Post-Operative Diet Stages – Gastric Band

The gastric band is positioned to create a small pouch stomach with a small capacity. Adherence to a post-operative diet is crucial to give adequate time for healing. The time immediately following surgery is to allow scar tissue to form around the band that has been placed. This healing process ensures correct positioning.

The band does limit the amount of food the stomach pouch can hold, but the patient is still in control of what kinds of foods are consumed. Eating improper food during the post-op period can cause damage. The stomach muscles during digestion squeeze and churn to break down food during the process. These actions place stress and pressure on the band and sutures placed during surgery.

Phase One: Clear Liquids

Starts day of surgery and should last 5-7 days

For 5-7 days after Gastric Band surgery, you will need to follow a clear liquid diet. The purpose of this phase is to allow for healing time and to stay hydrated. Dehydration is the most common reason for hospital readmission, so consuming at least 48oz a day is very important. During this phase, you should drink about 1 teaspoon at a time using a measuring spoon or the cap of a water bottle. Wait 60 seconds between each sip. It is crucial to drink slowly, take small sips, and drink at least 4 oz per hour.

Goal: Stay hydrated – consume a minimum of 48 oz of fluids to prevent dehydration, but aim for goal 64 oz. Learn more about dehydration here.

  • Gradually increase your intake of liquids from 4 to 8 ounces every hour.
  • Sip on liquids throughout the day to stay hydrated, setting reminders to remind you to sip.
  • If you are having trouble tolerating liquids, try playing with the temperature, as sometimes warmer and colder fluids settle better than room temperature.
  • Drink liquids with electrolytes such as Gatorade Zero to prevent dehydration.
  • Pay attention to signs of dehydration such as headaches, dizziness, nausea, lethargy, and concentrated (dark) urine.

Important: Fluids will not stretch your stomach or cause harm. You can have as many fluids as your body wants aiming for 64 oz.

Recommended Clear Liquids

All liquids should be transparent and sugar-free. Continuously sip small sips throughout your day.

  • Clear broth/bouillon (chicken, beef, vegetable)

  • Unsweetened caffeine-free herbal tea

  • Sugar-free drinks (Vitamin Zero Water, Powerade Zero, Propel, Crystal Light, etc.)

  • Light or diluted (60/40) juices (apple, white grape, cranberry)

  • Coconut water (no or low sugar)

  • Zero Sugar Protein WATER drinks (not protein shakes)

  • Sugar-free Jello

  • Sugar-free popsicles

  • Ice chips

  • Alkaline Water

  • NO carbonated beverages

PHASE 1: CLEAR LIQUIDS SAMPLE MENU

6:30-7:30 AM4 oz water
8:30-9:00 AM2 oz warm broth
9:30-10:00 AM4 oz diluted Apple, cranberry, white grape, Gatorade (60% water/40% juice)
10:00-10:30 AMSugar-free Jello (counts as 2 oz liquid)
10:30-11:30 AM4 oz water
1:30-2:30 PM6 oz diluted juice or a sugar-free beverage
2:30-3:00 PMSugar-free popsicle (counts as 2 oz)
3:00-4:00 PM4 oz water
4:00-5:00 PM4 oz diluted juice or sugar-free beverage
5:00-6:00 PM4 oz warm tea or broth
6:00-10:00 PM14 oz water, 1 sugar-free popsicle (2 oz)

Phase Two: Thick Liquids

Starts 5-7 days after surgery and can last up to 14 days

Goal: Stay hydrated and consume 60-90g of protein.

This stage in your diet allows a broad range of liquids and protein supplements. The goal of this phase is to consume 60-90g of protein. Protein will help to prevent hair loss, maintain muscle mass, and promote wound healing. A good rule of thumb for what is allowed on this diet is high-protein foods with the consistency of what can easily be strained through a straw.

Recommended Thick Liquids

  • All foods from the previous stage

  • Protein powders

  • Greek yogurt (needs to have more protein than sugar – Fage/Chobani plain, Greek yogurt, or Triple Zero by Dannon-Oikos)

  • Almond or coconut milk

  • FairLife Milk

  • Unsweetened applesauce (No-Sugar)

  • Vegetable juice (V8)

  • Hot cereals like oatmeal/cream of wheat/Kashi hot cereal (try watering it down or add unsweetened almond milk)

  • Sugar-free pudding

  • Soups (higher protein soups like bean soup, if chunky then blend before eating)

PHASE 2: THICK LIQUIDS SAMPLE MENU

BREAKFAST1-2 oz packet high protein oatmeal made with almond milk or Fair Life Milk 1 scoop unflavored whey protein isolate added in
MID-MORNINGProtein shake (minimum of 20 grams of protein) – clear or thick shake
LUNCH4 oz Greek-style yogurt blended with almond milk (choose a yogurt that has less than 5g sugar)
MID-AFTERNOONProtein shake (at least 20g protein)
DINNERPureed bean soup
EVENING4 oz Greek yogurt blended with almond milk

Avoid:

  • Carbonated beverages – Fill the stomach with gas.
  • Sugar – Extra calories that fight against weight loss and can cause dumping syndrome.
  • Coffee -It is acidic and can cause acid reflux. It is also a diuretic which can lead to dehydration.

