Every bariatric program has slightly different diet guidelines. Different procedures may have different guidelines as well.
The information below is not meant to replace your doctor’s or dietitian’s diet guidelines. It is however, meant to give you an idea of what to expect with your new diet.
THE BEFORE SURGERY DIET
Most bariatric programs recommend a one or two-week pre-op diet. The purpose of this diet is to reduce the size of your liver prior to surgery.
Many obese individuals have a fatty liver. Fat cells grow between liver cells and make the liver large, function poorly and hard for your surgeon to move out of the way during surgery.
The pre-op diet is typically very low in carbohydrates and high in protein. This forces your body to use your fat cells as energy. Your liver shrinks quickly and surgery becomes safer and easier.
Low carb and high protein is typically recommended before surgery.
THE AFTER SURGERY DIET
The typical post-operative bariatric surgery diet consists of four or five stages. Stages 3 and 4 are occasionally combined.
- Stage 1 – Clear Liquid Diet – For one or two weeks after surgery.
- Stage 2 – Full Liquid Diet – For one to two weeks after stage one.
- Stage 3 – Pureed Food – For one to four weeks after stage two.
- Stage 4 – Soft Foods – For one to two weeks after stage three.
- Stage 5 – Regular Diet – For the remainder of the patient’s life after stage three ,starts 8 to 12 weeks after surgery
STAGE ONE – CLEAR LIQUIDS
During the first stage, the patient’s diet will consist of water, broth, Jell-O, sugar-free popsicles, sugar-free crystal light. These substances should not contain any sugar or fat and should be consumed slowly.
You should avoid:
- Carbonated beverages
Try your best to get 64 ounces of water. Dehydration is very common after bariatric surgery. Sip, sip, sip all day long.
The clear liquids let your stomach heal and prevents you from getting sick which can also put undue pressure on your new stomach.
STAGE TWO – FULL LIQUID DIET WITH PROTEIN
Protein powder drink for stage 2. Stage two typically focuses on liquids and protein. Below are common foods for stage two.
- Non-fat Greek Yogurt
- Protein powder mixed with a sugar free non-carbonated clear liquid.
- Protein powder mixed with Greek Yogurt.
- Protein shake in 4 ounce increments throughout the day.
- Sugar free pudding.
- Soup with soft noodles.
- Non-fat yogurt.
- Carnation instant breakfast. Look for the sugar free option.
- Very thin creamed soups. No chunks.
- Sugar free sorbet.
- Very watery hot oatmeal. Check the sugar content.
- Sugar free, nonfat ice cream
- Thinned applesauce. Check sugar content.
Staying hydrated is extremely important. Get your fluids in throughout the day by drinking 4 to 6 ounces every hour.
STAGE THREE – PUREED FOODS
Scrambled eggs.Stage three typically focuses on introducing foods with a thin consistency. Below are some common foods for stage three.
- 1 protein shake per day.
- Almond milk or coconut milk makes a great protein shake.
- Cottage cheese (low fat)
- Soft cereals – Let your cereal sit in the non-fat milk until it’s soft.
- Soft vegetables – steam or boil them until they are soft.
- Soft cheeses – limit these, they are typically high in fat.
- Ground chicken or beef. Add some beef or chicken stock to keep the meat soft.
- Scrambled eggs – these are a great source of protein.
- Soft (steamed) fish. Remember to chew well.
- Canned tuna and salmon (you can add low fat mayo). Great source of protein.
- Mashed fruit. Bananas, avocados, and canned fruit (watch sugar content).
You should avoid the following foods:
- While smoothies are ok, limit their sugar content. Most smoothies have a lot of sugar.
- Starchy foods like pasta, rice and bread.
- Fibrous vegetables like celery, broccoli, asparagus, raw leafy green
- 500 calories is common at Stage 3. Remember to track with the Baritastic app!
STAGE FOUR – SOFT FOODS
By this point, patients are typically excited to get back to more ‘normal’ foods. However, most programs still recommend choosing soft foods to prevent undue stress on your new stomach. Remember to follow your bariatric programs diet guidelines! Now is not the time to cheat.
- All foods from previous stages.
- Continue your daily protein shakes.
- Any type of fish.
- Chicken and other tender meats are typically allowed.
- Make sure you chew thoroughly and take small bites.
- Vegetables (it’s still recommended that you cook these to soften them a bit).
- Sweet Potatoes
- Healthy cereals
You should avoid the following foods in week four:
- Fried foods
- Fibrous vegetables (i.e. celery and asparagus)
- Sugary drinks
- Pastas and other high carbohydrate, low nutrient foods (pizza).
- Whole milk and other whole milk dairy foods.
STAGE 5 – REGULAR DIET
Its time to start your new life.
Admittedly, the hardest part and the most important factor in your long-term success is your ability to implement a healthy, sustainable lifestyle. Does this mean you will never have a cookie again? Possibly, but probably not. It simply means you will choose healthy foods over unhealthy foods. You will shop healthy and your body will receive it’s energy from nutrient dense foods that keep you satiated.
You should choose healthy foods and have a good understanding of what is not healthy. For meals, protein is typically consumed first, followed by vegetables and finally by a small amount of healthy complex carbohydrates. Most programs recommend (recommendations vary based on target weight, height, and sex) the following macronutrient goals:
- ~1200 calories per day (this varies depending on the patient’s target weight and height)
- 65 to 85 grams of protein
- 40 to 80 grams of carbohydrates (ideally vegetables)
- Very little refined sugar
Most programs don’t have patients monitor their fat intake as long as they are getting regular blood work. But choose lean meats whenever possible.
Knowing Your Obese Self
From the nutritionist consults, from tracking your food on Baritastic, from your psychological counseling, you should know your triggers. You should know why you were obese. You should be able to recognize when you fall off the wagon and be able to get back up. You quickly shake off that bad day and get back on track.
Knowledge of healthy foods, an understanding of your body’s signals, its cravings, and how your body feels after eating certain foods and different amounts of those foods is paramount to your success.
For some people, chips in the pantry might not be a risk. Others can have a small dessert on special occasions. And still others should not indulge in dessert or keep carbohydrate-filled foods nearby.
Setting up your ‘regular diet’ should be a combination of discussions with your dietitian and putting to use what you have learned about you.