Post Bariatric Weight Loss Surgery Diet Plans
Doctors and nutritionists may vary in terms of what kind of diet plan to follow AFTER your weight loss surgery procedure, but most have the same basic idea.
Follow your particular instructions of course, but here are some plans from other Bariatric Surgeons and nutritionists when you find yourself needing a reminder or re-start.
From UCSF - Gastric Bypass Plan
In the Hospital
You'll receive clear liquids such as diluted juices and broth as well as Jello for your first meal after surgery. These foods are high in sugar but your portions will be very small. Gradually increase the amount you drink at each meal as tolerated.
First 2 Weeks
Begin adding thicker liquids that are low in fat and sugar. The goal is to eat small portions that empty easily from your pouch. Begin with portion sizes of only 1 tablespoon and increase to 2 tablespoons as tolerated.
Begin drinking 1/4 cup of liquids at a time and increase to a 1/2 cup as tolerated. Daily calorie intake should not be more than 400 calories a day. Focus on getting plenty of liquids — 1 to 1.5 liters per day — to stay well hydrated.
Thicker liquids include:
- Blended broth or low-fat soups
- High protein supplement diet drinks — less than 200 calories and 5 grams of carbohyrdrate and more than 20 grams of protein — per 8 to 11 ounce serving
- Lactose free or soy based low-calorie drinks
- Nonfat or 1 percent fat milk, if you can tolerate milk
For additional protein, add 2 tablespoons nonfat dry milk powder or egg substitute to each half cup of nonfat or low fat milk.
Other foods that can be consumed include:
- Diet pudding
- Hot cereals — refined cereals low in fiber such as cream of rice or cream of wheat do not use oatmeal — made with increased liquid to a soup-like consistency
- Low-fat cottage cheese
- Sugar-free and nonfat yogurt
Remember to drink a cup of water or other non-caloric fluids between meals. Take a multivitamin supplement everyday.
3 to 8 Weeks After Surgery
Add very small portions of pureed and soft foods as tolerated. Take very small bites and chew food very well. Do not take more than two bites every 20 minutes when consuming a new food.
These foods include applesauce, cottage cheese, hot cereals, mashed potatoes, noodles, well cooked, pureed vegetables, scrambled egg whites or egg substitute. You also may try canned fruits, canned tuna, other lean fish and ground meats or poultry.
Avoid bread and meats that are not easily chewed.
For up to two months, food intake is usually no more than 500 calories consumed in six to eight small meals a day. Recommended portion sizes are a 1/4 cup for solid foods and a 1/2 cup for liquids. Adjust foods to fit your preferences and tolerance.
The following is a sample menu.
Breakfast — 1/4 cup hot cereal made with nonfat milk
Mid-Morning — 1/2 cup nonfat milk
Late Morning — 1/2 cup tomato juice
Lunch — 1/2 cup low fat chicken noodle soup
Mid-afternoon — 1/4 cup low fat cottage cheese
Late Afternoon — 1/4 cup juice-packed canned fruit
Dinner — 2 ounces ground meat, 1/4 cup pureed or well cooked vegetables
Bedtime Snack — 1/4 cup nonfat milk
Remember to drink 1 cup of water or other non-caloric fluids between meals. Take a multivitamin and mineral supplement everyday.
2 to 6 Months After Surgery
During this period, increase your calorie consumption to 900 to 1,000 calories and at least 65 to 75 grams of protein a day. Recommended portion sizes are 1/4 cup for solids and 1/2 cup for liquids. Your daily servings for balanced nutrient intake should include:
- Three servings of milk or dairy, nonfat and low fat.
- Three servings of meat and meat alternatives, lean and low fat.
- Three servings of starch. Limit bread and rice.
- One serving of fruit serving. Avoid dried fruits and fruits with skin.
- Two servings of vegetables, well cooked only.
Discontinue high protein diet supplement drinks, if possible, and meet your protein needs with food.
This sample menu includes eight small meals a day. You may wish to eat more or less often. Adjust your meals to fit your preferences and tolerance. Be sure to eat at least six times a day, drink a cup of water or other non-caloric fluids between meals, and take a multivitamin supplement everyday.
