Weight Loss Surgery - Helpfull info for those thinking about surgery




missmeliss
12-20-2005, 12:13 AM
:comp: I got this info from my doctor and found it very helpful, it gives you a better understanding of the diet after surgery I thought. I even practiced sipping 1 oz. of water for 5 minutes and tried to make it last. Do some measurements at home to really bring all the info to life. Hope I help someone.:carrot:





Eating For “The New You”!Roux-en-Y Gastric Bypass Diet

The gastric bypass diet will be essential in promoting and maintaining weight loss after your surgery and preventing complications. The diet is intentionally low in calories, and will require lifetime vitamin and mineral supplementation.

Post-surgery dietary guidelines will vary by surgeon. You may hear of other patients who are given different guidelines following their weight loss surgery. It is important to remember that every surgeon does not perform the exact same weight loss procedure and dietary guidelines may be different epending on theprocedure and surgeon. What is most important is that you adhere to your surgeon's recommended guidelines.

Immediately after your gastric bypass surgery, you will be maintained on intravenous fluids and kept NPO (nothing by mouth). Some physicians allow a few ice chips at this stage. When your surgeon feels you are ready, he will order “The Grape Juice Test.” This will help determine your tolerance to liquids, and, if well tolerated, your diet will be advanced.

Below is the progression of the gastric bypass diet at Baptist Hospital:
Phase

Diet Type

Total meal size Meals per day

Phase 1 Clear liquid
1-2 oz. (or 2-4 Tbsp) 3-5
Phase 2 Full liquid
1-2 oz. (or 2-4 Tbsp) 3-5
Phase 3 Puree
1-2 oz. (or 2-4 Tbsp) 3-5
Phase 4 Soft
1-2 oz. (or 2-4 Tbsp) 3-5
Phase 5 Regular
1-2 oz. (or 2-4 Tbsp) 3-5

With time .... Regular diet

3-4 oz. (or ~1/2 cup) 3 meals

The length of time you will be on each phase will vary by surgeon and your tolerance. You will most likely go home on Phase 1 and be advanced through the phases week by week. *Remember: Advance to the next phase only when your surgeon advises.

Daily Supplements Prior to surgery, If you have not been taking a multivitamin/mineral supplement regularly, begin a daily
regimen now to ensure your nutrition status is at its best.
After the surgery, your surgeon will start you on the following as soon as you can tolerate:

1. 2 children’s chewable vitamins with iron (will advance to adult multivitamins later)
2. B-12 shots monthly

Once you are referred to the Bariatric Center, your vitamin/mineral regimen will be reviewed. You can expect
to be changed to a 3X/day supplement regimen including a high potency vitamin/mineral supplement, calcium citrate, and an iron supplement. Supplements are to continue for life. Follow-up care throughout your
lifetime will help identify if any further changes in your supplements are necessary.

2. Fluids
1. In the hospital, you will be maintained on IV fluids to prevent dehydration. Use this time to practice
taking small amounts and sipping slowly.

2. Sip all fluids slowly. Take at least 5 minutes to consume 1 oz (30cc) of fluid. You will be given
small 1 oz. medicine cups to help train you to take small amounts. Consider using a cocktail straw.

3. Drink between meals, not with meals. Wait at least 15 minutes before and 15-30 minutes after ameal before starting to drink your beverages.

4. Always be aware of your fluid intake! You should drink at least 48-64 oz of liquids each daybetween meals. Water is the best choice, but other choices include: iced or hot tea, coffee, herbalteas, Crystal Light or equivalent, Propel, or sugar-free flavored water. Sugar-free fluids arerecommended. You may use sweeteners such as Splenda, Equal, Sweet/Low or other as preferred.Cold or hot beverages may be used.

5. You may drink 4 to 8 oz. of fruit juice, Gatorade or Powerade daily, but these are a source ofsimple sugars that may cause dumping syndrome, and, in excess, may increase caloric intake limiting weight loss. Dilute these beverages 50/50 with water to help decrease the chances of dumping syndrome.

6. Avoid carbonated beverages the first 2 weeks after surgery (or per surgeons recommendations).Moderate amounts of sugar-free carbonated beverages may be consumed thereafter, but water or other non-carbonated beverage is preferred.

7. Consume caffeinated beverages in moderation. Caffeinated beverages can have a dehydratingeffect. Tea and coffee (even caffeine-free) can also interfere with iron absorption. Prior to surgery,you may want to wean yourself from caffeine to help prevent withdrawal and headaches post-op, as
your consumption will be limited right after surgery.

8. Milk provides essential nutrients like protein, calcium and other vitamins and minerals and should beincluded daily after advancing to the phase 2 diet and beyond. It does however, contain calories, andcould limit weight loss if consumed in excess. 2 cups of fat-free (skim) or 1% milk daily is recommended. If you do not tolerate milk after surgery, try soy milk or lactaid milk or you may needto increase protein supplements to provide an additional 16 grams of protein.

3.Eating Tips

1. Think slow: Take at least 5 minutes to consume 1 oz. of food. Never eat on the run. Relax, sit down and enjoy your meal. Avoid nibbling while preparing your meals. A two ounce meal should take at least 10 minutes to eat; a three ounce meal at least 15 minutes; and a four ounce meal at
least 20 minutes.

