How much should I be eating after weight loss surgery?

Those who have had weight loss surgery often ask how much they should be eating. Whilst is seems a simple question, there is no simple answer.

How much you should be eating is a hot topic on many online forums or support pages. If you have read the discussions it becomes clear that weight loss surgery clinics and support teams widely differ in how much they are recommending their patients eat. This is also clear when I chat with other health professionals at our obesity surgery conferences. If the professionals working in the area can’t get their story straight, how are people to know what to do?

Some surgeons recommend you limit meals to half a cup, some may say one cup, and others will say a bread and butter plate of food. Interestingly, one cup of food nicely fits on a bread and butter plate and this is the guide we use in our clinic.

Accredited Practising Dietitians (in Australia, Registered Dietitians in the USA) are university‐qualified experts on food and nutrition. Whilst even their recommendations on what you should eat following surgery will vary, what they will generally agree on is that it is difficult to meet your nutritional requirements eating half a cup of food, three times a day.

To date, there are no scientific studies on the exact amount of food people should include after gastric band and gastric bypass surgeries. Hopefully in time this will evolve. Research from Mercy Bariatrics in Perth, Western Australia, provides some excellent data to help guide serving sizes for those who have had a sleeve gastrectomy. Whilst initially very small amounts are tolerated, at six months after surgery most people will manage about half a cup of food at a time. By 12 to 18 months most people will manage about one cup of solid food. This is a guide only and will vary between people as there are different size sleeves.

A point relevant to all surgeries is that the people studied found they could indeed ‘fit’ more food in than what they felt satisfied with. After all forms of weight loss surgery, eating to the maximum amount you can tolerate is not recommended. I have a favourite quote from Dr. Teresa Girolamo, one of the GPs in our clinic: “It’s not a matter of seeing how much you can eat and get away with, but how little you can eat and be satisfied.” Testing the limits of how much you can eat increases your intake, particularly if it occurs repeatedly, and can compromise your results. Tune in to your feeling of satisfaction after eating and let that guide the amount of food you need to eat. Always stop eating before you feel any discomfort.

Create an environment that makes it easy for you to eat small portions. Ensure family and friends know you use a smaller plate/bowl/cutlery. Take these items with you if you travel. When eating out, order entrée size meals or if there are none available, separate your meal into an appropriate portion before you start eating. Tapas style menus, Asian or Indian eateries are often tailored to meals being shared, allowing you to dish up a small serve to suit your needs. It is fine to leave food on your plate when you have had enough, even if it is a smaller serve. Avoid the temptation to ‘clean the plate’. If ‘wasting’ food concerns you, carry a container with you when you eat out and take a serve home to have for another meal.

After gastric band surgery some people may find it takes some time before they feel satisfied on small amounts of food. Many people need their gastric band adjusted several times to help them feel satisfied on small serves. If small meals of solid food do not satisfy you, keep in regular contact with your support team until they do. Some people will find this will occur early in their journey, for others it may take longer. Be patient.

Whilst it is not necessary for you to measure or weigh everything you eat, it may be helpful to measure the amount you are usually serving. When you eat a meal, take note how much food it takes for you to feel satisfied and how much it takes to feel full. The aim is to feel satisfied after eating, so if you know roughly how much food this is you can avoid dishing up too much in future.

The recipes in my book and on my blog have been designed to provide approximately four, one cup serves. This does not mean a one cup serve is right for everyone, but does allows you to easily adapt the recipes to your requirements.