Bariatric Meal Plan for Sleeve Gastrectomy and Gastric Bypass

Ensure safe healing and recovery after weight loss surgery is critical. Especially after gastric sleeve and gastric bypass, it will be necessary for you to follow a nutritionally complete meal plan.

This nutrition plan also helps prevent over-stretching of the pouch, discomfort, improper healing, or malnutrition, we highly recommend that you follow our meal plan guidelines after bariatric surgery. The foundation of your success are the followings:  proper amount of protein and dense nutrients, hydration, portion control,  and taking your essential bariatric vitamins and minerals.

Phase 1: Clear Liquids (1 – 5 days)

This period will start when you are in the hospital and will consist of clear liquids. A clear liquid is anything that is transparent and can be seen through, like broths and vitamin water. The purpose of this phase is to make sure you get the proper hydration and allow your stomach and digestive tract to rest. Protein requirements and vitamins are not the focus during this phase; getting good hydration is.

Guidelines:

  • You MUST sip VERY SMALL amounts of fluid ALL DAY.
  • Sip 4-8 ounces per hour.
  • Daily goal is 64 ounces.
  • It may be difficult to get all your fluids in right after surgery. Your initial goal is 64 ounces with a minimum requirement of 48 ounces per day to prevent dehydration.
  • In the beginning, water may irritate your pouch. Warm temperature fluids will soothe and relax the pouch muscles.

Recommended Liquids:

  • Water
  • Clear broth/bouillon: chicken, beef, vegetable
  • Sugar-free vitamin water
  • Unsweetened, caffeine-free herbal tea
  • Sugar-free Jell-O
  • Sugar-free popsicles
  • No carbonated beverages

Do not drink coffee immediately after gastric sleeve.

Phase 2: Full/Thick Liquid Diet (5 – 14 days)

You will transition into phase two after day 5 of your surgery depending on how you feel. You will decide when you are ready for food with more substance. You will continue to focus on staying hydrated and increasing your fluids to 64 ounces along with incorporating protein, vitamin, and mineral supplementation.

Guidelines:

  • Minimum of 64 ounces of fluids daily
  • Goal of 60 – 80 grams of protein per day (Aim for 20 grams of protein per meal.)
  • Choose a protein supplement with at least 20 grams of protein and less than 10 grams of total carbohydrates.
  • If you start using yogurt during this phase, choose a high-protein, very low-sugar option, like Chobani or Fage Greek yogurt.
  • Begin vitamin and mineral supplementation.
  • Avoid using a straw, as it can incorporate too much air into your pouch, making you feel uncomfortable.
  • Be sure to read food labels for sugar and carbohydrate (CHO) content.
  • For gastric bypass patients, you want to be sure to eat less than 15 grams of total carbohydrates per sitting to prevent dumping syndrome.
  • Avoid all carbonated beverages. Even allowing soda to go flat needs to be eliminated due to the phosphorus in the soda that prevents calcium absorption and excess sugar, leading to weight gain. Soda has zero nutritional value and is loaded with chemicals that are hazardous to your health and slow down weight loss. Remember, your intake is drastically reduced after weight-loss surgery, and you will have to be selective with the foods you choose to put in your body.
  • Avoid drinkable yogurts. Drinkable yogurts tend to be high in sugar and low in protein. Many yogurts have as much sugar in them like soda.

Recommended Liquids:

  • All liquids from the previous clear liquid phase
  • Protein shakes/powders
  • Pureed soups with added unflavored protein
  • Clear fluid proteins
  • Sugar-free pudding with added protein

Phase 3: Pureed Foods/Soft Solids (Day 15 – 30 days)

The purpose of the Phase is to introduce slowly soft foods into your pouch as your body continues to heal and adjust to the changes. The goal is to have a protein with ALL three meals. During the soft solid phase of the meal plan, spend at least one week learning how to eat slowly and chew your food properly, so food does not get stuck. You can begin to transition slowly into whole foods by day 22 after surgery.

Guidelines:

  • Add only ONE food at a time.
  • Begin to weigh your food so you can start to visualize what an appropriate amount of food is after weight-loss surgery.
  • The recommendation is 4 ounces of food (by weight) per meal (3 ounces of protein and 1 ounce of something else).
  • Purchase a small pocket digital scale.
  • The goal for the day is 64 oz. of fluid to prevent dehydration after gastric sleeve and gastric bypass.

VERY IMPORTANT: STOP drinking 30 minutes before eating and DO NOT drink until 30 minutes after a meal.

  • Chew food thoroughly and slowly to applesauce consistency before swallowing.
  • Eat three meals a day and at least one protein shake per day.
  • Protein intake needs to be approximately 60-80 g a day.
  • Stop using low-fat or nonfat products and start using regular, real food. After weight-loss surgery, your intake is so minimal that the extra calories from whole foods will be beneficial. Also, low-fat/nonfat products are usually higher in carbohydrates and sugar.

