T Nation

Nutrition After Gastric Bypass?

#1

So, I tried posting in the Powerful Women forum, but unfortunately there weren’t any members with answers there (understandably so), so I thought I’d try here.

I had gastric bypass (specifically roux-en-y) in April 2017. I’m down over 100lbs, and I’ve decided to start lifting because I’m becoming skinny-fat, and frankly I don’t like it. On top of that, I have PCOS, which means my testosterone levels are higher than most women, so maybe I can see some decent results because of it.

I’m wondering if anyone has any thoughts/suggestions on eating enough to actually gain muscle? My stomach pouch is now about the size of a baseball, while the average stomach is the size of a football. I have no idea how I’m supposed to actually eat enough to build muscle? I eat protein at every meal, and I’m taking my shake every day, but honestly, sometimes there’s just no room to fit more in.

Thoughts?

New to Lifting, Some Considerations to Take Into Account
#2

What restrictions did your doctor tell you to follow? Are you strictly limited by quantity, like, “eat no more than X ounces of food every Y hours”? Do you have to specifically restrict fats, fiber, or other nutrients for digestive reasons?

You’re basically dealing with a medical condition, so typical advice you find in articles isn’t going to apply 100%, it’ll have to be modified, but the basics should still be in place - focus on quality protein and healthy fats, with enough carbs to accommodate training and recovery.

What’s your height and current weight?

#3

Well, so that’s the thing. What I’ve been advised to eat is based on a basically sedentary lifestyle - I’m supposed to eat no more than a cup of food at each meal, primarily protein, avoid red meat (because it’s apparently difficult for WLS patients to digest, but I haven’t had any issues with it). The assumption is that I’m doing low impact cardio (walking, swimming, etc) but those food recommendations aren’t going to cut it if I want to really start lifting and building muscle. I’m trying to increase my protein as much as possible but hey, space is limited, lol.

I’m 5’3" and 163lbs at the moment. A lot of it is muscle, if I’m being honest - when I was overweight I was running three days a week and training in Taekwon-Do three days a week as well, with one day off in seven.

#4

And how long does it take you to digest a “meal” that size? Or really, how many “meals” per day can you comfortably and efficiently have?

Not necessary. As long as you’re getting around 120g protein per day, you’ll be fine. With planning, that should be doable even with the literal and figurative constraints of the situation. Maybe look into protein pulsing between meals to reinforce growth and recovery.

Focus on nutrient density - foods that pack plenty of macros into a relatively smaller serving. This article talks more about it.

Have you spoken to a gastroenterologist or nutritionist about your situation and does your doc know you’re not planning on being sedentary?

#5

When you say “digest”, do you mean how long does it take for me to feel hungry again? Depends on what I’ve eaten - whole, healthy foods with protein can take a few hours, something like popcorn will take like, 30 minutes.

I’ll look into those links; thank you!

I guess it’s time to see my bariatric doctor to see what he has to say. I don’t really like seeing him, I feel like just a number when I’m at his office, but he knows more about my situation than say, my GP, so I guess it’s better than nothing?

Thanks for your replies and your help, I really appreciate it. :slight_smile:

#6

I meant like actually digest, not just appetite. How long after filling your mini-belly can you eat again without having what competitive eaters would call “a reversal”. If a cup of chicken breast takes five hours until there’s room for more, then you’re gonna have a rough time.

But if you can eat something every 2-3 hours, as per the classic bodybuilding suggestion, then that can actually play to your advantage and the only obstacle to deal with is meal prep.

#7

Hey!

Alright, I understand your question. Yes, I can eat every 3-4 hours comfortably, about a cup to a cup and a half of food at a go. Any suggestions on meal prep, or is there a forum I can ask that question specifically?

#8

If you don’t mind being asked, why did you have to undergo a roux-en-y?

#9

I don’t mind at all.

I had RNY because of my PCOS diagnosis, as well as my hypothyroidism. Those medical conditions qualified me to have my surgery covered by the province (Ontario). I had years of documented attempts to lose the weight (Atkins, Weight Watchers, 'The Plan" by Lyn-Genet Recitas); various exercise programs (couch to 5k, Taekwon-Do [where I actually did earn my black belt]).

