Running with a lap band, gastric bypass or sleeve

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Endurance based exercise, like marathon running, triathlon and multi day events like 100km trails, are attracting new participants by the masses. It’s by no surprise that they are attracting formerly obese people who want to participate in exercise. Large scale exercise events will keep you motivated and continue the weight loss process. It will also challenge your physical abilities in your new-found body.

Bariatric surgery is a common tool people are utilising to lose weight. This includes procedures like lap band, gastric bypass and gastric sleeve. A niche group of people who have undergone bariatric surgery are now becoming weekend warriors in their own right, in these longer adventure-type sports.

As this is a fairly new phenomenon, not many sports dietitians (or dietitians for that matter), have come across these recreational athletes with specialised needs. It’s also not something you can Google, which is unfortunate because running with a lap band, gastric bypass or sleeve has unique challenges.

How a lap band, gastric bypass or sleeve can affect your sports goals

The purpose of bariatric surgery is to increase feelings of fullness and decrease the urge to eat. This is how it causes weight loss long term. Restrictive eating is a contradiction for endurance-based sports because long-duration exercise has a high-energy requirement. This creates a huge barrier too, if you have had bariatric surgery. It has the potential to affect your ability to participate and perform at your personal best in endurance-based sports.

Those who have had a lap band or a sleeve, you would be familiar with experiencing an extremely low food intake immediately post-surgery. This is due to poor tolerance of food and feeling nauseous. In a lot of cases, a few mouthfuls of liquid or mashed food is more than enough. As time progresses, post-surgery, most people tolerate food better and find out their upper tolerable limits. Even one year post-surgery, this restricted food intake isn’t going to fuel endurance-based training or a marathon race.

In previous blog posts, I have already addressed the need to have a scientifically backed nutrition regime for better performance. If you don’t, you run the risk of hampering your performance by 8%, which means you will run slower. That, itself, is demoralising enough!

The scientific literature on this topic is scarce. I did however find a single case study of a woman who had gastric bypass surgery and documented her wins and struggles [1]. This article is targeted at those who have reached goal weight and are now looking at performing in endurance sports, with now different nutrition requirements.

Tips to racing post lap band, gastric bypass and sleeve surgery

The most important thing to remember, when racing in endurance sports, is that goals are different to normal weight loss plans. You do need to eat, to fuel your body for exercise; and your body needs carbohydrates. You will need to try and eat more carbohydrates and protein, in general. For most people, this may be a conflicting message from what you have heard your entire life regarding weight loss diets and combating weight regain.

 Physical and mental barriers will be difficult to overcome to begin with but with determination and drive, it can be achieved. Start off simply, by prioritising nutrients, so you get enough to fuel your training and recovery.

It’s important to stay on top of your protein and energy intake, so use dense sources of good fats and high quality protein. This may be helped by using things like milk fortified with protein whey or peanut butter in a single serve of milk shake. As time goes on, you will be able to eat more food – it just takes practice!

You may need to graze and eat every 1-2hrs during peak season, when training volume is high. Liquids, like yogurt and milk, are great pre and post training snacks to meet protein and energy requirements.

The focus of your eating regime should be about having enough carbohydrates to fuel your running. Make sure you are hydrated like a champion and well fuelled before stepping on to the starting line; this should be the focus of the three days prior to the race itself.

Race day tips to follow with a lap band, gastric bypass or sleeve

On race day, the biggest issue you will face is not only getting enough carbohydrates in but also hydration. Water, of course, fills the stomach pouch, making you feel full and may stop you consuming enough carbohydrates from food and supplements like gels and sports drinks during the race. Prioritise liquid carbs over plain water, if this is an issue. Better still, liquid carbs, like sports drinks, milk or juice, could be used. Aim to continuously sip a carbohydrate liquid throughout the race; you may also want to invest in a camel pack to carry your own water supply.

Like all athletes, sometimes rich sugary sports drinks, gels and juices containing fructose can cause dumping issues (serious bathroom problems). You can overcome this with practice and also diluting the products with water further. You may also want to try varying the sources of carbohydrate and liquid so you’re not taking in large amounts of sugar throughout the course of the race.

