Diet after weight loss surgery


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Understand that you have an active role in your healing process. You have undergone a major change in your life both physically and emotionally. We expect you to take personal responsibility for controlling the types of foods taken during the first eight weeks as well as throughout your life. You must learn to work with the surgery instead of viewing it as a “magic” procedure that will create weight loss without your involvement. I can only do my part, I expet you to do yours too!!

 

The purpose of dietary phases is to provide the appropriate time for the proper healing. To allow proper healing please remember that the following must be strictly adhered to in order to prevent possible complications while the tissues of your surgically altered stomach are healing, you must minimize the stress on those tissues.

 

Purpose

This diet is designed to restrict caloric intake to produce desired weight loss, to help develop appropriate eating habits and to prevent disruption or obstruction of your new anastomosis.

 

Primary Nutritional Goals

  • Learn proper eating habits that will promote weight loss while maintaining health at a reduced weight.
  • Consume adequate amounts of protein to minimize loss of lean body mass and facilitate healing.
  • Take adequate amounts of fluid to maintain hydration.
  • To evaluate and correct any micronutrient deficiencies, well in time.

 

Diet Principles

  • A strict no to 3S’s
    • 1. Straw
    • 2. Sugar
    • 3. Soda
  • Drink 6-8 cups of liquid each day
  • Sip one cup of liquid over an hour
  • Sip all the allowed beverages slowly
  • Include proteins first at each meal to help maximize protein intake
  • Stop drinking as soon as you feel full. Indications of fullness are:-
    • A feeling of pressure in the centre just below your ribcage
    • A feeling of nausea
    • A pain in your shoulder area or upper chest
    • Contact your team if any of the above symptoms persist or worsen.

 

Phases of Diet

Phase I

Clear Liquid Diet

In hospital stay

Phase II

Full liquid diet

2 weeks post the surgery

Phase III

Pureed diet

2 weeks post liquid diet

Phase IV

Soft to normal diet

4 weeks post surgery

 

Phase I – Clear Liquid Diet

You will be on  clear liquids while in the hospital. A clear liquid is a liquid you can see through. Sip liquids and stop when you feel full. You may need to drink more often as the amount of fluid you can take in at one time will be minimal. In this early postoperative phase only liquids are allowed so the new stomach has time to settle down. Stay hydrated with a lot of water.

 

Clear liquids include mainly unsweetened, non carbonated fluid such as

  • Weak tea
  • Coconut water
  • Lemon water
  • Vegetable clear broth
  • Chicken clear broth
  • Dal Pani

 

Phase II – Full liquid diet

You will consume full liquids after discharge from the hospital. You will remain on full liquids until your first two weeks post the surgery. Full liquids can be considered as nothing remains on a fork when lifting the clear liquid out of the container or dish. Anything that passes through a sieve can be consumed.

  • Coconut water
  • Lemon water
  • Veg clear broth/soup
  • Chick pea (kabuli channa) soup
  • Bengal gram (black channa) soup
  • Tomato soup
  • Double toned milk
  • Salted lassi
  • Mint refresher
  • Whey water
  • Dal soup
  • Chicken broth
  • Unsweetened iced tea
  • Fresh fruit juice strained (50% juice 50% water)

 

Phase III – Pureed Diet

You will begin with the pureed diet 2 weeks post the surgery only after your visit to the hospital. You will remain on a pureed diet for two weeks. A pureed diet is a diet that involves blending everything you eat. You may have regular table food; however, it must be in the consistency that you can draw it through a straw. Refrain from drinking through a straw due to the fact that it will increase gas. Blend the food into a liquid form without lumps, therefore a blender is an essential part of your kitchen. It will be impossible to take in 60-80 grams of protein through your food everyday for the first 8 weeks. You will need to use a power protein supplement at this time to assist you to ensure 60-80 gms protein per day.


