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Usually, most of the weight loss from gastric bypass and gastric sleeve surgeries happens during the first 12 months after the surgery. What happens after that?

For gastric band patients, how should they continue to lose until they reach their goal weight?

There are many things you can do to maintain your health and keep your weight where you want it. Exercise, eating right, daily vitamins, keeping a log, check-ups and continuing to go to a support group – all of these can help.

What you need to do is stay committed for the rest of your life.

In our experience, while all of those other steps are important, the single biggest key to long term success is protein. Protein satisfies you better, and longer, with fewer calories. That is how you keep your weight down.

  • The single biggest key to long term success is protein.
  • Start your day with protein.
  • Use protein to crowd out snacks that are higher in sugar and fat.

We talk with many patients who have had great weight loss success at first, and then they seem to let the plan slip away. All the things that worked so well – it’s almost human nature to say "Maybe I don’t HAVE to do all that every single day". That is the day Weight Regain begins. Stay on the plan for the rest of your life.

We want you to be successful. You can be successful, and it isn’t hard. You just have to make adjustments to stay healthy and keep the weight off.

Other Questions?

If you have more questions about surgery choices, please refer to the Help and Advice section of our website. You can see many answers to questions others are asking, and if you don’t find what you want, you can send us your question directly.

Staying on Track - Essentials


The story of protein is not complicated. Patients who tell us they continue to get their protein reach their goal weight, or get very close, and they maintain their weight loss.

Patients who tell us they haven’t been getting their protein are also regaining weight, sometimes a lot of weight.

Even for people who haven’t had weight loss surgery, protein is important for weight management. It’s no different if you have had surgery. Long term, you have to manage hunger, and protein is the best way to manage hunger. Protein helps you feel full. Dairy proteins, notably whey protein, have been shown in research to be particularly good at letting you feel full, and stay feeling full for a longer time.

Longer term, we recommend that you get 80 grams of high quality protein each day. High quality protein sources include: dairy (whey protein isolate supplements, yogurt, low fat cheese, skim milk), meat, fish and eggs.

For much more on this critical nutrient, see Protein in the Nutrition section here at BariBest.com.

Vitamins and Minerals

We include vitamins and minerals as Essentials because they are so very important to your health. They help your body regulate itself, and in particular, they contribute to weight management.

Vitamins and minerals are more important after weight loss surgery because:

  • You are consuming less of the food that provides the nutrients
  • In the case of gastric bypass, the portion of the small intestine where important vitamins are absorbed has been bypassed – so you don’t absorb those vitamins and minerals.
  • The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends supplements using Whey Protein Isolate as the protein source.

It would be easier to recognize a vitamin or mineral deficiency if it happened fast. Unfortunately, it is common for deficiencies to develop slowly, and sometimes deficiencies are hidden almost completely until it is too late. Taking your vitamins is an inexpensive insurance policy against deficiencies. At minimum, we recommend:

  • a multivitamin that is designed for your specific surgery
  • calcium (calcium citrate for bypass and sleeve patients)
  • separate vitamin B12 either as a “sublingual” (dissolves under the tongue) or a monthly injection at your doctor’s office

We also recommend getting blood work done routinely at your doctor’s office to insure that your protein, vitamin and mineral levels are good.

For much more on vitamins and minerals, see the Vitamins and Minerals section here at BariBest.com.

A good diet

If you follow these guidelines, you will be well on your way to having a good diet:

  • Start the day with a breakfast that has 30 grams of protein. Get 80 grams of high quality protein in total each day
  • Try to get fresh or frozen vegetables and fruit (know how much sugar is in a serving) each day. The is a good way to get fiber as well as other nutrients
  • If you feel hungry between meals try to have high protein, low fat and low carbohydrate snacks

Feeling good about yourself

First, and most important, remember that you are the only person who should decide how you feel about yourself. Not your friends, not your family, not Hollywood, not a magazine.

Someone once observed that the goal of a beauty magazine is to make you feel ugly. Why? Because the magazine only makes money if it sells adverting, and who advertises in beauty magazines? “Beauty aids” including cosmetics. You’ll buy more (and they will advertise more) if you feel like you need to fix yourself with those products.

Each day, remind yourself, that just like everyone else, you are a good, valuable person. It isn’t helpful to compare yourself with other people. A good part of the difference between you and them is due to luck, and it is impossible to really know what it is like in their shoes.

Staying committed

You can succeed, and you can stay on track. Others just like you have done it. Stay committed, and stick with your plan. Log your protein and vitamin intake, and anything else you believe needs to be tracked, and feel good when you reach your goal for that day.

