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Stages of the Eating Pattern Post-Op

FIRST TWO WEEKS

  • Consume liquids: anything that can easily pass through a straw (though do not drink with a straw).
  • Start the first two to three days with clear liquids like 100% juice diluted with water, low-fat broth, water, and non-caloric fluids.
  • After the first two to three days drink 1-2 ounces of a protein shake every three to four hours and sip on 48 ounces of non-caloric fluids between protein shakes to ensure ample protein intake and to prevent dehydration. Do this for 11-12 days.
  • Cold beverages cause the pouch to spasm, start with warm fluids or fluids at room temperature.
  • Introduce one new liquid item at a time to ensure tolerance.

ITEMS TO BUY

  • Low-fat broth/bouillon
  • Low-fat cream soups without solid pieces
  • Vegetable or tomato juice
  • 100% fruit juice without pulp (limit 1/2 cup a day)
  • Skim, 1%, rice, soy milk
  • Decaffeinated coffee/tea
  • Decaffeinated, sugar-free drinks that are non-carbonated
  • All sugar substitutes
  • A protein shake (see recommended products section)

SECOND TWO WEEKS

  • Consume "soft foods" (foods that do not require chewing or can be mashed with a fork). These foods should have no chunks and be soft and moist.
  • Eat 1-2 ounces of soft foods every three hours, emphasizing protein foods to ensure 50 grams of protein a day for women and 63 grams a day for men.
  • Take baby-spoon-size bites and chew until they reach a liquid consistency.
  • Sip non-caloric fluids between 1-2 ounce meals. Stop sipping non-caloric fluids a half-hour before each meal and do not resume sipping fluid for one hour after each meal. You must consume 48 ounces of clear, non-caloric fluids a day to prevent dehydration.
  • Clear fluids are fluids you can see through that have no food particles in them (such as pulp). Examples of clear fluids are grape/apple juices, broth, sugar-free Jello/Popsicles and decaffeinated tea/coffee.
  • Introduce one new food item at a time to ensure tolerance.

ITEMS TO BUY

  • Low-fat, low-sugar pudding
  • Cooked cereal (oatmeal, grits, Cream of Wheat, Farina)
  • Dry cereal with fat-free milk (just enough to make it soggy)
  • Dannon Lite and Fit creamy yogurt
  • Low-fat cottage cheese (small curd)
  • Chicken-, tuna-, salmon-, crab- and egg-salads made with low-fat mayo
  • Mashed potatoes
  • Unsweetened applesauce
  • Soft-cooked/scrambled eggs
  • Canned fruit in its own juice
  • Sugar-free Jell-O
  • Soft-cooked vegetables

Protein Amounts in Foods

NOTE: Eat these foods first to get the 50 grams for women and 63 grams for men in every day.

Egg = 6 grams
3 tbsp. meat, fish, seafood = 14 grams
3 ounces or 1 small (deck-of-cards sized) lean meats, fish, seafood = 21 grams
Dannon Lite and Fit Creamy yogurt = 8 grams
Hard block cheese (1 inch by inch cube) = 7 grams
Low fat cottage cheese ¼ cup = 13 grams
Skim/1%/lactaid free milk (8 ounce cup) = 8 grams

Once protein requirement is met for the day, these other foods may be consumed in the pureed stage:

  • Soups should be non-chunky. low-fat cream soups or pureed low-fat soups like Healthy Choice.
  • Add tasteless protein powder to boost protein in soups.
  • Try oatmeal, grits or instant mashed potatoes.
  • Try unsweetened applesauce and canned fruit in their own juice (no pineapple) and baby fruit, V-8 juice.

Week 5

  • Advance to regular consistency food as tolerable. Tolerance varies from person to person. Add regular foods slowly back into diet. Soft breads and thick meats won't be tolerated if not adjusted properly.
  • All foods should be low-fat, low-sugar or sugar-free and have high fiber.
  • Avoid broccoli, asparagus, dried fruit, corn, celery, artichokes, rhubarb, pineapple and dry/overcooked foods. These foods could obstruct the band if not overcooked and cut into tiny pieces.
  • Coconut, chips and popcorn can also obstruct the band and are best to be avoided.
  • Nuts are difficult to digest.
  • Eat 2-3 ounces of protein, 2 ounces of carbohydrate (1/4-1/2 cup of food) three to four times daily.
  • Introduce one new food item at a time.
  • Chew until food reaches a liquid state, to prevent vomiting.

POST-BAND FILLS

If a patient receives an adjustment:

  • Follow "Liquids" stage for 48 hours.
  • Advance back slowly to regular consistency foods.

TIPS ONCE EATING

  • Avoid overeating/vomiting at all costs. Both may cause slippage of the band and send you back to the operating room.
  • Eat slowly and chew foods until they are a mushy/thin consistency.
  • Work your way slowly up to meals of 1/4-1/2 cup of food.
  • Do not eat pieces of food that are too large and can block the stomach opening. Avoid thick meats and soft breads.
  • Stop eating when satisfied and comfortable. Do not become overly full. Overeating can cause the pouch to stretch prematurely and may cause vomiting. This may also cause a slip of the band and require surgery.
  • Eat three meals a day and consume protein with each meal.
  • Consume one protein shake a day.
  • Always read food labels for low fat, the sugar rule, and high fiber.

VITAMINS

  • All patients must take one chewable Bariatric Advantage multivitamin.
  • You may swallow a One A Day multivitamin after the first month.
  • Additionally, patients must take three Bariatric Advantage calcium chews a day for calcium.
  • You may swallow two calcium citrate vitamins with vitamin D to provide 1200-1500 mg/day after the first month.

VITAMIN SCHEDULE

Start immediately post operation

  • Take one multivitamin and one Calcium Chew
  • Wait two hours
  • Take one multivitamin and one Calcium Chew
  • Wait two hours
  • Take last calcium chew