Maladaptive Eating

What is maladaptive eating?

If the Surgeon or the Dietitian has told you that you have maladaptive eating, it means that you have changed what you eat or how you eat, in such a way that it is affecting how the band works. This means that how successful you are at losing the weight, and even more importantly keeping it off in the long term, is at risk. Maladaptive eating is very common after having Bariatric surgery and that is why we monitor for it and provide education and advice on how to avoid/cure it.

Examples of maladaptive eating:

• Eating for an extended period of time i.e. getting through all the food on your plate simply by taking a longer time period to do this. Rather than stopping when getting full or when 10 minutes has elapsed (whichever comes first).
• Choosing foods that pass easily through the band – foods such as soups, sloppy dishes, crackers, biscuits, ice-cream, Boost™ juices, smoothies etc. that can still be eaten in large quantities and do not allow the band to give you the restriction more solid food choices provide. Eating lots of snacks or ‘grazing’ rather than having three small meals.
• Drinking lots of high calorie sweetened drinks including alcohol which is not restricted by the band.
• Drinking too close to eating which tends to move the food through the small pouch more quickly and allows you to eat more, or makes you need to eat sooner than expected because you get hungry more quickly.
• Unfortunately, a lot of people feel that they are coping well because they are able to eat more ‘normally’ by eating in a maladaptive way. In actual fact they are not using the band to its full potential and therefore not getting the best out of it.

Comments we have heard that describe maladaptive eating include:

“I can only eat ½ slice of bread so I choose crackers instead because then I can eat 4 Cruskits™”

“I get full after the first 4 -5 mouthfuls but if I wait a few minutes and have a few sips of water, I can then finish my meal”

“I’ve stopped eating apples because I could only eat ¼ - ½ apple and what do I do with the rest of it?”

“I don’t have rice with my meal anymore because it fills me up too much”

“I don’t really have meals anymore because I get too full so I just have lots of snacks throughout the day”

“I worry that I will not have any energy because I eat so little so I make sure I have a big smoothie for breakfast and after dinner”

What can be done about maladaptive eating?

The good news is the band is still in place and ready to be worked with properly.

What is needed is education and commitment to get back to working with the band by making changes to both what, and how you eat.

Remember that the body needs very little food to survive and the object of the band is to allow you to greatly reduce the size of your meals but still give you a feeling of being satisfied and no longer hungry.

To use the band to its best ability:

• Choose solid food choices that mean you can only eat small quantities e.g. pasta, bread, rice, meat, chicken.
• View eating smaller serves of food as a GOOD thing, not something to worry about.
• Stop eating when you no longer feel hungry, not when you feel over full.
• Stop eating after 10 minutes regardless of what is left on your plate. This food is as much a waste inside the body as it is in the bin!
• Have three small meals including breakfast. You only need a snack in-between meals if you are hungry but remember snacks need to be solid and filling too e.g. fruit
• Drink only low calorie drinks and limit alcohol.
• Yoghurt is a snack not a meal and great to help you get your calcium intake but 200g low fat per day is sufficient. Limit cheese to one slice per day.

Remember you will have more energy than ever because you are losing weight and this takes enormous pressure off the heart, lungs and joints. Energy levels will not be affected by a smaller intake.