Gastric Bypass Diet: Surgical Preparation and Recovery
Your Diet Before and After a Gastric Bypass
A detailed long-term diet after gastric bypass surgery is a key component in a successful outcome to lose weight. Weight loss operations are tool to lose weight as it reduces the size of the stomach. Gastric bypass also alters the small intestine to reduce the absorption of food, allowing you to lose weight and improve health. But to successfully shed pounds and keep them off, you must commit to a new way of eating for the rest of your life, which is why a comprehensive gastric bypass surgery diet is so important. You not only must eat less but should also make wiser choices when selecting what to eat.
Preparing for Gastric Bypass Surgery: Pre-Op Diet
Your new way of eating begins long before your operation. Following a gastric bypass pre-surgery diet has two purposes. The first is to help you become used to smaller portions and the second, to make better food choices. Depending on your circumstances, you may begin preparing for weight loss surgery as soon as approved for the procedure. Your doctor will work with a bariatric dietician to develop an eating plan that best fits your situation.
Start your personalized eating plan as soon as you are cleared for the procedure, anywhere from a few months to a few weeks before your procedure. Be sure to lose the amount of weight specified by your medical team because if you don't, your operation could be postponed or canceled. Drink liquids like water throughout the day, but make sure you stop at least 30 minutes before each meal.
General Pre-Op Diet Guidelines
All bariatric patients have a slightly different pre-op gastric bypass diet, yet you can expect general food intake guidelines.
- Eliminate or reduce foods that are high in saturated fats, including whole milk, fried foods, and fatty meat
- Eliminate or reduce high-carbohydrate foods, including desserts, pasta, bread, and potatoes
- No high-sugar beverages such as soda and fruit juice
- Avoid alcohol
- Don't drink beverages with your meals
- Take a vitamin daily
Preparing for Gastric Bypass Surgery Through Diet
What you eat before surgery is just as important as what you don't eat. Your pre-surgery eating regimen relies heavily on protein intake, including protein shakes and powder. Protein is important for several reasons. It helps your body burn fat for fuel. Secondly, it strengthens and protects tissues. Depending on your overall health and weight, your medical team may allow you to eat some solids during this time.
Before the procedure, make sure you ask the anesthesiologist for instructions about what you can or can’t have before the procedure. These suggestions may vary depending on your situation. For example, your doctor may want you to drink carbohydrate-rich fluids up to two hours before surgery.
48-Hours Before Gastric Bypass Surgery
About two days before operation, you will begin a diet of clear liquids to clean out the digestive tract and allow for a problem-free surgery. During this period, you will only be able to consume the following:
- Chicken or vegetable broth
- Sugar-free Jell-O
- Low sugar sports drinks
- Low sugar or diluted apple juice
- Decaffeinated tea
- Coconut water
Also, be sure to ask your anesthesiologist and doctor what you should not have immediately before gastric bypass procedure.
What Should You Know About Gastric Bypass Pre-Surgery Diet
Your pre-surgery diet is geared toward reducing the amount of fat in and around your liver. Decreasing the amount of fat around your liver will make it easier for the surgeon to perform the procedure. It also reduces the risk of post-op complications.
Protein decreases hunger because tryptophan, an amino acid in protein, triggers the part of the brain that signals fullness. The more protein you eat, the less you will snack. Protein helps build muscle. As you gain muscle, your metabolism will run higher, and you'll be able to lose more weight. You'll burn more fat, even when resting.
Benefits of Following a Pre-Operative Diet
Following the guidelines of a pre-operative diet benefits patients undergoing weight loss surgery in several ways. Following the guidelines will help:
- Reduce body fat. Any amount of weight you lost prior to surgery is helpful.
- Preserve muscle. High-protein diets encourage your body to use fat for energy.
- Prepare you for weight loss operation and recovery through healthy wound healing
- Prepare you for life post-op. Your pre-operative weight loss plan helps you prepare for new eating habits for the rest of your life.
Diet After Gastric Bypass Surgery (The First Few Days After Surgery)
The aim of the gastric bypass diet in the days immediately following bariatric surgery is to allow your stomach and small intestine to heal. Your gastric bypass diet plan starts as clear liquids and progresses slowly toward solid foods as your stomach heals. Some foods can stress your stomach and the staple line used to create your new stomach, resulting in leaks and other problems, which is why you reintroduce foods slowly. Please note that the term week is only an approximation as your progress may be quicker or slower.