Breakfast — One egg or 1/4 cup egg substitute, 1/2 cup hot cereal
Mid-Morning — 1/2 cup nonfat milk
Late Morning — 1/2 cup tomato juice
Lunch — 1/2 cup low fat chicken noodle soup, two saltine crackers
Mid-Afternoon — 1/4 cup low fat cottage cheese, 1/4 cup water or juice-packed canned fruit
Late Afternoon — 1/2 cup sugar free nonfat yogurt
Dinner — 2 ounces lean meat or fish, 1/4 cup mashed potatoes, 1/4 cup pureed or well cooked vegetables
Bedtime Snack — 1/2 cup nonfat milk
6 Months After Surgery
Continue the goal of 900 to 1,000 calories in three meals and one to two snacks a day. Discontinue protein supplement drinks and increase the variety of low-fat, low-sugar and low-calorie foods as tolerated. Avoid raw vegetables, fruits with skins, dried fruits, breads, popcorn, nuts and red meats only if poorly tolerated.
Over time, increase the variety and consistency of foods in your diet. Some foods may continue to be poorly tolerated including red meat, chicken, breads, high fiber fruits and vegetables. Focus on low fat, low sugar and low calorie foods and continue to count your calories every day.
Consume at least 2 liters of fluids daily unless otherwise restricted by a medical condition.
Over time, increase the variety and consistency of foods in your diet. Some foods — including red meats, chicken, breads, high fiber fruits and vegetables — may be poorly tolerated. Focus on low-fat, low-sugar and low-calorie foods.
Your calorie consumption should not exceed 1,000 a day and your protein goal should be 65 to 90 grams a day. To stay on track, maintain a daily record of food portions and calories.
Phase 1: Liquid diet
You won't be allowed to eat for one to two days after gastric bypass surgery so that your stomach can start to heal. After that, while you're still in the hospital, you start a diet of liquids and semisolid foods to see how you tolerate foods after surgery.
Foods you may be able to have on phase 1 of the gastric bypass diet include:
- Unsweetened juice
- Strained cream soup
- Sugar-free gelatin
During phase 1, sip fluids slowly and drink only 2 to 3 ounces (59 to 89 milliliters, or mL) at a time. Don't drink carbonated or caffeinated beverages. And don't eat and drink at the same time. Wait about 30 minutes after a meal to drink anything.
Phase 2: Pureed foods
Once you're able to tolerate liquid foods for a few days, you can begin to eat pureed (mashed up) foods. During this two- to four-week-long phase, you can only eat foods that have the consistency of a smooth paste or a thick liquid, without any solid pieces of food in the mixture.
To puree your foods, choose solid foods that will blend well, such as:
- Lean ground meats
- Egg whites
- Soft fruits and vegetables
- Cottage cheese
Blend the solid food with a liquid, such as:
- Fat-free milk
- Juice with no sugar added
- Fat-free gravy
Keep in mind that your digestive system might still be sensitive to spicy foods or dairy products. If you'd like to eat these foods during this phase, add them into your diet slowly and in small amounts.
Phase 3: Soft, solid foods
With your doctor's OK, after a few weeks of pureed foods, you can add soft, solid foods to your diet. If you can mash your food with a fork, it's soft enough to include in this phase of your diet.
During this phase, your diet can include:
- Ground or finely diced meats
- Canned or soft, fresh fruit
- Cooked vegetables
You usually eat soft foods for eight weeks before eating foods of regular consistency with firmer texture, as recommended by your dietitian or doctor.
Phase 4: Solid foods
After about eight weeks on the gastric bypass diet, you can gradually return to eating firmer foods. You may find that you still have difficulty eating spicier foods or foods with crunchy textures. Start slowly with regular foods to see what foods you can tolerate.
