Bariatric Surgery (Weight Loss)

Gastric Bypass Surgery Diet

The aim of Bariatric surgery is to limit the consumption of food in order to facilitate the process of weight reduction. It is very essential to follow proper diet guidelines and lifestyle changes for achieving the maximum benefits. The gastric bypass diet is designed for people who are recovering from gastric bypass surgery to help them heal and change their eating habits. Your doctor or a registered dietitian can help you with a gastric bypass diet by guiding meal planning.

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A gastric bypass diet specifies what type and how much food you can eat at each meal. Closely following your gastric bypass diet can help you lose weight safely.

The gastric bypass diet has several purposes:

To allow the staple line in your stomach to heal without being stretched by the food you eat

To get you accustomed to eating the smaller amounts of food that can be digested comfortably and safely in your smaller stomach

To help you lose weight and avoid gaining excess weight

To avoid side effects and complications

Benefit of Gastric Bypass Diet

It allows a patient to eat small amounts of food that can be easily digested.

A proper diet helps in eliminating all complications and side effects.

To allow the staple line in the stomach to heal without getting expanded by the food eaten.

To help lose weight and avoid gaining excess weight.

Diet recommendations after gastric bypass surgery or other weight-loss surgery vary depending on the type of surgery, where the surgery is performed and your individual situation.

Most commonly, the gastric bypass diet has four phases to help you ease back into eating solid foods. How quickly you move from one step to the next depends on how fast your body heals and adjusts to the change in eating patterns. You can usually start eating regular foods with a firmer texture about three months after surgery.

After gastric bypass or other weight-loss surgery, you must pay extra attention to signs that you feel hungry or full. You may develop some food intolerances or aversions.

General Guidelines

Eat balanced meals with small portions.

Follow a diet low in calories, fats and sweets.

Keep a daily record of your food portions and of your calorie and protein intake.

Eat slowly and chew small bites of food thoroughly.

Avoid rice, bread, raw vegetables and fresh fruits, as well as meats that are not easily chewed, such as pork and steak. Ground meats are usually better tolerated.

Do not use straws, drink carbonated beverages or chew ice. They can introduce air into your pouch and cause discomfort.

Avoid sugar, sugar-containing foods and beverages, concentrated sweets and fruit juices.

For the first two months following surgery, your calorie intake should be between 300 and 600 calories a day, with a focus on thin and thicker liquids.

Daily caloric intake should not exceed 1,000 calories.

Fluid - Drink extra water and low-calorie or calorie-free fluids between meals to avoid dehydration. All liquids should be caffeine-free. Sip about 1 cup of fluid between each small meal, six to eight times a day. Drinking at least 2 liters (64 ounces or 8 cups) of fluids a day. You will gradually be able to meet this target. Strongly warn against drinking any alcoholic beverages. After surgery, alcohol is absorbed into your system much more quickly than before, making its sedative and mood-altering effects more difficult to predict and control.

Protein - Preserve muscle tissue by eating foods rich in protein. High-protein foods include eggs, meats, fish, seafood, tuna, poultry, soy milk, tofu, cottage cheese, yogurt and other milk products. Your goal should be a minimum of 65 to 75 grams of protein a day. Don't worry if you can't reach this goal in the first few months after surgery.

Supplements - You must take the following supplements on a daily basis to prevent nutrient deficiencies. Please remember that all pills must be crushed or cut into six to eight small pieces. You are not able to absorb whole pills as well as before surgery, and it can be difficult for the pills to pass through your new anatomy.

Multivitamins - Take a high-potency daily chewable multivitamin and mineral supplement that contains a minimum of 18 mg of iron, 400 mcg of folic acid, selenium, copper and zinc. Brands that contain this formula include Trader Joe’s and Centrum Adult chewable multivitamins. Take two tablets daily for at least three months after your surgery, and then one tablet daily for life.

Calcium Supplement - Take 1,200 to 2,000 mg of calcium daily to prevent calcium deficiency and bone disease. To enhance absorption, take the calcium in two to three divided doses throughout the day - for example, a 500 to 600 mg supplement taken three times a day. Calcium citrate is the preferred form of calcium.

