Dietary Guidelines for Bariatric Surgery

 

Welcome to the online diet guide for Bariatric Surgery! Please click on each heading to navigate through the content. Click on the “+” icons where available to expand for more information. To download a PDF copy of the dietary guide for future reference, click the PDF icon below.

After bariatric surgery, behavior modifications are necessary for your safety and success. We recommend the following for all patients.

Click on each item to read more.

Practice small portions

Your portions should be significantly smaller after surgery than they were prior to surgery.

Chew foods thoroughly

It is essential to chew your foods to the consistency of toothpaste. If you do not chew your food thoroughly, you may get food stuck, have pain, or regurgitate after eating.

Eat slowy

This will help you realize when you are feeling satisfied and prevent overeating.

Stop eating when you begin to feel satisfied

If you are feeling any pressure or pain after your meal, you have most likely eaten too much.

Eat protein first with your meals

High protein foods should be consumed first with each meal every day in order to make sure you are getting enough protein in throughout the day. If you don’t eat your high protein foods first, you may fill up on too much of other foods and not be able to get enough protein in to keep you healthy.

No drinking with or around meals

You should stop drinking 30 minutes before your meal and not drink anything until 30 minutes after your meal. Drinking too close to meals can liquefy the foods in your pouch and push the food through too quickly, so you won’t feel full or may be hungry between meals.

Drink 64 ounces of fluid daily

While this can be challenging since you will not be drinking with or around your meals, drinking enough fluid is essential to keep you hydrated.

Avoid carbonated beverages

Carbonation creates a lot of pressure on the inside of your pouch, which can cause pain and gas.

Limit alcohol and caffeine

Alcohol and caffeine can contribute to dehydration. Alcoholic beverages are also often high in calories.

After surgery, it is important to be taking vitamin and mineral supplements because you will not be able to get all the nutrients you need from eating such small portions and you will not absorb certain nutrients as well after your procedure. It is essential to choose high-quality, high-potency vitamin and mineral supplements that will be most appropriate for helping you meet your needs after surgery.

All supplements should be chewable, liquid or dissolvable and taken daily FOR LIFE!

Multivitamin

Gastric Bypass or Sleeve

Take 2 multivitamins per day

Gastric Band: Take 1 multivitamin per day

Acceptable Options:
  • Celebrate Multivitamin (Recommended)
  • Centrum Adult Chewable
  • Flintstones Chewable

Calcium with Vitamin D

All patients need to take calcium
  • Gastric Bypass and Sleeve: Your calcium must be in the form of calcium citrate for proper absorption (NOT calcium carbonate, calcium phosphate, etc.)
  • You need 1200-1500 mg per day between food and supplement, but your body can only absorb 400 – 600 mg at a time. This means you will need to take 2 or 3 calcium supplements spread out throughout the day.
  • Do not take calcium with iron or an iron-containing multivitamin. Iron and calcium block each others absorption, so you must take these at least two hours apart from one another.

Vitamin B-12

Vitamin B-12 is required for patients who have undergone the Gastric Bypass or Sleeve procedures (Supplemental Vitamin B-12 is not necessary with the band).
  • You need 350 – 600 mcg per day.
  • B-12 can be taken sublingually (under the tongue), as a nasal spray, or by injection.
  • B-12 is not absorbed through the gastrointestinal tract after surgery due to a lack of intrinsic factor so B-12 needs to go directly to the bloodstream rather than through the stomach.

Iron

An iron supplement is required for pre-menopausal women after gastric bypass and sleeve gastrectomy and others that are iron-deficient.
  • Calcium and iron must not be taken together.
  • Separate iron and calcium supplements by at least 2 hours.

Celebrate Vitamins
Order Vitamins Online (opens a new window)

—Protein is a part of every cell in your body, is essential for your overall health, helps you maintain muscle mass, and helps keep your metabolism going.

Women need 50 grams of protein per day

Men need 65 grams of protein per day

—This is not a high protein diet, but it is essential to get a good source of protein with every meal in order to meet your daily protein needs.

Protein Shakes

—Protein shakes can be very helpful for meeting protein needs during first few weeks after surgery.

—These should NOT be used long-term.

—Protein shakes often leave you feeling hungry and can lead to weight gain if continued past the first month or two after surgery.

—Whey protein is the preferred form of protein (rather than soy, egg, pea or other proteins).

—Avoid extra sugar, fat and calories in these shakes.

Acceptable Protein Shake Options

—Unjury™

—Beneprotein® by Resource

—Pro-Stat™ 64

—Perfect Zero Isopure®

—Nectar®

—Body Fortress 100% Whey Protein

—GNC 100% Whey Protein

—GNC Optimum Nutrition 100% Whey

—Syntrax Matrix 5.0

—Carb Solutions™

—Designer Whey Protein®

—Low Carb Slim Fast

—EAS AdvantEdge®

Protein Bars

—Stop protein shakes within the first month or two after surgery.

—If you cannot get enough protein from chicken, fish, eggs, beans, etc., a protein bar would be okay OCCASIONALLY to help you meet your needs.

—Choose bars with LESS THAN 200 calories and AT LEAST 15 grams of protein.

Acceptable Protein Bar Options

—Pure Protein Bar

—Balance Bar

—EAS  Lean 15 Bars

—Zone Perfect—Classic Flavor Bars

—Life Choice Protein Bars

—Supreme Protein Carb Conscious Bars

—Smart For Life Protein Bars

—SOME Atkin’s Advantage Bars

—Usually, the pre-operative clear liquid diet is recommended for 7-14 days. Your surgeon will have an individualized recommendation for the number of days that is right for you.