Post-Surgery Stage 1: A Liquid Diet
For about a week following bariatric surgery, you'll follow a full clear liquid diet similar to the one you follow before your operation. You may also be able to consume skim milk and protein shakes. When consuming your liquid diet, be sure to do it slowly and not rush. Take recovery at your own pace, and don't consume anything before you are ready. Take a daily vitamin with liquid
Post-Op Gastric Surgery Stage 2: Full Liquid
The slow transition to solid foods occurs during this week. Many patients have no appetite after gastric bypass surgery but slowly begin to regain it as they add more foods. Remember, your stomach will only hold two or three ounces of food, so you need to choose wisely. You'll begin to eat a variety of very soft food along with clear liquids from the first week. Liquids may also include decaffeinated coffee or tea and skim of 1% milk, as well as pureed foods of certain varieties. Sip liquids slowly, and don't use a straw to avoid drawing unwanted air into your stomach.
Foods that you may be able to add include:
- Sugar-free pudding
- Thinned applesauce
- Non-fat yogurt
- Thin creamy soups
- Sugar-free sorbet
- Watery oatmeal
- Non-fat, sugar-free ice cream
As you begin to add more foods that appeal to you, your appetite will increase. Nevertheless, don't rush your intake as your stomach still isn't ready as you may experience vomiting and other complications.
You may feel your appetite increase during the second week, but it’s not a reason to eat solid foods. Your digestive system is still unable to handle solids and can result in vomiting and other complications. During this time, you should remember to drink at least 64 ounces of water throughout the day.
Post-Surgery Stage 3: Blended
Stage 3 of your bariatric operation diet allows you to reintroduce select soft and blended foods into your diet consisting of small meals. You may be able to reintroduce small amounts of lean meat if pureed, along with smoothies, but check first with your surgeon. Most food that you introduce at this stage should be well-cooked and pureed to aid digestion. Continue to eat slowly and consume small meals. Among the certain foods that you can eat are:
- Cream or vegetable soup blended with chicken, turkey, or whitefish
- Cooked, peeled, and pureed fruits and vegetables
- Non-fat Greek yogurt
- Fat-free or low-fat cottage cheese
- Boiled, poached, or scrambled eggs
- Egg whites
- Canned tuna in water
- Mashed avocado
Post-Op Gastric Surgery Stage 4: Soft Foods
Stage Four is the period where you get to eat a lot more foods, but at the same time, you need to remember that it's important to consume high-protein soft foods like low-fat cottage cheese instead of junk foods in your diet and set the stage for the rest of your life. Tijuana Bariatric Center recommends that its patients stay in this stage longer than a week to give your stomach more time to heal. You should stay in this phase until about Day 40 following your procedure to see how your body reacts to new foods.
Your diet remains essentially the same as the previous week, with an emphasis on lean protein. Focus on eating slowly and thoroughly chewing all food. Foods that you may add include:
- Lean lunch meats
- Ground, finely chopped chicken, turkey, or fish
- Low-fat soft cheeses such as string cheese chewed well
- Cooked fruits without skin
- Soft, cooked vegetables like squash, carrots, and green beans
- Black, pinto, kidney, and lima beans, and lentils
- Mashed potatoes and sweet potatoes with skim milk and minimal butter
- Peanut butter
Stop eating when you feel full. Meat should not be tough or full of fat or gristle. If you have difficulty meeting your protein needs, take a sugarless protein supplement daily. Always remember to take a vitamin every day.
Begin to focus on long-term eating habits about six months after surgery. You should continue to lose weight for another six to 12 months and continue to improve your health. Once you have lost sufficient weight, limiting calories by eating several small meals per day is still important.
Gastric Bypass Surgery Recovery Timeline
The recovery time for gastric bypass surgery differs slightly from patient to patient. Most people stay in the hospital two to five days following laparoscopic surgery and can return to normal activities within three to five weeks. Continue to avoid smoking after gastric bypass surgery to aid your recovery. Weight loss begins immediately as your new stomach can only hold about 1 cup of food, and the number of calories your body can absorb is greatly reduced. Avoid strenuous activity for up to six weeks after gastric bypass. However, you can begin walking to reduce weight as soon as you can do so.
Your stomach and small intestine take longer to heal. Incisions will heal in about two to three weeks. The staple line in your stomach will heal in about six to eight weeks. Following the nutritional guidelines recommended by your doctor is essential to your recovery because your digestive tract needs time to readjust. During recovery, it is vital to drink 64 ounces of water every day so your body remains hydrated.