Prioritizing protein during this phase. All thick liquids should contain protein to prevent loss of muscle mass, hair loss, and malnutrition. Be sure to continue to aim for 68oz of clear fluids.

Phase Three: Soft Solids

Starts 10-21 days after surgery and can last up to 14 days, depending on toleration

Goal: Weigh your meals to 4-6 with protein being 3 oz, carbs 1-2 oz, and healthy fats at 1-2 tbsps.

During this phase, continue to focus on eating 60-90g of protein and drinking 64 oz of fluids. Be sure to chew all your food to applesauce consistency to prevent stomach irritation, swelling, and vomiting. If solid food is causing vomiting and nausea, you can go back to phase 2 for a few more days. If the vomiting and nausea persist, reach out to your physician.

In this phase, be sure to stop eating as soon as you feel full. The fullness sensation can be felt in the chest area due to the gastric band. Other common fullness symptoms after weight loss surgery include runny nose, hiccups, burping, or sneezing. You should begin to transition to getting all your protein from food sources at this stage.

You should begin taking your bariatric vitamins at 14 days post-op. As recommended by ASMBS guidelines, you should take the following supplements: bariatric multivitamin, calcium citrate, iron, and vitamin B12.

Recommended Soft Solids

  • Cottage cheese (low-fat)

  • Ricotta cheese

  • Soft Tofu

  • Scrambled Eggs

  • Egg, chicken, shrimp, tuna salad, salmon

  • Refried beans

  • String/soft cheese like laughing cow

  • Avocado

  • Cooked vegetables

  • Anything easily mashed with a fork

PHASE 3: SOFT SOLIDS SAMPLE MENU

BREAKFAST2 scrambled eggs & 1 oz string cheese (3 oz total)
MID-MORNINGProtein shake
LUNCH3 oz chicken salad 1 oz blended avocado
DINNER4 oz. cottage cheese 1 oz. of fruit blended in
EVENINGProtein shake or sugar-free pudding with protein blended in

***THE FOLLOWING  NEEDS TO BECOME A LIFELONG HABIT*** 

  • STOP drinking 30 minutes prior to eating and DO NOT drink until 30 minutes after a meal
  • Chew completely and slowly
  • Eat 4-6 small meals a day
  • Protein intake needs to be approximately 60-90 grams per day

Phase Four: Solid Foods

This phase begins 21 days or later after the gastric band procedure and continues long-term

Goal: Consume 46 oz per meal with protein being 3 oz, carbs 1-2 oz, and healthy fats at 1-2 tbsps.

This phase is long-term and can be different for everyone, but all should follow these general guidelines:

  • Eat slowly and chew to an applesauce consistency.
  • Stop eating as soon as you feel full.
  • Follow the 30-minute drinking rule.
  • Prioritize protein at every meal.
  • It is normal for non-protein foods to go down more easily, so for every one bite of non-protein food, have 3 bites of protein.
  • Follow these macros:
    • Calories: 1000-1200
    • Protein: 75g-105g (35%)
    • Carbs: <100g (25%)
    • Fats: 30-45g (40%)
    • Sugars: <25g
    • Fiber: >20g

Recommended Solid Foods: 

Always eat protein first followed by healthy carbohydrates and healthy fats. Here are some recommended foods:

ProteinCarbohydratesHealthy Fats
  • Seafood
  • Greek Yogurt
  • Poultry
  • Lean Meats
  • Cheese
  • Eggs
  • Tofu
  • Beans
  • Sweet Potatoes
  • Vegetables
  • Fruits
  • Beans and legumes
  • Whole Grains
  • Oats
  • Ezekiel Bread
  • Avocado
  • Olives
  • Nut butters
  • Olive oil
  • Grapeseed oil
  • Flaxseed oil
  • Avocado oil

Common Trigger Foods:

Some foods have difficulty passing through the opening of the stoma and may cause a blockage. Some foods that may cause problems include: :

