Bariatric surgery diet

Important:
If you currently control diabetes with medication, this will need to be adjusted during the pre- operative
diet. Please speak with your doctor, you may need to reduce your diabetes medication parallel to reducing
your food intake. Blood sugar level should be controlled more regularly to avoid hypo-glycemia. If you
control your diabetes by diet alone, you don’t need to be worried about your blood sugar.

Additional Pre Surgery Notes:

• Talk to your doctor about stopping certain medications prior to your surgery.
  The following medications are typically stopped 5-7 weeks before the treatment.
  Coumadin, Warfarin, Acenocoumarol, Marcumar, Xarelto, Pradaxa, other anti-coagulation medications (blood thinners) like: Aspirin, Clopidogrel, Plavix, Brilique, Motrin, Advil, Celebrex and any other NSAIDs
• If you have sleep apnea and use a CPAP machine, please bring it with you to Hospital
• Stop smoking. Smokers have an increased risk of blood clots and complications during and after the
  surgery.

7-14 days before the procedure, the compulsory preoperative diet should include:

• Only sugar-free and no caffeinated beverages, no fizzy drinks, no alcohol
• Fat low natural yoghurt, milk, smoothies, milkshakes
• Soup with no solid pieces of food
• Cooked vegetable
• Fruits juice (low in sugar)
• Fresh vegetables and fruits
• One daily steam cooked fish or dairy
• Minimum of 2 liters of fluid per day at regular intervals
• 2-3 times per day Protein shakes/ Nutri-drinks as replacement for meals
  (Macro Meal, Maxi Nutrition Promax, Chike, GNC Total Lean Shake 25)

If you have any questions, ask your KCM Coordinator!

Post bariatric surgery diet

You’ve just opened the door to a new, healthy life – congratulations!
You’ve chosen the most effective means of treating overweight problem and obesity related diseases, creating a sustainable weight loss. It is time now to move to the next stage – amending your lifestyle. The essential change you will be making is correcting your diet and the amount of food you can eat.

There is no room for cheating anymore. Abiding by the appropriate diet, especially the initial 4 weeks, will help you to prevent the postoperative complications. That is why, it is extremely important that you take the instructions seriously.
Non-compliance to your postoperative diet may result in diarrhoea, dehydration, constipation, bowel obstruction, or a very serious gastric leak.

Here are some basic rules for the first 6 weeks after your surgery:

• Consume food once it’s cooled down to a moderate temperature
• Do not consume carbonated drinks
• Take small portions (150g) meals every 2-4 hours
• Chew thoroughly
• Drink fluids 8-10 times per day, 100 ml – 150 ml each portion
• Drink no later than 30 min. before meal and not earlier than 30 min. after meal
• Avoid food that are too sweet, spicy, sour, greasy, hot or cold
• Consume slowly and stop eating as soon as you start feeling full up, even if it means leaving your food on the plate
• Avoid dishes with asparagus, spinach, leafy, cauliflower, broccoli stems, green beans, leeks, cabbage and onion
• Avoid products of small size which may be swallowed as a whole bit, for instance: broad beans, cherries, nuts, etc.
• Cancel the consumption of high energy products and replace them with a variety of low-calorie products to provide your body with a large amount of vitamins and minerals
• Take your medication and vitamins according to the recommendations
• The use of thromboprophylaxis reduces the risk of embolic complications

In case of adverse effects, like vomiting after meal, indigestion or nausea, ask yourself the question:

• Did I eat too fast?
• Was the meal sufficiently well chewed?
• Did I eat too much ?
• Did I drink with the meal?
• Did I drink too soon after meal?
• Did I lay down too soon after meal?

Your Diet – Weeks 1 to 5 and after:

WEEK 1 

Clear Liquids + Natural Yoghurt + Nutri drinks/ Protein shakes

In the first 5 days after surgery, clear liquids are the basis of the diet: water, lukewarm tea without sugar. In addition, natural yoghurt and protein Nutridrinks, and the products described below:
Do not worry, most patients do not feel hungry. The part of the stomach responsible for secret-ing the hunger hormone is almost completely removed during the operation.

You can consume:

• Water
• Tea
• Yoghurt
• Jelly or pudding (low-sugar)
• Low-fat broth

Avoid products containing:

• Sugar and caffeine

Do not consume:

• Carbonated beverages
• Sweet beverages

WEEK 2

Full Liquid Diet With High Protein + Nutridrink

Your diet may include all items from week 1 plus:

• Sugar free pudding or sorbet
• Soup with soft noodles or blended vegetable soup
• Watery porridge (low-sugar)
• Semi-skimmed or skimmed varieties of milk
• Almond milk or coconut milk are also greatprotein cocktails
• Other watery soups (without solid pieces)
• Diluted no-sugar added juice
• Sugar free, ice cream
• Thinned applesauce (low-sugar)
• Additionally 1 Nutri drink daily, which you can mix with yoghurt or low-fat milk

What to do when it feels like some food is stuck in the esophagus /stomach:

Immediately stop eating and try to get something to drink (small sips). If in the next few hours you will get the impression that the fluid does not go down, you should contact your doctor.