Long-Term Diet After Gastric Bypass Surgery
The long-term diet plan is different from your immediate post-op bariatric diet. In the months after surgery, you are still attempting to lose weight. At about Day 40, gradually introduce different textured solid food. Continue to avoid bread, rice, pasta, chia seeds, nuts, and crispy food like boxed cereal or crackers until sometime in the second or third month. Red meat like steak is harder to digest, so wait a few months after surgery before introducing it into your diet as it may take longer until you can tolerate them. You no longer need to blend food at this stage, but always make sure to chew everything you eat completely. Although you do not need to blend food, always make sure that it is tender and chew it well.
Following your procedure, some foods are more likely to cause pain, nausea, vomiting, or blockage. Add foods one at a time. If you can’t tolerate a food, try again in one to two weeks. Dairy foods can be troublesome as these may give you cramps, bloating, or diarrhea if you have trouble digesting lactose.
Eat small meals throughout the day, consisting of about 1 cup of food. Stop drinking liquids 30 minutes before each meal. When you begin eating, concentrate on protein first before eating other foods, and remember to stop eating when you feel full.
What Food to Eat After Gastric Bypass Surgery
Although you may think that you'll have severe restrictions on what you can eat in the long term, the variety of healthy food you can eat per day is quite large and includes many different cooked vegetables and fruit. Generally, you will want to plan your meals ahead of time. Choose healthy, nutrient-dense foods low in carbohydrates, moderate in good fats, and moderate to high in protein. Your healthy eating regimen will help improve or even eliminate health problems like type 2 diabetes. Always read the health information on packaging when deciding what to buy.
Meals Should Emphasize Protein
Choose lean protein like chicken breast, turkey, lean pork, Greek yogurt, low-fat cheese, and eggs. Legumes like lentils, kidney beans, and other dried beans also have high protein levels.
Eat Good Fats to Maintain Health
Foods with healthy fats include:
- Salmon and tuna
- Nuts and nut butter
- Coconut oil
What Fruits and Vegetables Can I Eat?
High-fiber fruits like strawberries, blueberries, and raspberries are a good choice for bariatric patients, along with fruits like pears, apples, and oranges. Vegetables like summer and winter squash are good choices, and broccoli, cauliflower, tomatoes, and bell peppers. Don't forget leafy green vegetables like spinach.
Can you eat popcorn after gastric bypass surgery? Sure, but only a cup at a time and without butter.
Gastric Bypass Post-Op Food Restrictions
Of course, you'll want to avoid foods that are high in calories to improve health and continue weight loss. Yet, you should also avoid empty calories. Ditch the junk food and fast food, and carbonated drinks. Foods you can't eat after gastric bypass surgery are:
- White bread, grains, or pasta
- Fried food
- Ice cream
- Fatty, sugary desserts
- Whole milk and full-fat dairy products
- Greasy and spicy foods
- Sweet corn
Gastric Bypass Surgery and Alcohol
Many gastric bypass patients want to know if they can enjoy occasional glasses of wine. The short answer is yes, but you have to gradually reintroduce drinking alcohol because of the rapid weight loss that your body undergoes. The altered structure of your stomach and small intestine makes your body metabolize alcohol differently.
Following surgery, blood alcohol levels peak higher and faster and take longer to drop. Some patients only need to have a single drink to become legally intoxicated. Because you are more sensitive to alcohol, you’re at a higher risk for developing alcohol use disorder.
Patients who have undergone RYGB are particularly at risk. A study published in the December 2022 issue of JAMA Surgery followed veterans from 127 health centers who underwent gastric bypass, gastric sleeve or gastric banding surgeries. Those who underwent gastric bypass were far more likely to enter the hospital for alcohol use disorders after their recoveries. In some cases, the alcohol use was so severe that it canceled the improvement in comorbidities provided by bariatric surgery. The study authors indicated that the change in metabolism pushed alcohol more quickly into the small intestine and was not a result of study participants drinking more.
To avoid the risk of alcohol abuse and the tendency to ingest too many empty calories, avoid drinking alcohol for the first six months after surgery. Your bariatric surgery provider should also thoroughly screen you to determine if you are already at risk for alcohol use disorder and whether another procedure would be more appropriate. Other alcohol consumption tips include:
- Don’t use carbonated or sugary drink mixers
- Eat a little while consuming alcohol to slow its absorption
- Remember that even small accounts can cause intoxication, so don’t drink and drive
With a proper gastric bypass before and after diet, your surgery, recovery, and long-term success will be more assured.
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