Gastric bypass surgery is a significant step toward better health, involving a reduction in stomach size and an alteration in the way your body digests food. Post-surgery, adhering to a specific diet is crucial for healing, obtaining necessary nutrients, and ensuring the procedure's long-term success. This article provides a detailed explanation of the gastric bypass diet phases, offering guidelines and recommendations to support your journey.
Understanding Gastric Bypass Surgery
Gastric bypass surgery, a type of weight loss surgery, reduces the size of your stomach, leading to a feeling of fullness after consuming smaller portions of food. During the procedure, the surgeon creates a small stomach pouch and connects it directly to the small intestine, bypassing most of the stomach and the upper part of the small intestine. This results in the body absorbing fewer calories from the food you eat.
Qualifying for Gastric Bypass Surgery
Before undergoing gastric bypass surgery, it's essential to meet specific criteria and understand the associated risks and benefits. Generally, candidates for this surgery:
- Have a body mass index (BMI) of 35 or greater.
- Have a BMI of 30 or greater and type 2 diabetes.
- Have a BMI of 30-34.9 and haven’t been able to lose weight with medication or lifestyle changes.
Additionally, viable candidates should be prepared to adopt new dietary habits that contribute to the surgery's positive and lasting effects.
The Importance of Pre- and Post-Surgery Diet
Prior to surgery, a special diet is necessary to reduce fat around the liver, minimizing the risk of complications during the procedure. Post-surgery, the diet consists of several weekly phases tailored to facilitate recovery, accommodate the smaller stomach, and promote healthier eating habits.
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Losing weight before surgery helps reduce the amount of fat in and around your liver and abdomen. This may allow you to have a laparoscopy rather than open surgery. Laparoscopic surgery is less invasive, requires much less recovery time, and is easier on your body.
Losing weight before your surgery not only helps keep you safer during the procedure but also helps you learn a new way of eating. Your exact eating plan and pre-op weight loss goal will be determined by a healthcare professional, likely with the help of a registered dietitian. Your eating plan may begin as soon as you’re cleared for the procedure. If you don’t lose enough weight before surgery, the procedure may be postponed or canceled. For this reason, you should start the diet plan as soon as you can.
Pre-Surgery Diet
The pre-surgery diet is designed to reduce fat in and around the liver, which can help prevent complications during the procedure.
General Guidelines
Guidelines will vary from person to person, but they may include the following:
- Eliminate or reduce your intake of saturated fats, including whole milk products, fatty meat, and fried foods.
- Eliminate or reduce your intake of foods that are high in carbohydrates, such as sugary desserts, pasta, potatoes, bread, and bread products.
- Eliminate high sugar beverages such as juice and sodas.
- Limit your portion sizes.
- Avoid binge eating.
- Don’t smoke cigarettes.
- Avoid substances not recommended by your doctor.
- Avoid alcoholic beverages.
- Don’t drink beverages with your meals.
- Take a daily multivitamin.
- Consume protein shakes or protein powder.
What to Eat
The pre-op diet largely consists of protein shakes and other high protein, low calorie foods that are easy to digest. Protein helps bolster and protect muscle tissue. This can help your body burn fat instead of muscle for fuel. Protein also helps keep your body strong, which can speed up recovery.
Read also: Guide to Pureed Foods Post-Surgery
As your surgery date nears, you may need to follow a mostly liquid or liquid-only diet. Depending on your weight and your overall health, your doctor may allow you to eat some solids during this time. These might include fish, watered-down hot cereal, or soft-boiled eggs.
Ahead of your surgery, make sure you ask the anesthesiologist for instructions about what you can or can’t consume before surgery. The recommendations may vary depending on your situation. For example, your doctor may want you to drink carbohydrate-rich fluids up to 2 hours before surgery.
Post-Surgery Diet: A Staged Approach
The postsurgery diet plan consists of several stages. Your bariatric surgery team or dietitian will determine how long each stage lasts and what you can eat and drink. All stages stress the importance of watching your portion sizes. This habit will help you continue to lose weight and prepare you for how you’ll eat for the rest of your life.
