Immediately after your surgery it is very important to follow the eating and drinking instructions given to you by your surgeon. The progressive phases of diet and exercise recommendations are designed to allow the procedure you underwent time to heal completely at the surgical site. This has been estimated to take a month or more. It is also important, especially in the first weeks after surgery, not to overeat or swallow large bites of food that have not been chewed extremely well. Problems may occur if these instructions are not strictly followed.
Your nutrition plan is divided into four phases, and each phase allows you to adjust to your new gastric pouch.
Right after surgery, you will be given small sips of water or ice chips to suck on. The day after the operation you will begin taking in fluids, but only drink a small amount at a time. Besides water, you should also choose liquids that have an adequate number of calories. To prevent nausea and vomiting, do not drink too much at any one time.
In the beginning, you will be allowed clear liquids only (liquids you can read a newspaper through). These include broth, Jello, juices (apply, cranberry, grape), tea, or popsicles.
Usually a day or two after surgery, you can advance to the first phase of your nutrition plan.
In addition, you should purchase a fiber supplement like Benefiber of Citrucel or other sugar-free supplement to avoid problems with constipation after the surgery.
Post-Op Nutrition Instructions
In order to sustain weight loss long-term, it is critical that your behaviors are modified early in the post-operative period. There are six cardinal rules that you must follow in order to attain a weight that is close to your ideal body weight.
1. Your primary source of nutrition needs to be protein. Fifty-five percent of all calories consumed should be lean, protein-based (eggs, cheese, yogurt, beans, fish, meat, protein supplement powder, etc.) Carbohydrates (whole grain cereals, whole grain pasta, brown rice, etc.) should make up only 30%. Fats (olive or canola oils, flaxseed oil) should only be 10-15% of the calories that you eat. Hair loss, cracked nails and defective healing and immunity are just some of the side effects of inadequate protein consumption, not to mention difficulty losing weight. Additionally, protein will keep you feeling satisfied for a longer period.
2. Drink an adequate amount of liquid daily, preferably water. You should consume between 64 and 80 ounces (8 to 10 8-ounce glasses) of non-caloric, decaffeinated liquid per day. This should be done slowly and throughout the day. Never drink more than 2 ounces of liquid in a 15-minute period. This amount should be increased by 10-20% when the weather is very hot and humid to prevent dehydration.
3. Always drink liquids separately from the solid foods you eat. Avoid liquids for a period of 15– 30 minutes before eating and 30–60 minutes after eating solid foods. If you drink when you’re eating, the liquid flushes solid food out of your pouch. This will make you eat more and feel hungry sooner.
4. Eat only three times per day once you begin Phase IV: Solid Foods (this should correspond to mealtimes). Be sure to chew your food thoroughly, 25–30 times, before swallowing. Only take small bites of food at a time (less than one teaspoon) as you gradually return to eating solid foods. Between meals snacking or “grazing” small amounts of food throughout the day will sabotage your weight loss and result in the inability to lose an adequate amount of weight.
5. Avoid foods that contain sugar. These foods will slow your weight loss. They contain empty calories. Foods to avoid include:
- Ice Cream
- Sugary soda
- Fruit juices
- Gelatins and puddings
6. Eat slowly. Chewing is key. Enjoy the taste of the food you are eating. Chew your food 25 times before swallowing. Solid food should be cut up into bite-sized pieces the size of your thumbnail. Make sure you are taking at least 20 minutes to eat. It takes that long for your stomach to tell your brain you’re full. If you eat too fast you may overeat, overfill your pouch and end up extremely uncomfortable and vomiting.
Stop eating as soon as you begin to feel full. Do not “stuff” yourself, as this may cause your stomach pouch to stretch – or worse, burst – causing long-term problems and complications.
Once you are eating solid foods, do not take in liquid calories. While your diet begins with liquids, it should not include liquid calories once you have progressed to solid foods. Liquids will pass through the restricted stomach, you will not feel full and can cause you not to lose weight.
All successful bariatric surgery patients have two things in common: they followed their dietary recommendations closely and they initiated a regular exercise program. Within a few days after surgery, begin walking and start other light physical activity. It is essential that within four to six weeks after surgery, you begin a regular exercise program. Initially this may simply be walking around the neighborhood four times per week for 40–60 minutes. Later (3–4 months post-op) it will also involve low-impact resistance training (swimming, light weightlifting, rowing, etc.) This will guarantee not only good weight loss, but will also improve your stamina, energy level, and overall health.