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.
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.
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:
Flavored Water: Propel, Hint
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.
Soy milk (check the sugar content)
Almond Milk (check the sugar content)
Yogurt (without fruit)
Strained cream soup
Thin cream of wheat or grits
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.
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.
Soft chicken, turkey (ground)
Well cooked vegetables
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)