You should call your doctor if you experience:

• Repetitive, frequent vomiting after meals
• General weakness, dizziness, fever, chills, etc.
• Black, loose stools
• Sudden, not retiring appearance of abdominal pain, or any other problems that concern you

The foods listed below are typically acceptable for week 3 after the surgery:

• Low-fat cottage cheese
• Grain products – soften them before eating
• Soft vegetables, steamed or boiled
• Blended or ‘overboiled’ soups
• Eggs or scrambled eggs (great source of proteins)
• Steamed fish, tinned tuna or salmon
• Fruit or vegetable puree, e.g. blended bananas, avocados
• Potatoes or carrots puree with a little bit of olive oil or butter
• Well-cooked rice or pasta

You should avoid:
• Sugar, fat, salt
• Fibrous vegetables like asparagus, raw leafy greens, peas

WEEK 3

Soft Blended Food

The third week brings some real food into your diet. But the good news is, you can start adding some “real” food to your diet. Nevertheless, the food must still be eaten soft or mixed. You still need to be careful to limit sugar, fat and salt.

The goals for week 3 include:

• Get your 60 grams of protein per day (e.g. 150 g cottage + 1 glass of skimmed milk + 100 g fresh fish + 1 Nutri drink/ Protein shake)
• Eat slowly, chew your food throughly
• One at the time and cautiously introduce new food slowly

Food might taste different and is tolerated differently than before the surgery. Give your organism some time to react to each new food. Doing so, will enable you to determine food that you
tolerate and food that is upsetting your stomach or cause diarrhoea or winds.

WEEK 4

Introducing More Dishes!

The first three weeks of the diet are behind you. Now it’s time to start introducing new dishes.
Your stomach is still sensitive, so still be careful, introduce foods slowly and be sure to chew each bite thoroughly.

You don’t need to blend food anymore, but you should still choose soft foods.

• Continue drinking Protein shakes/ Nutri drink (1x/day).
• Consume fruits
• You can introduce cooked beef very carefully (ensure you chew thoroughly)
• Any type of fish
• Eat vegetables (steamed or soft cooked)
• Potatoes (mashed or boiled potatoes)
• Cereal
• Caffeine can be introduced but you should limit this
• Soft wheat bread without seeds

You should avoid:

• Fizzy or sweet drinks
• Fried food
• Fibrous vegetables
• Candy, chocolate
• High carbohydrate and low nutrient foods like pizza
• Whole milk and whole milk dairy food
• Nuts

Healthy Snacks

While it is recommended that you only eat 5
small meals each day (3 main meals and 2
small snacks) and hydrate in-between meals.

We suggest:

• Hummus with rice crackers or boiled and cooled baby carrots
• Boiled egg
• Quarter of a baked sweet potato
• Banana, strawberries or other fresh fruit

WEEK 5 and after: 

Introduction Of New Dishes

Continue the introduction of new dishes one at the time, to see how are they tolerated.
Is important that food bites must be eaten very slowly and carefully, to avoid stomach discomfort or vomiting.

Keep checking for constipation, diarrhoea, and upset stomach.

• Eat several small meals every day, control your portions
• Hydrate throughout the day
• Stop drinking fluids 30 minutes before each meal
• Avoid snacking, if you do, choose a nutrient-dense food (fruit, vegetable, nuts)
• Take your recommended daily vitamins
• Ensure you get 60 grams of protein a day
• You can supplement daily with a Protein shake/ Nutri drink
• Avoid fizzy drinks

Incorporate sports / gymnastics into your daily routine – make it a habit

8 TIPS FOR HEALTHY EATING AFTER BARIATRIC SURGERY

1. Eat appropriate, nutrient-rich foods (e.g. apple, banana, fish). Avoid canned processed foods or ready meals.
2. Do not “drink” your calories. It won’t feed you. Avoid sweet drinks.
3. Expect an emotional roller-coaster. Don’t let food to comfort you and create a diet plan for every day.
4. Chew your food thoroughly and never rush while eating.
5. Control your portions. Plan what you are going to order if you’re going out and ask for half the portion at therestaurant. You may get a discount and you won’t be tempted to overeat.
6. Make water your new best friend. Drink it regularly through the day. Make sure you finish the entire bottle of still water every day, but remember not to drink with meals (this helps prevent stretching your pouch).
7. Keep moving and vary the types of activity.
8. Join our support group and make friends with other patients who can help you in difficult times.
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