Bariatric Food Coaching: Setting Protein, Carb and Fat Goals

Steph Wagner MS, RDN

July 10, 2019

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Weight Loss Surgery Protein Goals

Whether you use Baritastic or another app, what should you put for the protein goal?

 

First, a member email with a great weight loss surgery protein goal question.

 

Blog answering weight loss surgery protein goals question including how many grams of protein carbohydrate and fat. block quote stating the question what should i make my protein goal

I am excited about this question! I really hope my answer will help make things more simple. Protein goals can be hard to decipher after weight loss surgery. Possibly your program told you how many you should aim for but what about carbs and fat? How does the pie chart inside the food journal come into play?

Overwhelm is a very common emotion to feel when it comes to tracking food and numbers. Then you add in the layer of being a bariatric surgery patient. Confusion is bound to happen even when it feels like it should be clear cut. (And by the way, why do bariatric programs differ so much?)

Macronutrient pie chat goals for weight loss surgery patients, fifty percent protein, twenty percent carbohydrate and thirty percent fat

Let’s talk through the pie chart on Baritastic (or other food journals)

The pie chart is something to look at after you eat and journal, and then you learn from it.

Think of it as a learning tool and not a grading tool. We often think of food journals, scales and even the pie chart as a report card. No one likes to see D’s and F’s so when patients don’t feel like they are doing very well, they don’t journal at all so they don’t have to see the grade.

It really takes some mental practice to treat the food journal as a learning tool. It allows you to stay honest with yourself and learn from each day. The best thing we can do is try to keep the emotions out of it and stay matter of fact. “This is what I ate today, this is what I could do differently next time.”

One important note: look at your pie chart at the end of the day to get a better understanding of the day as a whole. 

I tend to ignore my pie chart until the day is over. While I can get a little bit of understanding with the pie chart through the day, I personally prefer to make sensible choices with my head, then journal it, then reflect on it at the end of the day. The protein, carbs and fat can look skewed after just one meal.

So what about the goals?

To start with the basics of my bariatric eating philosophy, I recommend eating 3 meals per day and making the protein your focus.

Eat two bites of the protein to every bite of vegetable. Two bites turkey burger, one bite zucchini. Don’t focus on how much, just focus on small bites and pausing in between bites. Listen to your fullness cues and ask yourself where you feel comfortable.

Blog answering bariatric surgery questions including how many grams of protein carbohydrate and fat. block quote stating the tip eat 2 bites of protein 1 bite of vegetable eat slowly, stop at fullness

After the meal, journal your food with your best guess. I do not worry about weighing things out perfectly. The palm of the hand is 3 ounces protein, your thumb is about 1 ounce of protein. The palm can also be half a cup of cooked vegetables. It is more realistic to stay with journaling long-term if kept more simple.

When you do this ratio of two bites protein, one bite vegetable and eat three times a day, focusing on your fluids in between your meals – the pie chart will average out around 50% protein, 20% carbs and 30% fat.

Not everyday will hit that perfectly but that would be a good frame to reference. Then you can see your pie chart at the end of the day and if the carbs or fat were higher than you thought, you can look back at your food and see why.

 

This is my approach to food journaling instead of counting calories.

I find it is a helpful way to stay accountable and aware of food choices, but more realistic than counting all the numbers and weighing food everyday.

If you are using Baritastic or another app, most will have you put in the goals for grams but not for the pie chart. I would write down the pie chart goals to help you remember. I personally only put in a water ‘goal’ on the app and leave the others blank. You could put 60 grams of protein as a goal as that’s the ASMBS recommendation.

I hope that answers your questions without being too long, but I truly do love these questions and the opportunity to help! Don’t hesitate to ask me anything.

This member emailed me at steph@foodcoach.me – all members have access to email me questions! Find out more about membership

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6 thoughts on “Bariatric Food Coaching: Setting Protein, Carb and Fat Goals”

  1. Hi steph
    Many thanks for that , as for me personally I weigh food
    Approx 80 percent of time and use your method ie palm thumb
    Etc the rest of time , but I like the pie chart it
    Is simple and very user friendly,in uk there is not
    As much emphasis on carbs,it’s more calories per
    100g as a guy ,I eat approx 1200/1400 calories a
    Day ,but using my fitness pal to journal it says I
    Am starving lol.
    Is it possible to switch carbs into calories or vice versa
    With an ish figure ie 10 kcal/ calories equals 1
    Carb type of thing just curious,and I know what curiosity
    Did to the cat .
    As ever many thanks from this side of the pond
    Warmest kindest regards

    Mark

  2. Hey Mark! One gram of carbohydrate has 4 calories. I’m not certain if I followed your question fully but I hope that was it or close to it! Let me know. – Steph

  3. Thanks Steph! I was just wondering those exact ratios. Great info and explanation!

  4. Hi Steph,
    First off, thank you for all you do! Secondly, I use an app to track my intake, and your percentages are a great guide, but could you tell me how to measure in terms of grams? My nutritionist has only mentioned a target of 60 grams of protein per day, but what is recommended for carbs and fats?
    Thanks,
    Noemi

  5. Hi Noemi!
    It’s all so individual depending on your pouch and your comfort levels. You can get a better idea of what grams that looks like after you’ve journaled for a little while and see your pie chart. I like to coach patients to eat three meals per day of lean meat and a non-starchy vegetable. Eat two bites of the lean meat to every one bite of the vegetable and listen to your pouch for your natural stopping cue. Some patients might eat a half a cup and some patients may eat a full cup. It doesn’t matter because it was lean meats and vegetables and they were listening to their body! If someone stopped at a half cup but really could have eaten a full cup, they might struggle with snacking later in the day. This is why the percentages are a helpful tool because it allows you to identify your own stopping point. Focusing on lean meats first, then vegetables, fruits no more than once per day with a meal and 2 servings of a healthy fat will typically level out to those percentages. I hope that helps! I know it’s a long winded answer!

  6. Steph, your information is spot on and I wished I had this information before my surgery and then after….I have been struggling, trying to figure out my pouch, and I really knew already by my feeling the fullness. Thank you so much!!

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