List of food items that can be included in puree diet are:-

  • Bathua / Cocumber / Ghia Raita
  • Soy bean gravy
  • Kadhi
  • Sambhar with idli
  • Dal soup
  • Vegetable soup
  • Tomato soup
  • Lentil soup
  • Pumpkin soup
  • Fruit custard
  • Custard with sugar free jelly
  • Suji porridge
  • Dalai with milk
  • Veg dalia with curd
  • Veg kichri with curd
  • Double toned milk curd
  • Double toned milk

 

Sample Meal Plan

 

8:00

Tea +Sooji Porridge + Milk

10:00

Sugar free protein shake (2-3 spoon in low fat milk)

12:00

Blenderized khichri + vegetables curd

2:00

Lassi salted

4:00

Tea/coffee

6:00

Chicken soup/vegetable soup

8:00

Blenderized khichri curd

10:00

Sugar free protein shake (2-3 spoon in low fat milk)

 

Phase IV – Soft diet – Normal diet

You will begin soft foods after 2 weeks of pureed diet. You will remain on soft foods for 2 weeks. The consistency of food will be as long as the food is easily mashed with a fork, you may eat it. You will no longer be required to blend your food.


You should concentrate on foods low in calories and high in protein. The purpose of soft foods is to allow your system to adjust to this new eating pattern. Soft foods include that are not limited to:

 

  • Egg whites – Scrambled, soft boiled and in the form of egg salad.
  • Legumes – Beans, lentils & peas. All should be in a mushy form that will pass through the pouch easily.
  • Dairy products – Use the low fat dairy products as they all have the same amount of protein. Shredded cottage cheeses (paneer), low fat yogurt, and skim milk are the best dairy products for weight reduction.
  • Avoid whole milk, ice cream and soft cheeses.
  • Cereals – Oatmeal and Dalia are good choices.
  • Fish – Fish is usually well tolerated. Each fish that is broiled not fried.
  • Potatoes – Boiled, mashed or baked are well tolerated (no skin).
  • Soups – Watch meats that are added to soup. Meat can be difficult to digest.
  • Vegetables – Most vegeatables are tolerated. Overcook them at this point. Avoid tough skins and raw fruits and vegetables at this stage of your diet.
  • Slowly you may be trying everything cooked at home. Do not be afraid to try new foods. Just remember to eat small amounts. Your diet at this point is going to be trial and error. Maintain a protein level of 80gms per day. As your diet advances remember to introduce one new food at a time. If you experience a problem with a particular food, please wait for a few days and try it again. Breads, roti, rice and dry vegetables are food most of the patients cannot tolerate.

 

Long term tips
It is important to make healthy food choices throughout your weight loss process to be as healthy as possible while losing weight. Healthy food and lifestyle choices are critical to maintain your weight loss in long-term. These tips are recommended for people who are in the maintenance phase of weight loss.

 

  • Eat three meals a day. Have a healthy snack only if hungry. Skipping meals does not promote weight loss and results in overeating in the long run.
  • Eat lean proteins first at each meal.
  • Include fruits and vegetables with meals.
  • Avoid drinking fluids with meals. Fluids may force foods through your pouch too quickly. This may cause dumping syndrome in Gastric Bypass patients and also all patients to become hungry quickly and eat more food throughout the day.
  • Strive to drink 6-8 cups of water daily. Artificially flavored drinks are fine, but we recommend that you avoid carbonated beverages, even diet soda. The carbonation in diet soda may contribute to enlargement of the small pouch.
  • Chew foods thoroughly. Your small pouch will not be able to physically breakdown foods that have not been chewed to a liquid consistency.
  • Avoid problematic foods such as tough, fibrous or overcooked meats, doughy breads, pasta, rice, skins and seeds of fruits and vegetables, nuts and popcorn.
  • Stop eating when you begin to feel full. It is critical that you do not eat to the point of feeling overfull. People have stretched their pouch by eating too much and have regained weight.
  • Weigh yourself in 15 days. It’s much easier to correct a 2 kg weight gain (physically and psychologically) than a 10 kg weight gain.
  • Exercise. Try to get at least 30 minutes of physical activity each day. Physical activity is defined as activities in addition to normal daily activities such as work, shopping or housekeeping.
  • Do not eat in between meals.