Healthy Eating After Bariatric Surgery
Updated: Aug 20, 2019
• You need to eat healthy, whole foods
• Make sure to eat your protein first
• Take steps to keep your blood sugar stable (see below)
• Remember to drink the right amount of water at the right times
• No snacking
So what should I eat now I have had Bariatric Surgery??
A good long-term bariatric diet follows 5 basic principles…
1. Eat healthily
Healthy bariatric eating has two angles… what you eat and how you eat. Here we focus on what you eat. We’ll get into the “how” further down the page.
Before getting into the details, we have some good news: eating healthy will probably be much easier after your procedure.
Many patients report enjoying healthy foods and exercising more than they did before surgery, and they report enjoying junk food and overeating less.
“Many patients…actually become repulsed at the thought of unhealthy food after surgery because of how it makes them feel.” The creative packaging in the supermarket can make it difficult to distinguish between the healthy and unhealthy foods.
In general, your bariatric diet should only consist of FOG foods…
• Farm – The food is raised on a farm (i.e. chicken, turkey, eggs, dairy products)
• Ocean – It comes from the ocean (i.e. fish)
• Ground – It is grown in the ground (i.e. fruits, vegetables, nuts, whole grains)
When possible, avoid anything that was modified by humans in any way.
A good rule of thumb can be applied by reading the label… if there are more than 3 to 5 ingredients or if there are any ingredients that you can’t pronounce, don’t buy it.
How you prepare your food is as important as what you buy…
• When cooking, bake, grill, poach…don’t fry.
• Use light milk instead of whole milk.
• Use chicken or vegetable broth instead of oil.
• Replace oil in recipes with applesauce or yogurt.
• Add spices or lemon juice to add flavor instead of olive oil or butter.
We know, we know… how boring, right?
Give it a shot. Not only will you eventually get used to the change, you will probably start to be turned off by not eating this way.
Many patients have said that after a while they actually became repulsed at the thought of unhealthy food because of how it made them feel compared to their new bariatric diet.
In addition, many patients’ taste for unhealthy food changes after surgery.
2. Protein first
Protein is one of the most important nutrients for your body, and you need a lot of it in order to stay healthy… up to 80 grams a day.
With your old stomach, this was no problem. But now that your stomach is down to the size of a golf ball, 80 grams is a big percentage of the available space.
Your body’s going to do all it can to get the adequate amount of protein, so if you’re not eating enough your body will begin to break down muscle.
This can cause you to feel nauseous, irritable, weak and tired. If lack of protein intake goes on too long it can ultimately cause general swelling, hair loss and skin problems, worsen your immune system and increase your risk of infection.
So eat you protein first. It can be found in many foods, including meat, fish, soy and dairy products, legumes and nuts.
When you’re picking your protein, be mindful of fat content as many protein sources contain ample amounts of it. Always opt for the lean or low-fat option.
If you’re having a tough time getting enough, it may be necessary to supplement your bariatric diet either every day or as needed.
For example, a daily supplement can be taken in the form of a pill or powder, or you can make yourself a protein shake at the end of a low-protein day.
3. Keep your blood sugar level stable
Stable blood sugar leads to stable hunger and stable relationships (no mood swings).
In order to keep your blood glucose level in check…
• Avoid simple carbohydrates - Foods with simple carbs include white bread, potatoes, white rice, corn, peas and anything that is obviously full of sugar like candy, ice cream or donuts.
• Eat good carbs in small portions - (along with your high amounts of protein), including vegetables, apples and the “brown foods” like whole-grain bread and brown rice. In addition to being good for your blood sugar level, they are often high in fibre which makes you full faster and helps to regulate your bowel movements.
4. Drink the right amount of water at the right times
Not just water!
It’s important that you remain hydrated after weight loss surgery… you must drink FLUIDS (preferably, low calorie ones such as unsweetened, caffeine-free herbal tea) but not just water. If you only drink water, you may develop electrolyte abnormalities such as water intoxication syndrome.
Talk with your team for recommendations specific to you, but usually no more than half of your fluids should be water.
You will need to drink a lot of fluids… between 48 and 64 ounces per day. That’s equal to about 8 cups or 2 litres.
This may be tough to do considering the size of your new stomach. To make things more difficult, you can’t drink with your meals and need to wait at least an hour after you eat before drinking anything.
If you don’t, the liquids will quickly flush the food through your stomach. This can affect digestion, make you feel hungry and lead to weight gain after bariatric surgery.
To meet your liquid intake goals, keep some liquids next to you at all times and sip a little every 15 to 20 minutes outside of meal time.
Stay on track by getting a special container, measuring out your daily amount of fluids every morning and putting it in the fridge (or on the counter if you prefer your liquids at room temperature).
