Dietary Guidelines – Post-Op Gastric Bypass Procedure

The purpose of your surgery is to reduce the amount of food you eat. After surgery you will be required to make several dietary changes. Bariatric surgery does not guarantee weight loss. It is best to think of bariatric surgery as a tool that you can use to help you lose weight. To achieve optimal weight loss, you will be required to do your part. The following dietary guidelines will be necessary for a successful weight loss journey.

Eating Guidelines:

  • Eat three meals per day. Avoid snacking between meals. Snacking can prevent weight loss or promote weight gain due to excess intake of calories.
  • Chew foods slowly and thoroughly. You should take at least 20 minutes to finish a meal. Put your fork down between bites and practice chewing each bite approximately 27 times. Your food should be a paste consistency before you swallow. Cut food into small bites. Foods that are tough or chewy may not be tolerated.
  • Eat small amounts. Your new stomach will not be able to hold much food. Stop when you feel full and do not overfill your pouch.
  • Eat protein rich foods first. After surgery, your body will need adequate protein to help build, repair, and maintain muscle tissue and organs. Protein deficiency can occur over an extended period of time which can cause fatigue, hair loss, and muscle wasting. You should always eat high protein foods first such as lean meats, tofu, beans, and low fat dairy products. You will also be encouraged to supplement with protein shakes or supplements to ensure that you are meeting your individual protein needs.
  • Avoid foods that are high in sugar and fat. To be successful with your weight loss and to prevent weight gain, you must follow a balanced diet. Foods that are high in sugar and fat are considered “empty calories” and do not provide any vitamins or nutrients.

Fluid Guidelines:

  • Do not drink liquids with meals. Stop drinking fluids 30 minutes prior to your mealtime, do not drink while you eat, and wait 30 minutes after your meal is finished to resume fluid intake. This will:
    • Prevent overfilling the stomach
    • Keep food from flushing through your stomach too quickly
    • Keep you feeling full longer
  • Sip fluids slowly. Do not gulp fluids after surgery. This may cause nausea or vomiting.
  • Drink 64 ounces of non-carbonated, sugar-free fluids daily. Avoid sodas, sweet teas, high calorie and high sugar juices, and alcohol. Plain water is ideal for hydration.
  • Limit caffeine. Caffeine may stimulate your appetite and may irritate your new stomach.

Dietary Stages:

Dietary Stage 1 – Bariatric Clear Liquid Diet
Days 1-2 (in hospital)

While you are in the hospital, you will be served a bariatric clear liquid diet. Sip fluids slowly, do not gulp. Avoid drinking out of a straw or bottle, as these methods can cause gas bubbles.

Stage 1 foods include:

  • water
  • ice chips
  • clear broths (chicken, beef, vegetable)
  • sugar-free Jell-o
  • caffeine-free, unsweetened tea
  • Crystal light or other sugar free drink mixes
  • sugar-free popsicles

Dietary Stage 2 – Bariatric Full Liquid Diet
Day 3 – Day 14 (approximately 2 weeks post-op)

Once you are home from the hospital, you may progress to a full liquid diet. A full liquid should be a smooth, liquid consistency (no lumps or seeds). Your diet will consist primarily of protein shakes, cream soups, and clear liquids. During this stage you may have small frequent meals. Be sure to take small tiny sips and stop when you feel full or feel pressure. You may also have clear liquids between meals.

Sample Menu:

Breakfast Snack Lunch Snack Dinner Snack
4-8 ounce protein shake 1/2 – 1 cup milk 1/2 cup cream of chicken soup (strained) 4 ounce protein shake 1/2 cup of cream of mushroom soup (strained) 4 ounce protein shake

Tips When Choosing a Protein Shake:

  • Approximately 20 grams of protein per serving
  • Less than 200 calories per serving
  • Less than 10 grams of sugar per serving
  • No added sugars or oils

Commonly Used Store-Bought Protein Shakes:

  • EAS AdvantEdge Carb Control Shake
  • Sugar-Free Carnation Instant Breakfast
  • Muscle Milk Light (Lactose Free)
  • Atkins Advantage Shake
  • EAS Myoplex Light
  • SlimFast Low Carb

Stage 2 Shopping List

  • Creamed soups (strained)
  • Campbell’s Soup at Hand
  • Low fat milk or light soy milk
  • Protein powder (flavored and unflavored)
  • Broth
  • Sugar-free Jell-o
  • Sugar-free popsicles
  • Dannon Light and Fit Yogurt Smoothies
  • Non-fat dry milk powder

Dietary Stage 3 – Bariatric Pureed Diet
Days 14 – 28 (until 4 weeks post-op)

At day 8 post-op, if you are tolerating your full liquid diet well, you may progress to a pureed diet. All foods must be blended to a baby food, soft consistency. Foods should be low in fat and sugar. You must chew your foods very well and eat slowly. Do not drink with your meals. Wait 30 minutes before and 30 minutes after to resume fluids. Foods should be eaten in this order: high protein rich foods should be eaten first, followed by vegetables, and lastly fruit.

