Your New Relationship with Food! You have worked very hard in preparation for Gastric Bypass Surgery. Now you will have to implement your new drinking and eating behaviors.
Remember these are guidelines and everybody is different, so dietary substitutions can be made with the help from your medical care team and dietitian. Your new stomach, also known as “the pouch,” is about 1 ounce in size. Your pouch will take about 6-8 weeks to heal. To help this healing process you will progress through 5 stages that are laid out in this booklet. Your meal plan will be high in protein to help the healing process, promote weight loss and preserve lean body mass (muscle). Your meal plan will also be low in fat (5 grams or less per serving) and low in sugar (14 grams or less per serving).
There are 5 Stages to your new meal plan: You will be on a high protein liquid diet for about 2-3 weeks, progress to soft-solid proteins for about 4-6 weeks and then move to soft, moist, whole foods to create a balanced diet. At each follow-up visit your dietitian/clinician will progress and advance your diet accordingly. As you advance through the 5 stages, you may consume any food you had in the previous stage. When advancing try one new food at a time by itself so that if you have difficulty tolerating it, you can eliminate it from your diet for 2-3 weeks and then attempt to re-introduce the food back into your daily diet. Your meals should take about 30-60 minutes to eat. It is recommended you take about 10 minutes for each ounce of food you eat. Taking tiny eraser size bites, chewing your food to a liquid consistency, sipping slowly on liquids etc… It is acceptable to be unable to finish the recommended serving size of a food.
DO NOT FORCE yourself to finish your food. Stop eating as soon as you start to feel full. If necessary, put the food away and finish it later. About 6-8 weeks after your surgery you will typically be at the last stage, at this time you will introduce various foods into your diet. Your dietitian will help you assess what your needs are and make a plan on how to meet them. Once on stage 5 this means you will be following these nutritional guidelines for the rest of your life. Over time you will be able to eat and tolerate more foods. To help with weight maintenance and healthy eating lifestyle it is important to keep the following things in mind:
- Exercise: After your clinician approves it, we encourage you to participate in cardiovascular and resistance training. Exercise is key for maintaining and building muscle mass and keeping weight off.
- Weight loss may slow down at times: Your weight loss may seem like a staircase. You are also going to experience “plateaus,” which are normal. Everyone will lose weight at different rates, so please do not compare you to other people. If you hit a plateau not losing weight for longer than 2 weeks, continue to keep food records and track your exercise. You may need to adjust your diet or exercise to help with your weight loss. If a plateau lasts longer than 4 weeks call your dietitian.
- This is a BIG change in your life: You may start to feel anxious about your choices and/or comments that are made to you about your weight loss. You may at times “feel fat”, deal with relationship changes, social changes, and experience new emotions. Remember you are not alone in this process. It is important for you stay involved in postoperative support groups, and continue to see your medical team, There are also some nutrition considerations with the gastric bypass you should be aware of and prepared for:
- Protein is key! Protein is essential after surgery to help the healing process, and preserve your lean body mass (muscles). Meeting your protein goals is essential.
EAT YOUR PROTEIN FIRST!
Fluids: It is important to maintain fluid intake of about 64 ounces or more per day. This will help maintain the appropriate body levels of fluids and replace the losses from weight loss. You need to take small slow sips of fluids throughout the day. Fluids should have minimum calories, no caffeine and no carbonation. To help meet both nutrition and fluid goals you need to keep fluids separate from meals by at least 30 minutes.
Mindful Eating: It is key to use all your mindful eating techniques to help meet your nutrition goals. Small frequent meals, tiny bites, eating slow etc.
Lactose intolerance: If you experience any bloating, gas, cramping or diarrhea in the initial stages you may have developed an intolerance to lactose from the sugar found in milk. This intolerance is often temporary and may resolve in 3-6 months. In the meantime, you may need to follow a lactose free diet.
Dumping Syndrome: Almost flu-like symptoms (nausea, Vomiting, sweating, bloating, diarrhea, etc) that usually Occur after high-fat or high sugary foods. The symptoms typically last about ½ hour. However, not everyone experiences dumping. To avoid these symptoms you should select foods that have 14 grams of sugar or less per serving and 3-5 grams of fat or less per serving.
