps with hunger control and metabolism. 

This means tapping into the power of the surgery, eating lean and solid protein sources, taking small bites, eating slowly and avoiding drinking during and for 45-60 minutes after the meal can keep hunger away. Then back to fluids in between meals. Surgery is more powerful than a small, frequent eating plan.

Note: For diabetics you’ve often heard to eat often for blood sugar control. I do recommend always having a snack on hand, something with protein and carbohydrates such as a protein bar. If you feel shaky like your blood sugar is dropping, check your sugar and eat something before it gets any lower.

However, surgery often stabilizes blood sugars so you may find your sugars are well controlled with the 3 meals a day of lean protein and vegetables and water in between. Follow your symptoms and blood sugars as a guide of when to eat instead of eating as a preventative measure.

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When good intentions turn to grazing

It’s easy for “small, frequent meals” to turn into “grazing” after surgery. Not hungry but eating because you feel you should? That may be forming a habit of eating when you don’t feel hunger.

Although! Sometimes you don’t have hunger at all after surgery and you DO have to eat when you aren’t hungry. That only goes for the three set meals of the day. Outside of that, don’t feel you need to force it. Keep going on water instead.

So why do so many bariatric programs differ? And how do you get in all your protein?

Bariatric programs are just like all the other doctors offices that differ. One pediatrician may recommend one medication. One dietitian may recommend one method. It may seem like it should all be standard but life is not that black and white, even when it comes to post-op diet plans.

Each bariatric professional will feel confident in their method of doing things…as they should! Wouldn’t you want someone who feels passionate about what they are recommending? It’s okay to find your own way and “agree to disagree” with approaches that differ from you preference.

No matter what, be sure you are using a professional for guidance instead of (well-intentioned) family and friends who may not be prepared to make recommendations on your personal and medical needs.

Counting protein, or not counting protein

Maybe you are eating every few hours to get your protein in.

Some programs will tell you to count your protein. Many programs I’ve worked in do not have you count protein.

Some programs will recommend 80 or even 100 grams of protein. However, the American Society of Metabolic and Bariatric Surgery recommends post-op patients get 60 grams of protein each day.

That’s the equivalent of about 3 ounces of lean meat per meal.

Instead of focusing on numbers, I encourage patients to eat two bites of lean meat to one bite vegetable. Pause in between each bite and stopping where they start to feel full to allow their pouch the lead the way. Doing this three meals per day with fluids in between leads to great results and a more simplified style of staying on track.

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Back to Basics

Get back to the basics to keep things simple. Nutrition gets complicated all too quickly! Again, be sure to visit with a professional for your own needs but a few of the basic post-op bariatric surgery recommendations I believe in include the following:

As always, if you do not have a bariatric doctor or dietitian, you are welcome to email me and I will help you locate someone in your area. Email me at Steph@bariatricfoodcoach.com

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