Sample Menu:

Breakfast Snack Lunch Snack Dinner Snack
1/2 cup low sugar yogurt1/4 cup unsweetened applesauce 1/2 – 1 cup of low fat milk 1/2 cup pureed creamy chicken salad (use low fat mayo)1/4 cup pureed carrots 4 ounce protein shake 1/2 cup small curd cottage cheese1/4 cup pureed pears 1/2 cup sugar free protein pudding

Stage 3 Shopping List:

Equipment Needs:

  • Blender
  • Measuring Cups

Grocery List

  • All stage 1 and stage 2 foods
  • Low fat broth (chicken, beef, vegetable)
  • Fat-free gravies
  • Low-fat mayonnaise
  • Ground/Pureed meats
    • Poultry
    • Chicken
  • Canned tuna, salmon, or chicken (packed in water)
  • Low-sugar yogurts (ex: Dannon light and fit, Kroger Carbmaster, Greek yogurt)
  • Sugar-free pudding
  • Small curd cottage cheese
  • Low fat ricotta cheese
  • Eggs
  • Plain oatmeal (or Quaker Weight Control oatmeal)
  • Fruits and Vegetables (must be pureed)
    • Unsweetened applesauce
    • Bananas
    • Peaches
    • Pears
    • Carrots
    • Squash
    • Cauliflower
  • Baby food fruits and vegetables
  • Fat-free refried beans
  • Cooked beans – mashed and pureed

Dietary Stage 4 – Bariatric Soft-Solid Diet
Week 5 post-op

Once you have tolerated 2 weeks of pureed foods, you may progress to your final dietary stage. Foods should be soft, but do not need to be blended or pureed. Always chew foods very well and eat slowly. Avoid foods that are high in fat, calories, or sugar. Use low-fat cooking methods with very little oil or fat. Remember your meal progression. High protein foods should ALWAYS be eaten first.

Sample Menu: (Portion sizes will vary by patient. Always stop eating when you feel full.)

Breakfast Snack Lunch Snack Dinner Snack
1 scrambled or poached egg1/2 cup canned peaches (in own juice) string cheese 1/2 cup chicken salad1/4-1/2 cup cooked squash and zucchini 4 ounce protein shake 3 ounces of baked salmon1/4-1/2 cup cooked green beans 1/2 cup yogurt

NOTE: It is normal to experience food intolerances. Chew foods thoroughly and slowly.

To maximize weight loss, the following foods should be AVOIDED:

  • Breaded or Fried Foods
  • Donuts
  • Snack Crackers
  • Potato Chips
  • Candy (including sugar-free)
  • Ice Cream
  • White Flour and White Flour Products
  • Muffins, pastries, pies and cookies
  • Sugar Coated Cereal
  • Soda (including diet)
  • Whole milk
  • Juice
  • Alcohol
  • High fat meats such as: bacon, sausage, hot dogs, bologna, vienna sausage, spam, potted meat, bratwurst, etc.

Stage 4 Shopping List:

  • All stage 1, 2 and 3 foods
  • Protein Rich Foods:
    • Skinless chicken breasts
    • Fish fillets (salmon, tuna, tilapia, halibut, etc.)
    • Turkey
    • Canned or vacuum sealed tuna, salmon, or chicken
    • Cottage cheese
    • Low-sugar yogurts
    • Eggs
    • Tofu
    • Low fat cheese (string cheese, 2% cubed cheese, 2% cheese slices)
    • 97% fat free luncheon or deli meets
    • Beans (white, pinto, navy, black, etc.)
    • Oatmeal (plain or low sugar – e.g. Quaker Weight Control)
  • Vegetables – fresh, frozen or canned – cooked soft
    • Green beans
    • Carrots
    • Cauliflower
    • Spinach
    • Broccoli
  • Fruits – fresh, frozen (no added sugar), canned (packed in own juice)
    • Pears
    • Peaches
    • Unsweetened Applesauce
    • Mandarin Oranges

After you are tolerating soft foods well, you may slowly progress to a “bariatric solid” diet. Introduce new textures carefully. You must chew thoroughly and eat slowly. Skins, seeds, nuts, and tough chewy meats should not be consumed until you are tolerating your diet well. Wait 12-16 weeks before introducing these food items. You will eventually be able to tolerate a variety of food groups. To get enough protein, you may need to supplement between meals with a protein shake or high protein snack.

Behavior Modification Techniques:

  • Do not eat in front of the TV
  • Do not read while eating
  • Do nto eat while working
  • Pre-portion food
  • Keep tempting foods out of the house
  • Keep healthy, nutritious foods IN the house
  • Focus on activities other than eating (exercise, hobbies, music, art, etc.)
  • Brush your teeth after meals (prevent self from eating more)
  • Do not stand at the food table at parties
  • Park your car awy from your destination
  • Take the stairs instead of the elevetors
  • Keep a food diary and exercise daily
  • Count your protein grams and fluid ounces daily
  • Get at least 8 hours of sleep every night.

Vitamin Supplementation

You will also need to supplement with vitams. Please see our Vitamin Supplementation Recommendations by clicking here.

Follow-Up Visits With The Dietitian:

Dietitian follow-up appointments are essential to successful weight loss following surgery. These visits are free of charge as a service to all of our bariatric patients.

Your first appointment with the dietitian should be made 6 weeks post-operatively. You may make this appointment by calling us at 615-867-1940. Please schedule your appointment prior to your 6 week post-surgery date to assure appointment time. Follow-up visits will be scheduled accordingly after your first appointment.