Soda After Bariatric Surgery: The Idea is Flat

The U.S. government recently issued a statement urging Americans to kick their soda habit.

The reason? Federal health officials are citing adverse health consequences for consuming sugars, especially the artificial ones found in “diet” sodas. For bariatric patients, sodas are a double whammy: the carbonation and the sugar (artificial or not).

The Sugar Debate

Natural sweeteners versus artificial ones. It sounds simple. It isn’t.

Traditional sodas can contain 40 grams of sugar or more in a single serving. That’s a metabolic event, not a small indulgence. Beverage companies responded by lowering the content, with some as low as 2 to 5 grams. That is, objectively, an improvement. But the sweetness still comes from somewhere.

Stevia, monk fruit, erythritol, and other sugar alcohols are marketed as “natural” or “healthier” alternatives. The general public is pretty convinced of the safety compared to the heavy sugar loads in traditional soda, and compared to high fructose corn syrup, they may be, when consumed in moderation.

But there is still a lot of debate – research has some major conflicts when it comes to the health profiles of various sweeteners. Some studies point to excess sugars as a link to or risk for type 2 diabetes and obesity. Some research points to a connection between non-sugar sweeteners and other health problems, while other studies show that sweets are a disruptor of the gut microbiome. Still, other studies say sugar replacements can lead to weight loss or reduce overall caloric intake. What can account for such varying results?

Different study designs and methodologies, the source of funding, the study population size, the health co-factors of the study participants, and the length of the study are among the variables that matter when interpreting results. It can be confusing to figure out, but as a bariatric patient, this makes sense: avoid all of it! To the best of your ability.

A “healthy soda” is a misleading contradiction. “Healthier” sweeteners can keep your taste buds calibrated to expect sweetness and trick your brain into intense cravings. Your intention may be to do your body a favor by switching to a low-calorie soda, only to collect those calories elsewhere later in the day. There is also little to no nutritional value.

After bariatric surgery, your stomach pouch is smaller, creating a smaller margin for nutritional error. Excess sweets can crowd out protein and nutrient-dense foods. The risk of deficiencies is already a concern with an altered digestive tract, and filling a smaller pouch with fizzy drinks can affect parts of your body, from energy and hair to mood and muscle mass.

You’ve done a lot of work to get where you are, so honor it. Avoiding excessive sweets keeps your weight loss trajectory moving forward and leaves more room in your digestive tract to absorb the nutrients you need to sustain feeling good, inside and out.

The Carbonation Factor

Let’s cut to the chase: carbonated drinks will make you feel full while not delivering much nutritional benefit.

Carbonation is carbon dioxide gas dissolved into liquid under pressure. When you open a can, the pressure releases, forming bubbles. That gas, aka the bubbles, expands in your stomach when you drink them. It might be satisfying at first, but for many bariatric patients, it leads to magnified bloating, belching, and discomfort.

Let’s keep going. Next stop, increased gastric pressure that pushes stomach contents upward into the esophagus, contributing to heartburn or worsening reflux. Many gastric sleeve patients already struggle with Gastroesophageal Reflux Disease (GERD), and adding bubbles to the equation does not help.

Then there is the ever-present question about whether the stomach pouch can stretch. The stomach is an adaptable organ, stretching to accommodate meals and then resuming its pre-meal size – over and over again. It does exactly what it is built to do. However,….

Gas buildup creates distention, and repeated expansion – whether from overeating or frequent carbonation – can cause discomfort and, over time, may reduce the effectiveness of your procedure. Especially in the early months after surgery, when healing is still underway, carbonation can create significant pressure in a very small space. Even if permanent stretching is unlikely from occasional exposure, why stress the pouch unnecessarily?

Similar to the argument against empty sugar calories, carbonation creates a false sense of fullness, limiting nourishment. Tally the fact that most carbonated drinks carry little to no nutritional benefit, and the math adds up: undernutrition can become a big problem.

