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 often served with onions and dill pickles and other seasonings. . They originally sold for five cents 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 “slide” type of meal.
For the weight loss surgery patient, slider foods are the bane of good intentions and ignorance that often cause dumping syndrome, weight loss plateaus, and eventually weight gain. Gliding foods, for weight loss surgery patients, are simple, bland processed carbohydrates of little to no nutritional value that glide directly through the surgical stomach pouch without providing nutrition or satiety. The most innocent slider foods are crackers, often eaten with hot tea or other drinks, to settle the stomach in case of illness or while recovering from surgery.
The most commonly eaten slider foods include pretzels, crackers (crackers, graham, Ritz, etc.) cracker snacks like Ritz Bits, popcorn, cheese snacks (Cheetos) or cheese crackers, tortilla chips with dip, chips, sugar-free cookies, cakes, and candy. You’ll notice that these sliders are often salty and cause dry mouth, so they need to be eaten with liquid to make them palatable. This is how they become slider foods. In addition, in most cases, they lack nutritional value.
For weight loss surgery patients, the digestion process is different than for those who have not undergone gastric surgery. When slider foods are eaten, they go into the stomach pouch and directly into the jejunum, where the body rapidly absorbs and stores the simple carbohydrate suspension. There is little thermic effect on simple carbohydrate digestion as there is on protein digestion, so little metabolic energy is expended. In most cases, patients in the weight loss phase who eat slider foods will experience a plateau in weight loss and possibly a reversal in weight gain. And sadly, they will start to believe that their surgical stomach pouch is not working properly because they never feel the fullness or restriction that they do when eating protein.
The very nature of the surgical gastric bag is to cause feelings of tightness or restriction when one has eaten enough food. However, when simple, bland carbohydrates are eaten, this oppression or restriction does not occur and one can continue to eat copious, unmeasured amounts of non-nutritious food without ever feeling uncomfortable.
Many patients turn to slider foods for this very reason. They don’t like the discomfort that comes with a full pouch from eating a measured serving of lean animal protein or dairy without fluids. However, it is this very restriction that is the desired outcome of the surgery. The discomfort is meant to signal the cessation of eating. Remembering the “Protein First” rule is crucial to weight control with bariatric surgery.
Gastric bypass, gastric band (gastric banding), and gastric sleeve patients are instructed to follow a high-protein diet to facilitate healing and promote weight loss. Bariatric centers advise 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, carbohydrate, fat, and alcohol), the patient must eat protein first.
Protein is not always the most comfortable dietary choice for weight loss surgery patients who feel restricted after eating a very small amount of food. However, for the surgical tool to work properly, a diet high in protein and low in simple carbohydrate sliders must be observed. The high protein diet should be followed even after a healthy body weight has been achieved in order to maintain a healthy weight and prevent weight regain.