What’s In Your Coffee?

Why do we ask our patients, “What’s in your coffee?”   My experience is that coffee is a common cause of mid-morning hunger, and is often part of a pattern that leads to long term weight regain after bariatric surgery.

Is Coffee Okay After Bariatric Surgery?

In the early recovery phase after bariatric surgery, we recommend against coffee because it makes you pee extra; it functions as what we call a “diuretic.”  That diuretic effect is likely to be problematic if you’re struggling with hydration, and especially in the midst of the natural ketosis which also causes diuresis.

Once you’re hydrating well, coffee itself is totally fine for bariatric surgery patients.  But again, drinking coffee in the morning is one of the most common causes of long-term weight gain that I see, so what gives?

Creamers and Sweeteners

The problem with weight gain comes not from the coffee itself, but from all the things that we put into the coffee, that taste so good, that change it from coffee to a caffeinated milkshake!

Non-dairy creamers like Coffee Mate or International Coffee are prime examples.  Although “non-dairy” is pitched as being healthy, check out this ingredient list for Coffee Mate:  water, sugar, vegetable oil, etc.  Another common formulation of Coffee Mate goes like this:  water, corn syrup solids, vegetable oil, etc.  So the problem is, that you’re putting sugar into your coffee.  That sugar in liquid form is absorbed briskly into your blood stream.  It makes your blood sugar spike up, then crash down to leave you with a low blood sugar that feels terrible.

Then, what do you need for your low blood sugar?  What’s your body screaming for?  Food!!

What kind of food is your body screaming for?  Carbs!!

Then, the carbs cause more blood sugar fluctuation, more hunger, bad food choices, insulin resistance and….. weight gain.

Other Additives

Many of you are thinking right now that they need coffee, and they hate black coffee, so what can they do?  What about honey, or Stevia, or Splenda?  What about Almond milk, or Muscle Milk?

It’s a tough message, but I’m concerned that any sweetener (whether real or fake) seems to promote weight gain.  The different sweeteners seem to have different ways of having an impact, but they all seem to end up working against you.  This effect seems to be dose-related, so if you can get your coffee down to the essence of sweetness rather than being a milkshake, that would be an improvement for most.

Plain Almond milk may be a good option, but please carefully look at the label and be sure it’s really made just from the almonds and that there aren’t any sweeteners or chemicals (neither real nor fake) before adding this to your coffee.
Muscle Milk is basically a protein shake, which I’ll cover in a moment.

Better Options

So if non-dairy creamers are bad, and sweeteners are bad, what’s a coffee drinker to do?  I think that dairy fats are probably OK to “soften” your coffee.  This would be half & half, or heavy whipping cream.  Some people are fans of butter in their coffee and metabolically that seems OK, but most people don’t find it tastes very good.  Even if you’re a fiend for sweet coffee, try this out for me and I think you’ll find that coffee with half & half is very enjoyable.

Protein Drinks

Wouldn’t a protein drink in their coffee be a perfect solution?  Well… I don’t think protein drinks are as toxic as the powdered creamers, but I’m not a big fan of protein drinks either.  I’ve outlined my objections elsewhere, but briefly here are my concerns with protein drinks:  The artificial sweeteners and the preservatives seem to stimulate hunger and push metabolism out of balance.  And these are liquid calories, which don’t satisfy as much as solid natural healthy food.  And as I’ve said elsewhere, it looks like adults should only have breakfast if they feel hungry, and that intentional fasting (skipping meals like breakfast) is often a part of healthy metabolism and healthy/reasonable hunger.  If you aren’t hungry then that protein drink is just extra protein, which is just extra calories, which is weight you don’t lose.

The Sugar Coaster

A connected note before closing out: food quality seems to be most important in the first part of your day.  If you start the day with carbs or artificial sweeteners, you’ll be hungry again in a couple of hours because your blood sugar is low.  So you eat some carbs which boosts your blood sugar… then your sugar crashes again, so you need carbs again…. etc.  I call this the “sugar coaster” (like a roller coaster) and it’s not a good ride to put yourself on each day.

So, coffee is OK.  The potential problem is what you put into it.  Choose well, and be healthy!

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