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To the weight loss surgery patient slider foods are the bane of good intentions and ignorance often causing dumping syndrome, weight loss plateaus, and eventually weight gain. Slider foods, to weight loss surgery patients, are soft simple processed carbohydrates of little or no nutritional value that slide right through the surgical stomach pouch without providing nutrition or satiation. The most innocent of slider foods are saltine crackers, often eaten with warm tea or other beverages, to soothe the stomach in illness or while recovering from surgery. Understanding Slider Foods The most commonly consumed slider foods include pretzels, crackers (saltines, graham, Ritz, etc.) filled cracker snacks such as Ritz Bits, popcorn, cheese snacks (Cheetos) or cheese crackers, tortilla chips with salsa, potato chips, sugar-free cookies, cakes, and candy. You will notice these slider foods are often salty and cause a dry mouth so they must be ingested with liquid to be palatable. This is how they become slider foods. They are also, most often, void of nutritional value. For weight loss surgery patients the process of digestion is different than those who have not undergone gastric surgery. When slider foods are consumed they go into the stomach pouch and exit directly into the jejunum where the simple carbohydrate slurry is quickly absorbed and stored by the body. There is little thermic effect in the digestion of simple carbohydrates like there is in the digestion of protein so little metabolic energy is expended. In most cases patients in the phase of weight loss who eat slider foods will experience a weight loss plateau and possibly the setback of weight gain. And sadly, they will begin to believe their surgical stomach pouch is not functioning properly because they never feel fullness or restriction like they experience when eating protein. The very nature of the surgical gastric pouch is to cause feelings of tightness or restriction when one has eaten enough food. However, when soft simple carbohydrates are eaten this tightness or restriction does not result and one can continue to eat, unmeasured, copious amounts of non-nutritional food without ever feeling uncomfortable. Many patients turn to slider foods for this very reason. They do not like the discomfort that results when the pouch is full from eating a measured portion of lean animal or dairy protein without liquids. Yet it is this very restriction that is the desired result of the surgery. The discomfort is intended to signal the cessation of eating. Remembering the “Protein First” rule is crucial to weight management with bariatric surgery. Gastric bypass, gastric banding (lap-band) and gastric sleeve patients are instructed to follow a high protein diet to facilitate healing and promote weight loss. Bariatric centers advise what is commonly known among weight loss surgery patients as the “Four Rules” the most important of which is “Protein First.” That means of all nutrients (protein, veggies, complex carbohydrates, then fat and alcohol) the patient is required to eat protein first. Protein is not always the most comfortable food choice for weight loss surgery patients who feel restriction after eating a very small amount of food. However, for the surgical tool to work correctly a diet rich in protein and low in simple carbohydrate slider foods must be observed. The high protein diet must be followed even after healthy body weight has been achieved in order to maintain a healthy weight and avoid weight regain.

Couldnt have said it better myself, FOOD IS EVIL!!!!! it is not your friend the devil puts it there for temptation just like alcohol and drugs. got to make that stiick in your mind, and yea me too. lol please let my next addiction be exercise and cleaning. much more healthier

I totally agree too...thanks for saying it so clearly. I'm an Aussie sleeved patient who was given a very clear understanding of the commitment to lifestyle change & that it is your responsibility to look after yourself (healthy food choices & exercise), with the assistance of a team who work in the practice (psychologist, dietitian, surgeon, Doctor GP, & Nurse Educator). Does this not happen else where? I respond with the question of personal care vs motivation that posts are asking about alcohol or chocolate consumption for example. I personally want to be well, healthy & within a normal health range that I abstain from these items.