How to Get Your Fix

If you’ve seen yourself as a soda aficionado, it can be disappointing after a weight loss procedure that your carbonation days are over. But are they? Let’s proceed with some caution here.

Every person has a different chemical makeup. Even two people with similar health profiles, similar starting weight, and the same surgery can have a drastically different post-op path. Take GLP-1, for example. (GLP-1 is a naturally occurring hormone that is produced by the intestines to help regulate blood sugar, satiety, and gastric emptying.) Because of genetic differences, some people produce more natural GLP-1 than others, and that affects the trajectory of weight loss between two seemingly “same” patients. The patient who produces less of this hormone intrinsically may not lose as much weight, plateau sooner, or experience weight gain more easily, making losing weight more challenging. That person will also have a different relationship with food in general, and especially sodas and sweets.

In general, we prefer that all our bariatric patients avoid sodas and other carbonated beverages. They tend to be full of empty calories, and with a smaller stomach pouch, that real estate is precious. After bariatric surgery, it becomes much easier to become nutrient-deficient, and with excess soda consumption, that risk is elevated. Not to mention the overall effect the empty calories will have.

When we consume healthy items high in protein and other essential nutrients, our bodies feel fuller longer. That keeps us from oversnacking and keeps caloric intake in check. In order to lose weight, you need to be expending more calories than you are consuming, so if you’re indulging in foods that move more quickly through your system, you’ll end up eating excess calories, and therefore sabotaging your weight loss success.

On the flip side, we know that deprivation has a way of turning into binge behavior. So, that’s where a happy medium makes sense. It’s okay for a soda to be a treat now and then. At a social gathering, it can serve as a substitute for alcohol or feel celebratory. At the end of a long week, it can feel refreshing to sit in a quiet spot and enjoy a few sips. What we don’t want is to start a bad habit – don’t make it a daily ritual. If you feel the urge to indulge in sweets and soda more often than you should, it’s absolutely appropriate to reach out to your care team, dietitian, or behavioral health therapist for advice or techniques to curb the sensation.

Soda Alternatives

Having a list of go-tos is also helpful when the urge hits.

• Infused water: Fun to experiment with and to drink. Plus, you get the benefit of added nutrients in your water. Vitamin K is the cucumber’s standout nutrient, and it also contains small amounts of potassium, magnesium, vitamin C, and a little bit of fiber if you eat the peel. Lemon, lime, and orange slices pack even more vitamin C, potassium, and flavor. Mint may not pack the same nutritional punch, but it does have qualities that help relax the digestive tract and reduce bloating. Most produce will also contain at least a small amount of antioxidants.
• Electrolytes: Sometimes what you’re craving isn’t soda. It’s stimulation. Flavor. A break from plain water. Electrolyte additives are great, especially after a workout or during the summer when you’re sweating more than usual. Sometimes electrolyte packets or tablets come with a little fizz, much less than soda, but it could be just what you need for a fizzy fix. You can also carry packets in your purse or backpack, so you have something for on the go, instead of wrestling with the healthiest choice in a gas station. (There usually aren’t any!) Caution: Look for electrolyte options with minimal added sweeteners.
• Coconut water: This can be a solid choice, again, especially around workouts. It contains natural electrolytes, and some brands include small bits of coconut meat for extra healthy fat and fiber. It’s way better than most sports drinks, but still watch out for sugar overload. Some versions add extra sugar despite the natural sweetness coconut already has, so don’t assume and check the label.

Once you understand the mechanics of what sugary drinks and carbonated sodas can do to your body, then you can make a more informed choice about consuming them. More often than not, you’ll want to avoid it.

At MIIS Weight Loss Institute, we are incredibly honored and proud to provide the best possible bariatric surgery and medical weight loss care. Our philosophy is centered on the highest-quality patient experience and the best clinical outcomes through compassionate care, using the most advanced minimally invasive surgical techniques. If you’re interested in bariatric surgery or medical weight loss solutions, contact our office for a no-obligation consultation.