Phase Four: The Bariatric Surgery Solid Food Diet

Duration: Maintain Phase 4 Nutrition Guidelines Forever

We are discussing Phase 4 – Solid Foods of the post weight loss surgery meal plan which starts at approximately three to four weeks after surgery. It is important to remember not to compare yourself to others as far as what you can eat or the rate at which you are losing weight.

Approved Solid Foods

Every person is different, and your body adapts to the surgery differently meaning you can incorporate different types of foods at different rates. Your primary goal is to get still 60 – 90 grams of protein and to drink a minimum of 48 to 64 ounces of fluids. Fluids should come predominantly from water, flavored herbal tea, and vitamin water.

Post-op Diet Phase 4 Solid Foods

All foods from previous stages
Cheese (any cheese other than American or Velveeta)
Dried beans: kidney, lentil, split pea
Lean Meats: fish, tuna, chicken, turkey (Make sure all meats are moist)
Canned fruit in natural juices
Soft cooked vegetable
Be careful of fibrous/gassy vegetables (celery, broccoli, cabbage, etc…)
Avoid the membrane of the fruit (skin on citrus)
Avoid tough meat
Fish
Shrimp
Eggs
Chicken
Tofu
Meatless products
Beans
Cottage cheese
Low-sugar Greek yogurt

No carbonated beverages post-surgery, especially soda. The carbonation creates gas and can cause significant discomfort. Also, remember not to drink with a straw, you will pull more air into your pouch that can cause pain. You can add coffee back in moderation when you are not experiencing acid reflux, and you don’t have any problems eating food or drinking fluids.

Learn More: Avoiding Dehydration Post-Surgery

Coffee is acidic, so it may exacerbate or create acid reflux and cause discomfort. Coffee is also a diuretic which pulls fluids out of you and can cause you to be dehydrated if you are not drinking enough other fluids.

Learn More: Drinking Coffee After Bariatric Surgery

You are still weighing your food, 3 meals at 6 ounces, and one protein shake per day. Your meals consist of 3 ounces of protein, 1 ounce of healthy fat, and 2 ounces of fruits, vegetables or starch. It may take a few months to be able to eat 6 ounces of food at one sitting. We recommend starting at 3 to 4 ounces and slowly increasing to 6 ounces.

What We Recommend

Become aware of how many ounces you can eat at one time and be sure not to force more than your body is ready to tolerate at this time. Depending on how many ounces you can take in at one time your total goal for the day is 12 to 18 ounces of total food and 9 of those ounces being protein. So if you can only eat 3 ounces at one time, you would eat 4 to 6 times per day having 2 ounces of protein and one ounce of something else. You always want to have some form of protein with each meal.

Not only will this assist with increased weight loss, but it also helps with maintaining muscle mass and will help prevent feelings of discomfort, being nauseous or bloated from gas being produced. You really will need to listen to your body and adapt this meal plan to fit where you are at and what foods you are able to tolerate.

Phase Four Tips

This phase is to slowly incorporate real whole food back into your diet. It may take up to 6 months for you to be able to eat most foods. When trying a new food try one new food at a time to see how you do. If a particular food does not agree with you, wait a few weeks and try again. It is very important that you learn to eat very slowly, cutting your food up into pea-size bits and chewing until the food is applesauce consistency before swallowing.

By training yourself to do this you minimize your chances of getting food stuck. This takes practice, so hopefully, you started doing this before surgery. When incorporating lean meats you may want to begin with a soft fish like tilapia and see how you do. When cooking your protein be sure to use cooking methods that will allow the meat to be very moist like using a crockpot or a slow cooker where you cook your protein in a broth or liquid base.

When incorporating vegetables start with cooked vegetables that have mostly insoluble fiber and are non-fibrous gassy vegetables like green beans, squash, eggplant, zucchini, leafy greens, and carrots. Vegetables that are high in sugar or contain more soluble fiber tend to create more gas and can cause discomfort. Gassy and fibrous vegetables like celery, broccoli, cabbage, onions, cauliflower, and peas you may want to wait a while before incorporating. See how you do with several cooked vegetables before moving on to raw veggies.

When incorporating fruit to start, you will want to remove all the skin. You may wish to start with canned fruit in its juice, rinsed and drained, to begin with then gradually change over to whole fruit. In time, you will be able to eat fruit with the skin but that may take a few months.

If you have had gastric bypass or duodenal switch be sure not to have more than 15 grams of carbohydrates per meal. You will want to read food labels as sometimes there are hidden sugars or carbohydrates. Taking in more than 15 grams of carbs per meal may cause you to have dumping that can be painful where you experience severe flu-like symptoms.

Remember to continue not to drink 30 minutes before you eat, while you are eating and 30 minutes afterward. After surgery, it is critical that you train yourself to be a mindful eater, having the time to eat without distraction or stressful emotions.

Feel free to join our Facebook support page for more information or view the post-surgical meal plan for specific guidelines that you can print out from our website; Links are below. Here at Mexico Bariatric Center, our goal is to take this journey with you and provide you with excellent care with both pre and post-surgical support.

Helpful Resources