Understandably, those of you with gastric bypass have unique individual differences on what you can and can’t tolerate, which is very different to those with lap bands or gastric sleeves.  Each procedure is different and you will need individualised advice to get your race day nutrition perfect.

Race day snacks you can carry

  • Gels squeezed into small water bottles, you can sip in small amounts, alternating with water
  • Plain rice or wheat crackers
  • Instant mashed potato (Deb) pre made, mixed with salt in zip lock bags. While you run you can bit the edge of the plastic off and squeeze it into your mouth
  • Milk tetra packs, flavoured or plain. Research has shown milk can hydrate and fuel you during a race just as well as a sports drink. It also has added protein for recovery.
  • Muesli bars
  • Plain arrowroot biscuits
  • Potato chips, this has the added benefit of additional sodium for better hydration.
  • Dextrose in water. Some athletes may find dextrose (pure glucose and not as sweet) is better tolerated than fructose based products.

There are many other carbohydrate based supplements on the market made from potato starch and rice starch that can also be used. You may have to try a few different brands before finding which one works for you.

Nutrition can be very complex post bariatric surgery, so visit a sports dietitian for a personalised plan. A sports dietitian can provide you with a periodised eating plan. This will allow you to change body composition over the training season, just in time to race. It will allow you to perform at your best, as your body shape changes and you accomplish new goals.

Reference [1] Case study: Nutrition challenges of a marathon runner with a gastric bypass. Nancy Clark. International Journal of Sport Nutrition and Exercise Metabolism, 2011, 21, 515-519 © 2011 Human Kinetics, Inc.

 

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16 Comments

  1. Thank you SO much for this post! I’m having surgery in a week, and am worried about future marathons (have already done 4 and wants to continue!) and fueling up. Looking for info about it but haven’t found anything.
    This is encouraging that it can be made, you just need expertice help.

    Thanks!

    • Hi Josephine,

      So glad you loved the post and you found it helpful. As I always say to people, there is always a workaround. Hope you enjoy and do well in your next marathon 🙂

  2. Gastric bypass patients should not drink fruit juice or sugar laden liquids…unless the goal is to make them want to crawl in a hole and die.
    People who have had GB do not tolerate sugar well, so fruit juice and sugared sports drinks and gels are not an appropriate recommendation.

    • Dear GBPatient,

      These recommendations are in the context of running a marathon and not normal life. In which I would agree normally no one should really drink sugary liquids. However, when running a marathon someone will well and truely collapse without enough sugar to keep them running, so in this case yes I would still recommend sugary drinks during competition.
      Most athletes have issues with fructose whilst exercises and the results are explosive bathroom issues if the person doesn’t practice using gels and sports drinks before competitions. There for these recommendations should be done with the help of a sports dietitian or coach who can put a protocol in place to prevent this from occurring. The alternative is using pure glucose or starches which will also do the trick. But of course that is up to the individual.

      Thanks for your comments

  3. I am a gastric bypass patient, my surgery was in May of 2013. I am 39 years old and I was never a runner prior to my surgery. I have completed 4 full marathons. My first full I completed in December of 2014 in 5 hours and 25 minutes. My PR is 4 hours and 15 minutes. I sought advice from numerous nutritionists and no one really knew what to tell me on fueling due to the issues with sugars and gastric space. I took my knowledge and looked at the research, there was not much either in research. So it was a process of trying different fuels. I found that the Vega brand to be the best. For a marathon I usually go through 2.5 packets. I do not drink except sips during a race. I start hydrating and nutritionally preparing for a marathon 3 weeks prior to a marathon. Hydration is key the week prior to the marathon. I live in the South so I also watch the weather. We have a lot of humidity which also affects you nutritionally. The key is to listen to your body.

    • Hi Christina,

      Thanks for your comment. It’s great to hear from a range of people who have tried and tested different methods of fuelling and hydration. It really helps others get a greater understanding on what they can try. So thank you so much for your detailed response. Happy training for your next marathon 🙂

  4. Thanks for posting this. I had a gastric sleeve and I’m having a harder time training now-I’m at a loss when it comes to fueling.

