Dietary guidelines post bariatric surgery

Apples

Bariatric surgery doesn't eliminate dieting altogether. It means that if patients adhere to the prescribed diet for the rest of their lives, they'll lose the excess weight and keep it off. On the contrary, if you ever go off the diet, you will gradually regain the weight lost.

It’s important to start implementing this diet even before the surgery because pre-surgery weight-loss helps the surgeon by making the laparoscopic approach easier and safer and increases the likelihood that the surgery can be completed less invasively.

Other dietary requirements are basic common-sense eating. With sensible eating and exercise habits (three healthy meals a day with healthy snacks), the weight-loss can be easily maintained after surgery.

The long-term goal of weight-loss surgery is to lose approximately 55 to 75 percent of your excess weight. The end result of weight-loss surgery is that patients will continue to require only small portions of food and eventually be able to tolerate all types of foods. Patients’ bodies will be satisfied with smaller amounts of food and they won’t have continued cravings for larger quantities of food at mealtimes.

Remember that this program is an individual process and patients may not progress from one diet plan to the next in the exact time frame given. Adapting to new foods won’t happen overnight; it’s a learning process. Also, keep in mind it takes approximately six months before the body will be able to tolerate all types of foods, especially meats, and it’s possible you won’t tolerate eating some foods at all.

Post-surgery dietary plan

  • Your bariatric surgery dictates that small amounts are eaten.
  • Only nutrient-dense items are allowed on the bariatric eating plan.
  • It’s imperative that food be eaten slowly and in very small quantities at mealtime. Take 30 minutes for each meal.
  • To prevent dehydration, strive to drink at least 6 cups of water each day. Sip fluids.
  • Stop sipping liquids within 30 minutes of each mealtime (once you reach the pureed diet stage).
  • After surgery, lifelong multivitamin and mineral supplements are recommended.

Bariatric clear liquid diet

You will start a clear liquid diet the first day after your surgery while you are in the hospital. You may drink skim milk, water, chicken or beef broth, or sugar-free gelatin. Do not start this until your surgeon orders this diet.

  1. You will drink out of medicine cups. Start by sipping 1 oz (30 ml) over the course of 30 minutes.
  2. If you do not get nausea or vomit the 1 oz over 30 minutes, you may drink 2 oz (60 ml) over 30 minutes.

Your goal is to drink 3 cups (24 oz) of skim milk and 6 cups (48 oz) of water.

Drink your milk (protein) before other clear liquids. Sip small amounts slowly throughout the day. Use your check-off sheet to make sure you are meeting your daily goal.

Bariatric full liquid diet

You will be on a full liquid diet days 2 to 14 after your surgery. Full liquids are foods that are normally liquid and foods that turn into liquid when they are at room temperature.

You need to:

  • Drink six 8 oz glasses of water each day. Take 5 to 15 minutes to drink 1 oz.
  • You may drink out of a regular glass. Do not use straws. Do not gulp liquids or drink quickly. This can cause abdominal pain and intense nausea.
  • Stop eating when you are full!
  • Start taking vitamin and mineral supplements after your 1 week follow-up visit, as ordered by your surgeon.
  • Follow all of the Golden Rules of Bariatric Surgery.

Start your vitamin/mineral supplements day 8 after surgery

Buy chewable or gel cap supplements for best absorption. Do not buy gummy or soft chews.

Vitamins suggested post-bariatric surgery

  • Chewable calcium citrate (600mg) with Vitamin D three times a day (morning noon and night)
  • Chewable complete multivitamin once in morning (add one at night if you’ve had gastric bypass (RNY) surgery)
  • Vitamin B12, 500 mg tablet once a day
  • Vitamin B-complex tablet once a day
  • Liquid iron once a day (do not take at the same time as calcium)
  • Vitamin D3 1000 IU once a day

Bariatric full liquid diet suggestions

  • During this period, you need to eat three very small meals a day. Initially 1 to 2 tablespoons of food may be all your body is able to tolerate. Stop if you feel a full pressure. Do not take an extra bite.
  • Take your time and eat slowly.
  • Walking can help food move out of stomach pouch.
  • Overall goal is to get 100 grams of protein and 100 grams carbohydrate each day, but you are doing well to get over 50-60gms of protein and carbs at this stage. Drinking 3 cups double milk each day provides 48 grams protein and 72 grams carbohydrate. These can be consumed hot, cold or flavored in a variety of ways.
  • If you feel gassy, bloated or have loose stools on this diet, it may be lactose intolerance. This is generally temporary. Take Lactase enzyme tablets (such as Lactaid) or eat yogurt or try soy milk or lactose-free milk to alleviate symptoms.
  • Constipation is not uncommon on this diet. Add Benefiber, FiberSure or Metamucil-Smooth to each double milk to promote regularity.

