Diet Stages After Weight Loss Surgery

Surgery is only a tool for weight loss.  How a patient uses that tool is what counts.  All procedures restrict the amount of food an individual can consume therefore food needs to be full of nutrients. Each bite counts when is comes to meeting daily nutrition requirements.  The goal of Bariatric Bits is to help patients choose the best food to meet their nutritional needs after weight loss surgery. This post discusses the diet stages after weight loss surgery.

Preoperative Diet

Many bariatric surgeons and surgery centers will ask patients to lose some weight prior to surgery.  The amount may be dependent on the surgeon’s preference and/or the patient’s situation (body composition, BMI, other health-related issues, and health insurance requirement).

Many patients will be asked to follow a very low-calorie diet (VLCD) 1-2 weeks prior to surgery in order to promote shrinkage of the liver.   Many individuals with BMI over 35 have fat accumulated on their liver.  This fat accumulation causes the liver to often be enlarged and stiff.  The enlargement causes the liver to spread across the abdomen.  The liver can then block the area in which the surgeon needs to work.  Since fat accumulation can make the liver stiff, moving the organ will be difficult.

A very low-calorie diet, low in carbohydrates and fat, promotes fat loss around the liver.  This will help shrink the liver in some patients and help loosen it, making lifting the organ easier and safer.

The pre-operative diet will vary among surgeons and surgical practices.  Commonly this diet consists of liquids, including protein shakes, and sugar-free clear beverages.  The diet may be as strict as drinking 3-5 protein shakes per day and drinking clear sugar-free liquids with no solid food permitted.  Some practices may allow non-starchy vegetables, yogurt, lean proteins, and/or fruit.  Always follow the instructions given to you by your surgical team.

Postoperative Diet

The diet postoperatively varies among surgery centers.  Many follow the same protocol, however, may vary in the length of time their patients need to follow each phase or stage.  Always progress as instructed by your surgical team.  Never advance on your own unless your surgeon allows this.  The post-operative diet phases/stages are designed to allow healing.  You may feel completely normal, but this may not be the case internally.  Advancing too quickly can lead to complications.

The general progression is as follows: 

Clear liquids: Stage/Phase 1 (3-7 days) sugar-free liquids that you can see through

This is the initial stage following surgery.  In this stage, you will have the most swelling internally at the new connected sites, which of course vary depending on your surgery.  Nothing thicker than water should go down to your stomach.  Liquids are considered clear when you can see through them when held up to light.  You should sip your liquids slowly as you will fill up very quickly.  Many patients can only handle 2-4 ounces per hour.  Those 2-4 ounces may take 1 hour to be finished.  If you drink too fast you may feel nausea and/or discomfort. Vomiting may result.

Common Liquid Choices:

Water

Flavored Water: Propel, Hint

Crystal Light

Sugar-free Jello

Chicken, beef or vegetable broth

Decaffeinated tea or coffee without cream or milk

Sugar-free water ice or popsicles

 

Full liquids Phase/Stage 2 (3-7 days)

In this phase liquids that are thicker and not “see-through”, often called full liquids, are allowed.  Milk is an example of a full liquid.

Common Choices:

Milk

Soy milk (check the sugar content)

Almond Milk (check the sugar content)

Yogurt (without fruit)

Sugar-free pudding

Strained cream soup

Thin cream of wheat or grits

Cottage cheese

Protein shakes

 

Pureed Phase/Stage 3 (1-2 weeks)

This stage is the most challenging.  Protein foods are incorporated, however, needs to be very soft, “baby food like”, without pieces. Food literally needs to be smooth enough to slide down. into the stomach.

Common Choices

Scrambled eggs

Pureed egg salad

Cottage Cheese

Soft Cheese

Yogurt

Mashed tuna salad (with “light” mayo)

Mashed chicken salad (with “light” mayo)

Mashed beans

Tofu

Pureed chicken, turkey, fish

 

Soft Food Phase/Stage 4 (1-3 weeks)

This stage incorporates soft solids (food should be soft enough to be easily mashed with only a fork). Protein should be the focus of each of three meals.  Often ¼ cup is the serving size per meal.

Common Choices

Soft chicken, turkey (ground)

Fish, Crabmeat

Luncheon Meats

Beans

Tofu

Well cooked vegetables

Potato

Soft fruit (banana, watermelon, canned fruit in water or no sugar added juice)

Crackers may be added (try crackers that mush easily in your mouth)