For many overweight and obese people, bariatric surgery is a springboard to better health. However, simply undergoing the surgery isn’t enough and would, quite frankly, be wasted without a lifestyle change following a post bariatric surgery diet.

Overview of a post-bariatric surgery diet plan:

A post-bariatric surgery diet plan is a gradual progression from a liquid diet to pureed, to soft and, then gradually moving on to solids.

  • General guidelines include the measures you should take after your surgery to enable healing and recovery. This instills a new eating pattern and lifestyle change to facilitate prolonged health benefits and weight management.
  • Post-bariatric surgery dietary guidelines outline your diet plan for the first year post-op, introducing you to a regular meal plan, optimizing nutrition, and minimizing post-surgical complications. 
  • Long term dietary guidelines focus on maintenance and frequent monitoring to ensure everlasting, sustainable success following your surgery. 

General guidelines

Before jumping into post-bariatric surgery diet guidelines, here are a few more general tips on what to do following your surgery.

  • Adopt healthy eating and drinking habits. Post-bariatric surgery requires that you adopt healthy eating patterns including a highly nutritious, protein-rich diet enriched with fruits, vegetables, legumes and soy products. 
  • Avoid drinking carbonated beverages. These can cause gas, bloating and expansion of the stomach pouch.
  • Separate your solids from liquids. The combined weight of these too can also lead to expansion of the stomach pouch. Wait 30 minutes after eating to drink.
  • Be physically active! Exercise is a core strategy to post-bariatric surgical success. Aim for at least 150 minutes of exercise every week and then build it up to 300 minutes. Include both cardio and strength training activities. The key to endless achievements is to be consistent – even a little exercise a day is better than none at all.
  • Avoid smoking and alcohol consumption. Your health always improves when these are avoided. Smoking impairs wound healing and can contribute to bariatric surgery complications. Similarly, excessive alcohol consumption is known to cause nutritional deficiencies, leads to weight gain and can lead to addiction.
  • Be slow to fast. Avoid fasting in the post bariatric surgery phase. Instead, ensure you’re consuming small and regular meals to avoid dehydration, hypoglycemia and reduced caloric intake. 
  • Conception and pregnancy. Pregnancy following bariatric surgery is considered high risk with potential complications. After undergoing the surgery, avoid getting pregnant for at least 12-18 months. 

Post-Bariatric surgical dietary guidelines

Post bariatric surgery dietary guidelines can be divided into two phases: the immediate phase, and the long term dietary follow up.

After your surgery, your dietitian will assess and advise you on a plan to gradually progress from liquids to pureed to soft and, finally, to solid food. It all depends on your body’s tolerance, the type of surgery you undergo, as well as other health factors.

Stage 1:

0-14 days post-surgery, you will slowly start on sugar free beverages (best is water), gradually working up to 8 cups a day as tolerated. You will also work up to 3 protein shakes a day. The easiest way to do this is to drink from 1 oz medicine cups and little by little working up to 4 oz of sugar free beverages and protein shakes. At this stage, you can also consume sugar free jell-o, sugar free popsicles and broth.

Stage 2:

After two weeks, you can slowly progress to include pureed and mashed foods. This is a point where you should be highly sensitive to your body’s reactions and discomforts. 

  • Start with foods that are, or can be, softened and pureed, like: boiled eggs, cooked and vegetables (green beans, broccoli, yellow summer squash), and legumes (refried beans, black beans and tofu)
  • Lean protein like steamed fish (non-breaded), tuna salad, chicken salad and egg salad
  • Dairy products such as cheese, low carb yogurt and cottage cheese
  • You’ll also start taking vitamin and mineral supplementation to prevent nutritional deficiencies and to compensate for the reduced calorie intake.
  • Remember to eat slowly, chew well and stop when feeling “comfortably full”.

Stage 3:

About a month after surgery, you can begin consuming soft foods with a wider range of fresh fruits, vegetables and legumes.

  • Tip: Aim for a balanced meal at all times and stay away from unhealthy foods and habits (e.g. junk food or binge-eating).
  • Your dietitian will focus on a protein-rich diet to improve healing. This involves reduced carbs and a fiber-rich diet.

Stage 4:

In the final stage of your shorter term post bariatric surgery diet, at about 3 to 4 months, you can (finally!) reintroduce solid foods into your menu.

  • Include fresh vegetables, fruits, lean protein and plenty of fluids to avoid dehydration.
  • Avoid taking simple carbohydrates like white bread, pasta and other bread-based products.
  • Drink at least 1.5 liters daily in the form of water, soups and unsweetened beverages. Avoid carbonated and sweetened drinks, juices and beverages.
  • Limit intake of calorie-dense, low-nutritious foods like milkshakes, ice-creams, fast and fried foods. You need to stay focused on eating nutritious, whole foods.
  • Always follow your doctor’s advice and be wary of any signs of complications like nausea, vomiting and abdominal pain.

Long-term bariatric surgical dietary guidelines

Many people wonder how long they need to follow a post bariatric surgery diet. The answer is: as long as they want to stay healthy and maintain their weight.

Beyond the first year after your surgery, instead of calling it a “diet”, consider it a lifestyle change – and one that’s for the better. Bariatric surgery demands total commitment to modify your existing eating patterns and behaviors, not only in the immediate phase but also long-term. 

Research indicates that lifelong dieting and eating modifications alter your brain signals . Your feelings of hunger and satiety may change, as well as your taste preferences. Best case scenario: after the initial 6 months post op, you may not even crave sweets and fried foods. 

Here are a few long term dietary guidelines for you to remain focused: 

Eat a balanced meal:

While there are different arguments for what constitutes a “balanced” meal, a safe bet is to consume a high-protein, high-fiber, low-carb diet. Include plenty of fresh fruits, vegetables, lean protein sources, soy products and whole grains. Chew slowly, only eat when you’re hungry, avoid empty calorie foods like soda, candy and baked goods.

Modify your eating patterns:

Learn to eat small, regular meals. Avoid skipping meals or other unhealthy eating patterns, like binge-eating or “grazing”. Consider adopting convenient practices, like meal planning and batch cooking. 

Pump up your fluid intake:

Drink plenty of fluids. The general recommendation is at least 8 cups of sugar free beverages daily to keep hydrated and avoid constipation, among other problems.

Supplement with minerals and vitamins:

Your doctor will start you on long term supplementation to compensate for reduced calorie intake and to avoid nutritional deficiencies.

  • Vitamin supplementation includes thiamine (B1), Vitamin B12, and fat soluble vitamins ADEK.
  • Mineral supplementation includes iron, calcium, folic acid, zinc and copper.
  • Trace minerals like magnesium, selenium. 

Regular monitoring and follow up:

Even after a year post op, you may need regular follow up with your dietitian. They might monitor your blood results, weight pattern and adjust your plan accordingly.

Remain active:

Eating well and being physically active most of the days should be your life mantra. Avoid sitting for long periods, walk an extra mile, ditch the car and walk to your local shops are simple ways to include more movement.

Regular counselling and support:

Don’t underestimate the power of emotional support. Make sure you have fully explored underlying emotional and psychological reasons behind unhealthy eating and life habits, like addictions. By understanding yourself better, sticking to a healthy lifestyle will be that much easier.

Your long term success post- surgery is heightened when you have support from your friends and family, as well as other bariatric surgery patients. Share your challenges and successes to stay motivated. 

If everyone took their health as seriously as a bariatric surgery patients, the world would look a lot healthier! For someone that is obese or overweight, bariatric surgery jumpstarts this journey – but discipline and commitment are required to reap its full benefits.

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