Stage 1: Liquid Diet
During stage 1, your nutritional intake is geared toward helping your body heal from surgery. Your diet can help you avoid postoperative complications. For the first few days, you’re only allowed to drink a few ounces of clear liquids at a time. This helps your stomach heal without being stretched out by food.
- Decaffeinated coffee and tea
- Skim milk
- Thin soup and broth
- Unsweetened juices
- Sugar-free gelatin
- Sugar-free ice pops
Stage 2: Pureed Diet
Once your doctor decides you’re ready, you can move on to stage 2. This stage consists of pureed foods that have a thick, pudding-like consistency. You can puree many foods at home with a food processor, blender, or other device.
Read also: The Hoxsey Diet
Spicy seasonings may irritate your stomach, so you may need to avoid these completely or try them one at a time. Avoid fruits and vegetables that have lots of seeds, such as strawberries or kiwi. You may also need to stay away from foods that are too fibrous to liquefy, such as broccoli and cauliflower. Instead, choose foods that liquefy well, such as:
Fruits: applesauce, bananas, canned fruits, peaches, apricots, pears, pineapples, melonsVegetables: spinach, carrots, summer squash, green beansProtein: yogurt, cottage cheese, ricotta cheese, beef, chicken, turkey, white fish (cod, tilapia, haddock), scrambled eggs
Stage 1 foods (which don’t contain solids) and vegetable juices such as V8 are also convenient options.
However, at this stage, it’s important not to drink fluids with your meals.
Stage 3: Soft-Foods Diet
You’ll probably eat nothing but pureed food for several weeks. Once your doctor decides you’re ready, you can start adding soft, easy-to-chew foods into your diet. These may include:
- Soft-boiled eggs
- Cottage cheese
- Ground lean meat or poultry
- Baked or steamed white fish
- Fresh fruit without skin, or canned fruits such as peaches and pears
- Cooked, diced vegetables
It’s important to eat small bites. Eat a little at a time and be mindful of portion sizes.
Stage 4: Stabilization
Stage 4 of the gastric bypass diet involves reintroducing solid food. It typically starts about 2 months after surgery. Because your stomach is much smaller, you’ll still need to dice or chop your food into small bites. Large pieces of food may cause a blockage, which can lead to pain, nausea, and vomiting.
Introduce new foods slowly. That way, you can best determine which ones your stomach can tolerate and which ones to avoid. Stop eating any food that causes abdominal discomfort, nausea, or vomiting.
Foods and Drinks to Avoid in Stage 4
You should not yet try to eat certain foods and drinks, such as those that are hard to digest. These include:
- Fibrous or stringy vegetables such as pea pods
- Popcorn
- Corn on the cob
- Carbonated beverages such as sodas and seltzer
- Tough meat
- Fried foods
- Crunchy foods such as pretzels, granola, seeds, and nuts
- Dried fruit
- Bread and bread products such as muffins
About 4 months after surgery, you may be able to resume eating normally. However, being mindful of your portion sizes is still important. Make sure your diet consists mostly of fruits, vegetables, lean protein, and healthy carbohydrates. Limit or avoid foods that are high in fat, carbohydrates, and calories.
Long-Term Dietary Guidelines
Gastric bypass surgery changes the size of your stomach and the way you digest food. You’ll likely need to change some of your dietary habits in order to get the nutrients you need, meet your weight loss goals, and help prevent complications from surgery.
The guidelines for your postoperative diet will also serve you throughout life. They include:
- Eat and drink slowly: Eating or drinking too quickly can cause food or liquid to move too rapidly from your stomach to your small intestine. This can cause symptoms such as nausea, vomiting, and cramping. Take at least 20-30 minutes to finish a meal.
- Chew carefully: Eat only small pieces of food at a time and chew each piece thoroughly. This can help prevent larger pieces of food from getting stuck in the opening between your smaller stomach pouch and your small intestine.
- Stay hydrated: Healthcare professionals recommend drinking around 64 ounces of fluids per day to avoid dehydration. Drinking with your meals can cause you to feel full and prevent you from eating enough nutrient-rich foods, so enjoy beverages between meals but not during meals.
