Diet Guidelines of Bariatric Surgery

Your doctor will refer you to an expert registered dietitian before surgery takes place. The dietitian will educate you about the diet you will have to follow before surgery. There are four stages of diet that will be explained to you, with different meal options that suit each stage.

The pre-operative diet will be similar to the Stage I diet after surgery, which is the first week post-surgery diet. It consists mainly of a low sugar, high protein liquid diet. Taking your daily 60-70 grams of protein is a must. No solids, carbohydrates, carbonated drinks or caffeine food should be taken in this stage.

This not only will serve to get you familiar with the post-operative diet, but it will also help shrink your liver by 20-25%, which is crucial to having an easier surgery with less complications.

The dietitian will educate you about the diet you will follow after surgery. This diet will be divided into four stages.

Your doctor and dietitian will ensure that you are well familiarized with the 4 stages of the diet, in addition to the different meals and their compositions. Your surgeon may modify the stages and/or combine two stages at each visit in the few months following the surgery, if needed. Everything will be shaped to fit your particular weight loss progress and maintain your neo-stomach as created by your surgeon, in order to achieve the best possible results.

At any stage you can have:

• Canned soups, homemade soups (vegetable, meat, poultry contents should be overcooked or blended in Stage III). However, limit cream soups.
• Sugar-free jello, sugar free popsicles, pedialyte, popsicles, sugar-free/fat-free ice cream.
• Artificial sweeteners that are acceptable: NutraSweet/ Equal, Sweet n’Low/ Saccharine and Splenda/ sucralose/Stevia.
• Flat diet soda, skim milk, crystal light, decaf coffee and tea, all broths, and any other sugar free beverages.
• Consume only the foods allowed on the diet (essential in the first 4 weeks) until informed otherwise by your MD.
• Eat slowly and chew thoroughly⎯at least 25 times!
• Avoid concentrated sugars, especially those in liquid form. They are filled with non-nutrient calories and slow down weight loss.
• Limit fats and fried foods; they are concentrated sources of calories.
• Remember the stomach can only hold 4-6 oz after surgery. You will probably feel satisfied after 2-3 tablespoons of food. Do not overeat! Over time your stomach will stretch. It takes 6-9 months (possibly longer) for your new stomach size to stabilize and allow you to determine your normal meal amount.
• Stop eating when you feel comfortably satisfied⎯if ignored, vomiting will follow, and you can stretch the size of the stomach. If you are unable to keep anything down and are having extreme difficulty staying hydrated, sip on Gatorade which also has electrolytes necessary for normal cell function. Once you feel better, return to non-caloric beverages such as water and diet drinks.
• Drink at least 6-8 cups (8oz) of fluid per day to prevent dehydration. Monitor for the following signs: headache, dizziness, nausea, lethargy, dark urine.
• Stop drinking liquids 15 minutes before meals and resume 30-45 minutes after meals.
• Eat 3 small nutrients dense meals + 1 high protein snack a day.
• Meals should include: protein first, then fruits and vegetables, and then whole grains.
• Set up a schedule for supplements (vitamins, minerals and protein shakes) and medications; remember to take Calcium with meals and separate from iron supplements.
• Introduce new foods one at a time in order to rule out intolerance.
• If a food is not tolerated, reintroduce it in 1 week. If you cannot tolerate dairy, substitute lactate for milk. You may need to take lactose pills with dairy, to help digest the lactose. You can also try soy milk fortified with calcium and vitamin D.
• Exercise! This is the key to long term weight loss and maintenance. Walking 30-45 minutes daily should be the main exercise for the first 6 weeks. Between 6-8 weeks, more strenuous exercises can be added.

• Soft bread and Rice.
• Spaghetti and other pastas – Macaroni and Cheese.
• Raisins, prunes, and other dried fruit (these are too sweet).
• Granola and other Cereals with nuts.
• Raw fruits and vegetables, buts and popcorn.
• Chips and crackers.
• Tough or chewy meat.
• Whole pieces of corn or whole peas ( puree before eating).
• High fat foods (butter, margarine, oil, regular mayonnaise, sour cream, cream cheese, salad dressing, whole milk, half and half, ice cream, cookies, pies, other desserts, bacon, and sausage.)