Post-Op Diet

Stage 1 Post-Op Diet – Days 1-21
Download Baraitric Consult Folder for sample meal plans, pages 36-39

When to Start Stage 1. You will need to start this diet the day you come home from the hospital. The first three weeks postoperatively are crucial for minimizing complications and maximizing your recovery. Adherence to the postoperative diet will set you off on the right foot for your weight loss journey to come as well as give you protection against a potential leak along the staple line of your new, smaller stomach. Following a full liquid diet for the first 3 weeks after surgery will give your body time to heal. This diet will also help you begin to understand how much food you can eat BEFORE you feel too full. This is a time of learning new behaviors and developing new lifestyle habits.

The main 3 goals during Stage 1 of the diet are to:

Rest the stomach and allow it time to heal
Stay hydrated by consuming ≥ 64oz fluid per day
Consume adequate amounts of protein to aid in the healing process.

* Do not worry about calorie intake at this time as your body will turn to your stored fat to obtain the energy that it needs to function.

1-2 oz. of fluid should be sipped every 10-15 minutes while awake.
Try and incorporate unflavored protein into all of your liquids so that you can meet your protein needs
Consume (sip) at least 4 oz. of liquids every hour and tally everything you drink for the first week to become familiar with your new normal
All liquids must be very thin. It must be able to flow through a strainer easily.

Most Common Questions Answered

Lactose intolerance: If you can’t tolerate milk, you may use Sugar Free, Dairy free* alternatives found in the dairy section of your grocery store.
You may use a sugar substitute in your coffee or tea. E.g. Stevia, Splenda, Sweet’N low, Equal, Triva
It is normal during the initial Post-Op time to have little or no appetite. At this time, it is likely for you to take in far less food than you need, but for this limited time, it doesn’t present a big problem. It is important to keep yourself hydrated using low to no calorie liquids and begin using food to teach yourself new habits that will keep you healthy and promote steady weight loss. You should not force yourself to eat.
Drink 64 oz. of liquid per day. Try to drink 1-2 oz. of liquids every 10-15 min throughout the day to stay hydrated. Include your protein supplement drinks, which meet both your liquid requirements AND your protein needs.
Above all else, find a protein drink that you enjoy. The protein is needed for the healing process as you go through the initial stages of recovery. You should aim to get 60g or more of protein per day. Protein shakes should have at least 20-30 grams of protein, be less than 10g Net carbohydrates and low in fat. To help our patients ensure adequate protein intake, we are proud to offer premium unflavored protein powder as we find that most patients get tired of drinking the same protein drink for 21 days. The unflavored protein powder is designed to be mixed in a variety of liquids and allows patients to significantly increase the variety of liquids that they can consume on this diet phase. Avoid commercial meal replacement shakes such as Atkins, Slim Fast, Boost, Pedialyte or Ensure.
Do NOT drink through straws or chew gum. Drinking through straws or chewing gum can cause air to enter the pouch which can cause pain, bloating and gas.
No Alcohol. It is recommended not to consume alcohol for the first 6 months after surgery.
Digestive issues: Nausea and constipation are common digestive symptoms the first couple of weeks.
- Nausea
  - Make sure you are sipping slowly and not gulping your beverages.
  - Have a hot cup of water with lemon to reduce mucus build up or drainage.
  - Don’t lay down too quickly after drinking.
  - Make sure you take your vitamins with a protein shake and not on an empty stomach.
  - Sip on broth or electrolytes
  - Drink ginger or peppermint tea
- Constipation
  - Make sure you walk 10- 15 minutes every hour that you are awake and make sure you are moving.
  - Try to get in 64 ounces of liquid per day.
  - Take probiotic supplements (Bariatric Advantage)
  - Can take milk of magnesia, stool softeners, Miralax or drink Smooth Move tea.
Why do I have to be on liquids only for three weeks? Due to swelling, anything thicker than water can easily become stuck, creating a “dam” effect and causing any intake after that to back up and push on the stomach walls. This can stress your new staple line and may result in a leak. A leak from your stomach is a serious complication resulting in sepsis and a long stay in the ICU.
I have read online that other bariatric surgeons only require two weeks of liquids. If it is okay for their patients, why not for me? Congratulations! You have come to the best bariatric surgery clinic in the nation, one who boasts complication rates far lower than the national average. The reason for this is because we noticed when leaks tend to happen, under what circumstances and realized by having an extra week of liquids we could eliminate this potentially life-threatening issue. Compliance with your postop diet mitigates much of the risk of a leak.
What about Jell-O? Pudding? Or ice cream? While these things do melt eventually, as they go through your body they remain thick enough to cause issues (this includes Sugar Free varieties). Also, this time is intended to detox your body from any lingering sugar addiction. Ice cream, smoothies, sugary full fat lattes and the like are not appropriate foods postoperatively at any stage.
Can I drink soda or other carbonated beverages? NO! Drinks that fizz are one-part liquid, four parts gas. The expansion of that gas in your new 4-6 oz. stomach will lead to stretching of your sleeve (or pouch for bypass patients), allowing you to consume more, thus ruining your odds of good weight loss results. Avoid carbonation for the rest of your life (even if it has gone flat) in order to keep your new tool functioning, healthy and helping you for life.

The bottom line: If you aren’t sure you can have it, put it in a strainer. Only that which runs freely and easily through the strainer is part of this phase of the diet! If it doesn’t go through, it is not for you!

Stage 2 Post-Op Diet – Days 22-42
Download Baraitric Consult Folder for sample meal plans, pages 40-42

When to Start Stage 2. Start this diet at Post-Op Day 22 and continue for 3 weeks. This is still time learning about your new body. Let your pouch be your guide on portion sizes. Stop eating BEFORE you feel full. Remember to use a food scale to weigh your food. Overeating and not chewing your food thoroughly can lead to nausea, vomiting, and stretching out your stomach.

* Start with softer foods like yogurt then transition into soft solid foods like ground turkey by the 3rd week. It is recommended to introduce new foods at dinner time.

Stage 2 Menu: Includes foods listed on the full liquid diet plus:

Eggs: softly scrambled, baked or poached
Fish or salmon: grilled, baked or poached (this includes tuna in water)
Chicken; ground, boiled, baked, canned (packed in water)
Deli meats: thinly sliced, avoid higher salt meats (i.e. pancetta)
Tofu (do not fry)
Nut butters (limit to 1 tablespoon per day)
Low fat or fat free cottage cheese, ricotta cheese, laughing cow cheese, light string cheese and thin deli sliced cheeses
Soft cooked or canned non-starchy vegetables (if eating green beans make sure to remove strings)
Low fat Plain Greek Yogurt (aim to find the lowest in sugar)
Sugar free applesauce
Hummus
Avocado
Soft Bananas (remove strings) and limit to no more than 2 per week
Beans: lentils, black beans, brown beans, non-refried beans

On day 36:

Lean ground beef (90% lean)

Foods to Avoid:

All raw fruit
All raw veggies, including lettuce and tomato
Cooked or raw asparagus, celery, corn, or peas
Cooked or raw Potatoes, Sweet Potatoes, Winter Squash and Plantains
All nuts
All high Carbohydrate/Sugary foods like bread, pasta, rice, crackers, tortillas, chips, dry cereal, cake, cookies, ice cream, etc.
Caffeine
Alcohol
Limit artificial sweeteners