Dr. Jekyll or Mr. Hyde, Batman or The Joker, Peter Pan or Captain Hook – there’s ‘good’ and ‘evil’ out there everywhere. Some might say I’m even ‘evil’ in their weight loss journey because of the foods I encourage them to avoid! I hope not, especially as I write about artificial sweeteners today and ask you if they are ‘good’ or ‘evil’ in your journey?

Have you been noticing any hot sweats or rapid pulse (heartbeat) after eating - soon after or even 2-3 hours later? Are you feeling tired/lethargic despite taking your supplements religiously? Have you been passing out or needing to lie down without having eaten sugar-rich foods like lollies, cakes or biscuits? How about your bowels - are you experiencing loose motions without eating any obviously high fat or sugar foods like ice cream or chocolate? If you’re thinking yes to any or all of these questions, I’m thinking this is a good chance to remind you about dumping and the fact it comes in two forms…

Early dumping involves the embarrassing symptom of urgent and loose bowel motions. It can be caused by a high load of fat from foods. The ‘remodelled’ digestive system is unable to process that fat which gets passed out the ‘other end’ in a very offensive way (sight & smell). A high load of sugar will have the same effect – drawing fluid into your intestines from surrounding tissues, and that rush of fluid leads to your very own Huka Falls in your gut if you get my meaning (i.e. explosive bowels).

Meanwhile, late dumping has nothing to do with the loo. It relates to a big release of insulin in response to a load of sugar being eaten. Sugar-laden foods include lollies, cakes, biscuits as well as many drinks. Remember, carbohydrates like bread, rice, pasta, and crackers all turn into sugar too. Once absorbed from your intestines, sugar naturally goes to your bloodstream, and insulin takes it from your blood for storage into your liver, muscles as well as fat cells. But an over-dose of insulin means all of the sugar is taken from your blood and you’ll feel like a person with diabetes when they’ve injected too much insulin into their system. In other words, you’ll suffer the serious health risk of low blood sugar levels and you can pass out without any warning. That’s a real worry, especially if you’re operating a vehicle or any other equipment that can cause you or others around you an injury or death.

Dumping is a way of bariatric surgery being a tool for your weight loss. How well you use that tool depends on your eating behaviour and food choices. Avoiding foods high in sugar or fat (otherwise known as ‘energy-dense’ foods) means avoiding dumping symptoms, and that means avoiding an energy or calorie intake greater than your output (i.e. more than necessary for your daily level of activity/exercise). So, paying attention to food choice and ingredients is important, and that’s where the blurred line of artificial sweeteners emerges.

Artificial sweeteners can be ‘good’ or ‘evil’ in my opinion. An occasional sugar-free drink might be fine for instance. On the other hand, large amounts or regular intake of them can cause dumping (early and late). You’ll notice the message on the packet of sugar-free products that says “excess consumption may have a laxative effect.” Basically, that’s due to the Huka Falls effect I was talking about earlier. Research also shows the human body mistakenly releases insulin in response to artificial sweeteners as if it were dealing with a high load of actual sugar. When I say research, I’m talking about the fancy university stuff, and I’m also talking about an actual case I’ve seen with my own eyes in clinic. This person was following all avoidance guidelines for preventing dumping, although in doing so was having a lot of sugar-free gum each day. Loose bowels weren’t the issue; late dumping was. Once the gum was removed, the symptoms disappeared…

The Take Home

At the end of the day I think artificial sweeteners have their unique place in a weight loss surgery journey. I must ask what role are they having for you on your journey though? I think an occasional sugar-free drink is fine, but if you’re using sweeteners to simply curb your craving rather than training yourself to avoid or ‘surf the urge’ for sweetness (i.e. sugar-free instead of regular chocolate at your danger time of evening), then I think that risks a slippery slope of old habits returning. If fizzy drinks, chocolate or lollies were your ‘kryptonite’ before surgery, are you making your post-op journey harder on yourself by hanging on to that habit of having sweetness, but using sugar-free products instead? At the end of the day, I’ll let you decide if they are ‘good’ or ‘evil’ in your own unique journey.

All the best until next time.