I didn't read most of the 13 pages of posts but want to put in my 2 cents on the main topic of this post. This site is great because it brings together people who are or are headed to the same destination - WLS but often from very different perspectives. Every insurance company has different requirements, every surgeon has different procedures and every dietitian has different opinions. Thus, pre-op plans and post-op phases can be very different for each of us. For example, my pre-op diet was 3 shakes, 2 bars, unlimited vegetables and 3oz Protein per day. Others have been liquid only. Those are vastly different but neither is wrong or dangerous. Some people ask questions because their process left them with little guidance. Others may ask questions to compare advice given by different providers. Some people are worried about everything - especially that their results are not normal. It is also true that some people are just plain stupid. I think it is fine to post a general rant about your general perceptions as to others' knowledge, commitment, dedication etc based on their posts. It is something else to attack someone who asks a question directly - even if it is a stupid question. Nothing useful can come from that. I for one am the type of person to look at everything critically - including advice from my doctors and dietitians and I would encourage everyone to do the same, This site is one of my resources. Just a couple examples - My soft foods diet from my dietitian says I can have ground turkey but that ground beef is a "problem food" and that I can have mashed potatoes, whole grain crackers and whole grain bread while at the same time saying that a ritz cracker or white bread is a "problem food." That doesn't make a ton of sense to me. Does problem food mean that there is a danger of splitting my sleeve open if I eat ground beef instead of ground turkey? Many providers have a way of answering questions without really giving you a straight answer. Maybe I come on here and ask a question to help me decide if my dietitian is telling me that ground beef is a problem food because it is fattier than ground turkey or if it is actually dangerous at this phase. I might not even want to or intend on eating ground beef but I want others' input as to what their programs are telling them. I don't need or want to be called names, accused of being a failure and otherwise lectured for that question. My thought is that if your inclination is to do one of those things, just move on to the next topic. The alcohol one is a great example. Many providers say no alcohol for a certain period of time. Is it because it is dangerous? Is it because it is empty calories? Why do they say that? For me, I asked my surgeon if I could have a drink at a special occasion 5 weeks after surgery. He said yes. He warned that alcohol is empty calories and something that can hinder weight loss. Perhaps someone else's dr. said no. By posting here and asking the question, the person could learn what other's doctors have said and could then ask appropriate follow-up questions of his or her doctor to learn why the dr. said no. If the dr explains that it is just empty calories, the person could choose to ignore the doctor. If the dr says based on your history it could be dangerous because of x, y and z, the person now knows why it is unsafe for them to have a drink. Aww heck I don't even remember my point anymore. Perhaps the thing to take from it all is some people are stupid and some people are jerks and there is no reason to interact with either of those types or get worked up by anything they post,

My surgeon does 2 weeks liquid, 2 weeks pureed, 2 weeks soft, then regular food. Of course they say no alcohol, popcorn, sweets, or carbs like bread, rice, Pasta, and I probably won't have have any of those for a while, mainly because I truly want to focus on protein being that I cannot eat very much.

No alcohol before surgery. Not good when your having anesthesia. Don't take the chance.

Thank you so much for sharing that article. It answered all the questions I had about "slider" foods. I'll guess I'll have to put them on the list of "things I just cannot have again". I'm an all or nothing type of person who KNOWS--like an alcoholic cannot have a sip of alcohol ever again---I CANNOT have just a tiny bite of some foods. Oh well. Life is good. I'm enjoying being able to move with less pain--so I can forgo certain things in order to be able to move with less pain.

Lynnette, If you are a medical professional like myself, you can do your own fills but the preferred method is having another medical professional do it for you. Theres no reason for al the slander you are getting from everyone & actually I find it extremely immature. We are all adults on this site & if we don't agree with what you are doing then no one needs to reply, I mean really people???!!! After all you are going to do what you want to do anyway. Having said that, please please please make sure you re-sterilize that needle each & every time you use it. You can boil the needle for a good 5 mins then let it air dry on a clean surface(wiped with alcohol is good NO BLEACH). I wish you didn't have to do this & I wish you the best. Understand if you don't use sterile technique you can get your port infected which can run up your tubing & eventually get to your band itself so please proceed with extreme caution. I know people who got banded in Mexico & what they have had to do is basically lie telling the new doctor that the one who originally did it is no longer doing it or is not available for your schedule. I'm not condoning lieing or stealing or self-medicating but I do understand its going to happen. Good luck!!

