A Patient’s Guide to Eating: Before and After Bariatric Surgery

Posted: Jul 17th 2020
Categories: Bariatrics

It’s common to hear this question from potential bariatric patients: “How does this affect what I’m able to eat?”. From your diet during recovery to enjoying life in the months following surgery, lifestyle changes are an important part of your weight loss journey.

Regardless of which bariatric procedure you’ll choose as your best fit, changes will be made to your digestive system. So it should come as little surprise that modifications will need to be made to your diet – what you’re eating, how much, and how often.

Wherever you are in your relationship with food, the team at Trinity Bariatrics believes you can benefit from the services of our dietitians. We understand that some patients have endured a lifelong challenge in their relationship with food. Others, however, are not at all triggered by food – and their journey to lose weight may be independent from what they’re eating.

Working with a Registered Dietitian (RD)

Our dietitians and nutritionists are an essential part of the Trinity Bariatric Surgery team. The patient’s professional relationship with a registered dietitian (RD) begins shortly after they are approved for surgery, then extends beyond the procedure itself. The support these providers give can help the patient maintain healthy behavior – in the weeks, months, even years after surgery is performed.

Prior to surgery, most patients meet with their dietitian twice. During the initial meeting, the dietitian will discuss a number of topics, including your weight history, past medical history, any current medication or vitamins, as well as a 24-hour food recall. The 24-hour recall helps dietitians understand what a baseline diet looks like for each patient.

Dietitians are also able to tailor your diet to any existing medical conditions. It’s quite common for a patient to have a preexisting gastrointestinal problem, like a food sensitivity or irritable bowel syndrome (IBS). Conditions like these are able to be taken into account, as are patients living with diabetes.

Two Weeks Before: Liver Reduction Diet

Patients are asked to adopt a “liver reduction diet” for two weeks leading up to the date of their surgical procedure. The goal of this is to optimize the patient’s condition going into surgery. This high protein-low carb eating plan is designed to get rid of excess fat that may be on the patient’s liver.

Many people do notice fairly significant weight loss (10-15 lbs.) during this time due to the change in their eating habits. However, patients are usually surprised to find out that the liver reduction diet is not an exclusively-liquid diet, but rather contains lean protein and green vegetables.

What Am I Allowed to Eat After the Procedure?

The following is intended to give potential patients a realistic overview of what they can expect from the dietary guidelines provided by Trinity Bariatrics. Please do not use this document as a replacement for the actual diet progression, which will be distributed to all Trinity patients upon their approval for surgery.

Protein is the most important component of a postoperative diet for bariatric surgery patients. Foods that are high in protein give patients the nourishment that we require, and also build a diet around high-quality, muscle-building meals.

Week One: Clear Liquid Diet

Starting when you are still in the hospital, patients will adopt a clear-liquid diet in the days following surgery. This includes water, decaffeinated herbal tea, broth, sugar-free popsicles, and sports drinks.

Toward the end of the first week, if all liquids are being tolerated well, the patient may integrate different types of milk (dairy or plant-based) – which can be mixed with meal replacement or protein powders for nourishment.

Week Two: Advanced Liquid Diet

Week 2 permits any liquid that was allowed in week 1. In addition, the patient will advance to slightly thicker milk- or plant-based liquids, such as drinkable yogurts and creamy soups. The patient guidelines provided by our office even have suggestions of specific brands to buy.

The key to week two is that pieces or chunks of food are still not to be ingested. For example, creamy soups may be permitted, but need to be strained before they can be eaten.

Weeks Three-Four: Transition to Pureed Foods

For the next two weeks, we advise patients that everything needs to be blended to the consistency of applesauce. Buying or borrowing a blender or food processor is recommended during this time. There are bariatric cookbooks available that highlight pureed meals that can be made during this time. Also, there are still restrictions on the types of food that you should be eating – mostly those low in fat, with no added sugar.

Why Are Our Stomachs Sensitive to Reintroducing Food?

It can be helpful for patients to think of their postoperative state as having a newborn stomach. Sutures and other modifications made in surgery mean patients have to build their digestion up by slowly reintroducing different types of foods, and taking care of themselves by keeping hydrated.

For example, in the gastric sleeve procedure, a patient’s stomach will have been stapled vertically. These staple lines are quite delicate, and if the patient were to have solid food right off the bat, they could potentially open them – increasing the risk of going septic in addition to other complications. Maintaining a liquid diet after surgery won’t affect the sutures; it will also prevent leaking of the patient’s new stomach.

Regardless of procedure performed, many patients have a low food tolerance following surgery because their stomach has been altered so much. A liquid diet is the ideal way for patients to get the nutrients they need while still allowing their stomach to heal following surgery.

What Is Dumping Syndrome?

When food moves through your digestive system faster than normal, it can cause unpleasant or uncomfortable symptoms. This is known as dumping syndrome, and it’s often marked by the occurrence of vomiting, diarrhea, or stomach cramps 30-60 minutes after eating.

In bariatric patients, it’s often caused by the consumption of added sugar. It can also occur due to dairy products, some fats, and fried foods. Thankfully, dumping syndrome is not a permanent medical condition. Patients can avoid experiencing dumping syndrome by closely following the dietary guidelines that will be provided to them by Trinity Bariatrics.

Postoperative Weight Gain and Revision Surgeries

A popular topic within the surgical weight loss community is the onset of weight gain after surgery, or a “revision surgery” to correct problems caused by the initial procedure. However, it is quite important to understand that the most common cause for weight gain and need for revision following bariatric surgery is the patient’s deviation from recommended lifestyle changes. Many of today’s high-calorie beverages and “convenience foods” are energy-dense and poor nutritional choices, which can overcome even the most effective surgical intervention.

Allowing unhealthy behaviors to become part of your postoperative routine is pushing the boundaries set by your bariatric surgeon. What this can do is stretch out the new stomach that was created by the initial procedure. In many, but not all cases, patients can do this themselves – simply by abandoning their healthy eating or regular exercise.

“When patients go through surgery, it’s just a tool,” says Kristen Gill, RDN, a Registered Dietitian and part of the Trinity Bariatric Surgery team. “If patients cannot demonstrate that they’re able to follow balanced eating, they may not be able to achieve long-term success.”

Again, this isn’t a challenge patients have to tackle alone. Our dietitians and physical therapists continue to support bariatric patients after their surgery. We believe that by providing patients with the right tools, education, and support to live their happiest and healthiest lives, each and every patient has the opportunity to reach success on their weight loss journey.

Ready to begin your weight loss journey? Call us at (716)893-0333.