- Get enough protein: Your body needs protein to build muscle and stay strong. Many bariatric surgery programs will recommend getting 60-100 grams of protein per day. Focus on eating high protein foods and limiting high fat, high sugar ones.
- Manage portion sizes: Ask your healthcare team or a dietitian for recommended portion sizes for the foods you eat. Using smaller plates and utensils is one way to help limit your portions.
- Listen to your body: If you find that you can’t tolerate a certain food, such as something spicy or fried, don’t eat it.
- Take recommended supplements: After gastric bypass, your body may have trouble absorbing vitamins and minerals. Your doctor may prescribe supplements such as vitamin B12, calcium, iron, and a multivitamin. You will likely need to take these for the rest of your life.
- Exercise: You may feel motivated to start or resume an exercise program. But right after surgery, you need to let your body heal. Go slowly. Over the next several months, you can slowly build up to strength training and cardio workouts. Think in terms of movement as well as exercise. Simple lifestyle changes such as these can help boost your physical fitness: walking instead of riding the bus, parking farther away from your destination, taking the stairs instead of the elevator.
Importance of Hydration
Staying hydrated is key after bariatric surgery. Aim for 48-60 ounces of fluid daily, but don't drink during meals. Wait 10-30 minutes after eating to sip again. Choose drinks with under 5 grams of carbs per 8 ounces, avoiding caffeine and carbonation. Watch for pale, straw-colored urine to gauge hydration. Stick to water, flavored water, and low-carb options like Propel Water or Diet Snapple. Use sweeteners like Splenda or Stevia instead of sugar. Also, clear broths and sugar-free options like Popsicles can help.
The Role of Protein
Protein aids in healing and muscle maintenance, making it essential post-surgery. Focus on incorporating protein-rich foods and supplements into your diet, as directed by your healthcare team.
Vitamin and Mineral Supplementation
Post-bariatric surgery, your body's ability to absorb certain nutrients is diminished. Adhere to the recommended vitamin and mineral supplements to prevent deficiencies. Starting two weeks post-op, you should have all your supplements in chewable, crushable, or liquid form for easy digestion.
- Make sure not to take calcium and iron at the same time-they don't mix well. Spread out your vitamin intake across the day. The monthly cost for these essential vitamins will be around $30-50, depending on the brand. Always choose a bariatric multivitamin that's approved by Southern Surgical to ensure you're getting the right nutrition.
Importance of Meal Preparation
Meal prep becomes more important than ever post-surgery. For the pureed and soft diet stages, focus on nutrient-rich foods that can be easily blended or are naturally soft. Eating slowly and mindfully can help prevent overeating and discomfort.
Potential Complications and How to Avoid Them
Following your recommended pre- and postsurgery dietary guidelines can help you avoid possible complications such as dehydration, nausea, and constipation.
Obstruction
Sometimes the connection between your stomach and your intestines can become narrowed. This can happen even if you’re careful about what you eat. If you have nausea, vomiting, or stomach pain for more than 2 days, let your doctor know. These are all symptoms of a possible obstruction.
Dumping Syndrome
Dumping syndrome happens when food moves too quickly from your stomach to your duodenum (the first part of your small intestine). It is common in people who have had gastric bypass surgery.
There are two types of dumping syndrome:
- Early dumping syndrome causes symptoms 30 minutes after you eat.
- Late dumping syndrome causes symptoms 1-3 hours after you eat.
Symptoms of early dumping syndrome include: nausea, vomiting, diarrhea, bloating an uncomfortably full feeling, stomach pain or cramping, sweating, lightheadedness headache, flushing of your face, fast heartbeat
Symptoms of late dumping syndrome include: lightheadedness, fainting, shakiness, tiredness, sweating, weakness, fast heartbeat
To help avoid dumping syndrome, a good general rule is to take at least 30 minutes to eat each meal. Limiting your portion sizes, eating and drinking slowly, and limiting your intake of high sugar, high fat foods can also help. Eating and drinking at the same time may also cause dumping syndrome. This is because it increases the volume of your intake. Wait 30-45 minutes after eating before you drink any liquids, and always sip liquids very slowly.