Honeymoon Period (lack of appetite): Often you may experience a lack of appetite after surgery. In turn this often causes patients to skip meals, depriving themselves of their nutritional needs. You will need to plan to have 4-6 5 small meals per day to meet your nutrition goals and have a successful weight loss.
Hair Loss: Sometimes after surgery patients will complain of hair loss. It can be related to not getting enough protein or vitamins in your diet. This is often the body’s response to rapid weight loss. Hair loss is usually not permanent and re growth typically occurs 3-6 months after it starts falling out. Talk to your dietitian if you are experiencing this.
Taste Changes: You may experience changes in taste and food preferences.
Vitamins: Being compliant with your vitamins is key for your health, meeting your nutrition goals, and preventing deficiencies. The most common deficiencies you may be at risk for are B12, Iron, Vitamin D and folate. We will test your labs periodically to help prevent and/or treat any deficiencies you may develop.
Keeping Self-Monitoring Logs: Keeping food records will help facilitate timing of your meals and help you keep track of what you need to finish by the end of the day.
Wondering what your diet will be like after your surgery? Learn which foods will help you heal and lose weight safely.
Diet recommendations after gastric bypass surgery vary depending on your individual situation.
A gastric bypass diet typically follows a staged approach to help you ease back into eating solid foods. How quickly you move from one step to the next depends on how fast your body heals and adjusts to the change in eating patterns. You can usually start eating regular foods about three months after surgery.
A new healthy diet
Gastric bypass surgery reduces the size of your stomach and changes the way food enters your intestines. After surgery, it’s important to get adequate nourishment while keeping your weight-loss goals on track. Your doctor is likely to recommend that you:
Eat and drink slowly. To avoid dumping syndrome, take at least 30 minutes to eat your meals and 30 to 60 minutes to drink 1 cup of liquid. Wait 30 minutes before or after each meal to drink liquids.
Keep meals small. Eat several small meals a day. You might start with six small meals a day, then move to four meals and finally, when following a regular diet, three meals a day. Each meal should include about a half-cup to 1 cup of food.
Drink liquids between meals. To avoid dehydration, you’ll need to drink at least 8 cups (1.9 liters) of fluids a day. But drinking too much liquid at or around mealtime can leave you feeling overly full and prevent you from eating enough nutrient-rich food.
Chew food thoroughly. The new opening that leads from your stomach into your small intestine is very narrow and can be blocked by larger pieces of food. Blockages prevent food from leaving your stomach and can cause vomiting, nausea and abdominal pain. Take small bites of food and chew them to a pureed consistency before swallowing.
Focus on high-protein foods. Eat these foods before you eat other foods in your meal.
Avoid foods that are high in fat and sugar. These foods travel quickly through your digestive system and cause dumping syndrome.
Take recommended vitamin and mineral supplements. After surgery your body won’t be able to absorb enough nutrients from your food. You’ll likely need to take a multivitamin supplement every day for the rest of your life.
The gastric bypass diet can help you recover from surgery and transition to a way of eating that is healthy and supports your weight-loss goals. Remember that if you return to unhealthy eating habits after weight-loss surgery, you may not lose all of your excess weight, or you may regain any weight that you do lose.
The greatest risks of the gastric bypass diet come from not following the diet properly. If you eat too much or eat food that you shouldn’t, you could have complications. These include:
Dumping syndrome. If too much food enters your small intestine quickly, you are likely to experience nausea, vomiting, dizziness, sweating and diarrhea. Eating too much or too fast, eating foods high in fat or sugar, and not chewing your food adequately can all cause nausea or vomiting after meals.
Dehydration. Because you’re not supposed to drink fluids with your meals, some people become dehydrated. That’s why you need to sip 64 ounces (1.9 liters) of water and other fluids throughout the day.
Constipation. A lack of physical activity and of fiber or fluid in your diet can cause constipation.
Blocked opening of your stomach pouch. Food can become lodged at the opening of your stomach pouch, even if you carefully follow the diet. Signs and symptoms of a blocked stomach opening include ongoing nausea, vomiting and abdominal pain. Call your doctor if you have these symptoms for more than two days.
Weight gain or failure to lose weight. If you continue to gain weight or fail to lose weight on the gastric bypass diet, talk to your doctor or dietitian.