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 . 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  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.