For most people, eating sliders is a good thing. Popularized by the American food chain, White Castle, a slider (originally slyder) is a miniature grilled hamburger or cheeseburger on a steamed bun that is often served with pickled onions and pickles and other seasonings. They originally sold for a nickel a piece in the 1940s, so it was affordable to add a side of fries for just pennies. By all accounts, this is a good kind of “slider” meal.
For the weight loss surgery patient, slippery foods are the bane of good intentions and ignorance that often cause dumping syndrome, weight loss plateaus, and eventually weight gain. Slip foods, for weight loss surgery patients, are simple, mild processed carbohydrates of little to no nutritional value that slide directly through the stomach’s surgical pouch without providing nutrition or satiety. The most innocent slip-on foods are saltine crackers, often eaten with hot tea or other beverages, to calm the stomach in case of illness or while recovering from surgery.
The most commonly consumed sliders include pretzels, crackers (crackers, graham, Ritz, etc.), filled cookie sandwiches like Ritz Bits, popcorn, cheese sandwiches (Cheetos) or cheese crackers, tortilla chips with salsa , French fries, no sugar. cookies, cakes and sweets. You will notice that these slippery foods are often salty and cause dry mouth, so they need to be ingested with liquid to make them tasty. This is how they become slippery foods. Also, in most cases, they lack nutritional value.
For weight loss surgery patients, the digestion process is different than for those who have not had gastric surgery. When slippery foods are eaten, they enter the stomach pouch and exit directly into the jejunum, where the suspension of simple carbohydrates is rapidly absorbed and stored by the body. There is little thermal effect in the digestion of simple carbohydrates as in the digestion of proteins, so little metabolic energy is expended. In most cases, patients in the weight loss phase who eat sliding foods will experience a weight loss plateau and possibly the reversal of weight gain. And sadly, they will begin to believe that the stomach surgical pouch is not working properly because they never feel full or restricted like they experience when they eat protein.
The very nature of the surgical gastric pouch is to cause a sensation of tightness or restriction when one has eaten enough food. However, when soft simple carbohydrates are eaten, this stress or restriction does not occur and one can continue to eat copious and unmeasured amounts of non-nutritious food without ever feeling uncomfortable.
Many patients turn to slip foods for this very reason. They don’t like the discomfort that results when the bag is full from eating a measured portion of lean animal or dairy protein without fluids. However, this very restriction is the desired outcome of the surgery. The discomfort is meant to signal the cessation of eating. Remembering the “protein first” rule is critical to weight management with bariatric surgery.
Gastric bypass, lap-band, and gastric sleeve patients are instructed to follow a high-protein diet to facilitate healing and promote weight loss. Bariatric centers recommend what is commonly known among weight loss surgery patients as the “Four Rules,” the most important of which is “Protein First.” That means that of all the nutrients (protein, carbohydrates, fat and alcohol) the patient is required to eat protein first.
Protein is not always the most comfortable food option for weight loss surgery patients who feel restricted after eating a very small amount of food. However, for the surgical tool to function properly, a diet rich in protein and low in simple carbohydrate slip foods must be observed. The high protein diet should be followed even after achieving a healthy body weight to maintain a healthy weight and prevent weight regain.