Eating after weight loss surgery can be confusing. You’re often on a strict, short-term post-op diet that can change week to week. Then, once you’ve recovered and moved into a maintenance diet, you may hear about “macros” (short for macronutrients), and how important they are for health and weight management.
But, what are macros and micros? Why do they matter? How will counting them help me after surgery? I’ll answer these questions and more in this guide. You’ll learn why bariatric patients particularly benefit from tracking macros and micros after surgery. I’ll also introduce you to DietAI’s calorie counter, a handy tool that makes counting calories, macros, and micros easier.
Table of Contents
Should Bariatric Patients Use Macros?
Protein: The Key Macro for Bariatric Patients
After bariatric surgery, maintaining a protein-rich diet is crucial for muscle preservation, tissue repair, and overall metabolic health. Protein also contributes to satiety, which can help patients manage hunger and stick to their calorie goals.
Carbs and Fats: Why Balance Matters
Tracking macros helps bariatric patients understand how much each macronutrient (protein, carbohydrates, and fats) they consume. This awareness can help them make informed decisions about their food choices and ensure they meet their nutritional needs.
Weight Management: How Macros Can Help
By focusing on macronutrient ratios, patients can optimize their weight loss journey and prevent weight regain. For example, increasing protein and decreasing carbohydrate intake can be a helpful strategy.
Individualized Needs: Finding the Right Macro Balance
The specific macronutrient ratios recommended for bariatric patients can vary depending on their needs and goals. It's best to work with a registered dietitian or healthcare professional to determine the most appropriate macronutrient distribution for their situation.
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Breakdown of Macros for Bariatric Patients
Protein: The Heavyweight Champion of Your Post-Op Diet
Bariatric surgery can drastically reduce stomach size, which limits how much food you can eat. This makes it especially important to prioritize nutrient-dense foods that meet your macronutrient goals. When it comes to bariatric nutrition, protein is the heavyweight champion. After surgery, aim for 40 percent of your daily calories from protein. This macronutrient is crucial for muscle repair and retention, particularly after surgery. It also helps with satiety, prevents muscle loss, and boosts metabolism. The recommended intake is approximately 60–100 grams of protein daily, depending on the individual’s needs.
Fats: The Unsung Hero of Your Recovery
Like protein, dietary fats are essential for healing after surgery. These nutrients help regulate hormones, absorb vitamins, and provide lasting energy to help you power through your post-op recovery. Aim for 40 percent of your daily calories from healthy fats and focus on nutrient-dense sources like avocados, olive oil, fatty fish, and nuts.
Carbohydrates: Choose Wisely
Carbohydrates provide your body with energy, but after bariatric surgery, reducing your intake is essential to prevent blood sugar spikes. Aim for 20 percent of your daily calories from carbs, focusing on complex carbohydrates for steady energy. A typical target is 50–80 grams daily, prioritizing fiber-rich foods like vegetables and whole grains.
Meal Frequency and Portion Control: Get Ready for a New Routine
After bariatric surgery, your stomach will be much smaller, so you’ll need to eat smaller meals and snacks more frequently throughout the day. This helps you meet your nutrition goals without overloading your new stomach. Focus on nutrient-dense foods that meet your macronutrient distribution.
Hydration and Supplementation: Don’t Forget the Essentials
In addition to meeting your macronutrient goals, staying hydrated and getting your vitamins and minerals is critical for recovery. Water intake is crucial for hydration, and patients must also take vitamin and mineral supplements (e.g., calcium, vitamin D, and B12) as absorption might be compromised.
8 Nutritional Tips for Bariatric Patients
1. Protein Power: Fueling Recovery and Weight Loss
After bariatric surgery, your body will need extra protein to promote healing and muscle preservation. Aim for 65 to 75 grams of protein each day. Fill your plate with protein-packed foods like eggs, fish, poultry, lean meats, tofu, and low-fat dairy products to get there. In the early days after surgery, when you might struggle to meet your protein goals, focus on protein-rich liquids such as shakes and broths.