The next section gives you Tools to stay committed and on track.

Staying on Track - Tools


Doing exercise starts with a question: What’s possible? If your body doesn’t let you do much exercise, then just do what you can.

  • Always get your doctor’s OK before starting out.
  • Start with baby steps: if you walk 3 minutes a day, and add one minute per week, soon you’ll be walking 15 minutes, and then 30 minutes.
  • Feel good about what you are doing.
  • Keep a sheet of paper on your refrigerator and write down what you do each day.

Setting a routine

There’s a lot to think about; things to do, things to distract, places to be. Ooops, I forgot my vitamins. It happens.

What a routine does is help you get those regular things done that are easy to forget.

Protein Example: You could make your morning protein shake the night before and put it right at eye-level in the fridge. Maybe set a reminder on your calendar or phone for a while. Pretty soon, you will remember automatically.

Another example: if you are a coffee drinker, just always make your first coffee a mocha, with a scoop of a high quality chocolate protein supplement.

Vitamin Example: if you always have your multivitamin just as you start your breakfast, pretty soon you won’t have to think about it. Make seeing breakfast your reminder.

Another example: you could have a Pill Organizer with days of the week, and put it next to the coffee maker, or the salt and pepper.

Planning your protein and meals

Set aside a time, maybe on the weekend, to plan your meals and make a grocery list. Be sure to plan a high quality protein supplement three times a day while you are losing weight, and twice a day while maintaining. One way or another, get 80 grams of high quality protein a day.

Plan to have fiber sources available. That can be vegetables, Benefiber, or some fruits. Always test small amounts first. Your surgeon’s office will have given you recommendations about fiber.

You can make meals ahead of time so they are available when you are hungry. It’s helpful to have protein shakes pre-made in the fridge so when the first hint of hunger hits, you have a solution that is ready immediately. Use the shake to crowd out some other less healthy (and higher calorie) snacks.

Keeping a protein log

Keep a copy of the UNJURY™ Protein Tracker on your refrigerator. Click here to download a printable copy. Each copy will cover a month.

Attending support group meetings

Support groups are a great way to share learning experiences. There are patients who are farther out from surgery who can help you know what to expect, and what works. Attending group meetings can help you get better results.

Regular check-ups

In addition to reviewing your progress with your doctor, it is really critical to get your lab work (mostly blood testing) to check your protein, vitamins and minerals.

In the Nutrition section, the nutrition needs for each kind of surgery are listed. There are also specific deficiencies that tend to be more common for each kind of surgery. Find those “Common Deficiencies” in the Nutrition section, and confirm your testing does check for those.

At the very minimum, see your doctor and have testing done at the 6 month, 12 month, and 24 month milestones, and annually for the next 3 years following that.

Common Mistakes

There is an old saying, "Those who forget history are condemned to repeat it”.

Here’s another way to say the same thing:

  • By knowing the mistakes others have made, you can avoid them! That’s valuable, because you are learning the easy way, not the hard way. Read on.

Here are some common mistakes that can cause weight regain after surgery.

1. Discontinuing Protein Supplements at the Solid Foods Stage

When the doctor's office says you can move on to solid foods after surgery, that doesn't automatically mean to stop using supplements. The ASMBS (American Society for Metabolic and Bariatric Surgery) 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.

Meeting protein needs through food alone can be difficult after surgery. High quality good tasting protein supplements help. We recommend supplements that get all their protein from Whey Protein Isolate (not whey protein concentrate, not soy protein).

Remember that protein is key to not being hungry -- and not being hungry is key to losing weight.

2. Choosing Protein Sources That Are High In Calories.

It is important to choose high quality protein sources without excess calories.

For example:

  • 22 almonds (1oz) provides 6 grams of protein and 162 calories
    *you would have to eat about 74 almonds (566 calories) to get 20 grams of protein
  • 1 serving of Chocolate UNJURY™ in 8oz of skim milk provides 28 grams of protein and 180 calories.
    *choosing UNJURY over almonds would save 468 calories and give you an extra 4 grams of protein!
  • You would have to eat about 74 almonds (566 calories) to get 20 grams of protein.

Click here for a comparison on protein sources




Protein (g)

Fat (g)

Calories Per Protein (g)

Protein Supplement using only Whey Protein Isolate

1 scoop/packet





Egg, Poached






American Cheese

1 slice





Peanut Butter

2 Tb





Dry Roasted Almonds

22 almonds





Special K Chocolate Peanut Butter Snack Bar*

1 bar





*SpecialK.com May 31, 2012

When a food has twenty calories per gram of protein, we certainly don’t consider it a high protein food.

