The long-term follow-up to obesity surgery is extremely important, particularly the proper management of nutrition. Changing your eating and activity habits are very important for you to be successful with keeping the weight off. Your commitment to lifestyle changes, both eating and physical activity, is the key to your long-term success.
What will I need to do to be successful?
- Do not drink any liquids with calories. All liquids need to have less than 10 calories per 8 ounce serving. Avoid milk, juice, regular pop, Kool-Aid, Gatorade, alcohol, cream soups, ice cream, sherbet, and regular Jello. These liquids have a lot of calories and they do NOT help you feel full. Your new stomach pouch will NOT limit how much of these items you can take in.
- Eat 3 small meals per day. Do not snack. Snacking, nibbling, grazing throughout the day will limit your weight loss and lead to weight gain. Do not drink any liquids until 45 minutes AFTER you eat. This will help prevent dumping syndrome and help you feel full longer. Eat slowly, take small bites and CHEW YOUR FOOD WELL. Stop eating before you feel full.
- Start and maintain a regular exercise program. Your goal should be to work up to at least 30 minutes of physical activity 5 times per week, unless your doctor tells you something different.
- Make smart food choices. The amount of food you can eat after surgery is very small. You need to make good choices about what you eat to help your body heal and stay healthy. Eat lean meats, fruits, vegetables, grains, and low-fat dairy foods. Do not eat foods high in fat and sugar. These foods have a lot of calories and do very little for our bodies.
- Keep yourself on a short leash. To keep the weight off you will need to weigh yourself once a week and compare this to your weight goal. If you have gained 3 to 5 pounds, this is the time to do something. Do not wait until you have gained more than this.
Food Choices After Surgery
Diet Guidelines for Week One and Two
Liquid Diet Guidelines
- Choose 6 "liquid meals" per day. Drink water between meals.
- Each "liquid meal" will consist of 1/2 cup (4 oz.) of liquid that contains protein and calories (See options below).
- Drink your "liquid meal" over a 20-30 minute period.
- At other times of the day, drink only non-calorie beverages. It is important to keep hydrated. Drink at least 64 ounces a day.
- Gastric Band Adjustments: You will need to follow the liquid diet for 48 hours after each band adjustment.
Examples of "liquid meal" choices:
- Carnation instant breakfast (no sugar added) with skim, low fat, or soy milk
- Ready-made liquid supplements (Examples: Ensure, Boost, Slim Fast)
- Yogurt smoothie
Remember: The above liquids are NOT appropriate after the first two weeks following your surgery!
Solid Diet Guidelines
- Eat only 3 meals a day – no eating between meals.
- Do not eat more than 1/2 cup total at your meal. It is important to measure your food portion.
- Do NOT drink liquids with your meals AND wait 45 minutes after you eat to restart drinking calorie-free liquids. Do not drink any liquids with calories. You will get calories and protein from solid food now.
- Be sure to eat slowly and chew your food well (20-30 times per bite).
- Eat a protein food with each of your meals. Eat your protein first.
- Eat at least one fruit and one vegetable each day as part of your meals.
Diet Guidelines for Week Three and Four
Solid Diet Guidelines
Soft, pureed food, easy to chew and digest.
Choose one of the following protein foods with each of your meals (1/4 cup):
- Cottage cheese
- Smooth Yogurt
- Pureed chicken or turkey
- Baby food meats
Diet Guidelines for Week Five and Six
- Applesauce, banana, canned fruit, melon, berries
- Potato or sweet potato
- Well cooked vegetables: carrots, beets, green beans, cauliflower
- Cooked cereal; oatmeal, cream of wheat, farina
- Baby food fruits and vegetables
- Saltine or graham crackers
Soft, bland, easy to chew and digest foods.
Choose 1 of the following protein foods with each of your meals (1/4 cup):
- Any of the Week 3 and 4 protein foods
- Creamy peanut butter
- Chicken or turkey
- Fish or tuna
- Legumes or beans
Choose 1 of the foods shown below to have with your protein food at each meal (1/4 cup):
- Any of the Week 3 and 4 fruit/vegetable/starch choices
- Toast, crackers
- Peeled fresh fruit
- Cooked or steamed vegetables
Diet Guidelines for Week Seven and Beyond
Regular foods. Begin slowly adding back a healthy variety of food. Continue to not eat greasy or high-fat foods, high sugar foods and liquid drinks that have calories.
Foods to Avoid
Certain foods may make you feel uncomfortable. You should avoid these foods for 6-8 weeks after surgery:
- Skins on foods like apples, potatoes, grapes and tomatoes
- Kernels and seeds in foods like popcorn or melon
- Raw vegetables
- Stringy foods like celery, broccoli and asparagus
- Any beef or pork
- Ground meats (beef, chicken, turkey, pork)
- Fatty, rich or fried foods
- High sugar foods like pie, cake and cookies
- Carbonated drinks like pop and mineral water
- Soft, fresh bread
- Pasta and rice
Liquids to Avoid
- Juice of any kind
- Popsicles and other frozen treats
- Ice cream, sherbet
- Cream soups
- Protein shakes
- Energy drinks
- Regular pop
- Sports drinks such as Gatorade
- Regular Jello
Vitamins and Mineral Supplements
For the rest of your life, you will need to take a daily multivitamin with iron and a calcium supplement (1500 mg). Not taking your multivitamin and calcium supplement may cause nutrition-related problems later in life.
A chewable multivitamin with minerals, such as Flintstones Complete may be easier to take. If you have a gastric bypass, you need to take 1 multivitamin twice a day. If you have an adjustable gastric band, take 1 multivitamin a day.
- Calcium Supplement
Take 500 mg of calcium three times a day for a total of 1,500 mg. Check the label on the calcium bottle for the amount of calcium in a pill. There are different forms of calcium:We recommend calcium citrate because it is best absorbed after surgery. Calcium citrate does not need to be taken with food.
The most common form of calcium is calcium carbonate. Calcium carbonate is not absorbed as well as calcium citrate and it must be taken with meals to be absorbed. Calcium carbonate may also cause gas after surgery.
- Additional Supplements
Some people will need vitamin B12 or extra iron supplements to prevent anemia. Your doctor will tell you if you need to be taking any other supplements.