Eating After Weight Loss Surgery at Advanced Surgical Associates

In the first few days after surgery you will be on a clear liquid diet. That means anything translucent is acceptable except for sugary, alcoholic and carbonated drinks, of course. The goal during this period is to keep you hydrated. All foods have some degree of water content and since you will not be eating anything solid you have to drink more fluid than you normally would. The target for most patients is six to eight glasses (eight ounce) a day.

Don’t drink your entire days’ worth of fluid right away. Sip your fluids consistently, all day long to remain hydrated and balanced. Some ideas for the clear liquid diet may include:

• Low-sodium beef, chicken or vegetable broth
• Water (with or without Crystal Light®)
• Low-sugar sports drinks
• Decaffeinated unsweetened tea
• Water with flavor enhancers*
• Certain low-sugar popsicles*

*An important note on artificial/no-calorie sweeteners: You can consume artificially sweetened drinks during this time. They will likely make bland drinks more tolerable. However artificial sweeteners have no nutritional value and may make it harder to lose weight. Please be judicious with your use of artificial sweeteners.

After the first few days, you will be able to transition into a modified liquid diet. Again, you will be avoiding any high sugar, alcoholic and carbonated drinks – these are bad for your stomach pouch and your diet. This liquid diet will expand your options dramatically. You’ll be able to drink low fat milk and protein shakes to boost your protein intake. You’ll also be able to drink some diluted fruit juices, broths, soups and more. Be mindful not to consume anything that has chunks, pieces, seeds or other solids.

You may also continue to consume clear liquids in addition to the suggestions below. Below, you will find a list of suggested liquid foods and drinks (in addition to those above):

Protein packed liquids:

• Yogurt (plain, no fat). Greek yogurt can be thinned with water
• Skim milk
• Protein-based meal replacements
• Protein powder mixes (low sugar)
• Low-fat cream-based soups** such as cream of chicken, mushroom, spinach, etc.*

*A quick note on soups. All soups must be strained or blended to remove any chunks. Canned soups tend to be very high in sodium and calories. Please check the nutrition label carefully before choosing your soup. Ideally, make your own soup with fresh ingredients from the produce department. Bear in mind that your tastes may change after surgery. What you liked in the past may not be palatable today. Feel free to try different liquid products (especially when it comes to protein meal replacements) to find the ones that you truly enjoy.

The transition to soft foods represents a huge leap toward normalcy after surgery. At this point, you’ll have a whole new world of options and a plenty of ways to trip up, too. Following your post-surgical guidelines is the single best way to avoid any pitfalls and keep your diet on the right path. The keys here are to make sure you:

• Eat a balanced diet.
• Chew thoroughly.
• Eat slowly.
• Eat three small meals per day.
• Do not drink half an hour before or after a meal.
• Stop eating when your hunger pangs have subsided, not when you feel full.

Below is a sample of foods to eat during this phase –remember that your particular situation, as well as your surgeon’s preferences, will determine what you can and cannot eat.

• Meats such as seafood and soft, low-fat, low-sodium lunch meats and poultry
• Tofu
• Low-fat, no-sugar-added cottage cheese and yogurts
• Applesauce (unsweetened)
• Cooked fruits and vegetables
• Fresh fruits, such as bananas, in moderation due to sugar content

Below is sample of foods and drinks to avoid:

• High-fiber foods
• Raw vegetables
• Seeds and nuts
• Dense meats such as chicken, beef and pork, unless pureed or finely minced
• Items high in sugar or saturated fats (especially fried and highly processed foods)

As with all phases of the bariatric diet, drinking enough water to stay well hydrated is crucial to success. Further, getting the right amount of protein is important. At this stage you may not be  able to get your required protein without a protein shake supplement.

Supplementation after weight loss surgery is a very important part of your health and successful resolution of weight-related diseases. The degree to which you will have to supplement your diet with vitamins and nutrients largely depends on the procedure that you undergo. No matter the procedure, you will have to supplement, to a degree, immediately after surgery as you will be on a modified and restricted diet. Gastric bypass patients will require the greatest degree of supplementation of any of the major bariatric procedures. This is because of the malabsorption due to bypassing part of the small intestine. Since the walls of the small intestine are very sensitive and therefore absorb nutrients, vitamins and calories, shrinking the surface area available drastically reduces nutritional absorption. This means that gastric bypass patients are more prone to nutritional deficiencies than are those who have undergone purely restrictive procedures such as gastric sleeve and gastric banding. The supplements that are most often needed are› Protein – you will have many protein options after surgery. It is important to consume the recommended daily allowance per your post-surgical instructions› Iron – a deficiency can cause anemia with symptom such as fatigue and muscle pain› Calcium – keeps bones, joints and teeth healthy› Vitamin C – an essential vitamin for your immune system that also aids in healing› Vitamin D – most often synthesized from sunlight, our bodies cannot use calcium without it› Vitamin B12 – a deficiency can cause fatigue

Each of these nutrients has very specific functions in the body and a deficiency in any one of them can cause a host of other problems. As an example, one of the most important nutrients – protein – is necessary for healing and also allows a patient to lose more weight because its density makes it harder to digest. Because most bariatric procedures severely restrict food consumption,it becomes very difficult for the patient to eat enough protein through their diet alone. Most often, patients will turn to protein shakes to fill the gap.Patients will visit our office several times after the procedure and they will be tested to make sure that they have no nutritional deficiencies. That, combined with a comprehensive supplementation plan provided by our surgeons and dietitian, should mean that each patient will receive the level of nutrition that is necessary to maintain healthy weight loss. While many patients will be able to taper off their supplementation, it is not recommended that they eliminate it entirely. While too much supplementation can be a bad thing, it’s also important that deficiencies do not arise. Patients who keep a food journal are more likely to consume the nutrients they need every day. Smartphone applications are particularly useful, offering a snapshot of nutritional intake on any given day. Further, sticking to the plan created by our support team and working closely with your dietitian or nutritionist to develop and modify the plan on a regular basis can help keep proper supplementation on track.