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   After Surgery
Transitioning from your pre surgical period to your post surgical plan of care can be a challenging time. Ultimately, adopting and maintaining the lifestyle changes that you have learned during your pre surgical preparation will be vital in producing long term success after surgery. The following information aims to guide you along your path to sustained weight loss and better health.


Eating Plan after Bariatric Surgery

These diet instructions are simply guidelines. Please keep in mind that early on some patients will not be able to eat the recommended amounts of food and supplements. A simple rule of thumb is to not eat more than the recommended amounts. If you get full before then, just stop eating. Also, if you have trouble with foods in a particular stage, you can always return to the previous stage.

Stage 1 - Clear Liquid (Days 0-3):

This will be your first stage after surgery. Hydration and protein are the main concerns. This stage consists of clear, sugar-free, and caffeine-free fluids. During this stage your aim is to consume no more than 4-6 ounces of fluid each hour. A clear liquid protein, such as Isopure will be incorporated into this stage. Your goal is to consume 60-75g of protein each day.


Stage 2 - Full Liquid (Days 4-14):

The full liquid phase will incorporate a more calorically dense, higher protein meal plan. During this stage you will move from clear liquid protein supplements to protein shakes such as Robard, EAS, Premier, etc. Continue to take your protein supplements as snacks to ensure that your body is meeting its protein needs.


Stage 3 - Pureed/Soft Foods (Days 15-45):

During this stage you will start adding soft/pureed foods into your diet. The goal is to slowly advance your diet, so you can gradually start getting used to solid foods. Stage 3 foods alone will not supply you with the protein your body needs, therefore you are recommended to continue taking your protein supplements.


Stage 4 - Regular Diet (Day 45 and Beyond):

Stage 4 includes all of the foods in Stages 1, 2, and 3, plus a wider variety of food options.


Additional documents

Diet After Bariatric Surgery [PDF]
Sample Menus - Stage 3 [PDF]
Sample Menus - Stage 4 [PDF]
Shopping List - Stage 1 & 2 [PDF]
Shopping List - Stage 3 [PDF]
Shopping List - Stage 4 [PDF]


Vitamin and Mineral Supplements

Sleeve Gastrectomy [PDF]
Gastric Bypass [PDF]


Labs

Bariatric Post-Operative Laboratory Guidelines [PDF]



Pregnancy after Bariatric Surgery

Follow these basic guidelines for pregnancy after bariatric surgery.

BEFORE you become pregnant:
  • Wait at least 18 months after surgery to become pregnant to ensure healthy fetal development.
  • Birth control pills may not be as effective after surgery. You may want to consider an additional contraceptive method.
  • Inform your OB/GYN doctor about your weight loss surgery.
  • Take an additional 400 mcg folate per day.
  • Take an additional iron supplement with at least 18 mg iron. Ferrous fumarate may be better tolerated.
  • Baseline labs are needed to determine your nutritional status and to identify any deficiencies.
Your care DURING your pregnancy:
  • Tell everyone involved in your care that you had bariatric surgery.
  • Do not take the glucose tolerance test (GTT), a test for gestational diabetes. The test involves drinking 50 grams of glucose, which can lead to dumping syndrome in patients who have had gastric bypass. Better tests are fasting glucose level or 2 hour post prandial (after a meal) glucose level.
Your diet DURING your pregnancy:
  • Add 300-500 calories to your recommended 1000-1200 calorie plan by adding 1-2 high protein snacks during pregnancy (during breastfeeding increase to 2-3 high protein snacks).
  • Continue to eat protein-based meals and snacks.
  • Continue to take your vitamins and minerals as recommended.
  • Take an additional 400 mcg folate and at least 18 mg iron per day.
  • Limit artificial sweeteners including aspartame (NutraSweet®) and sucralose (Splenda®) and avoid saccharin (Sweet'N Low®) and stevia (Truvia®).
  • ** Caution with Vitamin A: Pregnant women should not exceed 6,000 IU per day.
Weight gain DURING pregnancy:
  • If your BMI is greater than 29, aim for a maximum of 15 pounds weight gain.
  • If your BMI is between 25 and 29, then 15 to 25 pound weight gain is appropriate.
  • After bariatric surgery, weight gain standards are different. Discuss your weight gain with your doctor.