I'm not dieting in the sense of counting calories, fat grams, etc. But I am trying to follow the bandster guidelines I was given: each meal should be 2-3 oz of lean Protein and some veggies. That's doing the trick for me now that I have fill in the band. I do get in at least one piece of fruit per day as a snack, too. No beverages with calories (except occasional milk), a multi Vitamin every day. At this point it does still feel a bit like a "diet" - I have to still make the choice not to indulge in junk food, no alcohol, staying away from Pasta, potatoes and bread. And it's not always easy, particularly at special occasions or when goodies are offered at work. I just try to follow "most of the guidelines most of the time".

I'm a drug and alcohol counselor. I really hope you understand that even though you've quit drinking, it doesn't mean you're automatically cured of the issues that made you drink in the first place. Now you seem to be transferring your addiction back to food. You're dealing with your depression in very self destructive ways. I hope you're seeking treatment, a 12 step program or counseling. Without getting to the bottom of the reasons why you continue to abuse alcohol and food, there's a very high chance of relapse, both for drinking and for putting the weight back on. Good luck to you!

My addiction to alcohol was only short lived, maybe 5-6 months. I quickly realized I had to get it under control quick and I instinctively knew what I had to do, taper off. So that's what I did. I monitored what I drank over the course of a day. Since I was doing primarily shots of whiskey It was easy to simply reduce my intake by one shot every few days. I need to stress that although I was "eating crap" that my restriction is still intact from the surgery. So if I messed up and ate donuts then I could only eat 1 and not the dozen that I could eat before surgery. So I would eat a cupcake or what not and that would be my meal. When I regained 6 lbs it was primarily due to the fact that I was eating every 2-3 hours, and it was usually something sweet or carb-packed. I stopped doing that as well but continued to eat mostly carbs. I think the restriction is what led me to lose those 6 lbs and more. I'm almost 2 years out and the restriction is still strong. So what I've been eating mostly now is a Protein shake or an egg McMuffin for breakfast, a small Lunchable (the kind with meat, cheese and crackers) for lunch, and either a salad, bit of Pasta, and/or something sweet like a cupcake or two for dinner. So yeah, it's not good but it's nowhere near the abuse I did to my body before surgery.

I can manage some soda now without issue---do it on occasion. But just a drink or 2 of beer, has me burping ALL night. I cannot do it! I have drank other things, it is not the alcohol, it is the serious carbonation in the beer. I mean if you fill a cup with soda pop, it is usually over ice, which helps eliminate some carbonation, but the head on it disappears quickly, you can pour a beer, and it will sit with the head on it for a loooong time, and you see the bubbles coming up from the bottom of the glass forever! I do mixed drinks---have to skip the beer....which just does not seem right at the lake without beer! But even the bottled things like hard lemonade----way to carbonated. Like has been said though, I much prefer the 100+ pounds gone than the taste of that beer anyway! Kat

The ingredient in sugarfree stuff is probably malatol or another alcohol sugar. One problem is that the substitute sweeteners can cause a lot of gas and "D" if you eat to much of it. I think that I'd have the regular/real chocolate on occasion and really enjoy it rather than the sugar-free stuff...

I usually do Net Carbs...from all my days either on Atkins, South Beach, The Belly Fat Cure, I think I even remember something about this from WW... You basically subtract the Sugar alcohols and Fiber from the total Carbs. A label from an Atkins Protein bar: Total Carb: 29g Fiber: 11g Sugar Alcohols: 15g Net carbs: 3g Protein: 15g (pretty good for the carbs) I agree with others, you just have to find what your body responds too. I try not too do many bars, but when I'm on the road and don't have access to cold foods, its a good sub. Plus, when I get to eat fruits again...I want to make sure I am not feeling guilty about using all my carbs on one piece. I dont' think anyone got fat eating too many fruits and vegetables.