The purpose of the pre-operative clear liquid diet is to shrink your liver to make surgery easier and safer for you!

Dr. Wagner's diet consists of sugar-free clear liquids ONLY

Dr. Kumaran's diet consists of sugar-free clear liquids + liquid protein supplements up to 48 hours prior to surgery

Acceptable Clear Liquids

—Water

—Ice chips/cubes

—Sugar-Free Kool-Aid/Wyler’s, Crystal Light

—Gatorade diluted to half strength with water

—Thin broths or bouillon – limit to 2 servings per day

—Sugar-free popsicles and ices

—Coffee and tea with artificial sweeteners

—Diet sodas

—Sugar-Free Flavored Waters

—Sugar-free Jell-O, any flavor

—Sugar-free hard candy

—Sugar-free gum

—This diet is intended to help you heal after surgery and eases your stomach back into digesting regular foods as it becomes ready.

Week 1: Post Operative Clear Liquid Diet

—This diet should be followed from the day of surgery through one week after surgery.

—Main goal = Prevent dehydration

—Sip on fluids throughout the day to get 64 ounces a day.

—Aim for 4-6 ounces per hour while you are awake.

—You should start to incorporate protein in the form of protein water this week.

Acceptable Post Surgery Clear Liquids

—Protein Water (Isopure Plus Zero Carb Drink, Cytosport Whey Isolate Protein Drink or Designer Whey Protein2Go Drink Mix) – Aim for MINIMUM of 15 grams of protein per day from these sources.

—Water

—Ice chips/cubes

—Sugar-free drinks, like Sugar-Free Kool-Aid/Wyler’s, Crystal Light

—Gatorade diluted with water

—Thin broths or bouillon – limit to 2 servings per day

—Sugar-free popsicles and ices

—Decaf Coffee and tea with artificial sweeteners

—Sugar-free Flavored Waters

—Sugar-free Jell-O, any flavor

—Sugar-free hard candy, but NO GUM

Week 2: Full Liquid Diet

—This diet should start one week after surgery and you should follow this until two weeks after your surgery.

—All sugar-free liquids are allowed.

—Start taking your vitamin and mineral supplements this week. —These should be chewable, liquid or dissolvable and should be continued for life!

—Protein water should be continued this week.

Acceptable Full Liquids

—All clear liquids

—Skim milk

—Sugar-free hot chocolate

—Approved protein supplements (see earlier slide with this info)

—Cream soups with NO chunks or particles

—THINLY cooked Cream of Wheat, Malt-O-Meal or grits

—No sugar added applesauce (with no chunks)

—Sugar-free pudding

—Sugar-free fudgesicle

—Vegetable juices

—Low-fat smooth and creamy yogurt, with no fruit pieces or sugar added

Week 3: Soft Diet

—Be sure to chew your foods thoroughly.

—Be sure to start separating liquids from meals at this time.

Acceptable Soft Diet Options

—Hot cereal, like grits, oatmeal, cream of wheat

—Mashed potatoes

—Low-fat cottage cheese

—Blended soups and pureed foods

—Scrambled eggs

—Canned tuna/chicken mixed with light mayonnaise

—Saltines and graham crackers

—Peanut butter (no sugar added)

—Low-sugar and low-fiber cereals with skim milk, like Cheerios®, Rice Krispies® and corn flakes

—Canned fruits (canned in own juice or water), melons, ripe bananas

—Canned vegetables or tender cooked vegetables (no peels/seeds)

—Beans and lentils

—Tofu and soy products

Week 4-8: Modified Regular Diet

—You start to get back to a regular diet at this time.

—Try one new food at a time and chew well!

—DO NOT EAT:

—Breads, all types (until after 6 months)

—Rice, all types (until after 6 months)

—Pasta, all types (until after 6 months)

—Raw vegetables (until after first 8 weeks)

—Red meats (including beef, pork, venison, veal, lamb, etc.) (until after 8 weeks if you have the gastric band and until 6 months if you have the sleeve or gastric bypass)

Acceptable Options Week 4-8

Acceptable Foods:

—All clear liquids

—All full liquids

—All soft foods

—Chicken, turkey, fish (moist, soft-cooked)

—Reduced-fat or fat-free cheese

—Cooked vegetables

—Cooked fruits

—Raw fruits without skins

8+ Weeks: Diet Basics

—Bypass and sleeve patients should continue to not eat any red meats (including beef, pork, lamb, venison, veal, etc.) for the first 6 months.

—Avoid breads, rice, and pastas. Get your carbs from whole grains, fruits and vegetables

—Eat 3 meals per day, and limit snacks to once or twice a day.

—Always choose low-sugar, low-fat items when available.

—Eat your high protein foods first with your meals.

—Avoid carbonated beverages.

—Take required vitamin and mineral supplements daily.

—Limit alcoholic beverages.

—Exercise is essential to weight loss success after surgery.

—Start slowly, gradually building to 150 minutes per week/30 minutes a day 5 days per week.

—Find something you enjoy and make it a habit!

NO lifting more than 20 pounds for the first 2 weeks

NO vigorous activity for 6 weeks

—Our Dietitian:

Priscila Cleary

 

Priscila Cleary, MS, RDN, LD

—(314)776-7112

—priscila.cleary@hoab.org

 

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Diet Quiz

To confirm you have reviewed and understand the dietary guidelines for bariatric surgery, we require our patients to complete a brief quiz. Click the icon below to download the Diet Quiz. Instructions for submission are included in the file.