Here’s a link to delicious recipes using a high quality protein supplement: RECIPES. They are great easy ways to get a lot of protein without a lot of extra calories. As a result, they help you increase the portion of your calories that come from protein and that is really effective for weight loss.

3 Switching from a high quality whey protein isolate supplement to another less expensive product.

There are at least two reasons customer might find themselves with a low quality protein supplement.

  • They might not understand all of the differences in quality
  • Cheaper supplement brands try to hide the differences

What is quality protein?

First, it has a "PDCAAS” protein quality score of 100. (PDCAAS stands for Protein Digestibility Corrected Amino Acid Score.) The use of PDCAAS is widely supported in the medical and scientific community worldwide.

Protein Source


Whey Protein




Egg White


Soy Protein Isolate




1Source:Litchford, M., (2007), Protein Powders, Potions & Elixirs, Greensboro, NC

Case Software and Books

Clearly the perfect PDCAAS score of Whey Protein is one reason the ASMBS recommends Whey Protein Isolate. It is also important to be aware of the difference between Whey Protein Isolate and the cheaper Whey Protein Concentrate.

Whey Protein Isolate

Higher in Protein, Lower in Lactose, Best Tasting

Whey Protein Concentrate

Lower in Protein, Higher in Lactose, Poorer Taste

Clearly there are both nutritional advantages to Isolate, which is lower in lactose—milk sugar, sometimes much lower, and higher in protein. The primary reason some supplements use concentrate is because it is much cheaper.

Because the names are similar, and because the ASMBS recommends Whey Protein Isolate specifically, we offer this easy way to remember which is better:

Just remember: "I want Isolate”

For more valuable information about Protein Quality, just click here.

Other sources of protein in supplements

Because of the tight supplies and higher prices of whey protein isolate, companies have started substituting other sources of protein, and as you might expect praising their virtues. Just remember that they used Whey Protein Isolate when they could get it.

Examples: soy protein, pea protein, chia protein, rice protein, and using taurine, an amino acid they probably count toward the protein content, but which has very limited value in human nutrition.

An increasing number of protein supplements are resorting to a wide range of tricks to save money, at the expense of quality.

  • Switching to cheaper protein sources such as whey protein concentrate
  • Reducing the weight of the package
  • Reducing the amount of protein per serving
  • Switching from trusted suppliers to cheaper Chinese suppliers
  • Adding taurine instead of complete protein. Taurine causes the standard protein test to report higher protein. However, it has limited value in human nutrition.

Tampering with protein supplements in these ways can have a direct impact on your health and result in weight gain. Read below to find out how other patients have been affected by switching to less expensive products.

  • "I just wondered is there something really different about your (high quality whey protein isolate brand) protein? It’s the only one that doesn't make me feel like I ate too much sugar. When I have tried other protein powders they all make me feel nausea. (boldness added) I don't get that from yours. I even tried protein powder from plants etc. All does same thing, except yours. Am I the only one that is that sensitive to other powders?"
  • "Because my family is on a tight budget right now, I rationalized the cost savings for the cheaper brand. But once my weight kept creeping up & my gums started bleeding, that was it. I went online & bought my (high quality whey protein isolate brand) and put myself back on 3 shakes a day."

    Within 2 weeks, the gums stopped bleeding. Within 3 days I could tell a huge difference in my cravings and my appetite. I eat less at each meal when I'm on (high quality whey protein isolate brand) - and I started to feel like my "old self" again. I've lost 5 of the 10 extra pounds too."

4. No longer tracking protein intake after surgery

Protein is essential to every part of your body. When you don't consume enough protein, your body gets what it needs by taking away more protein from your muscles and organs -- to use it for building and repairing elsewhere. Eventually your muscle and organ tissues weaken.

The New York Times "Diagnosis" column by Lisa Sanders MD told the story of a man with severe chest pain who had been on a restrictive diet without medical advice. In the ER, they first thought it was a heart attack, but it wasn't. It was a case of protein malnutrition. "(Protein) malnutrition can eat away heart muscle." He wasn't getting enough protein to his heart. The walls of the left side of the man's heart were thin and weak -- painfully, dangerously weak.

One experienced support group moderator we know recommends 1 to 2 high quality protein shakes a day forever, as an "insurance policy" against that kind of problem.

When you track something, it gets done. When you just think about doing something, it often doesn’t get done. Track your protein every day for the rest of your life. It’s easy, and worth it!