Alcoholism is such a difficult thing to deal with. As well as divorcing an alcoholic, my brother drank terribly for many years. He has now been sober for close to 10 years. We still seem to walk on eggshells around him, like he will start drinking again if we do or say the wrong thing. When that is their life style it is VERY hard, there are so many fears, and angers festering inside. Have you ever attended Al Anon meetings? They were of great help to my Mom. Her biggest fears were that my brother would feel we abandoned him, or that he would drink himself to death, or have an accident and die, and she would have been mad and not speaking to him...so she always tried to talk to him. She got great support and guidance from the Al Anon group---plus a lot of people who understood the emotions she was going through. It was full of people who knew she was not a failure as a Mother, who understood how she could love and hate him all in the same breath. Please look into it, if just to have someone to relate to. I understand some of the fear, but to have the fears with your brother is nothing like it would be with your child---I cannot even imagine. Just know you are NOT alone. Hopefully as she gains momentum behind her with this push for sobriety she will begin to see you full of the love you have for her. Hang in there, and try to get some help for YOU as you deal with her---it will help her in turn. I am sorry I have no words of wisdom, I just wanted you to know someone was out here listening, and feeling full of compassion for you. I am going to say a prayer for you and your family tonight, and hope you all can find a way to work through this together!! Good Luck on your fill tomorrow, it really wasn't a big deal at all!!! The needle is a simple poke---same as any other shot or blood draw, nothing to panic over!!! (((hugs))) Kat

I looked online and immodium was on the safe list so I took some last night before bed and so far no more problems, although I'm very gurgly in the tummy. I'll probably take some more tomorrow before the flight just to be SAFE. I am kind of in the "screw it" mode right now and I'm wearing yoga pants with a white paint stain on the butt. Comfort over fashion! Oh and no sugar free stuff, believe me I know those sugar alcohols wreck havoc i've only had some broth, tea and unsweetened apple juice since surgery (and some water - oh and gatorade but the issues happened before I took a sip of gatorade) Plus some kind of Maalox type thing to coat my healing stomach.

I also a brother who is an alcoholic and my poor mother has been throught he** with him. She has been to al-anon and says it is wonderful. She says they taught her to love the person, but hate the disease.They also teach you that you cannot change the person's actions, only your REACTIONS.I believe going to meetings will give you the help and support you need. **hugs** and best of luck to you.

My doctor said no alcohol for one year. It's not worth the calories at this point. Maybe after I reach goal I'll change my mind.

I don't even think it's as easily categorizable as this. Dramatic weight loss can lead to emotional and mental upheavals, sure, but there are probably just as many people who find health through bariatric surgery and DROP their addictions without replacing them with anything. Is someone who became morbidly obese because they ate too much an "addict"? Not necessarily, of course. So someone who loses a lot of weight and later on becomes an alcoholic isn't necessarily "replacing" one addiction with another. Sure, there may be people who can point to their bariatric surgery as the start of an addiction. But any significant life event can trigger that sort of thing in people who are vulnerable--childbirth, divorce, winning the lottery, losing a job--whatever. I don't think there's anything special about bariatric surgery that creates new addicts.

Well, I go back to school in September, I'll have insurance again, so I will check out my options with that... I do see a therapist though in NYC who deals with people with body image issues and who have had WLS (she also had lapband)... but she has never said anything about maybe having bipolar. When they diagnosed me with borderline in Dec 02, and they put me on the prozac- every time I did something out of the ordinary they would up the dosage until I was at 60mg a day- the max dose. Then I just quit taking it because I started feeling better and sometimes I did crazy things like crossing the street without looking and drinking entire bottles of alcohol (think massive alcohol poisoning), then when I stopped it, and became involved with school (student affairs stuff), I basically had no problems. So its would make complete sense that I am bipolar, but I feel like I have a good sense of control over it at this point. I will talk to my therapist about it in September though. Although I'm not sure if I would want to upset my schooling with regulating medication if I am completely fine in school. I am thought of as one of the favorites- I'm an opera singer getting my masters and The Opera Office casts me in everything and even asks for little favors from me, and there are only a select that has that honor, so we'll see! Life is good, though... life is good.

I have only the last few months have been reading a womens blog who was an alcoholic. I don't think she ever said to what degree, but admits she had a big problem. She now runs ULATRA MARATHONS Like 3-4 a year. That is anything over 26.2 miles. Her latest was 103. She does a couple a year like that. When you read her blog, you can tell she is addicted. She trains every, every day no matter what. Gets up at 5:30 to trail run 8-10-12 miles a day. Hitting the gym while her kids are at activities. Bike riding 14 miles a day also. I can't image having the mental fortitude to do that let alone the physical. I think that's a heck of a transfer!

