Bariatric surgery is an excellent way to limit the amount of food you eat and assist in weight reduction, but significant changes in your diet and lifestyle by you are required to achieve maximum success. After your bariatric surgery, you will be losing weight very rapidly. Hence, proper nutrition, mineral and vitamin supplement are essential to maintain lean body mass (muscle), hydration and skin elasticity, and to minimize hair loss.
Primary nutrition goals after surgery
- Learn proper eating habits and behaviors that will promote continued weight loss.
- Consume adequate amounts of protein to minimize loss of lean body mass and facilitate wound healing.
- Take adequate amounts of fluid to maintain hydration.
- Make healthy food choices to take in proper nutrients for optimal health.
- Replenish vitamin and mineral supplements.
- The post-surgery meal plan requires a significant change in meal planning for most people. We recommend that you begin adapting your current meal plan to prepare for this change.
- Avoid fried or high-fat and sugar foods at all costs.
To lose weight effectively and permanently, you must be an active participant in your weight loss program. The stomach stapling surgery will help you to lose weight, but it is not “magic.” A well-balanced nutrition plan is necessary to help you reach and maintain your goal weight. Positive changes in your eating habits also are necessary to help you reach your goals of good health and weight control. After you are discharged from the hospital, you need to follow the diet plan outlined below, which progresses from liquids to solid foods over a period of eight weeks.
Weeks 1 & 2 (high-protein, low-calorie liquids)
Protein is essential for every function of your body. After surgery, protein is needed for healing and preventing infection. It is necessary for you to continue on liquids for two weeks after your discharge from the hospital to avoid putting stress on your staple line. Hence, your dietician will prescribe a number of high-protein liquid supplements. In addition to these supplements, you will be allowed to have coffee, tea, broth, Gatorade, clear and cream soups (strained), cooked cereals (soupy), low-fat yogurt (no-sugar-added and blended), diet soft drinks (gone flat), fruit juices (small amounts), sugar-free drinks, diet Jell-O, popsicles and water. You need a good fluid intake during this time so that you do not become dehydrated.
Weeks 3-5 (Pureed Stage)
During the pureed stage of the plan, it will be necessary for you to process most of your food in a blender. Another option is to eat baby food. It will also be important for you to develop an eating schedule that fits your lifestyle. The following guidelines will help you progress from liquids to semi-solid foods, and finally, to solid foods.
- Relax and enjoy mealtimes. If you are under stress or feeling anxious before a meal, you may want to avoid eating until you are more relaxed. Highly stressful situations often cause food intolerance.
- Eat six times a day (three meals and three snacks). Eating often is necessary to help you meet your nutritional needs and continue with your weight loss goals.
- Limit the size of each meal to approximately four tablespoons of food. You will discover that you can drink more liquid, so be sure to select low-calorie beverages. The more solid a food, the less of it you will be able to eat, so you will be getting fewer calories and losing more weight. Learning your capacity of certain foods is essential to weight management.
- Take small bites, chew well and put your fork or spoon down between bites. Taking small bites will help you in chewing your food better. Chew each bite at least 20 times before swallowing the food.
- Take at least 20-30 minutes to eat or drink each small meal or snack. Be sure to make time in your daily schedule for meals. Eating slowly will help you avoid problems with intolerance.
- Drink liquids between meals only. You may take small sips of liquid with your food, but drinking liquids with meals will cause your pouch to reject the food. Drink liquids one hour before or one hour after a meal.
- Include high-protein foods at each meal. The dietician will talk with you about protein food selections and how to include these foods in your menus. Also include foods from all food groups in your meal plan on a daily basis.
- It is not necessary for you to eat completely different meals from anyone else in your household during this stage of the nutrition plan. You are encouraged to select low-calorie, high-protein, and low-fat foods.
Week 6 (Soft Stage)
This stage of the nutrition plan could be called the soft/semi-solid stage, because you will be consuming solid foods that are well cooked. You can continue to consume soft foods you have already been eating in addition to the following foods that should be included in your meal plan at this time:
- Baked fish, chicken and turkey
- Dried beans, peas and lentils
- Lean ground beef and veal
- Creamy peanut butter
- Steamed or boiled vegetables
- Canned fruit packed in its own juices or soft, fresh fruit
- Cooked or dry cereals, crackers
- Toasted breads, baked potato (no skin), Melba toast
Remember to continue eating slowly and chewing well. Avoid drinking liquids with your meals and continue to follow the guidelines previously outlined.
Week 7 (regular stage)
Continue to advance the consistency of the foods you eat by including raw fruits and vegetables into your meal plans. Continue to select low-calorie, high-protein foods and low-fat foods. Always ask yourself, “Is there a lower calorie, more nutritious choice?”
Foods to avoid
You should avoid the following foods:
Nuts, seeds, skins (includes potato skins, onion skins, fruit peelings and the membrane between orange and grapefruit sections), the stringy portion of celery, asparagus, string beans, un-toasted bread, high-calorie foods and beverages and high-fat foods. Steak and pork may or may not be tolerated, depending on the individual.
You may discover individual intolerances with certain foods; this is very common. You should concentrate on the positive behaviors and good eating habits you are developing.
Before your discharge from the hospital, the dietician will instruct you on the bariatric surgery nutrition plan. You will be provided written and verbal information on how to advance from liquids to solid foods. He or she will discuss with you how to meet your nutritional needs and how to avoid possible intolerances. In your return visits, you will meet with the dietician.
The dietician will evaluate your overall nutritional intake and make recommendations on how to improve, if necessary. He or she also will help you identify problems, make suggestions on how to correct them and answer any questions you may have about your nutritional plan.
Remember that surgery is not a magical answer to losing weight. The more involved you are in your nutritional plan, the better your results will be. Be an active participant.
Vitamin and Mineral Supplements
The first few months after your surgery you will consume a very low-calorie diet. Due to the volume restriction of your new stomach, it will be difficult to eat a sufficient variety of nutrients each day. Hence, vitamin and mineral supplements are required. You will need the following supplements:
- Daily multi-vitamin – Should be chewable and contain at least 400 mg folate, 18 mg iron and 15 mg zinc and calcium citrate.
- Calcium citrate – Calcium must be in a citrate form, and you must take a total of 1200 mg of calcium each day. If you also are taking iron supplements, you must separate your iron and calcium supplements by two hours.
- Iron – Women who are menstruating or who have a history of anemia must take supplemental iron. Take your iron with a multi-vitamin or a vitamin C supplement for enhanced absorption. Iron supplements may cause constipation, so you may wish to take an over-the-counter stool softener when you begin taking them.
- B-12 – You will need to receive an injection of B-12 or daily sublingual pills by your three-month post-op visit and every three-six months thereafter.
- Examples of supplements includes Bariatric Advantage®, Celebrate® Nutritional Supplements and UNJURY® Medical Quality Protein.
For more detailed post-operative guidelines, select your surgery type and click the appropriate link below or call our bariatric coordinator, Gwen Hasse, RN, MSN at 352.265.0111 x29634.
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