Vitamin D Supplement - Take a total of 800 to 1,000 International Units (IUs) of vitamin D each day. This total amount should be taken in divided doses of 400 to 500 IUs twice a day. Vitamin D should be taken with your calcium supplement. If you prefer, you can take a combination calcium-vitamin D supplement to avoid taking multiple pills, so long as it contains the proper dosages.

Vitamin B12 Supplement - Take 500 mcg of vitamin B daily. It can be taken as a tablet, or in sublingual forms placed under the tongue.

Other Supplements - Some patients need additional folic acid or iron supplements, particularly women who are still menstruating. Your dietitian will discuss this with you.

Diet Progression After Bariatric Surgery

Immediately following surgery, you will begin with a clear liquid diet. You may gradually start adding thicker liquids to your diet after you are discharged from the hospital.

Two weeks following surgery, you may progress to blended and puréed foods. You may use high-protein (more than 20 grams protein), low-calorie (less than 200 calories) liquid supplement drinks or powders to meet your protein requirements during this period.

It is important to know that following surgery, your stomach size is very small - less than 1/4 cup, or about the size of an egg. The opening that allows food to pass out of your stomach is also very narrow. For this reason, it is important to take only two to three sips or bites at a time of any new food and then wait 10 minutes before taking more. This will help you learn your limits and tolerance. Liquids will empty faster from your stomach than soft solids.

If you overeat or eat too quickly, you may experience nausea or pain. You should avoid rich, creamy liquids such as gravies, sauces and ice creams.

Diet in the Hospital

A patient is required to follow a specific diet post surgery. The patient will be given broth, juices and Jell-O which are high in sugar content. The food portions after the surgery will be very small and the amount will be gradually increased after a patient gets the power to tolerate it.

Diet for First Two Weeks After the Surgery

It is advisable to drink thick liquids that include – 

Sugar-free pudding

1% or non-fat milk, if the patient is able to tolerate milk

Low-fat cottage cheese

Refined hot cereals that are low in fiber like cream of wheat or rice. Add extra liquid for creating a soup-like consistency

Optional low-calorie or high-protein liquid supplement drinks

Soy-based or lactose-free low-calorie drinks

Low-fat soups or blended broth-based soup

Also do not eat oatmeal

Diet for 2-4 Weeks Post Surgery

It is advisable to eat soft foods and puréed after 2-4 weeks of the surgery that include –

Tofu

Hot cereals

Applesauce

Noodles

Yogurt

Mashed potatoes

Lean fish

Cottage cheese

Lean ground meats or poultry

Well-cooked, puréed vegetables

Scrambled egg substitute or egg whites

Meal Plan for 2-8 weeks Until 2 Months Post Surgery

The calorie intake of the patient can be more than five hundred calories a day. All the meals should be divided into 6-8 small meals. The advisable portion size of liquids is 1/2cups and for 1/4cups for solids.

Meal Plan for 2-6 Months Post Surgery

It is recommended to consume 65-75 grams of protein and 900-1000 calories a day. The daily serving must include –

Two servings of well-cooked vegetables

Three servings of dairy products and milk including low-fat and non-fat products

Three servings of starch while limiting to rice and bread

One serving of fruit and avoid eating fruits with skin and dried fruits

Three servings of meat alternative or meat including low-fat and lean meat

Meal Plan for 6 Months After Surgery and Beyond

Patients should avoid eating dried fruits, popcorn, raw vegetables, red and nut meats, breads and fresh fruits with skin.

High-protein liquid supplement drinks should be discontinued

900-1000 calories should be consumed in a day

Increase the variety of low-calorie, low-fat and low-sugar foods

Eat only 2-3 snacks per day and also decrease to 3 meals in a day

Specific Guidelines After Gastric Bypass Surgery

It is advisable to chew the food slowly in small bites.

Daily calorie intake should not exceed thousand calories.

Eat balanced meals in small portions.

Chewing ice or drinking carbonated beverages can introduce air in the stomach leading to discomfort.

Follow a diet which is low in fats, sweets and calories.

Avoid eating fruit juices, sugar-containing foods, sugar and beverages.

Always keep a daily record of the food consumed in terms of protein and calorie intake.

The daily calorie intake should be in between 300-600 for the first two months.

Avoid eating fresh fruits, meats, bread, raw vegetables and rice. On the other hand, ground meats are generally better tolerated.