2. Hydration: Sip, Don’t Gulp
Getting enough fluids after bariatric surgery can help prevent complications such as constipation and gallstones. Staying hydrated is essential, but you may need to change how you drink. Aim for at least 64 ounces of caffeine-free, low-calorie liquids daily, and take small sips throughout the day. For example, try sipping 1 cup of fluid between each small meal and aiming for 6 to 8 meals daily. Avoid gulping fluids, which can introduce air into your new stomach pouch and cause discomfort. Also, steer clear of carbonated beverages, using straws, and chewing ice.
3. Mindful Eating: Take It Slow
After surgery, your new stomach pouch will be tiny. Eating mindfully is key if you want to avoid discomfort and make the most of your surgery. Start by taking small bites of food and chewing them thoroughly to aid digestion. Also, remember that you may only be able to tolerate one to two tablespoons of food at a time in the initial period after surgery. Go slowly and give your body time to adjust to your new eating habits.
4. Calorie Control: Less Is More
After bariatric surgery, you must retrain your body to eat again, which means sticking to a strict diet with plenty of structure. Your calorie intake should be between 300 and 600 calories daily for the first two months following surgery. Focus on thin and thicker liquids during this time. Also, avoid sugary foods, beverages, concentrated sweets, and fruit juices. Your long-term goal is to consume no more than 1,000 calories a day.
5. Supplementation: Don’t Skip the Vitamins
Because bariatric surgery alters your digestive system, your body may have trouble absorbing nutrients from food after surgery. To prevent deficiencies, it’s crucial to implement a supplementation routine. Start taking a daily multivitamin, calcium, and vitamin D supplements before surgery and continue to take them for life. All pills must be crushed or cut into small pieces to ensure proper absorption.
6. Solid Foods: Gradually Reintroduce Them
After surgery, your diet will progress from liquids to solid foods. Start with thin and thicker liquids, then move to pureed foods as tolerated. Soft foods will follow, and finally, you can return to a regular diet. Avoid rice, bread, raw vegetables, fresh fruits, and meats that are not easily chewed, such as pork and steak. Ground meats may be easier to tolerate.
7. Alcohol: Avoid It
Alcohol is absorbed into your system much more quickly after bariatric surgery. This makes its sedative and mood-altering effects more difficult to predict and control. For your safety and proper healing, avoid alcohol altogether after surgery.
8. Food Journal: Track Your Intake
Keeping a food journal is a great way to monitor your diet after bariatric surgery. Track your daily food portions, as well as your calorie and protein intake. This will help you adhere to dietary guidelines and make any necessary adjustments.
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How to Count Macros as a Bariatric Patient
1. Transforming Calorie Counting with DietAI
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2. Determine Your Calorie Needs
Before counting macros, bariatric patients must determine their overall calorie needs. This starts with determining resting energy expenditure and non-resting energy expenditure. Resting energy expenditure refers to the calories burned at rest, while non-resting energy expenditure refers to the calories burned during activity and digestion. Adding these two numbers gives the total number of calories burned daily, also known as total daily energy expenditure. To determine calorie needs, users can either use an online calculator or the Mifflin-St. Jeor equation.
For males, the equation is
10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) + 5.
For females, the equation is
10 x weight (kg) + 6.25 x height (cm) – 5 x age (years) – 161. Next, multiply the result by an activity factor to account for different levels of activity:
Sedentary: x 1.2 (little to no exercise)
Lightly active: x 1.375 (light exercise less than 3 days per week)
Moderately active: x 1.55 (moderate exercise most days of the week)
Very active: x 1.725 (challenging exercise every day)
Extra active: x 1.9 (strenuous exercise two or more times per day)
The final result gives the total daily energy expenditure. Calories can be added or subtracted from this number to reach different goals. For instance, those looking to lose weight should aim to consume fewer calories than they expend, while those seeking muscle mass should increase calories.