Avoid these foods
Even at this stage after surgery, avoid these foods:
- Nuts and seeds
- Dried fruits
- Sodas and carbonated beverages
- Stringy or fibrous vegetables, such as celery, broccoli, corn or cabbage
- Tough meats or meats with gristle
These foods are discouraged because they typically aren't well tolerated in the weeks after surgery and might cause gastrointestinal symptoms. Over time, you may be able to try some of these foods again, with the guidance of your doctor.
A return to normal
Three to four months after weight-loss surgery, you may be able to start returning to a normal healthy diet, depending on your situation and any foods you may not be able to tolerate. It's possible that foods that initially irritated your stomach after surgery may become more tolerable as your stomach continues to heal.
Throughout the phases
To ensure that you get enough vitamins and minerals and keep your weight-loss goals on track, at each phase of the gastric bypass diet, you should:
- Keep meals small. During the diet progression, you should eat several small meals a day and sip liquids slowly throughout the day (not with meals). You might first start with six small meals a day, then move to four meals and finally, when following a regular diet, decrease to three meals a day. Each meal should include about a half-cup to a cup of food. Make sure you eat only the recommended amounts and stop eating before you feel full.
- Take recommended vitamin and mineral supplements. Because a portion of your small intestine is bypassed after surgery, your body won't be able to absorb enough nutrients from your food. You'll need to take a multivitamin supplement every day for the rest of your life, so talk to your doctor about what type of multivitamin might be right for you, and whether you might need to take additional supplements, such as calcium.
- Drink liquids between meals. Drinking liquids with your meals can cause pain, nausea and vomiting as well as dumping syndrome. Also, drinking too much liquid at or around mealtime can leave you feeling overly full and prevent you from eating enough nutrient-rich foods. Expect to drink at least 6 to 8 cups (48 to 64 ounces or 1.4 to 1.9 liters) of fluids a day to prevent dehydration.
- Eat and drink slowly. Eating or drinking too quickly may cause dumping syndrome — when foods and liquids enter your small intestine rapidly and in larger amounts than normal, causing nausea, vomiting, dizziness, sweating and eventually diarrhea. To prevent dumping syndrome, choose foods and liquids low in fat and sugar, eat and drink slowly, and wait 30 to 45 minutes before or after each meal to drink liquids. Take at least 30 minutes to eat your meals and 30 to 60 minutes to drink 1 cup (237 milliliters) of liquid. Avoid foods high in fat and sugar, such as nondiet soda, candy, candy bars and ice cream.
- Chew food thoroughly. The new opening that leads from your stomach into your intestine is very small, and larger pieces of food can block the opening. Blockages prevent food from leaving your stomach and can cause vomiting, nausea and abdominal pain. Take small bites of food and chew them to a pureed consistency before swallowing. If you can't chew the food thoroughly, don't swallow it.
- Try new foods one at a time. After surgery, certain foods may cause nausea, pain and vomiting or may block the opening of the stomach. The ability to tolerate foods varies from person to person. Try one new food at a time and chew thoroughly before swallowing. If a food causes discomfort, don't eat it. As time passes, you may be able to eat this food. Foods and liquids that commonly cause discomfort include meat, bread, pasta, rice, raw vegetables, milk and carbonated beverages. Food textures not tolerated well include dry, sticky or stringy foods.
- Focus on high-protein foods. Immediately after your surgery, eating high-protein foods can help heal your wounds, regrow muscle and skin, and prevent hair loss. High-protein, low-fat choices remain a good long-term diet option after your surgery, as well. Try adding lean cuts of beef, chicken, pork, fish or beans to your diet. Low-fat cheese, cottage cheese and yogurts also are good protein sources.
- Avoid foods that are high in fat and sugar. After your surgery, it may be difficult for your digestive system to tolerate foods that are high in fat or added sugars. Avoid foods that are fried and look for sugar-free options of soft drinks and dairy products.
From Highland Hospital, download-able plans:
- Diet #1 (Discharge Diet): Liquid Meal Plan.
- Diet #2: Pureed Meal Plan.
- Diet #3: Soft Meal Plan .
- Diet #4: Lifestyle Meal Plan (Face Sheet).
From Brigham + Women's Hospital, Boston: