The diet following weight loss surgery is divided into stages of dietary progression. You should be working with your physician and dietitian to determine your appropriate stage. You will consume a liquid to semi-liquid diet that progresses to soft foods and finally a regular, healthy low fat diet. While the food consumed is similar for gastric banding and gastric bypass, the progression for the gastric bypass is slower. No matter which type of surgery you have, one of the most important things to remember is that everyone will advance at his or her own pace. The guidelines for dietary progression are:
- Clear Liquid
- Full Liquid
- Pureed Diet
- Maintenance Phase I
- Maintenance Phase II
Clear liquids are consumed in 30cc (1 ounce or 2 Tablespoons) increments every 15-20 minutes. Fluids are sipped not gulped! Examples of clear liquids that may be consumed are decaffeinated tea and coffee, clear broth, clear juices such as apple, grape, light cranberry, sugar-free Popsicles and sugar-free gelatin. Remembering to take a sip so frequently can be difficult. Use a kitchen timer to remind you to drink every 15-20 minutes. If you work daily on a computer, an automated reminder to “take a sip” can be useful.
Full liquids are the next dietary progression. You are still consuming one to two tablespoons every 15-20 minutes. Now you have a protein goal of 30 grams a day. You will alternate your full liquids with your clear liquids and consume six cups of liquid over a 12-hour period each day. When starting the full liquid diet you also incorporate low carbohydrate protein powders or shakes as well as milk, yogurt, cream of wheat or rice, farina and grits. In order to help you meet your protein goal, you may want to try double milk that has 16 grams of protein in approximately 1 cup. It is made by adding 1/3 cup nonfat dry milk powder to one cup of skim milk and is often used when making sugar-free pudding. With the initiation of dairy products, symptoms of lactose intolerance may be a problem. If you were lactose intolerant prior to the surgery, you will probably remain so after surgery. Some develop it after surgery but usually it is temporary. If the symptoms remain, try using lactose-free or soymilk. Chewable pills or drops that break down the lactose are also available.
The pureed diet provides more variety in food choices. Pureed foods are the consistency of baby food. You will gradually increase to ¼ cup (2 oz. or 60 cc) and will eat OR drink every 30 minutes. You will never eat and drink at the same time. Your protein goal is 60 grams a day. If you eliminate one source of protein then remember to substitute another good source of protein, such as exchanging a light yogurt for a scrambled egg. Examples of foods that can be introduced in this stage are shown in Table 1.
Maintenance Phase I consists of soft, low-fat food. It contains 5-6 small meals a day of ½-3/4 cup of food each consumed approximately 3-4 hours apart. You will continue taking a multivitamin and calcium supplement. The daily protein goal is 60 grams for gastric banding and 60-80 grams for gastric bypass. Phase I includes soft foods that are easy to chew or digest. It eliminates foods such as raw fruits and vegetables, chewy breads, fibrous cereals, popcorn, whole beans, nuts and tough meats. Rice and pasta need to be well chewed or avoided. Food should be chewed to the consistency of applesauce. Cooking and mashing the food may help you tolerate the consistency. Continue to sip water between meals, consuming at least 64 ounces a day.
You should stop drinking 15-30 minutes before meals and may need to wait up to 30 minutes to one hour after meals. If you drink while you are eating, the pouch will fill with liquid quickly and your food intake will be decreased! When you do this you sacrifice good nutrition from food and are not allowing yourself to adjust to normal eating.
Drinking following a meal results in the pressure of the liquid forcing the food out of the stomach too quickly. Examples of foods that can be introduced in Phase I are smooth peanut butter, frozen low fat convenience foods that are “carb controlled” and food that can be easily chewed such as tofu, flaky fish, moist chicken without the skin, mashed beans, soft fruit and cooked vegetables.
Adapted from source – Obesity Help
Doctors and nutritionists may vary in terms of what kind of diet plan to follow AFTER your weight loss surgery procedure, but most have the same basic idea.
Follow your particular instructions of course, but here are some plans from other Bariatric Surgeons and nutritionists when you find yourself needing a reminder or re-start.
From Highland Hospital, downloadable plans:
- Diet #1 (Discharge Diet): Liquid Meal Plan.
- Diet #2: Pureed Meal Plan.
- Diet #3: Soft Meal Plan .
- Diet #4: Lifestyle Meal Plan (Face Sheet).
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