Carbs And Bypass Surgery: The Keto Way

The ketogenic diet is a non-traditional, high-fat, low-carb diet that supports weight loss. It is a popular option for patients who have undergone gastric sleeve or bypass surgery. However, the keto diet is not suitable for everyone. It is a restrictive diet that requires careful planning to ensure adequate protein intake, as fatty foods are more caloric than protein and carbs. While the keto diet can be effective for short-term weight loss, there is insufficient research to support its long-term benefits after bariatric surgery. Additionally, it may not be suitable for patients with liver, pancreas, thyroid, or gallbladder conditions.

Weight loss after bariatric surgery

Bariatric surgery is a category of surgical operations intended to help people with obesity lose weight. It involves modifying the digestive system, usually the stomach and sometimes the small intestine, to regulate calorie consumption and absorption. It can also reduce hunger signals from the digestive system to the brain.

Types of Bariatric Surgery

• Gastric bypass
• Sleeve gastrectomy
• Gastric band
• Duodenal switch
• Roux-en-Y gastric bypass
• Biliopancreatic diversion with duodenal switch (BPD-DS)
• Stomach intestinal pylorus-sparing surgery (SIPS)

Weight Loss Results

Most people—about 90%—lose about 50% of their excess weight after bariatric surgery and keep it off. Different procedures have slightly different results. The average weight loss after gastric bypass is about 70% of excess body weight. After a duodenal switch, it's about 80%. Weight loss after sleeve gastrectomy ranges between 30% and 80%. These results are measured after a period of 18 to 24 months.

Lifestyle Changes After Bariatric Surgery

Bariatric surgery requires long-term lifestyle changes to be successful. Patients who have undergone bariatric surgery should expect to make a lifelong commitment to their weight-loss goals, including dietary changes and regular physical activity.

Diet After Bariatric Surgery

A bariatric diet typically consists of high-protein, low-carb, and low-fat foods. This includes protein-rich meals, whole grains, healthy fats, fruits, vegetables, and bariatric vitamin supplements. It is important to work with a dietitian to ensure adequate nutrition and prevent deficiencies.

Some people may consider a keto diet after bariatric surgery for additional weight loss. However, the standard keto diet may not be suitable as it is high in fat and low in protein. A modified keto diet with a higher percentage of protein may be an option for some individuals under medical supervision. It is important to consult with a specialist before starting any restrictive diet after bariatric surgery.

The keto diet and weight loss surgery

The keto diet is a non-traditional, high-fat, moderate protein, very low-carb diet. It supports the transition and maintenance of a metabolic state called ketosis, where the body runs on ketones (fat) instead of glucose (sugar) for energy. This diet is ideal for weight loss patients, especially those who have had gastric sleeve or bypass surgery.

The keto diet aims to force the body to switch to a different metabolic state by drastically reducing carbohydrate intake. With limited carbohydrates available, the body is forced to use its stored energy (fat) as fuel, leading to weight loss.

Who is it for?

The keto diet is not for everyone. It is a restrictive diet that requires careful planning to ensure adequate protein intake, as fatty foods are more calorie-dense than proteins and carbohydrates. It is also not suitable for those with liver, pancreas, thyroid, or gallbladder conditions.

Benefits of the keto diet:

• Highly processed foods are avoided
• Decreased blood lipid levels and blood pressure
• Maximized weight loss
• Improved hunger control

The keto diet has been suggested as a possible solution for patients who regain weight after bariatric surgery. However, it is important to note that the standard keto diet may not be suitable for weight loss surgery patients as it is typically very high in fat. A modified keto diet with a higher percentage of protein may be recommended by a dietitian for these patients.

Downsides of the keto diet:

• Sustainability: The keto diet is highly restrictive and may not be realistic as a long-term solution.
• Metabolic changes: The diet can lead to an imbalance in thyroid hormones and negatively affect those with prior thyroid issues.
• Steatorrhea: The high-fat content can cause steatorrhea (fatty stools) and nutrient malabsorption, especially in weight loss surgery patients.
• Keto-Flu: Many people experience symptoms such as brain fog, headaches, fatigue, irritability, nausea, and constipation about a week after starting the diet due to metabolic changes.

In conclusion, while the keto diet may be an effective tool for weight loss, it is important to consult with a specialist before starting any restrictive diet, especially for weight loss surgery patients. Modifications to the standard keto diet may be necessary to ensure it is safe and effective for each individual.

The keto diet's health benefits

The keto diet, short for the ketogenic diet, is a non-traditional, high-fat, low-carb diet that supports a metabolic state known as ketosis. In this state, the body runs on ketones derived from fat instead of glucose. While the keto diet is not for everyone, it offers several health benefits, especially for weight loss and gastric bypass surgery patients. Here are some of the key health benefits of the keto diet:

• Weight Loss: The keto diet is highly effective for weight loss. By significantly reducing carbohydrate intake, the body is forced to switch to burning stored fat for energy, leading to weight loss. This dietary approach is particularly beneficial for individuals who have struggled with obesity and weight regain after bariatric surgery.
• Improved Hunger Control: The keto diet can help individuals control their hunger and manage their appetite. By increasing fat intake and reducing carbohydrates, the body stays satiated for longer periods, reducing cravings and snacking between meals.
• Avoidance of Highly Processed Foods: The keto diet naturally leads to the avoidance of highly processed and packaged foods that are typically high in carbohydrates and unhealthy fats. This encourages individuals to consume whole, unprocessed foods, such as healthy fats, low-carb dairy, and non-starchy vegetables.
• Decreased Blood Lipid Levels and Blood Pressure: Following the keto diet has been associated with a decrease in blood lipid levels and a reduction in blood pressure. This benefit is particularly relevant for individuals who have undergone heart bypass surgery or are at risk of cardiovascular disease.
• Improved Blood Glucose Maintenance: The keto diet can aid in maintaining healthy blood glucose levels. By reducing carbohydrate intake, the body's reliance on glucose as a primary energy source decreases, which can help stabilize blood sugar levels and may be beneficial for individuals with insulin resistance or type 2 diabetes.
• Increased Energy and Focus: Some individuals report experiencing improved energy levels and enhanced focus while on the keto diet. The stable energy levels provided by ketones can lead to increased productivity and a more sustained attention span throughout the day.

