What will my portion sizes be after a weight loss procedure?

What will my portion sizes be after a weight loss procedure?

By Kamyra La Fauci – Accredited Practising Dietitian

Whether you’re thinking of having a weight loss procedure, or have recently committed to one, its normal to wonder what your diet will look like afterwards, especially the portion sizes of your meals.  

Whilst all weight loss procedures are designed to reduce the capacity of the stomach, the degree of restriction varies between the type of procedure as well as the individual’s personal restriction.  To make things a little clearer, we have outlined the endoscopic and surgical procedures we offer at The BMI Clinic, and what to expect with each.  

Non-surgical procedures  

Intragastric Balloon 

In the first month post balloon insertion, portion sizes are kept small ~1/2 cup per meal to minimise symptoms and to ensure the balloon is well tolerated. After this period, portion sizes typically increase to ~ 1 cup in the following 2 months and eventually to an entrée sized plate per main meal. Whilst this is a guide, portion sizes may vary depending on the personal level of restriction and the size of the balloon.  It is important to discuss this with your Dietitian to determine what is best for you. 

Endoscopic Sleeve Gastroplasty (ESG) 

Like the Intragastric balloon, portion sizes are initially ~1/2 cup per meal and remain at this size for the first 6 weeks to allow the sutures to heal and to minimise complications and adverse symptoms. After the diet progression is completed, portion sizes typically increase from 1/2 cup to 1 cup for the next 2 months, and slowly progress to an entrée plate sized meal.  This is the recommended portion size to adhere to lifelong to ensure the sutures are kept intact. 

Surgical Procedures 

Compared to Endoscopic procedures, portion sizes after weight loss surgery are much smaller due to the larger level of restriction. Also, weight loss surgery alters the hormone Ghrelin that affects appetite, meaning less physical hunger is experienced in the first 1-2 years after the operation. After this period, physical hunger may slightly increase, but is often significantly less compared to before the operation and is well managed through diet and lifestyle changes. 

Sleeve Gastrectomy 

In the initial 6 weeks after a Sleeve Gastrectomy, portion sizes are kept small around ¼ – ½ cup to allow the staple line to heal and to minimise complications and adverse symptoms. Typically, these portion sizes remain for at least the first 3-6 months, and slowly increase to 1 cup per meal within 12 months. For most, 1 cup is the typical portion size for main meals in the longer term. 

Gastric Bypass  

In the first 6 weeks after Gastric Bypass surgery, portion sizes are ~1/4 – 1/3 cup per meal. Once solids can be introduced, portion sizes remain at this size, and slow increase to ½ cup in the first 6 months. Typically, portion sizes will remain at ½ cup to 1 cup maximum lifelong, depending on the individual and the type of meal.  Compared to other procedures, the gastric bypass provides the large restriction and therefore the smallest portion sizes.   

In summary, no matter what weight loss procedure you decide on, regular support from your healthcare team, in particular your Doctor, Dietitian and Psychologist is the key to success to manage your portion sizes over time.  

It’s important to understand that no weight loss procedure is bulletproof, and if portion sizes are consistently increased over time, the integrity of the stomach after endoscopic or surgical procedures can be compromised. Working closely with your Dietitian is important to determine how you can successfully structure your meals to manage your appetite, and to tailor your portions depending on the density and textures of different foods is vital for successful weight loss and  maintenance lifelong.