What to Eat During Maintenance Phase & Macronutrients 101

So you finally met your goal weight after having bariatric surgery – congratulations! All of your hard work like exercising regularly, getting enough sleep, drinking plenty of fluids, and following the diet plan has paid off. Now that you’ve crossed the finish line, you don’t have to worry about any of that stuff anymore, right? WRONG! There is no “finish line” when it comes to health and wellness. It is something that is always being worked on. Believe it or not, not much changes after reaching your goal weight. You are going to continue making those healthy choices every day that have gotten you to where you wanted to be. 

Maintenance phase is when you are maintaining the weight that you have lost. It is normal for there to be a little range and not stay at one static number, say maintaining between 155-160lbs for example. There is no way to know exactly how much weight each person will lose, but following the recommended diet plan and lifestyle changes will help with successful weight loss and long-term maintenance. Studies show that about 90% of bariatric surgery patients lose 50% or more of their excess body weight and are able to maintain a long-term weight loss₁.

During maintenance phase, you will still continue focusing on meeting the 60-80 gram protein goal, but that amount may increase depending on your level of physical activity. Remember to choose lean sources of protein so you do not consume excess calories from fat. Lean protein sources include low fat dairy, skinless chicken/turkey breast, tofu, seafood, eggs, and certain cuts of beef and pork. You also want to include 2-3 servings of vegetables and 1 serving of fruit a day, if possible. 

You can begin to incorporate small amounts of complex carbohydrates, especially if you are doing moderate-high intensity exercise regularly as our bodies do need some carbohydrates for fuel.  Complex carbohydrates are those that contain fiber, vitamins, and minerals and digest slowly, keeping you full longer. Examples of complex carbohydrates include fruit, beans, potatoes, squash, oats, barley, quinoa, whole wheat bread, and brown rice. Complex carbohydrates can also help reduce constipation, which is common after bariatric surgery. 

It’s best to avoid unhealthy sources of carbohydrates that can cause spikes in blood sugar, lead to weight gain, heart disease, and dumping syndrome. Examples of these foods include soda, juice, or other sugary beverages, candy, cookies, pastries, frosting, muffins, ice cream, chocolate, etc. 

When it comes to fats, the source matters as there are some types of fat that are considered heart healthy, and some types of fats that can contribute to high cholesterol and heart disease. Saturated and trans fats are the unhealthy types of fats that should be limited in the diet. 

Saturated fats are found in:

• ice cream, cheese, heavy cream, red meat, butter, whole milk, poultry skin, coconut oil, and palm oil

Trans fats are found in:

• highly processed foods like chicken nuggets, pastries, onion rings, cake, cookies, chips, shortening, and stick margarine

Unsaturated fats are the healthier type of fats and are found in:

• nuts, seeds, avocados, olives & olive oil, and some seafood

Here’s a sample of what a day might look like during maintenance phase, depending on how far out from surgery you are. (You may or may not be able to eat the amounts listed in this example, depending on when you meet your goal weight.) 

Breakfast:

• 2 scrambled eggs, 1 thin slice whole wheat toast with peanut butter

22oz water or sugar free beverages between breakfast and lunch

Lunch:

• 3oz chicken breast with 2 Tbsp. sugar free BBQ sauce, 2-3oz steamed broccoli

22oz water or sugar free beverages between lunch and dinner

Snack:

• low fat cheese stick, small apple

Dinner:

• 3oz salmon, 2oz cooked carrots, 1-2oz. roasted potatoes

22oz water or sugar free beverages between meals/snacks

Snack:

Sugar free popsicle or low fat, low sugar Greek yogurt

Fluid Total: 66 ounces
Protein Total: about 88 grams

So you’ve been given a protein goal to shoot for, but what about the other two macronutrients that make up food, carbohydrates and fats? This is a question I often get asked as patients get further out from their surgery and are paying more attention to what they are eating, increasing their physical activity, and reading nutrition labels. The answer to this question is a bit complex, as there is a lot of variance from person to person. Someone who is not doing anything beyond a 20 minute walk a couple times a week does not need the same number of calories or carbohydrates as someone who is doing a combination of strength training and cardio exercise for 45-60 minutes 5 times a week. Specifics on these numbers is something that can be discussed with your dietitian during a post-op appointment, that way it is more tailored to your individual needs. Check out the free app Baritastic to get familiar with logging your dietary intake if you want to learn more! 

_{Reference:
1.    https://www.uclahealth.org/comet/endoscopic-suturing-for-weight-gain-after-bariatric-surgery}