Dietary Progression

The long-term goal of surgery is for you to reach a healthy weight by eating the right foods and exercising regularly. After surgery you will begin slowly and go through three dietary stages:

• Bariatric Clear Liquids
• Pureed Food
• Soft/Solid Foods 

Remember, everything you eat must fit through your very small, brand new stoma. Your new stomach is very sensitive and sometimes not terribly forgiving. You will be developing new eating habits that may be difficult at first, but will most certainly be worth it.

Stage 1

In the hospital for the first stage, you will be consuming only broth, diluted fruit juice, sugar-free drinks and protein powder. Low carbohydrate, high protein supplements are available, if your body will tolerate them. This will be the diet you return to if you are ever sick or in discomfort.

It will be important not to drink too quickly. It is recommended that you consume only 1 ounce every 15 minutes at first. Eventually you will be drinking continuously between meals to stay hydrated. Most people need to consume 6-8 cups of liquid per day.

Carbonated, caffeinated and sugar drinks are not recommended. Carbonation can stretch your pouch and irritate your new stomach. Caffeine is also a stomach irritant and can make it harder for you to stay hydrated. Sugar drinks can trigger dumping syndrome in those patients with the gastric bypass, when you get sick from too much sugar hitting your intestines at one time. Adjustable gastric banding patients do not experience dumping syndrome.

Stage 2

In approximately one week, with your doctor's approval, you will advance to pureed foods. Use a blender to achieve the right consistency. From now on, every bite of food you take needs to be chewed to applesauce consistency before you swallow. Never forget your new anatomy and the small stoma through which the food must pass.

At first you will only be eating about 1-2 tablespoons of food at a time. Always eat your "Protein First," vegetables next, fruits and then starch, if you have room. Eating protein first is a very important rule. You need protein to maintain your muscle mass, for healing and overall good health and for you immune system. You will be given a protein goal to meet your individualized needs.

Stage 3

Small amounts of solid foods may be started in approximately 4-6 weeks, with your surgeon's approval. Only eat 3 times per day with no snacking unless it is a planned amount of protein or calcium containing food. Drink plenty of sugar-free liquids between meals.

Vegetables should be the next food you eat after protein. These are "nutrient dense," meaning they pack the most nutrition per calorie. Since you don't have much space in your pouch, you need to fit as much good nutrition into your diet as possible. Five small servings per day of vegetables and fruits is a good goal when you are able to eat more food.

Remember, starch foods come last, only if you are not full. Use fats sparingly, though you need approximately 3 teaspoons of fat per day to meet your minimum needs. Consuming no fats may increase hair loss and skin problems during the weight loss period.

You must drink plenty of water between meals. Remember not to drink for 30 minutes before or after eating. Mixing liquids with solids makes the pouch empty too quickly, which means you may eat more food without feeling full. You also may feel too full from the liquids and then not eat enough of the required foods.

NOTE: After every adjustment, gastric band patients should return to Stage 1 and progress forward. (Band adjustments are made on an outpatient basis and involve a saline injection or removal of saline to loosen or tighten the band.)

Vitamins and Minerals

At home after the gastric bypass surgery, start taking the chewable or liquid multivitamins, calcium with Vitamin D, and B12 supplements recommended during your nutrition sessions. After a month, you may switch to regular vitamin and calcium pills. You need to take these every day for the rest of your life. Since your duodenum is bypassed, it is impossible for you to get all the required vitamins and minerals you need from food.

For gastric band patients, supplements may be recommended due to a lower intake (not malabsorption). After every adjustments, pills must again be taken in chewable or liquid form.