Protein! Your smartest strategy for long term success is to make protein THE priority in meals and snacks. Be sure to eat your protein-rich foods first to help you consume the amount of protein you need each day. This strategy will help prevent weight regain. 

For more information on protein, listen to these episodes of the Bariatric Surgery Success podcast:

EP 31: Does Protein Help Prevent Weight Regain?

EP 42: What to Eat in the Weeks Following Bariatric Surgery?

EP 43: How to Eat for the Long Haul after Bariatric Surgery, Part 1

EP 44: How to Eat for the Long Haul after Bariatric Surgery, Part 2

EP 48: Is Pea Protein a Smart Choice after Bariatric Surgery?

After bariatric surgery, protein helps you heal the wound, form enzymes and hormones, and it works to build and maintain muscles. Fat free mass or muscle mass is the calorie burning machine in the body which improves body composition, meaning more muscle mass and less body fat mass. So think of it this way, protein helps to keep your metabolism stoked. Another protein bonus is that it keeps you feeling full, ultimately helping to prevent that dreaded weight regain. Without adequate protein, your body cannot perform all of these needed functions as it should.

Do you know how many grams of protein you need daily? The recommendation for protein is between 60-120 grams all depending on your daily activity level and workouts.

Listen to:

EP 31: Does Protein Help Prevent Weight Regain?

Weight loss surgery significantly decreases the amount of food that you can eat and tolerate at a meal and in a day. With this decrease in the amount of food eaten comes a decrease in nutrition including calories, vitamins and minerals, fiber, naturally occurring plant nutrients called phytonutrients, etc. What this means to you and your success is that nutrition becomes very important. Developing a lifestyle built around eating well and planning your nutrition needs will help you feel good each day and be able to get out there and do what you want to do. 

Subscribe to the Bariatric Surgery Success podcast so you can get all the latest nutrition information, strategies and tips to help you rock your new lifestyle. 

Getting enough nutrients day-to-day comes down to building a lifestyle after surgery with a focus on nutrition. You may have heard the term macros which refers to the three macronutrients protein, carbohydrate and fat. You can consume all of these macros once you’re back to a regular diet with the focus on protein. Vitamins and minerals are known as your micronutrients as they’re needed in smaller amounts and will come both from food and from supplements.  

Listen to:

EP 137: The Latest Bariatric Sports Nutrition for after WLS

EP 136: Getting Enough Calcium & Vitamin D: Bariatric Nutrition Q & A

EP 132: 15 Bariatric-Friendly Carbs: Bariatric Nutrition Q & A

EP: 49: Is Fat Taboo after Bariatric Surgery?

Vitamin and mineral supplementation is a lifelong part of bariatric surgery. When you have weight loss surgery, vitamin and mineral supplementation is one of those items that will be on your daily to-do list from now on. Call it a behavior modification, lifestyle change or a tweak to your daily routine. However you look at it, supplements are part of your new lifelong strategy for success.

Nutritional deficiencies are common after weight loss surgery and the type of surgery performed does make a difference. For example, vitamin and mineral deficiencies are more common after procedures like Roux-en-Y gastric bypass or biliopancreatic diversion as compared to sleeve gastrectomy and adjustable gastric banding. That’s why you always hear me say to circle back with your health care team for clarity if you’re unsure about which supplements they recommend for your procedure. Recommendations vary between surgical centers and even professional groups so don’t be surprised if your supplements suggestions are different from someone else you know who’s had surgery.

Let’s start with three important tips to keep in mind:

1. Vitamin & mineral supplementation usually begins when you go home from the hospital which is typically 2–4 days after surgery. So if you’ve had surgery and are home now, you should have started on supplements. 
2. Your body has changed in its ability to absorb vitamins and minerals. How much it’s changed depends on the surgical procedure. When selecting your products, chewable or suckable pills, or liquids are a really good idea the first 3-6 months. Then if you choose and your health care provider doesn’t have you on any specific regimen, you can switch to capsules or tablets.
3. Routine vitamin and mineral screenings/lab tests should be part of your care from your health care team. How often and what they screen for will vary with your procedure.

A lot has changed in the vitamin-mineral world. In the not-to-distant past, bariatric-specific supplements weren’t common so we combined various over-the-counter products to get what we needed. Today, many companies provide a wide variety of bariatric supplements. In fact, there are so many to choose from, it’s easy to become overwhelmed or unclear about which ones to take. You’ll need to do some label sleuthing.

So which supplements do you need? General suggestions for bariatric surgery, knowing that your health care team may tweak these, include multivitamin and mineral supplements along with vitamin B-12, iron, folate, calcium, vitamin D and thiamine and possibly additional fat soluble vitamins A,E,K for the bileopancreatic diversion procedure.