Keep walking to promote regularity, as well. Walk at least 30 minutes/day. If you lift weights, you need to lift less than 10 lbs and avoid any abdominal exercises.

Bariatric pureed diet

You will be on a pureed diet days 15 to 30 after your surgery. Pureed foods are a very smooth consistency, such as applesauce.

You need to:

  • Drink six 8 oz glasses of water each day.
  • Take 30 minutes to eat 3 to 4 oz of food.
  • Stop eating when you are full!
  • Take vitamin and mineral supplements as ordered.
  • Follow all of the Golden Rules of Bariatric Surgery.

Bariatric pureed diet foods include:

  • Mashed potatoes
  • Unsweetened applesauce
  • Refried beans
  • Cottage cheese
  • Scrambled egg (light and fluffy)
  • Farina (Cream of Wheat or Malt-O-Meal-plain, not flavored)
  • Pureed meats (puree ¼ cup broth with ¼ cup chopped meat)
  • Pureed vegetables (puree ¼ cup vegetable with water or broth)
  • Pureed fruits (puree ¼ cup fruit with 2 to 4 tablespoons of water)

When you start the pureed diet:

  • Eat protein food first (3 ounces (21 gm) per meal); carbohydrates second (15-20 gm/meal)
  • Continue to strive to get 100 grams protein and 100 grams carbohydrate per day
  • Make your last milk a double milk if you don’t have 100gms protein in by end of day

Bariatric soft diet

You will be on a soft diet days 31 to 60 after your surgery. You will start this after your 1 month follow-up visit.

You need to:

  • Chew foods to a pureed consistency (chew 20 to 30 times before swallowing).
  • Slowly add soft foods to your meals and snacks.
  • Take 30 minutes to eat 3 to 4 oz of food.
  • Drink 3 skim milk or yogurt snacks each day.
  • Drink six 8 oz glasses of water each day.
  • Stop eating when you are full!
  • Take vitamin and mineral supplements as ordered.
  • Follow all of the Golden Rules of Bariatric Surgery.
  • Start doing strength-building exercise in your daily routine, such as strength and aerobics for 60 minutes each day.

Bariatric soft diet foods include:

  • Well cooked vegetables (no skin)
  • Canned fruits (in own juice or light syrup) or ripe fruit (no skin)
  • Fish
  • Tender meats/poultry (cook in water, crock pot or slow cooker)
  • Anything allowed on the pureed, full, or clear liquid diets

When you start the soft diet:

  • Eat protein food first (3 ounces per meal (21 gm); 9 ounces total)-100 gm/day
  • Eat carbohydrate second (15-20 gms/meal)-100 gm/day
  • Chew your food to puree consistency. Take 20-30 chews before swallowing.
  • Add variety and intensity to your exercise. This is the time to add heavier weights.
  • Make your last milk a double milk or a Greek yogurt if you don’t have 100 gms protein/carbs by end of day

Bariatric general diet

You will be on a general bariatric diet for the rest of your life starting day 61 after your surgery. Your diet will consist of three small meals as well as 8 ounces of skim milk for snacks three times a day.

You need to:

  • Continue to drink at least six 8 oz cups of plain water per day. Do not drink with a meal, for 30 minutes prior to a meal, or 30 minutes after a meal.
  • Eat protein food first, then carbohydrates second.
  • Chew food to pureed consistency (chew 20 to 30 times before swallowing).
  • Do not eat red meat that is tough or has gristle for 4 months after your surgery. You may eat beef cooked in a slow cooker if it is tender.
  • Do not eat white bread for 4 months after your surgery.
  • Eat lean foods, such as baked, broiled, grilled, or steamed foods. Do not eat fried or breaded foods.
  • Take vitamin and mineral supplements as ordered.
  • Follow all of the Golden Rules of Bariatric Surgery (including follow-up appointments, exercise, dietary guidelines, etc.).
  • Keep doing strength and aerobic exercise for 60 minutes or more each day. Add variety and intensity to your routine.
Last reviewed: 
June 2018

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