Spread your consumption throughout the day so that the container is empty before you go to bed.
5. Don’t snack
Snacking between meals is the quickest way to halt your weight loss progress and to gain your weight back after you hit the low point.
Don’t do it.
By far the best way to keep you honest is to keep regularly journal in the Baritastic food tracker, in the app.
Plan all of your meals ahead of time.
When you go to the supermarket, only buy the foods that you have planned. Then only eat what you’ve planned, when you’ve planned (more on this in module 2 )
• Special diet requirements after each type of weight loss surgery, including gastric sleeve, gastric bypass, Lap-Band, duodenal switch, Gastric Balloon.
The advice throughout this page – both above and below this section – applies to everyone, regardless of procedure. However, there are certain precautions you’ll need to take depending on which procedure you have.
Gastric Sleeve Diet
Your smaller stomach after gastric sleeve surgery will lead to a couple of important changes in your diet:
1. You will feel full much sooner than you did before
2. If you eat too quickly, you may have difficulty swallowing. This is the result of food backing up into the oesophagus after the stomach pouch has been filled. To avoid this, chew your food thoroughly, eat slowly and eat foods that are more easily digested. This should get better as your pouch stretches over time.
Diarrhoea is relatively common after gastric sleeve surgery. Eating a pre-planned gastric sleeve diet will usually get things back to normal, although some patients find that the diarrhoea is caused by lactose intolerance (not necessarily caused by surgery, but the new stomach can make lactose intolerance symptoms more prevalent). If that’s the case, you’ll need to avoid dairy products.
Gastric Bypass Diet
Just like gastric sleeve surgery, you’ll feel full sooner after eating due to the smaller size of your stomach. You may also lose certain food cravings due to hormonal changes resulting from the surgery.
Most gastric bypass patients (about 80%) will experience dumping syndrome when they eat the wrong foods.
Conveniently, the wrong foods are the unhealthy ones, so while dumping syndrome symptoms are unpleasant, they help you keep your gastric bypass diet in check.
While diarrhea does occur for some patients (see Gastric Sleeve Diet section above for recommendations), constipation is more common after gastric bypass and usually means that you need to drink more water.
Due to the malabsorptive component of gastric bypass surgery, your doctors will insist that you take bariatric vitamins for the rest of your life to avoid extremely dangerous vitamin deficiencies.
Alcohol Advice for Gastric Bypass
The physiological effects of alcohol are amplified following gastric bypass. This is supported by a study suggesting gastric bypass patients will have a higher blood alcohol content than control subjects after consuming the same amount of alcohol.
Instances of individuals receiving Driving Under the Influence charges after consuming small amounts of alcohol have been reported.
Studies also indicate that patients who’ve undergone gastric bypass have an increased risk of developing an alcohol use disorder after surgery.
Researchers have not conclusively determined why, but some experts suggest it is related to changes in the “pleasure center” of the brain.
Faster absorption and increased potency of alcohol after gastric bypass may influence reward circuitry in the brain, effectively increasing the likelihood of developing alcohol related issues.
For individuals with a pre-existing alcohol abuse disorder, surgeons may advise an extended period of sobriety prior to receiving gastric bypass. Patients with a history of alcohol abuse disorders may be at higher risk of additional alcohol related problems after gastric bypass.
The gastric band reduces the amount of food you can eat before feeling full by creating a small stomach "pouch" on the upper portion of your stomach.
As a result, you should follow the same precautions as those listed in the gastric sleeve section above.
Unlike the other procedures, the rest of your stomach will still be intact below your band. As a result, drinking water 30 minutes before through 30 minutes after meals will make it even easier to "flush" food through your smaller stomach pouch causing you to eat more than you should.
Duodenal Switch Diet
Duodenal switch surgery is so effective due to both reducing the size of the stomach AND through limiting the amount of food that your system absorbs.
To offset this lack of absorption, you’ll need to take several different vitamins and supplements every day or risk developing serious, life-threatening vitamin deficiency.
Supplements will likely include:
• Multi-vitamin/mineral supplement
• Fat soluble vitamins (A, D, E, and K) in a ‘dry’ form
• Probiotics (beneficial bacterium found in the intestinal tract)
Routine tests are essential to make sure your body is getting the nutrients it needs.
Intragastric Balloon Diet
Your surgeon will have you on a liquid- and soft-food-only diet for up to 10 days following your procedure: liquid-only for the first few days followed by the slow introduction of soft foods.
After the first 10 days you will likely be allowed to transition into a mostly normal diet along with a daily vitamin and mineral regimen. Your surgeon may also recommend staying away from “sticky” carbs like pasta which may stick to your balloon and increase your chances of vomiting.