Intermittent Fasting After Bariatric Surgery

Is intermittent fasting safe after weight loss surgery? Yes, however it is not recommended immediately following bariatric surgery.

Intermittent fasting has gained immense popularity in recent years as yet another dietary strategy to help with weight management. Quite a lot of our bariatric patients inquire about this approach about 2+ years post-op in an attempt to “get back on track”, lose more weight or lose the regained weight.

What Is Intermittent Fasting?

Intermittent fasting is a diet where you eat food within a certain time frame throughout the day and spend extended hours fasting. For example, if you have your last meal at 7 p.m. and your next meal at 11 a.m., you will be fasting for 16 hours.

For individuals who have undergone bariatric surgery, intermittent fasting (IF) can be an effective tool to help maintain long-term weight loss. Mainly, it helps patients to stay more disciplined as the allotted food window is restricted, which leads to consumption of fewer calories and further weight loss.

In this blog post, we’ll explore the science behind intermittent fasting, its benefits, contraindications, and suggest ways on how you could incorporate it into your post-bariatric surgery lifestyle.

The Science Behind Intermittent Fasting

Researchers claim that intermittent fasting triggers a process called autophagy, a cellular cleansing and repair mechanism, which has been linked to various health improvements. They say IF is backed by solid scientific evidence. When you fast intermittently, your body goes through various metabolic changes that can have a positive impact on your health:

Insulin sensitivity: fasting can improve insulin sensitivity, which is crucial for individuals with a history of obesity. It helps the body use insulin more efficiently and reduces the risk of developing type 2 diabetes.

Weight loss: intermittent fasting can lead to a reduction in calorie intake, making it easier to maintain a caloric deficit, ultimately resulting in weight loss.

Autophagy: fasting triggers a cellular process called autophagy, which cleans out damaged cells and supports overall cellular health.

Inflammation: studies have shown that IF can reduce markers of inflammation in the body, potentially lowering the risk of chronic diseases.

Hormonal changes: fasting can increase the release of norepinephrine and human growth hormone, promoting fat loss and muscle preservation.

Bariatric patients can particularly benefit from intermittent fasting due to the following reasons:

1. Weight loss: IF can help bariatric patients maintain their post-surgery weight loss by promoting fat loss and preserving lean muscle mass.
2. Improved insulin control: bariatric surgery often improves insulin sensitivity, and IF can further enhance these effects, reducing the risk of diabetes.
3. Healthy eating patterns: IF can help establish healthier eating patterns, reducing the risk of overeating and promoting mindful eating. Intermittent fasting should be accompanied by a nutritionally dense diet and a consistent eating schedule to fully nourish your body and avoid deficiencies.
4. Reduced risk of comorbidities: by reducing body weight and improving metabolic health, IF can lower the risk of obesity-related comorbidities such as heart disease, hypertension, and sleep apnea.

Contraindications for bariatric patients

While intermittent fasting offers many benefits, it may not be suitable for everyone, especially for those who have undergone bariatric surgery. Individuals should exercise caution or consult their healthcare provider before attempting intermittent fasting if they have:

1. Hypoglycemia:

Bariatric patients are already at risk of low blood sugar levels. Fasting may further exacerbate this issue. Certainly, let’s delve deeper into the issue and provide some tips on how to avoid it when considering intermittent fasting:

• Monitor blood sugar levels: regularly monitor your blood sugar levels during your fasting periods. This can help you identify any significant drops and take corrective action promptly.
• Choose your fasting window carefully: opt for fasting windows that align with your body’s natural rhythm and blood sugar patterns. For some, fasting overnight and having breakfast later in the morning may work better to avoid low blood sugar.
• Consume complex carbohydrates: when you do eat, focus on complex carbohydrates like whole grains, vegetables, and legumes, which release glucose more steadily into your bloodstream, reducing the risk of sharp blood sugar fluctuations.
• Include protein and healthy fats: incorporate lean protein sources and healthy fats into your meals to help stabilize blood sugar levels. These macronutrients slow down digestion and provide sustained energy.
• Stay consistent: consistency is key. Try to keep your meal and fasting times consistent to train your body’s internal clock to anticipate food intake, which can help prevent extreme drops in blood sugar.
• Have emergency snacks, be prepared for emergencies. Keep a small, healthy snack on hand in case you start to experience hypoglycemic symptoms such as dizziness, fatigue, or sweating.
• Remember that each bariatric patient’s experience with intermittent fasting may vary, and what works best for one person may not be suitable for another. It’s crucial to work closely with your healthcare team to develop a fasting plan that is tailored to your specific needs, considering your unique medical history and surgery type. By being proactive and cautious, you can reduce the risk of hypoglycemia and enjoy the benefits of intermittent fasting safely.

1. Nutritional deficiencies:

Post-surgery patients are required to take vitamins and supplements due to reduced nutrient absorption. Fasting may complicate this issue. Bariatric surgery can affect nutrient absorption, making it essential to ensure that any fasting approach doesn’t aggravate these issues.

How to incorporate intermittent fasting

If you and your nutritionist decide that intermittent fasting is right for you, here’s a basic guide on how to get started.

Choose a fasting method: there are various fasting methods, including the 16/8 method (fasting for 16 hours, eating within an 8-hour window) or the 5:2 method (eating normally for five days and consuming fewer calories on two non-consecutive days). Typically, individuals limit themselves to 500- 600 calories on these days. It’s essential to choose non-consecutive days, allowing at least one regular eating day between them.

The idea behind the 5:2 method is that by significantly reducing calorie intake for two days a week, you create a calorie deficit, which can contribute to weight loss over time. On the remaining five days, you are encouraged to eat a balanced and nutritious diet to maintain overall health and ensure you’re getting the necessary nutrients.

Stay hydrated: drink plenty of water during fasting periods to stay hydrated (64 oz), if you work out, you shoud drink more.

Monitor your body: pay attention to your body’s signals. If you experience extreme hunger or discomfort, reconsider your fasting approach.

Start slow: if you’re new to fasting, start with shorter fasting windows and gradually extend them as your body adapts.

Consult your healthcare provider: regularly consult your healthcare provider to monitor your progress and ensure your fasting regimen aligns with your health goals.

Conclusion

Intermittent fasting can be useful for bariatric patients in maintaining their post-surgery weight loss and improving overall health. Learn more at Intermittent Fasting For Maintenance of Weight Loss.  However, it’s essential to approach it with caution, especially considering the unique challenges bariatric surgery patients face.

For some of our patients, prolonged fasting is required as part of their religious practices, such as Ramadan. For more useful information on this subject go to Ramadan and Fasting After Bariatric Surgery.

In general, our nutritionists favor a sustainable approach. Very strict diets are designed to last for a limited time. After that, patients return to their regular eating habits. The main goal is to ensure that those habits are healthy ones.  We highly recommend following our low-carb protein-enriched diet with 5-6 small meals per day as your permanent, well-balanced, and sustainable solution. And any time our patients inquire about the best way to “get back on track”, we refer them to the Pre-Op Diet.

Please consult with your healthcare provider before starting any fasting regimen and ensure it aligns with your specific health needs and goals. By understanding the science, benefits, contraindications, and how to incorporate intermittent fasting, bariatric patients can make informed decisions to support their long-term health and well-being.

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