Gastric Surgery and Endurance Training

I have read dozens of articles and watched countless videos about the struggle athletes face in order to sufficiently nourish and hydrate in preparation for endurance activities post gastric surgery.  Let me just say…the struggle is real!  I continue the quest to learn how to get enough carbs, protein and hydration in order to run 26.2 miles without having a total body breakdown.

While preparing for gastric sleeve surgery in the summer of 2018, I learned how a gastric sleeve patient needs to eat.  I came to understand that protein would be my closest ally.  It would constitute the majority of my diet, and I would have to eat it first – before veges, fruits and carbs.  I also learned that I should not drink during meals.  I can drink right up to the beginning of a meal, but once that fork hits my mouth, no more sips until at least 30 minutes after I finish eating.  Easy, right?  I thought so too. Honestly the diet is not that bad. Following these and other simple guidelines (portion control, exercise, etc.), I was able to lose over 130 pounds fairly quickly.  In fact, I lose 35 pounds prior to surgery utilizing these guidelines.  An added benefit to consuming protein (80-100 grams/day) was the ability to increase muscle mass fairly quickly through kickboxing and strength training.  All was going well.  That is,  until I started to prepare for the New York City Marathon in April of 2019.

Research says that in order to prepare for endurance runs, training and workouts, one has to carb load, consume very little protein and hydrate constantly.  Basically, do the complete opposite of what gastric sleeve patients have to do.  The complete opposite of what had brought me to my current state of weight loss success.  And herein lies the challenge. My immediate concern was whether or not I would gain back all of those pounds by not sticking to the gastric sleeve dietary guidelines.  The only common ground between those guidelines and the guidelines for endurance runs is the hydration component, and still, there was the small glitch that the suggested water intake is greater with endurance running.  It is challenging enough to get the amount of water I need daily based on having gastric sleeve surgery, which is roughly 64 ounces a day.  Keep in mind, my stomach can only hould 3-5 oz. of liquid or food, which leads to my dilemma:  Is it even possible for a post gastric sleeve patient to carb load? 

As I train, I continue to learn more about my body as I listen more to my body.  As the weight came off, I began running.  I started off slowly, and tried to increase the distance each week.  Presently, I am able to run 20 miles without my blood pressure plummeting afterwards, and without having bouts of dizziness.  There have been several instances where I’ve experienced dizziness, nausea and a drop in blood pressure after running. This led to several tweaks  I’ve had to make along the way such as hydrating while I run and forcing myself to drink and eat at certain mile markers.  I am experimenting with eating gels, wafers, snacks  as I run. I am also changing my diet in order to carb load and hydrate before and during activity and I am switching to a high protein diet after the run to assist in muscle recovery and maintenance of my current weight. I have adopted a “hybrid diet” so to speak, and on my off days, the gastric sleeve diet wins.

I am excited to complete my training and run the New York City Marathon on November 3, 2019.  It has always been a dream of mine to run (and finish!) a marathon.  Naturally, my mind drifts to what might come next, like the Boston Marathon, or even an ultra marathon (50 or 100 miles)!  My wife thinks I’m a little crazy, and maybe I am, but I honestly believe that the human body is an amazing thing and that when sufficiently trained and nourished, it can accomplish most anything! 

If anyone is struggling with any of the same issues or has any questions, please leave your comments below.

I am running the 2019 New York City Marathon and the 2020 Boston Marathon on behalf of the Jeffrey Coombs Memorial Foundation ( Please consider donating here:

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