These amazing athletes require special sports nutrition considerations, counseling skills and the ability to refer out when needed.
I’ve worked with a variety of bariatric surgery athletes over the last decade and consulted with many more. They have some particular needs when it comes to fueling and hydrating, and even more considerations when it comes to adjusting their menu – and feeling completely comfortable with those changes!
Major Lessons from Working with Athletes after Bariatric Surgery
Don’t stop taking vitamins when training picks up for your first Ironman triathlon “just to see what happens.” What happens is not positive.
If it’s been months since your surgery and you can only tolerate small amounts of fluid, avoid signing up for the Roof of Africa hard enduro dirt bike race. It’s hot, it’s dry and dehydration, a problem for ALL racers, will only be worse for you.
If it’s been years since your surgery and you can only tolerate small amounts of fluid, don’t race in Las Vegas in the summer. See above, then maybe aim for cooler off-season races instead.
Counseling Discoveries for Bariatric Surgery Athletes
The standard post-surgery diet will NOT support significant training. Expect injuries or adapt.
The standard diet after bariatric surgery is great for re-learning how to eat and relearning hunger and satiety cues. It allows the person to focus on protein, maximizing fat burn, and healing after the surgery. It’s also something like 1200 calories. Energy Availability (EA) is a metric used to describe how much energy is left for life after exercise calories are accounted for. Too much exercise on not enough calories and things start to degrade. It’s often a slow slide, too, with a few minor tweaks, then a little more serious problems, then really serious issues.
What to do about this: See the next point.
Increases in food and fluid can be stressful, even if you’re exercising a LOT. This is completely normal and understandable.
Caloric increases outside of exercise, or at regular eating times, are the most stressful in my experience.
What to do about this: slow increases in the areas you’re most comfortable. For example, increases during exercise, especially for endurance athletes, seems to be easier than other options. This has the added benefit of improving the quality of the workouts and allowing the athlete to practice fueling for their event. Patience and working within the boundaries that feel safe are key!
Some athletes gradually expand their meals as well, but this varies widely between athletes and between types of sports. It will also depend on how heavy their training load is.
Eating disorders and disordered eating that existed before the bariatric surgery can still exist after the surgery.
These issues can impede an athlete’s ability to fuel for workouts, either from overeating or under eating. They also frequently cause a great deal of stress and anxiety. They do NOT just disappear because an athlete had bariatric surgery!
I generally refer out on eating disorders. That’s an area of specialty that I have not specialized in. I can only be an expert in so many areas and I know several people in my area who can do a much better job with this than I can. That said, I am happy to work with that specialist and the athlete to get the athlete to their goal, however.
Working with athletes who have undergone bariatric surgery and transformed their lives is tremendously rewarding. But it requires knowledge and experience!
If you’d like to know if I can work with a post-bariatric surgery athlete that you know, please reach out! When I can’t work with an athlete, I can refer you to someone who can.
Here’s a previous blog post that details some early fueling considerations.