Because my family GP and the province had evidence that I wasn’t trying to find an “easy way out” and that I’d made multiple, varying attempts to lose weight, I was able to have the surgery costs covered by our provincial health care plan.

Granted, the surgery did nearly kill me, and it turned my entire life upside down, but I don’t regret it, and I’d do it again if given the choice.

#10

Forgive me for the technicalities alright?

It’s incorrect to say that you had RNY for PCOS and hypothyroidism. Reading back, I’m assuming it was because you were overweight and had RNY as gastric bypass to lose weight, and that WLS is weight loss surgery, correct? Again, sorry for the technicalities, because RNY is a procedure that has many applications.

What’s your goal? Because right now, by BMI, you’re still overweight (no offense). I understand you want to gain muscle, but I’m not sure if you want to lose more weight, maintain, or gain. The thing about bariatric surgery as a weight losing surgery is that yes, your stomach may be the size of a baseball now, but if you eat too much, over time, the stomach will slowly expand again. That’s why bariatric surgery for weight loss will only do so much for those who are obese but aren’t willing to make the lifestyle change. Your’s is a different case since you have hypothyroidism and PCOS, but it still applies that if you eat too much, your stomach will slowly expand again.

#11

Sorry, I guess I misunderstood your original question.

Yes, I had RNY as a weight loss tool. The mitigating factors were the PCOS and the hypothyroidism. I was miserable, depressed, and frankly, I wanted to have a baby. At the weight I was (265lbs) it was essentially impossible (I did get pregnant in September 2015, but unfortunately miscarried).

I’m also aware that I’m still overweight, based on BMI (which is a calculation I disagree with, but that’s another conversation all together). Ideally I’d like to lose more “weight”, but I realize that if I start lifting and gaining muscle, my scale will likely go up. I’m ok with that. My hope is that by lifting I gain muscle, strength, and self confidence. I’m managing my calorie intake right now with my semi-sedentary life (I work two jobs, one of them I’m on my feet the entire time I’m working). That’s why I’ve asked about how to maximize my macros without increasing my food intake, as in, I don’t want to eat a kilo of bacon like my enormous boyfriend does, but I want to ensure I’m getting enough calories, as well as the right kinds of calories, to really benefit myself along this new journey.

Does that make a little more sense? Lmk if it doesn’t. :slight_smile:

#12

The Supplements & Nutrition forum is most appropriate for meal prep questions. If you want a new thread just for that, it should be fine.

As for general meal prep, shoot for around 25g protein 4-5 times a day and you’ll be covered on that end. Fill it in with good carbs and healthy fats to round out the calorie intake. This article covers a solid general approach to meal prep.

#13

Alright, here goes.

Keep your hypothyroidism and PCOS in check with your physician. With hypothyroidism, you have a lower resting metabolic rate which means your caloric expenditure per day is lower. With PCOS, you’re basically like a diabetic. Both of which make you prone to gaining weight.

I agree with Chris that your best bet is to go for nutrient dense foods. Since space is limited for the macros, don’t sacrifice space for micronutrients, which is what concerns me more. Remember, you’ve had gastric bypass, so there are specific micronutrients that you should watch out for. Consult your physician and work with a nutritionist. To start, sticking with “less carbs, more protein” is a good general rule. Add to that good amount of fruits and vegetables for the micronutrients. A nutritionist knowledgeable with what micronutrients are at risk for in a bypass surgery will surely be of help to you. Others here would be more knowledgeable to help you out with the specifics for the macros than I would be.

But honestly, right now, I wouldn’t be too concerned with things like “I have to hit this specific amount of protein per day” before you start to lift. If you’re forcing yourself to eat and feel full all the time just in order to reach this amount of calories or protein, then you’ll defeat the purpose of your bypass. This is why I mentioned about the stomach re-exapanding to accomodate. Also remember, total caloric intake per day is key to weight loss. For now, go ahead, lift, and enjoy it. You’ll be fine.

On a different note, yes, BMI is a different discussion all together, but if you really know how to use it from a medical standpoint, it’s actually a pretty decent tool.