Bariatric Surgery Myths—Truth About Straws, Coffee & Bubbles
Myth #4. You can never drink from a straw. FALSE
There is a common misconception that bariatric surgery patients can never drink from a straw again. The concern is that drinking from a straw can cause a patient to bring in air and make them overfully full. Or, patients can drink too quickly from straws, and this also makes them feel overly full. I believe this is an outdated restriction.
At our practice, patients can use a straw as soon as they get home from the hospital. Straws are a great, simple way to get fluid in, and some patients prefer to use straws to drink. As long as you drink slowly from the straw and use it as intended, straws are completely benign and allowed. You will see many patients using large Stanley cups and using a straw to drink from them. I think this is a great way to stay hydrated through the day. If straws make you happy, please keep using them!
Myth #5. I can never have a carbonated beverage again. FALSE
Everyone loves some bubbles or carbonation in their drink. Who doesn’t like a nice sparkling water or a fuzzy energy drink? After a period of time, carbonated drinks are allowed in moderation!
Immediately after surgery, I recommend that patients avoid carbonation. This is because immediately post-operative, the stomach is swollen and there is minimal capacity. Carbonation and bubbles immediately po-op will likely cause the stomach to be too full and can lead to symptoms of reflux. The bubbles also take up valuable space in your new stomach that would be better suited for protein.
Fast forward a couple of weeks. The stomach has healed. The post-op swelling has decreased. Patients have advanced to the final stage of their diet and are eating chicken breast, salad, and other drier, crunchier foods. There is still a good amount of restriction from their recent bariatric surgery, but food and hydration are much easier now, and patients have a good routine. At this point, you can try a carbonated beverage. I tell most patients to open the can and let some of the bubbles out. Also, be aware that carbonated beverages, whether you had bariatric surgery or not, can always fill up the stomach and cause some reflux, so take small sips and plan to drink a smaller quantity. But as a frequent drinker of a fuzzy energy drink (I’m partial to Red Bulls and Celsius), I would also not want to deprive my patients of these as well! Carbonated beverages, in a healed bariatric surgery patient, are allowed!
Myth #6. Caffeine is not allowed after surgery. FALSE!
To all future bariatric surgery patients, we are not going to take away your coffee!
Many patients hear that caffeine and coffee are not allowed after bariatric surgery. This is due to the belief that caffeine can be considered a mild diuretic, meaning that it makes you urinate. Post-operatively, the concern was that this diuretic effect would dehydrate our patients. There was also a concern that coffee could cause gastric ulcers. Therefore, some practices ban caffeine and coffee in their patients.
In my opinion, the risks of caffeine are exaggerated. Numerous studies have looked closely at coffee and gastric ulcers and found no significant increased risk. In addition, a coffee or a moderate amount of caffeine is not much of a significant diuretic. Post-operatively, patients can have a cup or two of black coffee. I consider black coffee to actually be a “clear” liquid, as it is essentially just flavored water. Once patients move onto the protein shake stage of their diet, many coffee drinking patients can use their protein drink in place of creamer in their coffee for a “pro-fee”. This is a great way to get your protein in, as well as get a jump start to your day. When choosing a caffeinated beverage, moderation and choosing healthy options are key. The general recommendation is about 400 mg of caffeine or less per day. Avoid sugary caffeinated beverages (real sugar sodas or energy drinks) and avoid excessive fat to your coffee (heavy lattes with whipped cream). I recommend sugar-free caffeinated beverages, black coffee, or coffee with a light amount of low-fat milk.
As a frequent coffee drinker myself, I know how important a cup of coffee can be, and I want all my patients to enjoy their morning cup of Joe!
Myth #7. “Bariatric surgery is the easy way out.” FALSE!
This is one of the most hurtful misconceptions there is. This misconception is held by many members of society, other physicians, and even other individuals with the disease of obesity. This belief is held by those who choose to ignore the science and ignore the proven fact that obesity is a disease and needs to be treated as such. Statements like these try to shame patients or place guilt on patients, and could NOT be more wrong.
Science has, without a doubt, shown that obesity is a disease of the metabolism. People with the disease of obesity are predisposed to gaining weight as a result of the environment which we live. The disease of obesity is like many diseases in which there is a role for both the environment and a genetic predisposition. For example, people with fair skin who are exposed to prolonged sun exposure have a higher risk of developing skin cancer than someone with darker skin. Similarly, patients with certain changes to their metabolism are more susceptible to abnormal fat deposition as a result of the environment in which we live. The environment that we live in is one in which ultra-processed food is readily available, there is a lack of fresh fruits and vegetables, and a sedentary lifestyle is often required by our jobs.
To acknowledge and treat obesity as the disease it is means that we need to provide our patients with the full range of medical therapies. This includes the use of medications, the use of surgery, or even a combination of the two. Treating obesity like a disease also requires treatment from a specialist who knows all the best treatments and can recommend the best treatment for your specific form of disease.