Bariatric Food Coaching: Soft versus Solid Protein
Soft Protein Foods vs Solid Protein Foods after Bariatric Surgery
Why soft solid protein textures matter for hunger control
*Click here for the PDF of this blog to use for group discussion
A member question…
This is a fantastic question. Soft solid protein is a really helpful discussion that makes sense when we talk about it, but sometimes we don’t think to talk about it!
You may have also heard this is “slider foods” to watch out for.
The texture of protein matters BIG TIME after bariatric surgery. Not just in the healing phases but in controlling hunger long term.
In my bariatric food coaching, I like to put protein sources into three main categories.
Liquid protein: protein shakes, protein waters
Soft protein: Greek yogurt, cottage cheese, scrambled eggs, refried beans, flakey fish, shaved deli meat, tuna salad, dark meat poultry
Solid protein: chicken breast, hamburger patty, pork chop, pork tenderloin, steak
Every bariatric program is different in how they progress the diet after surgery and what foods they put in what stages. These three categories may not line up with what your program approved you to eat during a “soft stage” diet, this is just the way I categorize the texture of proteins.
Why solid (or ‘hard’) proteins?
This member said her surgeon recommended hard proteins. What does that mean and why would she/he say that?
Once you have progressed enough from your surgery and are fully cleared for solid textured protein, those are the textures that are most recommended for fullness and prolonged satiety.
Satiety: the feeling of fullness
When a Gastric Sleeve or Bypass patient has a leftover hamburger patty for lunch with a few green beans, that meal will stay with them longer. Note: if he/she takes black bean sized bites, eats slowly and doesn’t drink liquid during or 45 minutes after the meal
This patient would have maximized their surgery pouch by filling up on a solid, hard protein that fills them up on a smaller portion size and keeps them full longer. A ground beef or turkey burger patty is dense and packed with protein so it will take longer to transit through the stomach pouch.
Compare that to softer proteins
If instead a patient ate some tuna salad and cottage cheese for lunch, he or she could have eaten a larger portion because the soft protein goes down easier. Hunger would also be more likely to return sooner because the soft texture would move through the stomach pouch more quickly.
A leftover burger patty would fill up the stomach with less food, keep hunger away.
Tuna salad and cottage cheese would have a larger portion and hunger would return sooner.
Even if both of those meals are protein packed, one would likely lead to better weight loss results in the end. A smaller portion and less snacking with the solid protein option.
Note: this is not to say you should never have flakey fish or dark meat chicken. It IS to say to pay attention to textures and your hunger control. If you are struggling with snacking and keeping hunger in check, take a look at textures.
When solid proteins don’t go down well
What if the idea of a chicken breast or a hamburger patty sounds like a recipe for discomfort and queasiness?
If you struggle to feel well after a solid protein, the most likely reason is too large of bites or eating too quickly. Because the opening of your stomach pouch is so small, bites larger than even a black bean can back up at the top of the stomach and make you feel:
a) uncomfortable
b) pre-mature fullness
Pre-mature fullness: when you stop eating after a few bites, think you are full, but hungry an hour later
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What about the liquid proteins?
I covered the soft versus solid proteins after bariatric surgery. What about liquid proteins?
This is a little more complex in my opinion. More often than not, protein shakes are not needed for long after weight loss surgery. Again, many bariatric programs differ in their recommendations so this is where it gets complex.
The ASMBS (American Society of Metabolic and Bariatric Surgery) recommends 60 grams of protein a day. That number can be reached when a patient is eating 3 ounces of protein at three meals a day. This means most patients can wean down and off liquid protein as their intake grows at their meal times.
My personal coaching does not recommend replacing a meal with a protein shake but instead focusing on a food based protein at meals. Members can find out more in my video course The Do’s and Don’ts of Protein.
Become a MemberTo sum it up, food based solid protein wins
Let’s sum up the basics. To maximize the hunger control available to you with your pouch, set a schedule of three meals a day and focus on a food based, solid protein at each meal.
You will fill up at each meal and feel satisfied in between meals.
For sure it isn’t always easy (read: food is everywhere) but this basic, foundational practice is what sets you up for better success when temptation calls!