While the keto diet offers these potential health benefits, it is important to consult with a healthcare professional before starting any new diet, especially for individuals with specific medical conditions or those who have undergone bariatric surgery. Additionally, long-term adherence to the keto diet may be challenging due to its restrictive nature, and modifications may be necessary to ensure adequate nutrient intake and sustainability.

The keto diet's downsides

The keto diet is a high-fat, low-carb diet that has gained popularity as a weight-loss tool. While it may be effective for weight loss, there are several downsides and potential risks associated with this restrictive diet. Here are some key considerations:

Restrictive and Difficult to Sustain:

The keto diet involves stringent food restrictions, making it challenging for many people to stick to in the long term. It requires a significant reduction in carbohydrates, which are typically a major source of energy for the body and brain. This drastic change can be difficult to adjust to and maintain.

Potential Health Risks:

The high-fat nature of the keto diet has been linked to possible negative impacts on heart health. The diet is associated with increased levels of LDL cholesterol, often referred to as "bad" cholesterol, which is a risk factor for heart disease. Additionally, the high intake of saturated fats encouraged in the keto diet may further increase the risk of cardiovascular disease.

Nutrient Deficiencies:

By eliminating or reducing certain food groups, the keto diet can lead to nutrient deficiencies. Specifically, it may result in a lack of vitamins, minerals, and fiber that are typically obtained from fresh fruits, legumes, vegetables, and whole grains. This can have various negative consequences for overall health and well-being.

Kidney and Liver Problems:

The keto diet has been associated with an increased risk of kidney stones and an overload on the kidneys due to the high protein intake. It may also worsen existing liver conditions, as the liver has to metabolize large amounts of fat. These organs may be vulnerable to additional stress and potential damage.

Constipation and Gastrointestinal Issues:

The keto diet is low in fibrous foods, which can lead to constipation. Additionally, some people on the keto diet experience steatorrhea (fatty stools) due to the high-fat intake. This can cause nutrient malabsorption and other gastrointestinal complications.

"Keto Flu" and Other Side Effects:

Many people on the keto diet experience a group of symptoms known as the "keto flu," which includes fatigue, headache, brain fog, irritability, nausea, and constipation. These symptoms are attributed to the metabolic changes the body undergoes when transitioning to using fats for energy.

Not Suitable for Everyone:

The keto diet is not recommended for individuals with certain medical conditions, such as diseases of the pancreas, liver, thyroid, kidney, or gallbladder. It is also not advised for those with a history of kidney stones, eating disorders, or gallbladder removal. The diet's high-fat content and potential impact on organ function make it unsuitable for some individuals.

While the keto diet may be beneficial for specific medical conditions and short-term weight loss, it is important to carefully consider the potential downsides and risks. It is always advisable to consult with a healthcare professional before starting any restrictive diet, especially one as demanding as the keto diet.

The keto diet's food groups

The keto diet is a high-fat, low-carb, and moderate-protein diet. It is important to note that the keto diet is restrictive and may not be suitable for everyone. Here is a breakdown of the food groups that are typically included in a keto diet:

Fats & Oils

Try to get your fats from natural sources, such as meat and nuts. Supplement with saturated and monounsaturated fats like coconut oil, butter, and olive oil. Animal fats (non-hydrogenated), avocado, and macadamia/Brazil nuts are also good choices.

Protein

Stick with organic, pasture-raised, and grass-fed meat where possible. Most meats do not have added sugar, so they can be consumed in moderate quantities. Remember that too much protein on a ketogenic diet can lead to lower levels of ketone production. Some examples of keto-friendly proteins include fish, shellfish, whole eggs, beef, pork, poultry, offal/organ meats, bacon, sausage, and nut butter.

Vegetables

Fresh or frozen vegetables are fine. Stick with above-ground, leafy greens such as spinach, kale, Swiss chard, and turnip greens. Some other keto-friendly vegetables include asparagus, avocado, celery, mushrooms, zucchini, cucumbers, and green bell peppers.

Dairy

Most dairy is fine on the keto diet, but make sure to buy full-fat dairy items. Harder cheeses typically have fewer carbs. Some examples include heavy whipping cream, cottage cheese, cream cheese, Greek yogurt, aged cheddar, and sour cream.

Nuts and Seeds

Nuts and seeds can be used in moderation to add texture and flavour to meals. Try to use fattier nuts like macadamias, almonds, and brazil nuts. Roasted nuts are best to remove any anti-nutrients.

Beverages

Water should be your staple beverage. You can also drink bone broth, coffee, tea, and unsweetened almond/coconut milk. Alcohol, in moderation, is also allowed on the keto diet, but beer and wine are too high in carbs.

Frequently asked questions