Recommended Foods:

  • Scrambled eggs
  • Cottage/ricotta cheese
  • Pureed beans
  • String cheese
  • Soft tofu
  • Greek yogurt (Chobani or Fage)
  • Chicken, egg, shrimp salads
  • Unflavored whey protein isolate

Phase 4: One Month and Beyond

At this period, you start back on solid foods. Start with 2 to 4 ounces of solid food per meal and then slowly increase the amount of solid food per meal until you are eating at least 4 ounces per meal but no more than 6 ounces.

At each meal, you want to have at least 3 ounces of protein. In the beginning, mentally identify your protein source. You may wish to get a digital pocket scale to weigh your food at the beginning, so you know what 3 ounces of protein looks like as well as what 4 to 6 ounces of food is visual. You will find it is easier for non-protein foods to go down, so you may gravitate to choosing non-protein foods. You want to train yourself right at the beginning to eat protein. Eat three bites of protein to everyone bite of carbohydrate  (3 to 1 rule).

It is easy to get certain foods stuck, so from this phase forward, it will be crucial for you to slow down and chew your food thoroughly, pausing between bites.

Recommended Foods

Protein

Eat protein first. Make sure you have 3 ounces of protein at each meal. Add 1 to 3 ounces of healthy fats, fruits, vegetables or starches if you can tolerate them. Pay close attention to how you feel with the introduction of new foods.

Best Tolerated

  • Fish
  • Shrimp
  • Eggs
  • Chicken
  • Tofu
  • Meatless products
  • Beans
  • Cottage cheese
  • Low-sugar Greek yogurt

Difficult to Tolerate

  • Red meat

Items like bacon, sausage, salami, bologna, pastrami, pepperoni and hot dogs are considered fats, not protein.

 Raw Vegetables/Salads

Remember that raw vegetables are harder to digest. In the beginning, they can easily irritate your pouch. Do n’t forget to take small bites and chew thoroughly. With gastric bypass surgery, you may want to wait approximately four months before trying raw vegetables. It is recommended to try one new food at a time and to try them while at home.

Best Tolerated

  • Fresh or frozen cooked vegetables, like green beans, carrots, sweet potatoes and squash

Difficult to Tolerate

  • Raw vegetables- uncooked
  • vegetables with tough skin or seeds, like celery or tomatoes
  • Vegetables like cabbage, cauliflower or broccoli may cause gas distress- thus cooking them would be better for absorption.

Citrus Fruits

With all fruits, eat as part of your meal after you have had at least three bites of protein. Remember that the acid in citrus fruits can irritate your pouch. Don’t forget to avoid the membrane portion (skin) of the fruit.

Best Tolerated

  • Fresh fruit, peeled with no skin
  • Canned fruit in water or natural juice that has been drained and rinsed

Difficult to Tolerate

  • Fruits with skin or seeds

Starches

There are two types of carbohydrates: whole grains and simple sugars. Focus on eating whole grains, such as:

  • Ezekiel bread
  • Whole grain tortilla
  • Crackers
  • Oatmeal
  • Sweet potatoes
  • Quinoa

Minimize simple, refined grains, like candy, white rice, pasta, cereals and processed sugars, including cookies, cakes, and pastries.

You want to limit the amount of starch you have at each meal to 1 or 2 ounces. Be sure that you only eat a starch with your protein. Starches can act like a sponge in your pouch, leaving you little to no room for healthy proteins and essential fats.

Oils and Essential Fats

It is important to include essential fats in your daily meal plan to prevent deficiencies. Examples of healthy fats are:

  • Avocado
  • Olives
  • A variety of nuts
  • Oils, like olive, grape seed or coconut

Fats to Minimize

  • Fried foods
  • Saturated fats, like bacon, sausage, pepperoni, salami and bologna
  • Mayonnaise/Miracle Whip
  • Salad dressings
  • Sour cream
  • Margarine/butter

 Food Intolerance

You may be intolerant to certain foods after surgery. Eating smaller portions, eating slowly, chewing food well and avoiding high-sugar foods may resolve food intolerance. It is crucial for weight-loss surgery patients to stop eating when they are satisfied; one other bite is enough to cause a problem. You can follow these guidelines below as a precaution to minimize problems:

  1. Avoid foods that are dry, like roast beef, turkey, and other meats, as well as sticky foods, like peanut butter and gummy bread and stringy foods, like celery or fibrous skin on fruit.
  2. Avoid foods that may get stuck, like bread, pasta, and rice. These foods tend to become gummy and act like a sponge, causing a blockage in the pouch. Toasted bread, crackers, tortillas, and quinoa, are more tolerable.
  3. Abdominal cramping may be caused by vegetables like cauliflower or broccoli.
  4. Lactose intolerance: Approximately 1% of gastric bypass patients develop intolerance to milk or dairy products. Symptoms may include gas, bloating, cramps, and diarrhea. If this occurs, you can use lactose-free milk, unsweetened almond or coconut milk or a lactose enzyme.
  5. Alcohol: After surgery, you may feel the effects of alcohol more quickly with less consumption. Please be mindful of increased sensitivity to alcohol.

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