Steph :)
What if you cannot eat solid proteins at all? No matter what size bite I take, or how slowly I eat, my stomach post RNY does NOT like any meat, particularly if it is a fatty meat. After eating only one or two bites, I feel like I’ve been stabbed in the stomach, usually followed by dumping. This is sometimes alleviated by taking an enzyme, but not always. The pain is severe, so much that I am now afraid to eat beef, which was my favorite!
I’m sorry to hear that Christine! Certainly some patients need extra time and coaching through the process to getting solid proteins. I know with my patients I’ve tried different techniques like drinking warm broth before eating. Or we go through the food list and highlight all the foods that tend to go the best and start there and slowly graduate towards a new item. Also if the tummy is irritated in anyway it will be even more sensitive so sometimes we give the pouch rest with shakes until it’s a better time to try again. Some patients it does take more time to get towards more solid proteins but more often than not my patients do get there with a lot of consistent work towards it!
Hi Steph and all who read I get the solid protein and don’t have a problem with it , but I go to the gym approx 5 times a week , (well you know mad dogs and Englishmen lol)rather than a snack which I do have occasionally I have a protein drink because the trainer I have says I am not having enough I have Greek yogurt with fruit usually blueberry or raspberry in morning or boiled eggs , crisp read and ham/ turkey at lunch usually 2 and steak chicken or fish with veg for dinner plus 40 g of protein with skimmed milk as a snack on average my meals weigh no more than 200grams but I am happy with that just me number person according to my fitness pal I am starving myself lol and not eating enough protein so will having a protein shake as a snack be detrimental thanks
Mark
Ps gone from 322lbs to 168lbs and I seem to have plateaud here but good thing not put any back on
Hi, Steph!
I am 11 months out from my surgery and have lost 108 lbs. I was a big snacker before my surgery and now I’m starting to nibble between meals. I eat lots of protein. How can I curb this urge to snack and do you recommend it?
I also have a problem waiting 30 minutes before I drink and it reminds me by causing a lot of pain. As I get closer to my goal (40 more lbs. to go) I’m getting nervous about how I can maintain this weight loss.
Any ideas?
Thanks!
Steph (yes, my name is Stephanie too!)
Hello other Steph!
I agree you’ll want to pay attention to your snacking habits and work your way into new habits. So to answer part of the question, I don’t recommend snacking in between meals. To answer the first part of the question I’ll point you to a blog I wrote about head hunger versus true hunger. If you’re filling up on protein and you think it’s more mental than physical…those are different tools and tactics than if it’s a true hunger issue. The first part of the battle is being sure which hunger it is!
Drinking too soon after your meal could cause some of the snacking as it moves food through your stomach a bit faster. I agree that’s also a habit to take a look at. It’s so powerful to stay honest with yourself like you’re doing so you can identify what’s going on and what to focus on! Most people set timers and hide their water to keep it off their mind.
Hi Mark!
I think your protein shake sounds just fine in the midst of your plan and your activity level. Nothing detrimental at all! Your weight loss sounds fantastic. Let me know if you want me to take a closer look at your food journal but all sounds good to me.
Hi Steph,
I am 10 months post op, I have found that solid protein is exceptionally hard to eat for me. I find even small amounts makes me want to double over with pain and nausea, then it turns into horrible gas. I find this true for many veggies as well. My diet has become very limited with cottage cheese, yogurts and avocado. What can you recommend to help my intake of nutrients? oh an I forgot to mention I am training for my first triathlon.
any advise would be greatly appreciated
Thank you,
Yesha
@Yesha
I’m so sorry to hear about your difficulty! How frustrating and limiting for you. (Although congratulations on training for a triathlon!) My feedback for this would be finding more individual food coaching from a bariatric dietitian. I have a few things I would go through to work towards more texture in your foods, if it were me. If you need helping finding someone or you have a dietitian that would be interested in talking it out with me, either of you can email me at steph@foodcoach.me.
Love this post. Very helpful for me and my patients! Information like this is exactly what we need.
Taylor McD
Hi Steph – can this be available in a PDF for patient discussion? Great topic! Thank you
@k_tuepker just updated this blog to have a PDF!
Funny question….is the black bean size a dry bean or cooked bean?
You are the only one I’ve heard talking about protein textures and it makes sense!
@Rebecca I wouldn’t stress it too much. You could start on the smaller side (dry) and assess from there!