    • Hi Bridget,

      You’re welcome. I hope this post helped then 🙂
      Keep at it, come times it’s just a matter of trying a few different things until you find something that works and remember you’re not the only one!

      I’m surprised by the number of people commenting, that this is a real issue. The more people that share their struggles with fuelling, helps us professionals come up with new ideas to help you all.

      Thanks for commenting and keep plugging away at the running 🙂

  5. Ramesh Somisety on

    I have undergone a Gastric Sleeve 10 days back. I never ran 50 meters also in my life. However, i have set a target of participating in a 10 km run to begin with. Can runners who have undergone Gastric Sleeve advice me on the following in the same way:

    a) From when i can start walking.

    b)Running.

    c)Do i require supplements for 10 k race also

    d)Is it advisable within 4 months

    e)other advices if any please. Once this is thro, i want to set higher targets. I was 115 kgs before surgery 10 days back and am now 107 kgs and currently on liquids for 3 weeks and will start solids from 4th week.

    • Hi Ramesh,

      Thanks for your comments. Do you have a medical doctor and in house dietitian that is looking after you post surgery? Surgeries can be complicated at times and everyone is different. With a few of your questions it would be a good idea to call up your surgeon or local doctor and ask them;
      1. When you can start exercising?
      2. When to switch to solid food?

      The answers to these two questions really depends on how well you’re healing and if you had any complications during the surgery.

      In regards to supplementation during 10km running, typically no, people don’t need to use supplements. However, in the case of a gastric sleeve it depends how well you can eat and hydrate prior to racing. This might be something you need to test out during training before the big day.

      Great news on the weight loss thus far, hope everything goes really well for you and you achieve the goals you set 🙂

  6. I had the gastric sleeve over a year and a half ago and am now a runner. My nutritionist advised me to fuel every 30 mins of running and to drink G2 diluted with water for replenishing electrolytes during the run. She also advised that I should eat at least 15 grams of carbs prior to starting the run and protein and carbs within an hour after I have completed my run. I utilize the runners jelly beans for extra carbs during my run. Every 30 mins or so I chew a few and sip a bit of G2 and it has served to fuel my runs very well. I am currently training for a half and have completed two unofficial. My time for the second was 12 mins less than my first (2:12:01). My nutritionist also suggested I practice with the carb gels and jelly beans prior to running. I found that about 3 jelly beans at a time keeps my tiny tummy from feeling bad and keeps me fueled enough to keep moving.

  7. Hi

    thanks for your post…very few info on that subject indeed….
    is there any study or recommandation to compare bypass vs. sleeve with patients doing endurance sports?
    Part of my journey to lose weight I have completed few full distance Ironman and I hope I can continue post-op…

    thanks
    Gary

    • Hi Gary,

      The bypass and sleeve requirements are very different. Obviously with the sleeve getting enough food in is easier, there is also no dumping syndrome. The bypass a little more tricky, might have todo some experiments with how much carbs you can tolerate in one go.
      In terms of studies, there is basically one study in the whole world that did a case observation of one lady who ran a marathon after a bypass. The literature is very limited indeed!
      A sports dietitian would be able to help you put together a plan though. I do see bariatric patients and I’m a sports dietitian, if you’re in Sydney I’d be happy to take you on board.

  8. Norma Vasquez on

    I’m so glad I found you. I had the gastric sleeve 4 years ago. I have been running 5ks for the last 3 years. At least one a month. I have also done a 10k. I want to run a half marathon in December. I’m a bit nervous because I don’t know what kind of diet plan to follow. I also would like to lose some weight that has crept up on me. Last Thursday I ran 3 miles and almost fainted. I know I was hydrated well so that’s not the problem. My problem is what I eat. What diet plan would you recommend for weight lose and marathon training?

    • Hi Norma,
      Thanks for reading the blog 🙂 The trick is to try to increase carb intake on your training days by increasing frequency of snacks/meals and liquids. Rest days are an opportunity to work on the weight loss goal by reducing calories on those days. Remember you may gain a little bit of weight from increasing muscle mass. You may also hold more glycogen and water in your muscle from increasing your carbs. So 2-3kg up during high training loads is common, however this should taper off after the race. As in the weight will come down again.