Bariatrics Program

Diet Overview

Bariatric surgery is an excellent way to limit the amount of food you eat and assist in weight reduction, but significant adaptation of your diet and lifestyle are required to achieve maximum success.  After your bariatric surgery, you will be losing weight very rapidly. Hence, proper nutrition is essential to maintain lean body mass (muscle), hydration, skin elasticity, and to minimize hair loss.

The primary nutrition goals after surgery are as follows:

  • Learn proper eating habits that will promote continued weight loss
  • Consume adequate amounts of protein to minimize loss of lean body mass, and facilitate wound healing
  • Take adequate amounts of fluid to maintain hydration
  • Take in nutrients for optimal health via healthy food choices
  • Replenish vitamin and mineral supplementations
  • The post bariatric surgery meal plan requires a significant change in meal planning for most people. We recommend that you begin adapting your current meal plan to prepare for this change
  • Avoid fried or high fat foods at all costs

 

Nutrition Plan: 

In order to loose weight effectively and permanently, you must be an active participant in your weight loss program. The stomach stapling surgery will help you to lose weight, but it is not "magic". A well balanced nutrition plan is necessary to help you reach and maintain your goal weight. Making changes in your eating habits will also leads to a lifetime of good health and weight control. The following describes the plan's progression from liquids to solid foods, following your discharge from the hospital.

 

Weeks 1 & 2 (high protein, low calorie liquids)

Protein is essential for every function of your body. After surgery, protein is needed for healing and infection prevention. It is necessary for you to continue on liquids for two weeks after your discharge from the hospital to avoid putting stress on your staple line. Hence, your dietician will prescribe a number of high protein liquid supplements. In addition to these supplements, you will be allowed to have coffee, tea, broth, Gatorade, clear, and cream soups (strained), cooked cereals (soupy), low fat yogurt (no sugar added and blended), diet soft drinks (gone flat), fruit juices (small amounts), sugar free drinks, diet Jell-O, popsicles, and water. You need a good fluid intake during this time, so that you do not get dehydrated.

Weeks 3 & 4 (Pureed Stage)

 During the pureed stage of the plan it will be necessary for you to blenderize most of your food, or you may want to use baby food. It will also be important for you to develop an eating schedule for yourself that fits your lifestyle. The following are a number of guidelines that you will find helpful in making the necessary changes from liquids to semi-solid to solid foods.

  • Relax and enjoy mealtimes. If you are under stress or feeling anxious before a meal, you may want to avoid eating until you are more relaxed. Highly stressful situations often cause food intolerance.
  • Eat six times a day, three meals and three snacks. Eating often is necessary to help you meet your nutritional needs and continue with your weight loss goals.
  • Limit the size of each meal to approximately four tablespoons of food. You will discover that you can drink more liquid, so be sure to select low calories beverages. The more solid a food, the less of it you will be able to eat, so you will be getting fewer calories and losing more weight. Learning your capacity of certain foods is essential so weight management.
  • Take small bites, chew well, and put your fork or spoon down between bites. Taking small bites will help you in chewing your food better. Chew each bite at least 20 times before swallowing the food.
  • Take at least 20-30 minutes to eat or drink each small meal or snack. Be sure to make time in your daily schedule for meals. Eating slowly will help you to avoid problems with intolerance.
  • Drink liquids between meals only. You may take small sips of liquid with your food, but drinking liquids with meals will cause your pouch to reject the food. Drink liquids one hour before or one hour after a meal.
  • Include high protein foods at each meal. The dietician will discuss with you protein food selections and how to include these foods in your menus. Also include foods from all food groups in your meal plan on a daily basis.

 

It is not necessary for you to eat completely different meals from anyone else in your household during this stage of the nutrition plan. You are encouraged to select low calorie, high protein, and low fat foods.

Week 6 (Soft Stage)

This stage of the nutrition plan could be called the soft-semi-solid stage because you will be consuming solid foods that are well cooked. You can continue to consume soft foods you have already been eating in addition to the following foods that should be included in your meal plan at this time:

Baked fish, chicken, and turkey

Dried beans, peas, and lentils

Lean Ground beef and veal

Creamy peanut butter

Steamed or boiled vegetables

Canned fruit, packed in its own juices or soft fresh fruit

Cooked or dry cereals, crackers

Toasted breads, baked potato (no skin), Melba toast

 Remember to continue eating slowly and chewing well. Avoid drinking liquids with your meals, and continue to follow the guidelines previously outlined.

 Week 7 (regular stage)

 Continue to advance the consistency of the foods you eat by including raw fruits and vegetables into your meal plans. Continue to select low calorie, high protein foods, and low fat foods. Always ask yourself, "Is there a lower calorie, more nutritious choice?"

Foods to avoid

 You are encouraged to avoid the following foods:

Nuts, seeds, skins (includes potato skins, onion skins, fruit peelings, and the membrane between orange and grapefruit sections), the stringy portion of celery, asparagus, string beans, un toasted bread, high caloric, high fat foods, and high caloric beverages. Steak and pork may or may not be tolerated depending on the individual.

You may discover individual intolerances with certain foods; this is very common. You should concentrate on the positive behaviors and good eating habits you are developing.

Dieticians Role

Prior to your discharge from the hospital, the dietician will instruct you on the bariatric surgery nutrition plan. You will be provided written and verbal information on how to advance from liquids to solid foods. She will discuss with you how to meet your nutritional needs as well as how to avoid possible intolerances. In your return visits you will meet with the dietician on a regularly.

They will evaluate your overall nutritional intake and make recommendations on how to improve if necessary. The dietician will also help you identify problems and make suggestions on how to correct them, as well as answering any questions you may have regarding your nutritional plan.

Remember that surgery is not the magical answer to losing weight. The more involved you are in your nutritional plan, the better your results will be. Be an active participant.

Vitamin and Mineral Supplementation

The first few months after your surgery you will consume a very low calorie diet, and due to the volume restriction of your new stomach it will be difficult to eat enough of a variety of different foods each day to consume adequate amounts of various nutrients. Hence, vitamin and mineral supplements are required.

Daily Multivitamin

·         Chewable

·         Must contain at least

o       400mg Folate

o       18mg Iron

o       15mg Zinc

Calcium Citrate

  • Calcium must be in a citrate form.
  • You must take a total of 1200 mg of calcium per day.
  • If you are on Iron supplements you must separate your iron supplement from your calcium by at least 2 hours

Iron

  • Women who are menstruating or who have a history of anemia will need to take supplemental iron.
  • Supplemental iron
  • Take your iron with your multi-vitamin or a vitamin C for enhanced absorption.

 

You may also wish to take an over the counter stool softener when starting iron supplements as they may cause constipation

 

B-12

  • You will need to receive an injection of B-12 by your 6-month post-op visit and every 6 months thereafter.

 

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