Pureed foods
After about a week of tolerating liquids, you can begin to eat strained and pureed (mashed up) foods. The foods should have the consistency of a smooth paste or a thick liquid, without any solid pieces of food in the mixture.
You can eat three to six small meals a day. Each meal should consist of 4 to 6 tablespoons of food. Eat slowly — about 30 minutes for each meal.
Choose foods that will puree well, such as:
Lean ground meat, poultry or fish
Cottage cheese
Soft scrambled eggs
Cooked cereal
Soft fruits and cooked vegetables
Strained cream soups
Blend solid foods with a liquid, such as:
Water
Skim milk
Juice with no sugar added
Broth
EATING AFTER SURGERY
This is commonly called the POST-OP DIET. The post-op diet is designed to:
Allow your stomach to heal without being stretched by the food you eat
Get you used to eating the smaller amounts of food that your smaller stomach can comfortably and safely digest
Help you lose weight and avoid gaining weight
Avoid side effects and complications from the surgery
Diet details
Diet recommendations after bariatric surgery vary depending on your individual situation.
The post-op diet typically follows a staged approach to help you ease back into eating solid foods. How quickly you move from one step to the next depends on how fast your body heals and adjusts to the change in eating patterns. In most cases, you can expect to start eating regular foods about three months after surgery.
At each stage of the post-op diet, you must be careful to:
Drink 64 ounces of fluid a day, to avoid dehydration.
Sip liquids between meals, not with meals. Wait about 30 minutes after a meal to drink anything and avoid drinking 30 minutes before a meal.
Eat and drink slowly, to avoid dumping syndrome — which occurs when foods and liquids enter your small intestine rapidly and in larger amounts than normal, causing nausea, vomiting, dizziness, sweating and diarrhea.
Eat protein-rich foods daily.
Choose foods and drinks that are low in fats and sugar.
Avoid alcohol.
Limit caffeine, which can cause dehydration.
Take vitamin and mineral supplements daily as directed by your health provider.
Chew foods thoroughly to a pureed consistency before swallowing, once you progress beyond liquids only.
IN SHORT- You’ve prepared for this! Follow the bariatric check list!
THE POST OP DIET SCHEDULE
DIET IN HOSPITAL: Day 1 and 2
Clear Fluids
DIET WHILE HEALING AT HOME:
Week 1 and 2: Liquid Diet
Week 3 Liquid Diet with addition of oatmeal and cottage cheese
Week 4 and 5 Pureed Diet
Weeks 6-9 Soft Diet
Week 10 and onward: Full Diet of healthy eating as usual.
Clear Fluids:
This is what you will eat for the first day or two in hospital. It’s important to stay hydrated after surgery. When you first wake up from the operation you may now feel like eating or drinking but again- try and sip clear fluids every 15 minutes. Make sure you SIP SLOWLY. Take about 15 ml (a tablespoon) every 15 minutes.
These fluids usually include:
water
diluted juice
broth
decaffeinated tea or coffee
Sugar free Jello
WEEK 1 AND 2: LIQUID DIET:
This is the diet you will start when you leave hospital and follow it for the first two weeks.
You will need to:
start taking your chewable vitamins and supplements (see vitamin section on this page)
Start taking your daily protein supplements
Drink 2-4 cups of water every day- sipping slowly throughout the day
Eat/drink only the liquid foods in the table below
add unflavoured protein powder to your hot or cold drinks 1-2 times a day
drink 1-2 protein shakes per day
(We’ve included a video on how to add properly protein powder to you hot and cold liquids - to avoid clumps!)
At week three you can add cottage cheese and oatmeal to the liquid diet.
Soft foods
After a few weeks of pureed foods, and with your doctor's OK, you can add soft foods to your diet. They should be small, tender and easily chewed pieces of food.
You can eat three to five small meals a day. Each meal should consist of one-third to one-half cup of food. Chew each bite until the food is pureed consistency before swallowing.
Soft foods include:
Ground lean meat or poultry
Flaked fish
Eggs
Cottage cheese
Cooked or dried cereal
Rice
Canned or soft fresh fruit, without seeds or skin
Cooked vegetables, without skin
Solid foods
After about eight weeks on the gastric bypass diet, you can gradually return to eating firmer foods. Start with eating three meals a day, with each meal consisting of 1 to 1-1/2 cups of food. It's important to stop eating before you feel completely full.
Depending on how you tolerate solid food, you may be able to vary the number of meals and amount of food at each meal. Talk to your dietitian about what's best for you.
Try new foods one at a time. Certain foods may cause pain, nausea or vomiting after gastric bypass surgery.
Foods that can cause problems at this stage include:
Breads
Carbonated drinks
Raw vegetables
Cooked fibrous vegetables, such as celery, broccoli, corn or cabbage
Tough meats or meats with gristle
Red meat
Fried foods
Highly seasoned or spicy foods
Nuts and seeds
Popcorn
Over time, you might be able to try some of these foods again, with the guidance of your doctor.
THINGS TO WATCH FOR AFTER SURGERY:
DUMPING SYNDROME:
Dumping syndrome happens when food moves too quickly through your stomach pouch and into the small intestine.
Signs that you might have dumping syndrome:
Very fast heart beat (heart palpitations)
Stomach cramping and pain
Explosive diarrhea
Nausea or upset stomach
Dizziness
Cold sweats
Flushing
Sweating
When does it happen?
Early dumping syndrome happens 15 to 30 minutes after eating. Late dumping syndrome happens 2 to 4 hours after eating.
Why does this happen?
Dumping syndrome happens when undigested sugar or fat passes out of the stomach and into the small intestine. In other words, it happens when food is “dumped” into the intestine before it has been broken down. Foods can also be dumped into the intestine if solid food and liquids are consumed at the same time.
Many patients find they get dumping syndrome with foods that are higher in simple sugars such as candy, liquid sugars
Knowing which foods are high in sugar will help you avoid foods that can cause dumping syndrome. There is no exact amount of sugar that will cause dumping syndrome.
What can you do?
Everyone’s digestive tract is unique. Not everyone will get dumping syndrome from the same foods. Know what foods cause you to have dumping syndrome. It will help you to avoid these foods and prevent dumping syndrome in the future. As well- make sure you eat protein with every meal. This helps to avoid dumping syndrome significantly. Also remember to separate your liquids and solid food by 30 minutes.
HAIR LOSS
Hair loss is a common side effect of weight loss surgery. Usually this happens between 4 months and 9 months after surgery.
Why does this happen?
Hair loss can happen for many reasons. Sometimes it is related to nutrition and sometimes it is not.
Reasons related to nutrition are:
Iron deficiency
Zinc deficiency
Low protein intake
Reasons not related to nutrition are:
Major surgery
Rapid weight loss
Hair loss not related to nutrition cannot be avoided after weight loss surgery. Usually, this kind of hair loss will happen very soon after surgery.Hair loss that happens much later after surgery is often caused by vitamin and mineral deficiencies. Follow the diet and supplement schedules you learn about in this book to prevent this kind of hair loss. Your Registered Dietitian can help you manage any deficiencies. This is why it is important to complete your blood work before appointments with the Registered Dietitian.
What can you do?
There is no way to prevent hair loss. But, you can do things to minimize it:
Make sure you are eating at least 60g of protein a day
Make sure you are taking all of your vitamin/mineral supplements
Have your blood work checked to screen for any vitamin or mineral deficiencies
When your weight begins to stabilize your hair will grow back. Your hair may grow back differently from before. For example, if you had straight hair it may grow back curly.