Keep a copy of the BariBest™ Protein and Vitamin Tracker on your refrigerator. Click here to download a printable copy. Each copy will cover a month.

5. Letting hunger get in the driver’s seat

If you are human, you have had the experience of getting home so hungry you are really starving! Maybe you missed lunch. You walk in the door looking for something – anything – that is fast and now. Chips or cookies maybe. Five minutes later, the entire bag is gone.

You overeat -- the wrong things – because you are starving. Hunger is in the driver’s seat and caused you to make the wrong choice.

Because nobody makes good decisions when they are hungry, the trick is to keep hunger out of the driver’s seat. Have good quality high protein foods with you during the day -- in your car, at work – wherever you are. One good solution that really satisfies hunger is high quality whey protein isolate shakes. Just keep them in a cooler with some blue ice packs or regular ice.

6. Following bad advice

Online chat rooms and bulletin boards are one of the least trustworthy sources of advice because people don’t even have to identify themselves. So what you get are "fake posters”.

Example: Jack Plotts is a sales manager at a supplement company we will call SuppCo.. Jack goes to an obesity-oriented website and creates a realistic sounding username: "Cathy-in-Ohio”. The online profile says Cathy has a dog and a cat, and her surgery was done by Dr. Bartlett in Dayton. Cathy raves about how SuppCo. products are so great and talks about how the competitor’s products made her sick. Of course that is all just Jack Plotts talking. There is no Cathy-in-Ohio.

Example: now let’s talk about the username "Blooming-Birdie-of-TX”. She really is named Birdie and she did have a gastric bypass. She posts a lot, and has strong opinions about everything. She particularly likes two supplement companies. The only thing she doesn’t mention is that those same two supplement companies buy advertising on her blog, and give her $2000 a month with the understanding that she will post good things about their products and bad things about others.

This is more common that you think. In fact, Jack Plotts actually has eight screen names, and uses each one for different kinds of posts…just to make it hard to see through his games.

This is more common than you would wish, and it all happens on obesity sites that are supposed to be trying to provide you with help. That’s actually why we started BariBest.com. To give you information that is 100% written or reviewed by medical professionals and comes from a company that is widely respected in the bariatric community, UNJURY® Protein.

7. Taking a protein vacation

It’s summertime, or Christmas time, or Thanksgiving or any other travel or holiday time. You are with family and friends. It’s natural to want to relax and indulge.

The only problem is, this is when weight loss stops and you start to plateau, or even gain. But the problem is worse than just a plateau or a few pounds gained.

First, you are breaking down your good habits, the things that kept you on track and successful so far.

Second, your body was getting used to less calories, and now you are teaching it to get used to more calories.

Here are some tricks to stay on track during those times:

  • Plan. Plan to have protein shakes with you, to help keep your protein up and crowd out some of the bad snacks and treats.
  • Find a way to make more fun protein recipes while on vacation. Here are some ideas:
    • Start your day with a great tasting iced coffee or latte and add Vanilla or Chocolate high-quality protein shake
    • For lunch have a delicious smoothie with fruit and vanilla high-quality protein shake
    • Make a slushie by mixing lemonade and a berry flavored high-quality protein shake with crushed ice
    • Just before you go to an event with family or friends, have a high-quality protein shake. You won’t be as tempted to overeat.


You can avoid these mistakes and stay on track. Even if you have gotten off track, you can recover and reach your goals. We talk regularly with patients who do. See the next page for help on how to get back on track.

Getting Back on Track

Slip-ups happen. When they do, you have ways to get back on track:

  • Recognize that you are off track

    Sometimes patients plateau, or begin to regain weight, and can’t figure out why. This is actually common. There can be a variety of reasons, but in our experience the most likely reason is that the patient is not getting enough protein.

    Figure out how much protein you are getting by keeping track for a week. One easy ways is to download a copy of the UNJURY™ Protein and Vitamin Tracker and put it on your refrigerator. Click here to download a printable copy.

    Get at least 80 grams of high quality protein a day.

  • Figure out why you got off track

    By knowing what caused you to get off track, you can take steps to prevent a repeat. To review the list of Common Mistakes, click here.

  • Change Your Strategy to fix where you slipped. Have a Plan.

    Decide whether snacking is the problem. If it is, it is okay to keep snacking -- but find a healthier snack. Have a high quality protein shake. Make it ahead of time - 2 scoops in 16 ounces of skim milk and have it ready in your fridge.

    If you lose focus on protein, remember how important it is to your weight loss success.