A new type of athlete is appearing in the offices of sports dietitians: formerly obese people who have undergone gastric bypass surgery and now aspire to be marathoners, triathletes, and other types of endurance athletes. The standard nutrition advice offered to bypass patients is contrary to the standard sports advice given to athletes. Bypass athletes need to limit carbohydrates, fluids and energy intake, and consume a protein-based diet. This case study describes the sports nutrition concerns of a woman who, after having had gastric bypass surgery, trained to run a marathon (42 km). Due to her limited ability to consume food and fluids, she experienced difficulty preventing fatigue and dehydration during her long training runs and the marathon itself. She learned through trial and error how to survive the nutritional challenges and complete the marathon. Health professionals need to be aware of the potential medical risks associated with endurance exercise in bypass patients. Research is needed to determine the best sports nutrition practices for bypass patients. Only then can sports dietitians better educate this small but growing contingent of endurance athletes, so the athletes can meet their training and performance goals and reduce the risk of experiencing serious health consequences.
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