Bariatric Surgery Diet and Vitamin Instruction Guide
Physicians East Bariatrics
This guide is to provide you with an overview of the diet and vitamin regimen that you will be using following your bariatric surgery. This information was reviewed with you at the Patient Education Class and at your Nutritional evaluation that you had during your pre-operative evaluation process. You were given written information at that time that was more specific in regards to your diet and vitamin regimen. You will need to continue to refer back to this information for a more comprehensive explanation of the progression of your diet. Keep a journal or log of your meals daily. This will help you to keep track of what you are doing right and wrong in regards to what you are eating and drinking. If you need for our staff or Nutritionist to review this with you, please feel free to contact our office.
It is required by our program that you go back to see the Nutritionist one month following your surgery for further instructions regarding your diet. You may call Physicians East at 252-413-6683 to schedule this appointment.
Stages of Your Diet
While in the hospital following surgery your diet will consist of:
-2 ounces of a nutritional protein supplement three times a day (three meals)
-1 to 2 ounces of water every hour in between your meals
Your nurse will be in charge of measuring the amounts for you.
Gastric Bypass/Sleeve Gastrectomy:
Stage I
Once you have been discharged from the hospital your diet will consist of a clear liquid or full liquid diet. You will be following this diet for 1 to 14 days or the first 2 weeks following surgery.
The amount consumed at each meal will be 2 ounces or 1/4 cup of liquid.
You will need 6 meals a day. Example: 8am, 10am, noon, 2pm, 5pm, 8pm
Your meal choices can consist of: -Water -Clear Broth such as Chicken or Beef Broth -Any of the beverages that you can sip on in between meals for hydration -Skim Milk, Nonfat Acidophilus Milk, Plain Soy Milk (Introduce slowly to determine if lactose intolerant) -Oral Supplements: Boost/Ensure/Glucerna/Slimfast/Advant Edge
You will need to add protein powder to your meal choices to equal 60 to 80 grams of protein daily. Your nutritionist will determine the amount of protein that you will need at each meal.
You can purchase the protein powder from Medical Park Pharmacy.
NO solid foods at this stage.
You will need to sip on non-sweetened, non-carbonated beverages in between meals for hydration. These liquids include: -Water/Flavored Water -Crystal Light -Diet V-8 Splash -Carb Countdown Low Carb Orange Juice -Carb Countdown Low Carb Milk -Sugar Free Popsicles or Sugar Free Jello
Stage II
This stage of your diet will consist of pureed foods. You will be on this stage for days 14 to 28 or week 3 and 4 following surgery.
The amount of each meal should be between 2 to 4 ounces or 1/4 to 1/2 cups of food.
You will still need to have 6 meals a day.
Your food choices can consist of: -Pureed Vegetables -Fruit smoothies -Vegetables -Fat-free light yogurt -Sugar Free Pudding -Low fat Cream Soups -Baby Food (Stage I food) -Low fat Cottage Cheese -Creamy Mashed Potatoes -Unsweetened Applesauce -Pureed Meats (NO CHUNKS)
You will need to continue to add the protein powder to your food (60 to 80 grams per day)
Your food should be of a smooth, soft consistency that requires no chewing. Your food should not contain any chunks.
Continue to sip on fluids as directed in Stage I in between meals. Avoid drinking liquids 30 minutes before and after a meal.
Stage III
This stage of your diet will consist of soft foods. You will be on this diet for days 28 to 42 or week 5 and 6 following surgery.
You will be eating 3 meals a day with 1 to 3 snacks per day.
You will be having between 2 and 4 ounces or 1/4 to 1/2 cup of food at each meal. Stop eating when you become full.
You will need to continue to sip on fluids in between meals as directed in Stage I and II. Stop drinking fluids 30 minutes before and after meals.
Your diet should consist of foods that are fork tender, soft and moist. Tough and dry foods may not be tolerated well.
