Time for food again! Advice needed

So I am 2 weeks out of surgery and I can start eating soft foods again! I am excited because while I am not "hungry" I do get the need for something more substantial than Pureed and strained soup.

Any advice on adding food to my diet? Any gotchas from the pros?

Also, what is the best free online food journaling app or website?

Thanks in advance.

Cottage cheese and refried beans (with cheese melted on top!) were two of my favorite soft foods. But really, my doctor said anything I can mush with a fork is fair game. At that point I was also allowed to have mashed potatoes. I had been jonesing for Sloppy Joe sauce on mashed potatoes for WEEKS by then, but when I finally had it, it just wasn't as good as I'd imagined it would be. My husband finished it. :)

My favorite journal app is Sparkpeople.com. I used it on the computer, and with the mobile app. It's FREE, and the food database is incredible. You can also enter your own recipes and it will calculate the nutritional values. And you can track your activity, your water - really just about anything you want to track. I've been using it for years. I've tried other apps but I'm just so familiar and comfortable with SparkPeople (and I've entered dozens of my own recipes in it!) that I keep going back to it.

To the OP-- mashed potatoes are not a great choice. Some programs allow them, but you're much better off looking for something high in protein and low in carbs. A good rule is 10g protein for every 100 calories :)

True. While the tiny amounts you'd eat them in probably wouldn't add up to a crazy amount of carbs, why not optimize your precious stomach space and weight loss with a protein choice? Or if carbs are involved, something with more nutritiou*****h. I think some surgeons put stuff like potatoes or cream of wheat on the menu to help your body get used to eating again, but food like that really isn't going to help anyone on a long term basis.

Problem with mashed potatoes is that ebee a TSB has enough simple starches to stimulate the Insulin production. Even 10 years post op one heaping Tsp of mashed potatoes may cause RH in me. Candies are not as bad for me as mashed potatoes are.

A fisrt few weeks after WLS our body gets into ketosis and that can help to lose fat much better than if we are not in ketosis. And I know that when I limit calories and carbs at the same time - my hunger is really in control, and I don't crave carbs.

Just because you have a certain morbidity that may require a special diet doesn't mean everyone does - most particularly those who don't have a bypass and aren't prone to RH. As for the desirability of ketosis, you may like the bad breath and BO, but such things are not a requirement of healthy weight loss. Yes, dropping ketones is a natural result of burning our fat reserves, but having to drive oneself into it by consuming fats in preference to carbohydrates is just fad diet mythology - it is the caloric deficit that drives the burning of our fat stores.

Many need a special diet to accommodate some morbidity that we may have - it may be low carbohydrate, low fat, low protein, low acid, low fiber, gluten free, etc. One of the big advantages of our WLS is that it is insensitive to whatever diet we may need - the caloric deficit driven by the surgery ensures that. Then, we need to adopt a diet that we can sustain and help control our weight - which may be something quite different than what someone else may need. Promoting one diet over another as a one size fits all solution is the very essence of a fad diet.

Even VSG person or someone who had DS can have RH. Just because you don't, it doesn't mean others won't get that.

If you read my post - I wrote how MY BODY reacts to potatoes. Early post op WLS I had no idea about RH, or really understood how my body could react to different foods.

Comments from vets helped me understand what I possibly could be experiencing. I know that as RNY person, my body could be more sensitive to carbs. But since digestion and absorbtion of carbs starts in our mouth and and stomach - some people who has sleeve can also deal with RH, if they are carb sensitive.

In addition, early post op we are in ketosis because our body does not get enough calories, and burns our fat for energy.

Learning good habits - like, i.e avoiding high carb foods - can help a person in a long run.

Eating low carbs long term can help limiting BS fluctuations and hunger. Regardless if someone had RNY or a sleeve.

Lots of things will stimulate insulin production, so there is no reason to lift out a particular food, such as potatoes, unless there is a specific problem that that person is having. Yes, others can have RH, even non-WLS people, but the existence of such outliers is no reason to be prescribing a particular diet or course of treatment to someone who is not so affected - that's just bad medicine. So, much like recommending that an RNY patient should be on a PPI or a reflux/low acid diet simply because there are a few outlying cases of GERD with the RNY, one shouldn't be trying to correct RH or dumping in cases where it does not exist. These types of unnecessary dietary restrictions is why some suffer malnutritrion, or have to supplement more than they otherwise should if they maintained a relatively normal dietary balance, something we see fairly commonly in these forums.

The experience of vets is very useful, both in person through support groups if possible, and online. Where it loses value is when individual experiences are offered up as general coolie cutter advice - right: "XYZ triggers cravings in me so I avoid it"; wrong: "XYZ is a trigger food and we should not have it". Yes, simple carbohydrates and sugars start absorption in the mouth and on down - but not complex carbohydrates which can have a substantial delay that can be very useful. Ultimately, they all get absorbed calorically (DS excepted) irrespective where that absorption begins, understanding the where and how of absorption is useful in managing our physiology, but location of absorption is neither right nor wrong, good nor bad.

