While weight loss surgery is considered to be the best intervention for obesity by most experts, it’s still a major procedure requiring ongoing effort by patients in the days, weeks, months and years after surgery. A big part of facilitating success — both in terms of weight loss and overall health — is adhering to the four-stage, post-op dietary guidelines.
Here’s a closer look at the plan, along with tips for transitioning between the stages, as set forth by Obesity Coverage’s “The Big Gastric Bypass Diet Guide.”
The stomach needs time to heal following bariatric surgery. Because certain foods stress the stomach, cause leaks, and otherwise interfere with healing, patients should only consume clear liquids for up to a week after the procedure.
While the specifics may differ from doctor to doctor and patient to patient, most dietary guidelines recommend that clear liquids be consumed at an hourly rate of one to two ounces. These may include water, fat-free milk, fat-free broth, and sugar-free gelatin. Slow sipping is essential, as is avoiding straws, as they can lead to uncomfortable air build-up in the stomach.
Hydration is key during this stage. Additionally, some doctors may recommend that bariatric patients begin incorporating protein shakes into their diet during this initial week.
After completing Stage One, weight loss patients progress to Stage Two. Lasting between one and two weeks, Stage Two introduces liquified protein sources to the diet. Most doctors recommend a diet consisting of several small meals throughout the day adding up to approximately 60 to 70 grams of protein and 64 ounces of clear liquids. (The fluids in the pureed meals don’t count.)
Recommended pureed protein sources typically include protein shakes, egg whites, non-fat soft cheese, and nonfat cottage cheese — all of which should be pureed using water or fat-free broth/milk.
Post-op patients should avoid caffeinated and carbonated beverages, as well as refined sugars, sugar alcohol, and other simple carbohydrates. It’s also important that patients refrain from drinking clear liquids with pureed meals.
As weight loss patients are prone to malabsorption and nutrient deficiencies, they should also be taking liquid form or chewable multivitamins, as well as a calcium citrate supplement. (However, the latter should be taken at least two hours apart from multivitamins, as each can interfere with the other’s absorption.)
During weeks four and five, while the protein and fluid intake targets stay the same, weight loss patients are usually given the go-ahead to gradually introduce soft foods. Instructs Obesity Coverage, “If a food can be easily mashed with a fork, knife, or a spoon, then it is a candidate for stage three of the post-op gastric bypass diet.”
Protein in the form of lean meat, dairy, and eggs remains the “star” of the bariatric meal. Additionally, certain vegetables and small portions of fat may be allowed.
As post-op patients proceed through the stages, their doctors and/or dietitians may reevaluate their supplement and vitamin doses.
Approximately six weeks after bariatric surgery, the much-anticipated day arrives when patients can officially start eating “real” food. This isn’t a free-for-all, however. Says Obesity Coverage, “A diet consisting of protein, vegetables, a limited amount of grains, and very little, if any, refined sugars should be followed for the rest of your life.”
Following best practices for starting solids can help patients stay happy and healthy, including the following:
Furthermore, certain foods, including beef, pork, shellfish, grapes, nuts, whole grains, corn and beans, can challenge the digestion, and should be eaten with caution.
Other tips for achieving a smooth transition to real food: Meal planning, shopping for and stocking up on healthy options, involving the whole family, and avoiding greasy and spicy foods.
Patients should also be reminded that the return to solid foods doesn’t mean a return to prior eating habits. Bariatric weight loss is about changing not only how we eat, but also how we think about eating. This means eschewing the foods that led to weight gain in the first place and instead focusing on healthy new behaviors.
One popular new bariatric post-op bariatric food option is Achieve from Rational Foods. This nutrient-dense option is not only ideal for patients in Stage 2, but also for those in Stages 3 and 4. Packed with protein, ready-to-eat, and shelf-stable for up to two years, Achieve decreases temptation while increasing satisfaction for bariatric patients.
Keep in mind that the stages of bariatric eating aren’t one-size-fits-all, nor do all tips work for everyone. When it comes to real food for bariatric patients, individuals should be encouraged to explore different options in order to determine what works best for them.