I’m at 6 weeks now and would definitely do a cruise. You’ll be able to eat yogurt, oatmeal, ham and eggs for breakfast. The lunch and dinner buffet and menus will have lots of options for protein and vegetables…especially fish. You’ll be full after a small portion. I haven’t been eating salads because I don’t feel ready for raw vegetables and hard fruits like apples. I would skip dessert, bread, and alcohol. You could bring some protein powder in case you’re low on protein with the small portions. With the pre diet and surgery, you would probably be down 25 pounds by your cruise.

I am sooooo glad you posted this. I will bookmark the link and post it in every single "Can I cheat on my pre-op?" I was way too scared to cheat for that very reason. They told me if I don't lose and even GAIN weight before surgery, they will cancel, no ifs or buts. In general, I think it largely depends on how big you are - no offense. The bigger you are, the more important is the shrinking of the liver. There is so much mass in your abdomen at BMI of 53.9 vs. 43.9 vs. 35 etc., - think of the Biggest Loser whatever you want, but I think their X-Ray-like body fat scan image gives a good idea of what is going on inside. If you were "just" a 40, maybe they wouldn't have had to cancel it. Another thing I think they consider is the general discipline. After surgery, there is A LOT of discipline and self-control required for a few weeks. Discipline to drink your Water, drink your Protein - at least at my surgeon's office they said that they are simply worried that if you lack discipline before surgery, you will most probably lack discipline after surgery --- just after surgery, the lack of discipline can be FATAL and cause leaks. The other question would be, if there is no evidence that the liver shrinks - why do 98% of all surgeons make us go through the liquid or pre-op diet? Just to fcuk with our heads and torture us? I'd like to believe that's not the case from a medical professional. Maybe they all get together once a year, eat ribs and burgers and drink copious amounts of alcohol and chuckle about how they torture the fatties one last time before surgery, haha! You'll get there. I looks like your office is trying to work with you, and they sure as hell know they got you straightened out and you'll probably not do THAT again! Good luck and all the best - you'll get it next time and be 10x as good!

I have been an avid baker and cook my whole life. This morning I went through my kitchen a gathered all of my baking ingredients and sweets; tons of chocolate chips, sugars, lard, shortening, condensed milk, etc and put it all in a storage bin. I couldn't bring myself to get rid of it so I put it out of sight in the basement. Just now, I threw it all out. It was liberating. I remember years ago I burned my ex's love letters that I had held on to for years, after that I was able to finally move on. It felt good getting rid of that food myself, like an alcoholic clearing out their liquor cabinet on the path to a new start.

Hi, Yes, I will be 12 weeks post op sleeve next week. My surgeon is Dr. Baggs Richmond Kaiser. Once I passed the psych eval it went real quick. Everyone has been great but I have nothing to compare it with accept for others WLS stories. I go to a non Kaiser Bariatric surgery support group in St. Helena so I get to hear what their program is like. I will say that Kaiser sounds more strict compared to others programs. I have not had any complications to speak of really, couple acid reflux moments. I have lost 80lbs since March still working on goal weight. Some days is feels like I should be to goal already but it is a journey not a race. Glad to answer any questions you may have. Very happy I went through with it, feel great, look forward to feeling even better. KP in general were setting the bar really high to get approved, then I heard they had to ease up. Just make sure you have all your medial tests up to date, do whatever they recommend and by all means lose weight before. The more you can lose pre-op the better it will be. I lost 23lbs my first month that is what fast tracked me from March start date to June surgery. Deal with any addictions now, food, drinking, smoking. Caffeine was the hardest by far for me. And I did not listen went cold turkey into surgery with a screaming, horrible headache after recovery. I knew exactly what the headache meant. Even on the pain killers my head hurt. The first nurse messed up brought real tea on my tray, boy was I happy. Although I could only take a few sips it got rid of the headache. And I am back on caffeine so I am a fine one to talk about addiction. I have only tried to drink alcohol one time and that was not fun, just feels gross after feeling so healthy and good. Not worth it. So yeah, great experience all around. Good luck!!!