3. Decide Your Ideal Macronutrient Breakdown
After determining calorie needs, the next step is deciding what macronutrient ratio works best for you.
Typical macronutrient recommendations are as follows
Carbs: 45%–65% of total calories
Fats: 20%–35% of total calories
Proteins: 10%–35% of total calories
Keep in mind that these recommendations may not fit your specific needs. Your ratio can be fine-tuned to achieve specific objectives. For example, a person who wants to improve blood sugar control and lose excess body fat may excel on a meal plan consisting of 35% carbs, 30% fat, and 35% protein. Someone pursuing a ketogenic diet would need much more fat and fewer carbs, while an endurance athlete may need higher carb intake. As you can see, macronutrient ratios can vary depending on dietary preferences, weight loss goals, and other factors.
4. Example of Counting Macros
Here’s an example of calculating macronutrients for a 2,000-calorie diet consisting of 40% carbs, 30% protein, and 30% fat.
Carbs
4 calories per g
40% of 2,000 calories = 800 calories of carbs per day
Total g of carbs allowed per day = 800/4 = 200 g
Proteins
4 calories per g
30% of 2,000 calories = 600 calories of protein per day
Total grams of protein allowed per day = 600/4 = 150 g
Fats
9 calories per g
30% of 2,000 calories = 600 calories of protein per day
Total grams of fat allowed per day = 600/9 = 67 g
In this scenario, your ideal daily intake would be 200 g of carbs, 150 g of protein, and 67 g of fat.
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Macros, short for macronutrients, are nutrients the body needs in large amounts to provide energy and support bodily functions. Three primary macronutrients comprise the bulk of our diet: carbohydrates, proteins, and fats. Each macro type affects the body differently and has unique roles in health and nutrition. For example, protein is crucial for building and repairing tissues, while carbohydrates are the body's primary energy source.
Fats help with hormone regulation and the absorption of nutrients. Each macro also contains different calories per gram: Protein and carbohydrates each contain 4 calories per gram, while fat has 9 calories per gram. All three macros are vital to health, and each plays a role in any diet, whether you're trying to lose weight, gain muscle, or simply maintain a balanced eating regimen.
A diet focused on macros isn't about eliminating any of these nutrients but rather optimizing the ratios of each to meet specific health goals. For example, a bodybuilder may aim for a protein-rich diet to support muscle growth and recovery. In contrast, a dieter may want to reduce carbohydrates to lose weight and improve metabolic function. Both can benefit from a balanced intake of all three macros, but adjusting the ratios to fit their unique goals can help them achieve results faster.
What Are Micros?
Micronutrients, or “micros,” are vitamins and minerals essential to human health. Unlike macros, micros are needed in smaller amounts and don’t provide energy (calories). Instead, they help regulate body processes and support cellular functions. There are dozens of vitamins and minerals, each playing various roles in human health. For example, calcium is vital for strong bones and teeth and helps support muscle and nerve functions. Iron helps transport oxygen in the blood and is crucial for energy metabolism. Foods rich in vitamins and minerals are often called “nutrient dense” because they can improve health and help reduce the risk of chronic diseases. Micronutrients can also be categorized into two groups:
1. Vitamins
Organic compounds can be broken down by heat, air, or acid. They’re classified as water-soluble or fat-soluble.
2. Minerals
Inorganic elements that can’t be broken down. They’re categorized as macrominerals or trace minerals, depending on the amounts needed by the body. While vitamins and minerals are vital to human health, they have different roles. For example, vitamin C helps support the immune system and aids iron absorption. Iron, in contrast, helps transport oxygen in the blood. Getting adequate amounts of both can improve health and reduce the risk of chronic diseases. Like macros, all micros are needed for the body to function correctly. A deficiency in any specific vitamin or mineral can lead to health issues and negatively impact bodily functions. For example, insufficient iron levels can cause anemia, leading to fatigue and reduced performance. Foods rich in vitamins and minerals are often called “nutrient dense” because they can improve health and help reduce the risk of chronic diseases.
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