  • Raw Vegetables
  • Chicken
  • Dry, tough foods – like steak and sometimes chicken and shrimp
  • Sticky foods – like pasta, rice, and bread (Wait until 2 months to try)
  • Peanut butter
  • Gum – can cause a blockage, which will likely need medical intervention
  • Crunch foods – like popcorn, nuts, and seeds, which are hard to break down adequately in the mouth (Wait until 2 months to try)
  • High-fat foods
  • Foods with skins, peels, or husks like corn, fruit, and seeds
  • High-sugar foods – like candy, sweets, and dessert

Fats to Minimize: 

  • Fried foods 
  • Saturated fats, like bacon, sausage, pepperoni, salami, and bologna 
  • Mayonnaise/Miracle Whip 
  • Store-bought salad dressings 
  • Sour cream 
  • Margarine

Remember: 

  • Only add ONE new food at a time! 
  • AVOID starchy food like white rice, pasta, bread due to the gummy texture
  • Chew completely and slowly
  • Protein Supplements: 60-90g
  • Drink at least 6-8 cups of water and any other non-calorie, non-carbonated beverages
  • Stop drinking 30 minutes prior to eating and DO NOT drink until 30 minutes after a meal
  • ALL NEW FOODS NEED TO BE SOFT, COOKED, OR CANNED
  • AVOID all raw fruit with skin, raw fibrous vegetables, and popcorn
  • RECORD all new foods and any problems you have with these new foods in a food diary. Let your doctor know of any problems or questions you may have.
  • CHEW your food very well before swallowing. The consistency of the food should be like mashed potatoes. Make sure that each bite is very small (as if you were feeding a baby) and continue to eat small amounts slowly. Eat about 2 Tablespoons over 10-15 minutes.
  • CONTINUE to take your multiple vitamins, calcium supplements, iron, and B12 supplements as directed
  • AVOID beverages that have alcohol or caffeine and those that are carbonated
  • AVOID using a straw or chewing gum

FREQUENTLY ASKED QUESTIONS

ALCOHOL POST-OP

Avoid drinking alcohol for the first six months after the surgery.

For more information, check out our blog on alcohol.

Acid Reflux

The primary symptom of acid reflux is heartburn and involves burning of the lower esophagus by stomach acids. A band adjusted too tightly or an inflamed stomach lining are common culprits related to this post-op problem with gastric banding.

Dumping Syndrome

Dumping syndrome occurs when foods leave the stomach and enter the intestine too quickly. Eating foods high in simple sugars or fat has the highest prevalence of causing dumping.

For more information, check out our blog on dumping syndrome.

Nausea & Vomiting

One of the leading causes of nausea and vomiting after surgery is not following the post-operative nutrition guidelines. If you are experiencing issues with nausea or vomiting, ask yourself these questions to avoid further issues:

  1. How long am I taking to eat and/or drink?
  2. Am I eating and/or drinking slowly enough?
  3. Did I drink fluids with my meal or too soon before or after the meal?
  4. Am I eating more than I should?
  5. Do I continue to eat after I feel satisfied?
  6. Am I chewing solid foods until they resemble a pureed consistency?
  7. Did I lie down too soon after my meal?
  8. Did I eat hard-to-digest foods such as tough meat or untoasted bread products?

If you vomit, do not eat solid foods. Instead, return to sugar-free, clear liquids (Phase 1). If you’ve said “yes” to any of the questions above, consume liquids until solid food is once again comfortable to eat. If vomiting persists throughout the day and/or you’ve answered “no” to all the above questions, and the vomiting is not improving, call the surgical liaison or see your local medical provider.

Learn more: 13 Ways to Stop Nausea and Vomiting

Band Adjustments

Adjustment of the lap band that is the foundation of this procedure will likely be required intermittently. Your band will need to be tightened if weight loss stops or if you experience increased hunger despite regular meals. Adjustments are determined on an individual basis. Several factors can determine what kind of adjustment is needed, including patient weight and adaptation by the stomach and esophagus to the banding.

DIARRHEA

Post-operatively, diarrhea can be caused by undigested food, sorbitol, and high-fat foods, passing through the gastrointestinal tract too quickly. We recommend reducing the amount of fat you are consuming as well as taking a probiotic with a CFU of 50 billion or higher. If the issue persists, please see your physician.

LACTOSE INTOLERANCE

While not a common side effect, it is possible for patients to become lactose intolerant after bariatric surgery. Eating or drinking lactose-rich dairy products can trigger uncomfortable side effects like bloating, stomach pain, gas, and loose stools. Symptoms begin about 30 minutes to 2 hours after eating or drinking foods containing lactose.

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