If you’ve hit a stall after vertical sleeve gastrectomy, you might be considering intermittent fasting as a way to get the scale moving again. It does seem to be everywhere these days, with people claiming near-miraculous results. Not surprisingly, many of my patients are wondering whether it should become part of their gastric sleeve diet. So let’s take a closer look at intermittent fasting (IF).

What is it?
In a nutshell, IF means that there are certain times of the day or week when you simply don’t eat. There are a variety of ways to structure it, but one of the most common is a 16:8 approach, where you fast for 16 hours and contain your eating to just eight hours. Other popular styles include fasting two days a week, fasting every other day, or marking off specific meals to skip during the week. Note: despite the name, whole-day fasts might include ingesting a few hundred calories, rather than zero.

Why might it help?
The idea of restricting the times at which you’re allowed to eat often restricts the number of calories you consume. But multiple studies reveal that something about IF itself has benefits that can’t be explained by calorie restriction alone. Among the upsides, of course, is weight loss, but IF can also speed up your metabolism and burn fat while leaving muscle. Health-related perks like lowered cholesterol and reduced inflammation aren’t uncommon either. Keep in mind that those aren’t guarantees for everyone; they’re possibilities suggested by research.

Is it right for me?
There are some things I recommend across the board: lots of protein, lots of water, and a consistent exercise regimen, to name a few. Intermittent fasting isn’t one of them. In certain situations, it works great. In others, it can be disastrous. Skip it if:

• You’re still new to VSG. If you’re in any of the healing stages post-VSG, do NOT try intermittent fasting. Foods are so restricted during this time that you’ll need every bit that you’re allowed in order to get enough calories to function. And because the first six months or so following the procedure is when weight tends to fall off the easiest, you shouldn’t need IF then.

• Your bloodwork shows deficiencies. The good thing about vertical sleeve gastrectomy is that it doesn’t typically cause the malabsorption issues that other bariatric surgeries can. But your body chemistry is unique, which means that only your personal physician can determine whether you are deficient in any vitamins or minerals. If so, IF likely isn’t a good idea.

• You have a history of disordered eating. If you’ve ever struggled specifically with restrictive eating disorders (anorexia, for example), IF can open old wounds—and even trigger you into a potential relapse. If you associate not eating with being “good,” then a method whose goal is not eating for substantial periods of time just doesn’t make sense.

• You’ll need a “reward” afterward. This is a mental thing. But because so many overweight and obese people view food as a reward, some find it difficult to eat healthily during non-fasting hours (a huge part of the plan). Rather, they view unhealthy foods as their “reward” for doing well during their fast, which negates the benefits of IF.

• You’re pregnant. Pregnancy is a time to focus on nutrients, not fasting. This holds true if you’re battling a serious disease, as well.

The bottom line with intermittent fasting is that it can be a good solution. But because it carries some risk, you should always talk with the primary care physician overseeing your VSG progress before trying it.

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