Have you met those bariatric athletes who’ve had their surgery, flourished as an athlete, and managed to fuel themselves successfully?
That’s a massive accomplishment! I’ve only met a couple and they’re generally several years out from the surgery. Athletes who are months out are often still struggling to find the right mix of fluids and foods for training.
This can be really frustrating! Taking the long view can help, as can keeping the end goal in mind. Read on to see how post-surgical nutrition and sports nutrition are in opposition and what to do about it. Personalization and experimentation are essential for success!
It is important to note that there is a noticeable gap in the research when it comes to post-bariatric surgery athletes.
There are guidelines for eating post-bariatric surgery and there are guidelines for eating for athletic performance. There is one case study that I’m aware of in an athlete training for and running a marathon after bariatric surgery. Bariatric athletes really don’t have much to go on!
Sports Nutrition Guidelines
The current sports nutrition guidelines call for athletes to consume 30-60 grams of carbs/hour, more if exercising for multiple hours at a time. Due to reductions in blood flow to the GI tract and possibly jostling, combinations of simple sugars and dextrins work well.
An athlete should also consume fluid to stay hydrated. This can vary from a fraction of a liter/hour to several liters/hour. Some athletes also require extra electrolytes before or during workouts. That’s on top of fueling workouts before starting and recovering afterwards with whole foods that provide carbohydrates, protein and fat.
Bariatric Surgery Guidelines
Bariatric post-surgery guidelines are very stringent! The food consumed MUST support repair and growth after surgery and help maintain muscle mass and tissue function during weight loss. After any of these surgeries, the call is for 60-120 g of protein per day, vegetables and ~1.5L of fluid. One should drink to stay hydrated, but consume the fluid slowly and at least 30 minutes on either side of a meal.
Keep in mind that the stomach is very small, so a meal is also very small: ~2 ounces of protein and a couple bites of vegetable. Simple carbohydrates and processed foods are not allowed. Overall calories are fairly low, especially in the early weeks and months after surgery.
Early Issues with Fueling in Bariatric Athletes
Differences between a post-op bariatric diet and a standard athlete’s diet are really stark! In the first weeks and months after surgery, an athlete won’t be exercising enough to need sports nutrition. But as time goes on and distances become longer, there could absolutely be a need for fueling and hydrating appropriately. It makes sense to start hydrated and fueled. Bariatric athletes would then fuel with the lower carbohydrate sports drinks and solid foods taken in small amounts over a training session. Attaining and maintaining metabolic flexibility is also useful, but that requires integration of a coach or appropriate training plan, the dietitian and the athlete.
The keys here are personalization and experimentation.
Some athletes cannot take in enough carbohydrates or fluids for months or years after surgery. And some never get to the point that they can consume a standard athlete training plate. People also adapt over time, so if an athlete can’t eat enough or stay hydrated this year, maybe they’ll be able to next year or the year after. The outcomes to be avoided are dumping syndrome, nausea, vomiting and general GI upset.
Are you a post-surgery athlete that needs help with fueling? Reach out to me here! Or see some of the things I’ve learned working with bariatric athletes.