The Definitive Guide to Sugars & Natural/Artificial Sweeteners after Bariatric Surgery

Over the years, we have touched on sugar and alternative sweeteners / sugar subs many times on this website and in our blog. Several years ago, zero calorie natural and artificial sweeteners were considered a staple for those having undergone bariatric surgery. Recent research has brought new scrutiny on these compounds that include:

  • Saccharin – artificial, found in Sweet & Low (Pink packet) and others
  • Sucralose – artificial, found in Splenda (Yellow packet)
  • Aspartame – artificial, found in Equal (Blue packet) and others
  • Neotame – artificial
  • Acesulfame – artificial
  • Stevia – natural, derivative of the stevia plant

All of the above are approved by the FDA, and these compounds are found in many of our everyday items including:

  • Yogurt
  • Vitamins
  • Gum
  • Ice creams and frozen yogurts
  • Toothpaste
  • Cereals and snacks
  • Sodas, iced teas/coffees and alcoholic drinks
  • Cakes, cookies and other bakery items
  • Salad dressings
  • And much, much more

…so they must be safe…right?

As low-calorie sweeteners become ubiquitous, new research is making it ever more apparent that excessive intake of any added sweetener, regardless of caloric content, can cause severe negative health effects over the long-term. While there is no definitive consensus on why this happens or what exactly strikes a good balance (moderation), there is plenty we do know:

What We Know About Sugar

Refined, added sugar is a bad carb, plain and simple. As a simple carb, sugar offers no nutrition and represents empty calories. Unfortunately, the modern palette has gotten used to added sugars and it’s getting harder to find anything without some, or lots, of sugar added.

Sugar occurring naturally in many of the most nutritious foods we consume is not so bad (although we still need to limit consumption). The problem is, we no longer find those naturally sweetened foods as palatable and we don’t eat enough of them.

The result has been an epidemic of added sugar consumption the likes of which we have never seen before. Diabetes and obesity, two diseases linked, at least in part, to sugar consumption, are skyrocketing and our options for getting it under control are shrinking.

Until recently, artificial sweeteners were the supposed cure for the epidemic.

What We Know about Artificial Sweeteners

Some artificial sweeteners are better than others, no doubt, but with the rise in consumption of these compounds are we doing ourselves any favors? Let’s jump in.

Of course, the main benefit of artificial sweeteners is that they offer the sweet taste we crave without the calories. Drinking a diet soda versus the regular kind can save 140+ calories per bottle. Baking a cake with sucralose versus regular sugar can save thousands of calories. Seems like a win-win.

So, what’s the catch? There are a few and they’re biggies

  • There is a tendency to believe that if we save calories on one hand (by drinking diet soda), we can splurge on the other (maybe eating a cheeseburger). Clearly that logic can be destructive to one’s long-term health, but in the moment, it just makes sense! Obviously, any such thoughts need to be dispelled.
  • It is becoming clearer with each new study that artificial sweeteners may be changing our palates to where we need sugar in EVERYTHING to enjoy our food and drink. This means that low-sugar items become less and less appealing and those that fill our sweet cravings become the staples in our diets. As our tastes change, so do the processed foods that cater to those tastes – the result? Intake of low-nutrition, processed foods that manage our cravings, but do not offer quality nutrition.
  • Artificial sweeteners, much like sugar, may be addictive, at least in animal studies. Just like every craving, over time we need more and more to keep us happy. You may have started with half a packet of sweetener, but a year later need a full packet to enjoy that same coffee. Some studies have drawn comparisons of addictiveness at the level of illegal drugs such as cocaine. Trying to detox our bodies of such a powerful compound does not happen easily.
  • Sugar substitutes may, in fact, trick the body into believing it needs more calories, which it will crave and receive from other sources.
  • Even though there is some scientific consensus that many artificial sweeteners a not carcinogens in small amounts, they have become an ever-larger part of our diets. First, we do not know if these compounds could cause cancer in the quantities being consumed today and second, we do not fully know how these compounds affect our gastrointestinal or hormonal systems.

What about Other Natural Sweeteners?

There are a plethora of natural sweeteners out there, some that offer very compelling benefits – for example, being organic, derived from plants and zero or very low calories. However, the negatives are the same – extreme sweetness, regardless of the calories, can work against us, natural or not, for the same reasons mentioned above.

What’s the takeaway on sugar and natural and artificial sweetener?

To be sure there is a place for them all. However, we must reduce our dependence on them…just as we detox from a drug, removing added sugars and all forms of added sweetener from our lives will make us healthier and reduce those cravings that are so hard to resist.

OK, You’ve Told Me what NOT to Do, Now What Are My Options?

  1. Understand that you will not be able to avoid artificial sweeteners, especially right after bariatric surgery (most protein shakes have it), but you can minimize your exposure to it. A) choose your products carefully by checking ingredients, b) avoid the consumption of non-essential foods and drinks like zero calorie flavored drinks sweetened artificially and c) work with your nutritionist and support group peers to find new and interesting options.
  2. Get back to basics. What did our parents and grandparents eat and drink when obesity was not a national crisis? What portions did they find filling? How can we emulate that? Changing what a “treat” means (maybe instead of cake, we try fruit) and limiting portions (get the taste but not the quantity) can both help.
  3. Remember that healthy weight loss requires a combination of factors for long term success. Yes, diet is a very important component, but exercise and mental health are key to losing weight too. Getting your physical and mental house in order helps limit your consumption of bad foods too. That helps us keep our cravings in check.
  4. Learn to love water again. It’s not the tastiest thing out there, but it sure does make us feel better when we’re dragging through the day due to dehydration. For added flavor, there is nothing wrong with steeping fruits and vegetables in the bottle – a little lemon, cucumber, mint or watermelon adds negligible, if any, calories and offers a more satisfying taste.

As with everything after bariatric surgery, moderation is key. We don’t expect you to cut out sugar entirely – it would be torture and, quite frankly, unsustainable. Rather, we want to see you consume sugar in appropriate quantities and ideally in the form of whole fruits, not in juices or added to other foods and drinks.

Advanced Surgical Associates is one of the first exclusively surgical groups practicing in Union County New Jersey. And that is just the first of many firsts for ASA. For over 40 years, we have pioneered breakthrough surgical patient care in North Jersey in both general and weight loss surgery. ASA also offers gastric bypass, gastric sleeve and gastric banding to those suffering from obesity in New Jersey.
© 2018, Advanced Surgical Associates, Bariatric & General Surgery, Springfield, New Jersey