High fiber, high moisture complex carbohydrates included in the weight loss surgery diet provide healthy nutrients and vitamins and feelings of satiation without adversely affecting blood sugar or weight management.

Serving: 2 Roma Tomatoes, 1 cup broccoli, 1 cup baby carrots, 4 medium button mushrooms, 1 cup fresh ripe strawberries, 1/2 cup fresh black berries, 1 large kiwifruit. Volume: about 5 cups.

Calories: 281

Carbohydrate: 63g

Protein: 11g

Fat: 1g

Sodium: 215mg

Cost*: $3.30

In comparison let's look at the top three processed simple carbohydrate snack foods that WLS patients report including in their diet:

Fig Newtons: 2 Cookies

Original Wheat Thins: 16 Crackers

Pretzel Twists: 10 twists

Total food volume: 1 cup 

Calories: 489

Carbohydrate: 92g

Protein: 9g

Fat: 10g

Sodium: 1424mg

Cost*: $2.19

As you can see, with only three foods and 1 cup of food volume we are 40 grams shy of our daily intake of carbohydrate (92g of 130g RDA). In addition these foods are frequently eaten as snacks and most of us know we can (and sometimes do) exceed the portion size without discomfort or even awareness. We would only need to add one Fig Newton, 8 Wheat Thins and 5 more pretzel twists to reach our daily carbohydrate intake. In addition, these simple carbohydrates fail to provide health promoting nutrients and vitamins and they may adversely affect blood sugar levels and weight management goals. 

My current practice of awareness is knowing that if the product is manufactured and labeled and I chose to eat that product I must count and record the carbohydrate values. You will notice when shopping that infrequently fresh fruits and vegetables are labeled for nutrition; they are not manufactured food. As a weight loss surgery patient with limited stomach space it is highly unlikely I will ever exceed the RDA of 130g per day when I chose fruit and vegetable carbs over processed simple carbs. 

The big bonus that comes from eating complex carbohydrates is not calculated in weight and measure. It is the freedom from self-loathing and moral judgment that so often accompanies our food choices. In all my work with weight loss surgery patients I have never heard someone say, "I just couldn't stop eating fresh vegetables, I was out of control, I am so angry at myself for doing that." Not once.  The same cannot be said for our top three simple carbohydrate snacks that quickly become slider foods derailing our weight management. 

And finally, when we eat these healthy nutrient dense fruits and vegetables we stay full longer and report fewer cravings for snacky-carbs. Our overall health improves, skin and hair become radiant, we maintain steady energy levels, weight management is achieved and we don't feel badly about ourselves.  

*Cost is based on package items purchased at a big box warehouse store on April 1, 2011. Prices may vary by region and season.   

Learn more about simple carbs and how they become slider foods and derail our weight management efforts. 

LivingAfterWLS General Store 

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Simple Carbohydrates:

Foods that contain a lot of sugar --syrups, jelly, honey, soda, molasses and have few, if any, vitamins and minerals and no fiber.

Complex Carbohydrates:

Foods that contain a lot of starch --vegetables, fruits, beans, whole grains, and pasta. They are rich in vitamins, minerals, and fiber.

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People in pursuit of healthy weight management know to stick close to the veggie tray at parties and buffets. After all, vegetables are good healthy food full of beneficial vitamins, nutrients and fiber. But some vegetables, particularly cruciferous vegetables like the ubiquitous broccoli and cauliflower, can cause severe gastric upset when eaten raw by patients of gastric weight loss surgery. In fact, there are many examples of weight loss surgery patients who have experienced gastric distress so severe after eating raw broccoli or cauliflower that a trip to the emergency room was needed.

The reason weight loss surgery patients of all procedures (gastric bypass, gastric sleeve, adjustable gastric banding or lap-band) are prone to discomfort after eating raw cruciferous vegetables is a matter of balance. The vegetables are rich in enzymes which are believed to aid digestion. However, due to the shortened gastric tract and loss of stomach acid the vegetables cannot be fully digested in their short trip through the intestinal tract. The problem is compounded by the presence of cellulose, the dietary fiber in the vegetables that requires intestinal bacteria to process. Even without gastric weight loss surgery many humans lack enough intestinal bacteria to break down the cellulose enough to avoid symptoms of gas, bloating, and cramping.

After weight loss surgery many patients are intently focused on becoming healthy and in control of their weight through proper diet and nutrition and increased daily activity. These are admirable pursuits which often lead to the conundrum over eating good healthy vegetables at the risk of severe gastric distress. Frustrated patients wonder, If it is so good for me why does it make me feel so bad? Good question. There are a few measures that may be taken to reduce the discomfort that follows eating raw vegetables so we can have our nutrients and enjoy them too. Take a look:

Experiment cautiously

If you do not know how you will respond to raw vegetables go easy at first and avoid discomfort or embarrassment that may come from eating too much of a good thing. In addition, remember that from day to day foods will sit differently. Always practice restraint while you get a feel for how food is setting with you that day.

Lightly steam or parboil vegetables

to begin breaking-down the cellular structure thus helping the intestinal acid get busy more quickly with digestion. Remember, if you cannot digest the vegetable you will not be able to absorb the vitamins and nutrients in the vegetable. To serve the steamed or parboiled vegetables chilled simply prepare them in advance, drain of water and pat dry. Plate, cover and chill. Then serve cold with a lightly seasoned veggie dip made from yogurt which contains healthy bacteria that will aid in digestion. Avoid dairy-based dips, such as those made with sour cream, as this may increase the chance of stomach discomfort.

Take a digestive enzyme

as directed prior to or shortly after eating raw vegetables. There are many digestive enzyme supplements available at reasonable cost. Many weight loss surgery patients report that papaya enzyme is effective in reducing digestive discomfort. According to one maker of papaya enzyme the dietary supplement contains "papain, a proteolytic enzyme and a popular ingredient in dietary supplements used for digestion. Taken after meals, it is a perfect natural supplement that may assist in digestion and may help reduce the effects of poor digestion, including heartburn and gas." As with all dietary supplements keep in mind the FDA does not evaluate these claims or approve supplements for their claimed use. Consumers should consult with a health care professional before using any dietary supplement.

Chew, chew, chew. Remember that digestion begins in the mouth and it is critical to chew completely all raw vegetables in order to give your gastric system the best conditions under which to digest food and benefit from the vitamins and nutrients it contains.