#42 What to Eat in the Weeks Following Bariatric Surgery

bariatric surgery success podcast beyond bariatric surgery podcast

HOST: Registered Dietitian Nutritionist Dr. Susan Mitchell 

You’ve had bariatric surgery and your new journey has begun. It’s an exciting time, isn’t it, but can also be a time of confusion and uncertainly. What do you eat now? Next week? Next month and down the track? I have tips for you to try and suggested recommendations for the best outcome in these first 6-8 weeks.

Hi, I’m registered dietitian nutritionist Dr. Susan Mitchell. You’re listening to the Bariatric Surgery Success podcast episode number 42. I like to give a shout out to Nick, who had this to say about the podcast: “Have enjoyed listening to your podcasts - really great to have information directly relevant to bariatric surgery related eating” Thank you, Nick. I often hear that after surgery it’s so confusing as to which direction to go. I’m glad to help and to know that the information is relevant. Thank you for listening Nick and thank each of you for listening and sharing with your friends.

Your diet is going to morph a lot in the next days, weeks and months as your body heals from the surgery. What you eat will change as the days and weeks pass by. Let’s focus on the initial six-eight weeks following your surgery. Remember that every surgeon or surgery center may have their own nutritional regimen for you to follow depending on your surgery. Today’s information will work in tandem with that information but if you have any questions specific to your case, always circle back to your surgery center or office. 

Think of your next six-eight weeks as a gradual progression in terms of food texture and consistency. Immediately following your surgery, your diet will be room temperature clear liquids or basically anything you can see thru for 24-48 hours up to 4 days. You will slowly be working your way to up to 8-12 cups/day or about 2 to almost 3 liters of water and other liquids. You’ll start with small sips every 15 minutes as tolerated and build from there. Did you know that dehydration is the main reason for re-hospitalization after bariatric surgery? That’s why fluids are so important to start your journey off right. 

Clear liquids don’t include carbonated beverages as they tend to introduce air and cause discomfort…something you do not want right now. Water, diluted fruit juice, protein water, broth, bouillon, low-sugar clear protein drinks, all work during this initial phase. Protein waters and low-sugar clear protein drinks are a good way to start adding protein back in to your diet from the very beginning.

If you have no issues, somewhere between days 3-7 you’ll add other liquids, called full liquids that you can’t see thru, such as milk, soy milk, and sugar free drinkable yogurt as you continue to heal. Milk, soy milk and drinkable yogurt all contain protein So you can see you’re starting to include protein sources right away as you did with the clear liquid protein drinks. You may also drink high-protein low-calorie liquid supplement drinks with 20 or more grams of protein and around 200 or less calories. You can also try powders that you stir into milk to meet your protein requirements during this full liquid phase. How many grams of protein should you have each day on full liquids? Aim for 60-70 grams total so read the nutrition labels closely. Look at the serving size and then how many grams of protein are in that serving. Try to keep your carbohydrate intake around 50 grams per day. For example if you’re having a blended, drinkable vegetable soup, again, check the nutritional label and see how many total grams of carbs are in a serving. If you drink half a serving, cut those numbers in half. 

Depending on your surgical center you may stay on full liquids 1-2 weeks while other centers suggest up to 21 days or about 3 weeks. So, how are you doing? Hanging in there? I know you can do this tough work. Keep going.  

After these 2-3 weeks on a full liquid diet, it’s typically time to move on to a pureed then mashed, soft diet such as scrambled or boiled eggs, soft meatballs, vegetables that are cooked and peeled (notice the word peeled for right now) and soft peeled fruit…again peeled for right now. The ideal way is to start with smooth, blended or pureed foods and work you way to foods that are more mashed than blended and then to soft foods. 

Tip 1: you will fill up much more quickly than you did before surgery so eat your protein food first and chew it so well that it becomes pureed almost like baby food in your mouth. You still want to eat that 60-70 grams of protein a day so starting with it first helps you be successful with that daily goal

Tip 2: don’t miss this…now is the time to separate liquids from solid food. What does that mean? Drink your beverages 15-30 minutes before you eat and 30 minutes after you eat. Why? Your capacity for food is much smaller and you want to get in the needed calories and nutrition for your body. You will accomplish this more easily by separating liquids from food and will not have as many side effects.  Remember 8+ cups of water or 2 plus liters is what you are aiming for each day along with your food.

At 4-6 weeks out from surgery and you are doing well, it’s about time to add some solid foods to your diet including legumes (or all types of beans and split peas cooked soft), fresh vegetables, fresh fruit and a small amount of starchy foods such as baked or mashed potatoes, corn or peas. Notice when we talk about carb foods such as fruit, veggies or potatoes, we’re not talking about more refined carbs like candy, cakes, cookies, etc. Why? These refined or also called simple carbs set you up for dumping syndrome that occurs if you eat foods high in sugar and fat. Symptoms of dumping syndrome include light-headedness, sweating, rapid heart rate, cramping and abdominal pain, nausea and diarrhea. That’s the last thing you want right now as you are healing.

About 6-8 weeks have passed now and you did it. You’ve progressed and are now ready at this 6-8 week point to transition to a regular, healthy, balanced diet. This step is so important. You’ve had surgery, yes, and you will eat less, true, but you will still eat regular nutritious foods that provide you with broad spectrum nutrition and satiety or that feeling of fullness. Did you catch that? One of the big reasons to move forward to healthy regular foods is to help prevent weight regain and feel satisfied from the various foods that you eat. So if you’re thinking, Oooh, not sure i want to go back to real food, that’s what got me in trouble to start with and I don’t want to gain weight, remember that your focus is on real healthy nutritious and tasty foods yes, but also on smaller portions and foods that are lower in calories.  If you are dealing with any pain, nausea or vomiting be sure and consult your bariatric dietitian. We’ll be talking about what a healthy diet and lifestyle for the long haul look like in an upcoming podcast. Well done, pat yourself on the back for me.

Don’t forget to join me in the NEW private FB group …the Bariatric Surgery Success community. This is a great place to ask questions about your diet and the things we talk about in the podcast like today. You’ll see the link to join in the weekly newsletter or you can join right now from the website Breakingdownnutrition.com You’ll see the JOIN button on the homepage. AND if you’re not receiving the newsletter, sign up while you’re on the homepage. You’ll be the first to know about new podcast episodes, freebies and other resources. Have a good week and I’ll see you in the Facebook group.

 

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