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BariBest™ Questions and Answers

Even if you don’t have a question, this page has a lot of great information that is good for everyone who has had, or is considering, weight loss surgery.

Check it out and see if we can tell you something new!

IMPORTANT: These answers are all general recommendations based on information available to us. These recommendations might not apply to you, or be right for you. Always check with your physician before altering any part of your regimen or treatment.

In each of these sections we have included answers to common questions.

Following those, we have questions from individuals who are considering weight loss surgery or who have had weight loss surgery. All information on BariBest is reviewed by medical professionals, including the answers to individual questions, so you can have confidence in those answers.



BariBest™ Questions and Answers: Weight Loss

How fast will I lose weight?

The only good answer is, it depends. It depends on:

  • each individual patient
  • which surgery
  • how closely the patient sticks to the plan recommended by the surgeon
  • protein: protein can make a major difference in the pace of weight loss. The ASMBS (bariatric surgeons organization) recommends 60 to 80 grams of high quality protein. BariBest™ recommends 80 grams per day for Bypass and Sleeve patients, and 90 grams per day for Band patients.

What causes weight loss plateau?

The first potential cause to look at is insufficient protein. Don’t just “think” you are getting the right amount of protein. Actually keep a log of how much protein you get each day, on a sheet on your refrigerator. (You can download and print a copy of the BariBest Protein Tracker here.) Count only high quality protein from whey protein supplements and other dairy proteins, meat, fish, eggs, and soy.

Exclude collagen protein, protein from nuts, peanut butter, beans, grains, and vegetables as these tend to be lower or very low quality.

If the tracker doesn’t show 80 grams of protein per day, increase to 80 grams per day.

What causes weight regain?

Our years of talking with thousands of patients have convinced us that insufficient protein is the root cause of most weight regain.

Here is how it happens: we all start with good intentions, and stick with the recommended plan. Things are going well, and so maybe we could go off the plan just a little today. And then we go off the plan a little more the next day or next week. Eventually we are off the plan, and don’t really even notice it. We don’t even realize that being off-plan is the reason we are starting to gain weight.

If you stick with our recommended amount of high quality protein, and generally eat well and exercise if you can, almost always, you will not regain.

Did we answer your question? If not email your question to Nutrition@BariBest.com


BariBest™ Questions and Answers: Protein

Why do I need protein?

Every cell in your body is partly made of protein. Hormones are made with protein. Healing requires protein. Your immune system needs protein. That is true for everyone.

There are two reasons why protein is particularly important for weight loss surgery patients:

  • it is important to weight loss success
  • it is important to get enough protein during rapid weight loss so you body doesn’t take protein from your muscles (including your heart muscle)

How much protein do I need?

The ASMBS (bariatric surgeons organization) has issued recommendations that patients get 60 to 80 grams of quality protein each day.

BariBest™ recommends 80 grams of high quality protein each day. See our Protein section for more information on why, and how to do that. Just remember that patients who get their protein long term usually get to their goal weight and stay there. Patients who don’t get their protein tend to not reach their goal, and to regain over time.

How long do I take protein shakes?

Often patients get the impression that they just need protein shakes for a little while. Sometimes even the surgeon contributes to this impression. Here’s the problem with that:

If you don’t get enough protein (we recommend 80 grams of high quality protein per day), you can hurt your health, experience hair loss, and experience weight regain.

You can get 80 grams of high quality protein from food, but it’s not easy, and if you don’t keep track daily, you almost certainly won’t do it.

Know how much quality protein is in foods. Many foods have 7 grams of protein per unit or per ounce. Examples:

  • 7 grams of protein per one egg
  • 7 grams of protein per ounce of beef, chicken, pork, fish
    (1 ounce after cooking and shrinking)
    (a common serving size is 3 ounces)
  • Skim milk has 1 gram per ounce of milk, so 8 grams per cup (almost 7)
  • Other dairy products will show the grams of protein on the label.

If you do a little arithmetic, you can see that getting enough protein from foods isn’t so easy. If you want 80 grams of quality protein, here are the amounts of one food you would need per day:

How much of this food

To get 80 grams of protein

2Beef, Pork, Chicken or Fish

12 ounces after cooking,
(almost a pound before cooking)

Eggs

12 eggs

Milk

10 cups of milk


Clearly you can combine some of each, but with much-reduced capacity after surgery, it isn’t easy.

That’s how protein supplements can help. One scoop of a high quality supplement powder typically provides about 20 grams of protein depending on the scoop size. If you mix the scoop of protein into 8 ounces of skim milk, that increases the total protein to about 28 grams.


How do I know what protein shake to buy?

The ASMBS recommends a supplement whose protein comes from Whey Protein Isolate. We agree. It is also important that the supplement tastes good. If you don’t like your protein, you won’t use it, and that can undermine your weight loss success – and your health. Finally, it is important that you be able to trust the company that makes your supplement. More than ever before, companies are cheating on ingredients to save money, and they don’t make it easy to know.

Choose a trusted brand. Your health depends on it.

BariBest.com is written and managed by UNJURY® Protein and OPURITY® Vitamins. UNJURY® is so widely trusted that it is recommended at America’s Top-Rated hospitals. Equally important, it is top-rated by patients for taste.


What are whey protein isolate and whey protein concentrate?

Whey protein isolate is recommended by the ASMBS. It is the preferred ingredient, because it has:

  • More protein, sometimes much more
  • Less lactose and tastes better.

So one short way to remember which is which is: "I want I solate."

Not all companies can get the supplies of whey protein isolate they want, so they might tell you how good some other protein is. They didn’t do that when they could get enough whey protein isolate.