Listen to the following episodes for a lot more in-depth information to help you make the right decisions for your situation:

EP 136: Are You Getting Enough Calcium & Vitamin D: Bariatric Nutrition Q & A

EP 53: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 1

EP 54: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 2

EP 15: Vitamin B12 and Bariatric Surgery

A bariatric multivitamin covers the same range of nutrients found in an off the shelf multivitamin but the proportions are very different. These supplements are specific to the vitamins and minerals, also referred to as nutrients, that are needed after bariatric surgery. There is often more to a supplement regimen than just the multivitamin meaning that additional calcium or B12 for example may be required.

Nutritional deficiencies are common after weight loss surgery and the type of surgery performed does make a difference. For example, vitamin and mineral deficiencies are more common after procedures like Roux-en-Y gastric bypass or biliopancreatic diversion as compared to sleeve gastrectomy and adjustable gastric banding. 

It’s not uncommon to be deficient in some of these nutrients even before surgery, especially if you eat a lot of highly processed foods and not so many whole foods which is so easy to do in our fast paced, grab it and go world.

Add to that a low intake of food and therefore nutrients after surgery and you do not have enough foods loaded with vitamins and minerals to meet your daily needs. It can be very difficult to physically take in enough food to provide your nutritional needs. Skipping multivitamins after bariatric surgery makes vitamin and mineral deficiencies and their related health issues common. 

Gastric banding or lapbanding is purely restrictive – nothing has been removed so it simply comes down to not enough food coming in to meet nutritional needs.  Sleeve gastrectomy is not generally considered as causing malabsorption. However, because removal of 80% of your stomach removes 80% of the cells that produce gastric acid and intrinsic factor, this leads to malabsorption of nutrients not necessarily calories. 

The lack of gastric acid which your stomach lining produces potentially affects the absorption of not only B12 but also folic acid, vitamin C, beta carotene, iron, magnesium, zinc, copper,  and other trace minerals (meaning you only need very small quantities of them). So if your absorption lessens, you become at risk of deficiency. To help prevent deficiencies all of these nutrients should be found in a good quality bariatric vitamin whereas they may not be in a standard off the shelf version. 

Listen to the following episodes for a lot more in-depth information to help you make the right decisions for your situation:

EP 136: Are You Getting Enough Calcium & Vitamin D: Bariatric Nutrition Q & A

EP 53: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 1

EP 54: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 2

EP 15: Vitamin B12 and Bariatric Surgery

Here’s some good news. Hair loss after weight loss surgery is very common, not permanent, and your hair should grow back. I know it feels awful but it’s totally normal to lose 5-15% of your hair from surgery and the rapid weight loss that follows. Typically this loss doesn't last more than six months then it grows back. It’s just a pain in your patootie to go through.

You might be wondering why hair loss happens. There are many causes that include stress, thyroid issues, extreme diet changes, too little protein, too few calories, hormonal imbalance and iron or zinc deficiency. Even medication like a beta-blocker or too much vitamin A can cause hair loss. 

Follow up with your health care team for blood work to make sure there are no underlying health issues such as hypothyroid that would affect hair growth and loss. At the same time, lab work can check for vitamin and mineral deficiencies such as iron or zinc.

Think about your situation. You’ve had surgery, cut your calories very low, possibly too little protein, maybe an underactive thyroid. Sprinkle in low levels of iron, zinc, biotin or folate and you have a recipe for hair loss.

The physiological stress of surgery and rapid weight loss can cause the body to focus vitamins and minerals on the heart, brain and other functions instead of hair growth. As your body adjusts to the changes, the hair loss slows and then stops. Hair should grow back normally if there are no vitamin and mineral deficiencies and you are consuming adequate protein.

To learn more about hair loss listen to:

EP 57: Help! My Hair is Falling Out after Surgery

EP 53: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 1

EP 54: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 2

Be sure and take your bariatric-specific vitamin and mineral supplements daily or as your product recommends. It should contain iron, zinc, biotin, copper and other nutrients tied to healthy hair. Don’t miss this…if you do not have a deficiency, taking more of these supplements will not make your hair grow back any faster and excessive levels of vitamin A and zinc for example can be potentially harmful. 

Follow up with your health care team for blood work to make sure there are no underlying health issues such as hypothyroid that would affect hair growth and loss. At the same time, lab work can check for vitamin and mineral deficiencies such as iron or zinc.

If you’re wondering if you take the correct bariatric supplements that your body needs after surgery, listen to: 

EP 53: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 1

EP 54: 6 Must-Have Vitamin & Mineral Supplements after Bariatric Surgery, Part 2

EP 57: Help! My Hair is Falling Out after Surgery