You will start adding meats to your diet. Meat choices include:
-Any seafood: broiled white fish, steamed shrimp, canned tuna,
lobster, scallops
-Canned chicken or slow cooked chicken
-Soft ham, turkey, ground hamburger, eggs, peanut butter or low fat cheese
Avoid tough and fibrous meats such as steak and pork chops until 6 months following surgery.
No raw fruits or vegetables, breads or rice until 6 months following surgery.
Always have protein first at mealtime. (60 to 80 grams a day)
At 6 weeks following surgery, you will be able to eat 3 meals a day with 2 snacks that consist of meat, fruit and vegetables. You will still need to eat small amounts and measure the amounts of foods that you are eating.
Gastric Band:
Stage I
Once you have been discharged from the hospital, your diet will consist of a full liquid and pureed diet. You will be on this stage for days 1 to 14 or week 1 and 2 following surgery.
The amount of each meal should be between 2 to 4 ounces or 1/4 to 1/2 cups of food.
You will need to have 6 meals a day. Example: 8am, 10am, noon, 2pm, 5pm, 8pm
Your food choices can consist of: -Pureed Vegetables -Fruit smoothies -Vegetables -Fat-free light yogurt -Sugar Free Pudding -Low fat Cream Soups -Baby Food (Stage I food) -Low fat Cottage Cheese -Creamy Mashed Potatoes -Unsweetened Applesauce -Pureed Meats (NO CHUNKS)
You will need to add protein powder to your food (60 to 80 grams per day). This may be purchased at Medical Park Pharmacy.
Your food should be of a smooth, soft consistency that requires no chewing. Your food should not contain any chunks.
You will need to sip on non-sweetened, non-carbonated beverages in between meals for hydration. These liquids include: -Water/Flavored Water -Crystal Light -Diet V-8 Splash -Carb Countdown Low Carb Orange Juice -Carb Countdown Low Carb Milk -Sugar Free Popsicles or Sugar Free Jello
Stage II
This stage of your diet will consist of soft foods. You will be on this diet for days 14 to 28 or week 2 through 4 following surgery.
You will be eating 3 meals a day with 1 to 3 snacks per day.
You will be having between 2 and 4 ounces or 1/4 to 1/2 cup of food at each meal. Stop eating when you become full.
You will need to continue to sip on fluids in between meals as directed in Stage I. Stop drinking fluids 30 minutes before and after meals.
Your diet should consist of foods that are fork tender, soft and moist. Tough and dry foods may not be tolerated well.
You will start adding meats to your diet. Meat choices include:
-Any seafood: broiled white fish, steamed shrimp, canned tuna,
lobster, scallops
-Canned chicken or slow cooked chicken
-Soft ham, turkey, ground hamburger, eggs, peanut butter or cheese
Avoid tough and fibrous meats such as steak and pork chops until one month following surgery.
No breads or rice until 6 months following surgery.
Always have protein first at mealtime. (60 to 80 grams a day)
*One month after surgery, you will be able to introduce salads, fresh fruits and vegetables to your diet.
Tips for Preparing Pureed Foods:
Prepare fresh fruits or vegetables by scrubbing, paring or peeling, and removing seeds.
Prepare meats by removing all bones, skin, connective tissue, gristle and fat.
Cook foods, when necessary, boiling them in a small, covered saucepan with a small amount of water until tender. The amount of water is important — the less water used, the more nutrients stay in the food.
Puree food using a blender, food processor, baby food grinder, spoon or fork. Grind up tough foods. Cut food into small pieces or thin slices. Take out seeds and pits from fruit.
Test for smoothness by rubbing a small amount of food between your fingers. Add a liquid such as formula, water or fruit juice to achieve a desired consistency.
If pureed food is not being used right away, refrigerate quickly.
To freeze: pour cooled, pureed food into a paper cupcake liner or a section of a clean ice cube tray, and cover with foil. When frozen solid, store cubes in a freezer container in the freezer in a freezer bag or box.
Reheat frozen cube in a heat-resistant container in a pan of hot water.