Whey protein concentrate can be as low as 25% protein and 50% lactose (milk sugar),

Whey protein isolate must be at least 90% protein and has essentially no lactose.

So when you need protein, you can see why "I want I solate."


What is lactose?

Lactose is a sugar found in milk. There are two reasons why bariatric patients should keep their lactose intake low:

  • They might be lactose intolerant (occasionally this develops post surgery)
  • Too much of any sugar in a short time can cause dumping syndrome (see below)

What is lactose intolerance and how can I know if I am lactose intolerant?

Lactose intolerance is the inability to digest lactose. Lactose is a type of sugar found in milk and some dairy products. It happens when your body does not make enough of the enzyme lactase, which breaks down lactose. Lactose intolerance can be partial, in the sense that a little lactose doesn’t cause symptoms, but more lactose does.

Symptoms include gas, bloating, and other kinds of digestive upset. They usually begin between 30 minutes and 2 hours after consuming more lactose than your body can process. You can determine whether you have lactose by keeping track of your reactions to foods that contain lactose.

While many dairy products contain lactose, many common cheeses are low in lactose, and quality whey protein isolate contains essentially no lactose.


Can I get too much protein?

For healthy people, there is no upper limit to protein. Any extra protein that the body doesn’t use will pass through and be excreted. If you are using UNJURY Protein, we recommend that you don’t use more than 5 servings a day unless your doctor advises more.

People with serious kidney problems should contact their doctor about protein consumption.


Is soy protein a good choice?

Soy protein is a source of good quality protein. Some brands use it because it costs about half as much as whey protein.

Generally the taste is not as good as a similar quality whey protein.

The ASMBS recommends whey protein isolate and we believe it is a better choice. There is a large body of research supporting the benefits and advantages of whey protein.


How much protein can be absorbed at one time.

Everyone varies in how much protein they can use at one time. It may be that an “average” person can use only about 30 grams of protein at one time.

We do suggest that it might be optimal to “spread out” one’s protein consumption somewhat, getting some in the morning, and some in the afternoon or evening or both.

Did we answer your question? If not email your question to Nutrition@BariBest.com



BariBest™ Questions and Answers: Vitamins and Minerals

Why do I need vitamins?

First, vitamins are important for many metabolic functions that regulate body size.

Second, studies have found that obese individuals are at high risk for many vitamin and mineral deficiencies. For more information on this, visit the NUTRITION section.

In short, they are very important to your heath, and you may have deficiencies.


Why do I have to take special vitamins?

Various medical studies have shown that certain vitamin deficiencies are more common following each of the types of weight loss surgery.

Good quality bariatric vitamins are formulated to address the common deficiencies associated with the type of surgery you have had.

When is the best time to take vitamins?

For many vitamins, the time of day is not as important as being sure you take them daily. There are two timing considerations you should consider:

  • Calcium, in higher amounts, appears to interfere with your ability to utilize iron. For that reason, it is suggested that you take calcium at a time that is separated from your multivitamin (or other iron you are taking) by about two hours or more.
  • The absorption of fat-soluble vitamins such as A, D, and E, is better when you have also recently consumed food that contains a few grams of fat. So in general, it might be good to take your multivitamin or Vitamin D supplement with food.

Why do I need a special B-12?

Bypass and Sleeve patients need a special B-12 because their surgeries reduce their ability of their digestive tract to utilize B-12. For that reason, a monthly injection, or using a daily sub-lingual tablet is recommended. (Sublingual is from Latin, and means “under the tongue”. You let a tablet dissolve under the tongue, and it passes directly through the tissue under the tongue into your bloodstream.)

Some bariatric multivitamins contain very high doses of B-12 on the possibility that a very small percentage (1% or 2%) is absorbed in the lower part of the small intestine. We don’t believe there is enough good research for you to depend on this because a B-12 deficiency can damage your nervous system. Do the sublingual or the injection as recommended.


Does biotin help hair loss?

The only research we have been able to find supporting the use of biotin for hair loss is in one cosmetology journal. We believe that there would be more studies supporting the value of biotin for hair loss if it really were helpful.

In contrast, there is good research that says protein can be helpful with hair loss, and it is a common, correctable cause of hair loss among bariatric patients. However, there can be other causes as well, so ask your doctor if you have hair loss that might be unusual.


Why is calcium citrate better than calcium carbonate?

Calcium citrate is better for Bypass and Sleeve patients because calcium citrate does not require stomach acid for utilization. Both of those surgeries substantially reduce the amount of stomach acid produced.

Did we answer your question? If not email your question to Nutrition@BariBest.com



BariBest™ Questions and Answers: Surgery - Related

How big will my stomach be?

Here’s a very rough way to estimate the volume of a stomach:

Before surgery:

4 cups (32 ounces)


After surgery:

 

Gastric bypass

roughly 2 ounces, a bit more than the volume of a golf ball

Gastric sleeve

volume (and approximately the shape) of a banana

Gastric band

volume varies, roughly four ounces, but the stomach is more the shape of an hourglass


What causes hair loss?

First, if you have unusual hair loss, you should see your doctor. The reason for the hair loss could be serious.

One potential cause of hair loss in bariatric patients is called “telogen effluvium”. It is the shock that the surgery causes to the body.

Another common cause of hair loss in bariatric patients is lack of protein.

Can I still drink diet soda?

Avoid carbonated beverages. This is especially important for safety reasons in the weeks following surgery. Carbonated beverages can irritate the stomach lining, and sometimes can contribute to reflux. They can also stretch the pouch/stomach and reduce the effectiveness of your surgery in helping you lose weight.

Did we answer your question? If not email your question to Nutrition@BariBest.com