Common Food Intolerances with Bariatric Surgery

Many patients report food intolerances, especially immediately following surgery once you are allowed to progress to “normal” eating.  Some foods may not sit well and cause an uncomfortable feeling or discomfort for a while.  What should you expect if you are a pre-op patient or early post-op?  What are considered “normal” food intolerances?  Are there other causes of food intolerances?

Common Food Intolerances.  A few foods that are commonly not well tolerated following bariatric surgery may include, but not limited to, pasta, breads, rice, beef, chicken, pork, eggs, stringy vegetables, fruit with membranes, foods with seeds, and cow’s milk (or other dairy foods with lactose).

However, with this in mind, every patient is different in what they tolerate.  Also, keep in mind that each day may be different.  One day you may tolerate a food that you may not tolerate another day.  Another thing to keep in mind is some patients experience taste changes after weight loss surgery.  You simply may not have a desire for certain foods that you liked prior to your surgery or the opposite, you may now love foods you did not like prior to your bariatric surgery.

Why are Certain Foods Not Tolerated?  Some food intolerances are temporary and occur because your new “baby stomach” is not ready to handle that particular food yet.  It is almost like feeding a new baby.  You might want to start with one new food at a time, alone, and see how it is tolerated and then advance from there.  By trying only one new food at a time, it helps to determine which food was not tolerated.  Remember, to eat only a bite or two of the new food.  It may be a good idea to try all new foods at home until you know better what you can/can’t tolerate.  If you experience a food intolerance, many professionals recommend waiting a few weeks and then try it again.

Another reason a food may not be tolerated includes advancing the diet stage too quickly.  Some patients need longer than the normal recommended time in a diet stage before advancing to the next stage.  This is something you can discuss with your surgeon and/or dietitian.

Tips to Reduce Food Intolerances.  There are several tricks of the trade that may help with reducing your risk of food intolerance.  Please talk to your surgeon, dietitian, and/or program before trying any of these to ensure your program is comfortable with your eating plan.

  • Pasta and rice – some patients do well with undercooking slightly or overcooking slightly, however, most patients do not tolerate these foods until 9-12 months post-op.
  • Fresh bread – try toasting to make more tolerable, however, most patients do not tolerate bread until about 6-12 months post-op
  • Beef, chicken, pork – make sure you are using a cooking method that maintains moisture.  Only cook to the safe temperature.  Overcooking dries food out making it is less tolerable.   You can also try using a meat tenderizer or a marinade (watch sugar and fat content) to make meat more tolerable.
  • Shrimp – many patients reported the smaller the shrimp, the better they tolerate them, so avoid those lovely prawns until you get further out from your surgery
  • Eggs – this one is a tricky one.  Some patients tolerate hard-boiled eggs, while others do not.  Some patients tolerate scrambled eggs, while others do not.  So try varying the method of how you cook your eggs to see if that makes a difference.
  • Stringy vegetables – use a blender and strainer to separate indigestible fiber.  Some patients may need to wait until 6-12 months post-op to eat certain foods, such as celery, asparagus, etc.
  • Fruit membranes – remove the membranes of oranges, grapefruits, and other citrus fruits to increase tolerance
  • Skins of fruits and vegetables – remove the skin of fruits until better tolerated, such as apples, plums, peaches, pears, cucumbers, potatoes, etc.
  • Lettuce – lettuce does not seem to be well tolerated for some patients.  Even though we know dark, leafy greens are more nutritious, some patients tolerate iceberg lettuce better initially and then can try the greener lettuce when a little further out from surgery.  Other patients have shared with me, the fresher the lettuce the better it was tolerated.
  • Foods with seeds – avoid eating the seed if possible or wait to eat this food until a little further out from your weight loss surgery (examples include strawberries).
  • Cow’s milk (or other dairy foods) – try soy milk, lactose-free milk, rice milk, or almond milk (look for light or lower calorie options).
  • Portion size – oftentimes it may not be the actual food; it may be the portion size of that food.  Many times the foods that seem to be “not tolerated,” are actually foods that fill us up faster, therefore requiring that you eat less of them.  As we know it is difficult to ascertain exactly how much of each food you can tolerate in the beginning as it takes time and practice to figure out what each individual can tolerate.  For example, chicken is a common food that is not well tolerated.  Even if you can eat 6 bites of yogurt, you most likely cannot eat 6 bites of chicken.  Chicken is a more solid protein and 1-2 bites may be all you can tolerate early out of surgery.   Eating 1 bite extra is overeating, which causes its own discomfort.  Work to retrain your mind on recognizing the feeling of fullness, so you can avoid the uncomfortable “stuffed” feeling.
  • Pace of eating – it is important to keep in mind the speed at which you are eating.  You may be able to tolerate a certain food if you eat it slower and ensure you are chewing properly.

While this list is not all-inclusive and every patient is different, we hope this will help make your transition to your new eating plan after surgery a little easier for you.  Please keep in mind every program has different recommendations and every patient is different.  Something that works for you, may not work for your bariatric buddy. 

© By Heather Mackie, MS, RD, LD

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