Equipment Needed to Make Pureed Food
Sieve/strainer: It should have a small mesh. You can press foods through it with the back of a spoon. It can be used for juices, soft fruits and vegetables, but not meats.
Spoon, forks and potato masher: Use these to mash soft foods, such as most canned fruits, egg yolks, bananas and potatoes, to the right consistency.
Food mills or grinders: You may already have a food mill in your canning supplies, but if you don’t, they are available in stores that sell kitchen supplies. The larger mills and grinders are useful when preparing soft meats and both can be used for cooked fruits, vegetables and soft fresh fruits.
Blenders: Your blender can come in handy in preparing food. Hand-held blenders are useful pieces of equipment that you may want to consider.
Plastic ice cube trays: Use trays for freezing extra food that you prepare. After the food is frozen, remove the cubes and store in a container designed for freezing.
Vitamin and Mineral Supplements Following Your Surgery
Our protocol for vitamin and minerals should be strictly adhered to on a daily basis to help to prevent nutritional deficiencies. Vitamins are available to you in several different brands in order for you to be able to choose which type if better for you. For the first year after surgery, all of your medications must be in a chewable, crushable or liquid form. Please contact your doctors who prescribe your medications for you to assist you in changing the forms of medications that you take, so that they are easier for you to take following surgery. Your vitamin and mineral protocol is a lifetime commitment. Please refer back to the information given to you by your Nutritionist at the time of your Nutrition evaluation.
Gastric Bypass/Sleeve Gastrectomy Patients:
Bariatric Advantage: Available at Medical Park Pharmacy.
Multi-Formula Vitamin Chewable: 2 a day, 1 in a.m. with breakfast and 1 in the p.m. with supper.
Calcium Citrate Crystals, unflavored powder: 2 Scoops in am beverage and 2 scoops in afternoon beverage.
Iron: 1 chewable at lunch- 18mg dosage
Vitamin B12: 1 sublingual tablet at lunch- 1000 mcg
Optisource:Available at Medical Park Pharmacy, Health Wise Pharmacy and Wal-Greens.
Take 2 Optisource in the am with breakfast & 2 Optisource in the pm with supper.
PLUS you need additional 500 mg of Chewable Calcium Citrate with Vitamin D: Take 2 with lunch.
Total of 6 supplements a day.
Over the counter (OTC):Buying your vitamin and minerals at your local pharmacy:
Centrum Chewables: Take 1 in the morning w/ breakfast and 1 at night w/ supper.
Calcium Citrate with Vitamin D, 1500 mg per day
Take 2 with am snack, 2 with afternoon snack and 2 with bedtime snack. (Do not take all of it at once)
Vitamin B 12, 250-500 mcg per day: 1 sublingual tablet daily (place under your tongue and it dissolves) or an injection by your MD once a month.
Iron as needed.
Total of about 9 supplements a day.
Gastric Banding Patients:
Bariatric Advantage:Available at Medical Park Pharmacy.
Vitaband: Take 2 per day, 1 with breakfast and 1 with supper.
Additional Calcium Citrate of 1,000mg per day needed
Optisource:Available at Medical Park Pharmacy, Health Wise Pharmacy and Wal-Greens
Take 2 per day, 1 with breakfast and 1 with supper.
Additional Calcium Citrate of 1,000mg per day needed
Over the counter (OTC):Buying your vitamin and minerals at your local pharmacy:
Centrum chewables, Take 2 per day, 1 with breakfast and 1 with supper.
Additional Calcium Citrate of 1,500mg per day needed: 90 Day
Quick Reference
Gastric Bypass/Sleeve Gastrectomy:
Stage I
Clear or Full Liquid Diet with Protein Powder
Stage II
Pureed Food (No chunks) with Protein Powder
Stage III
Soft Foods with meats
Gastric Band:
Stage I
Full liquid or puree diet (no chunks) with Protein Powder
Stage II
Soft foods with meats (no liquid calories)
If you have any questions regarding your diet or vitamin regimen, please feel free to ask your surgeon, his staff or your nutritionist.
Updated 7/2011