Yes, some people can be carbohydrate sensitive - there is a genetic predisposition towards diabetes and insulin resistance that includes a genuine carbohydrate sensitivity, and those with this makeup can benefit from low carb dieting; for most others it is just another fad diet. There are many who claim that they are "carb sensitive" by virtue that they may gain a bit after consuming some increased amount, but they are usually only seeing water weight fluctuations resulting from their low glycogen levels - a manically low carb diet causes that carb sensitivity, which goes away if they maintained a relatively normal dietary balance instead.

Yes, ketosis will result from the caloric deficit after our WLS. It also results from maintaining a high fat, low carb diet without a caloric deficit (or even a surplus) resulting in no weight loss or even a gain; ketosis does not equal weight loss. This is why high fat, low carb diets are often prescribed to non-WLS gastrectomy patients - to avoid or minimize weight loss. Adding fat bombs or bulletproof coffee to one's diet may help achieve ketosis (for whatever reason one wants to do that,) but will not yield additional weight loss, unless those added calories are lost somewhere else in the diet. Some speak of ketosis not as a normal result of weight losing caloric deficit, but as the desirable end game. Sorry, ketosis is not an ******!

Good habits are essential to good long term success in this game. Avoiding high carbohydrate foods is not necessarily one of them - there are a lot of highly nutritious high carbohydrate foods that are entirely consistent with good weight control. There are also lots of high calorie/low nutrition junk foods that should generally be avoided, and they can be of both a high carbohydrate and high fat nature (and are often both.) Good nutrition, and weight control, entails maximizing the good while minimizing the bad.

BS and hunger control is very compositionally varied, and is quite dependent upon the blend of fats, carbs and proteins in the particular food or meal, and quite specifically fiber content. Some of the most long term satisfying foods on our menu can be high carb, specifically when we get into high fiber vegetables. They can be much more satisfying, not to mention much lower calorie, than some high fat SBUX drinks.

These basic dietary descriptions such as low carb or fat, or random macro counts or ratios, can be very deceptive when it comes to real world eating, and can result in some fairly malnutritive eating habits, as they are really a rather poor measure of what a good diet should be for a person. To one person a "keto" diet may mean an all natural, non packaged/processed diet avoiding the common junk foods of today, while to another it just simply means

The problem is that obesity is a disorder of insulin resistance and that fat cells remain damaged for this up to ten years; it takes ten years for the body to recycle fat cells via autophagy. The only way to recycle them more expediently is to have them removed. During this time I'd argue it's more prudent to avoid higher carb choices for biochemical reasons which are obvious.

Ketosis isn't necessarily the be and end all of everything - it's merely energy production in the absence of glucose which occurs at an ATP deficit. You actually expend more calories whilst in ketosis to create ATP. I'd argue ketogenic diets are most useful for someone T2D (and no, you won't go into ketoacidosis eating low carb if done correctly) or with neurological issues which predispose them to not utilizing glucose correctly, but those are tangents.

The issue is that caloric restriction will not always instigate ketosis if carbohydrate is high enough - particularly since higher-carbohydrate pureed foods are easier to ingest, and so we overeat them. The other issue, is that in the absence of vagal feedbac****il the afferent nerves are healed, there is still a biochemical response from insulin that can stimulate overeating. Satiety is not just physical - it's also chemical and behavioral. Insulin can absolutely stimulate overeating, because it's a more powerful hunger hormone than ghrelin.

Much like saying people who have experienced positive weight loss with ketosis or that RH is a person-specific correlation, stating that highly nutritive carbohydrate-based plant foods leading to positive weight loss is also a correlation based on your experience.

Even after nearly 500 pounds of weight loss I'd probably still be more likely to gravitate to the donuts and don't find salad as stimulating... again, as you say, everyone is different. Someone who was "only" 350 pounds may very well be able to do so with ease. My experience is not the same for everyone else. At any rate, this is a tangent.

Going back to the OP, the reality is that many of us who have weighed 400+ or more are unable to eat carbohydrate easily long-term at least until several years, if not over a decade, out from surgery. Close to surgery though I would argue that more prudent advice is typically to suggest limiting carbohydrate closer to surgery. Refried beans and mashed potatoes are certainly not nutritive compared to animal meat which has more vitamins (B and C) in addition to protein and fat which are both needed to, well, heal from surgery. Mashed potatoes will do nothing for you besides provide psychological comfort...which is often a bad association to reinforce early out from surgery if we have been super morbidly obese.

So . . . a low carb diet post WLS is not actually a fad diet? Even when an internet nincompoop asserts, over and over again, that it is?