2. Think small: Measure all your foods. See table below for measuring tips. Use smaller plates such as salad plate or coffee saucer to help ensure smaller portions and make food more appealing. Small bites are necessary–consider using baby silverware to help ensure small bites. Practice putting your fork or spoon down between bites to avoid putting too much in your mouth at one time.

3. Concentrate on what you put in your mouth: Chew thoroughly. Swallowing foods that are not chewed thoroughly may cause food to block the opening from your new pouch to the intestine. It may cause vomiting.

4. Learn to listen to your body: With your smaller stomach pouch, you will probably be able to identifysignals of fullness that you may not have experienced before. Learn to stop eating at the first signs of fullness. If left shoulder or esophageal pain develop, stop eating immediately–this is a sign you have overeaten. “Listening to your body” will also help you identify foods that are not well tolerated.

5. Introduce one new food at a time: This may help identify foods that are not well tolerated.

6. Aim for 60 grams of protein daily initially after surgery: Always include a good protein source with each meal. Eat your protein foods first to ensure these are eaten before you become to full. Choose 2 cups of milk daily. Use a protein supplement in the initial stages, or if you are not tolerating
protein foods.

7. No solid red meat for 6 months: Beef, pork, lamb, venison, etc, are difficult to chew adequately.

On phase 3, puree red meat is allowed if it is pureed smooth,
and on phase 4 (soft)
and phase 5(regular) lean finely ground meats are allowed.

Measuring Tips:
1 oz. = 30cc = 2 Tablespoons = 1/8 cup
2 oz. = 60cc = 4 Tablespoons = 1/4 cup
3 oz. = 6 Tablespoons
4 oz. = 8 Tablespoons = ½ cup

4
Phase 1 – Clear Liquid Diet
2 oz meals; 3-5 times per day

Juice
Limit 4-8 oz. per day
Clear juices: grape, apple, cranberry,
Powerade, Gatorade
Fluids (calorie-free)
At least 48-64 oz.
Water, sugar-free flavored water,
coffee, sugar-free tea, Propel, Crystal-
Lite, sugar free popsicles, chicken,
beef or vegetable broth

Gelatin
1-2 oz. portion
sugar-free

Other
Use in moderation
sugar-free sweetener (Equal, Splenda,
Sweet/Low)
Mild seasonings and spices.

Sample Clear Liquid Menu:
Breakfast--1-2 oz sugar-free red gelatin
Beverage between meals
4 oz apple juice diluted with 4 oz water and 8 oz water, sipped through morning
Lunch1-2 oz sugar-free green gelatin
Beverage between meals
8 oz. sugar-free koolaid
Snack 1—1/2 sugar-free popscicle
Beverage between meals
12 oz Crystal Lite and 8 oz. water, sipped through afternoon
Dinner--1-2 oz sugar-free yellow gelatin
Beverage between meals
12 oz black cherry Propel and 8 oz hot chicken broth sipped through evening
(Total fluids for day = about 64 fluid oz.)
*Take at least 5 minutes to consume 1 oz food or drink.
*Wait 15 minutes before or after meals to begin drinking.

6
Phase 2 – Full Liquid Diet
1-2 oz meals; 3-5 times per day
Food Group
How Much
Foods Choices
Juice
Limit 4-8 oz. per day
grape, apple, cranberry, pineapple,
orange, or grapefruit juice, Powerade,
Gatorade
Fluids (low-calorie)
At least 48-64 oz.
water, sugar-free flavored water,
coffee, sugar-free tea, Propel, Crystal-
Lite, SFKoolaid, SFpopsicles, chicken,
beef or vegetable broth
Refined cooked cereals
1-2 oz portions
Cream of rice, cream of wheat, thin
grits (cook with lots of water or milk)
Strained soup
1-2 oz portions
Strained soups, strained cream soups
(avoid tomato or bean based soups)
Other
1-2 oz. portions
Sugar-free pudding or egg custard,
Sugar-free gelatin
Milk or yogurt
2 cups
Fat-free (skim), 1% milk, buttermilk,
soy, lactaid; Plain or sugar-free vanilla
or other flavored smooth yogurt
Protein supplement
To equal ~35-40 grams
See supplement list on page 14
Sample Full Liquid Menu:
Morning Afternoon Evening
Breakfast
1-2 oz. thin grits w/1/4 tsp
margarine & sprinkle salt
Lunch
1-2 oz strained
cream of mushroom soup
Dinner
1-2 oz sugar-free
vanilla yogurt
Snack 1 Snack 2
1-2 oz sugar-free 1-2 oz sugar-free pudding
egg custard
Bevarages
1 cup (8oz) fat free milk
8 oz water
Protein drink (20 grams)
Beverages
16 oz Crystal Lite
Protein drink (20 grams)
Beverages
1 cup (8 oz.) fat-free milk
8 oz water
*Take at least 5 minutes to consume 1 oz food or drink. (Total protein = 61 grams)
*Wait 15 minutes before and 15-30 minutes after meals to begin drinking.

7
Phase 3 – Pureed Diet
1-2 oz meals; 3-5 times per day
The pureed diet consists of low residue foods requiring minimal chewing. It is designed to avoid
obstruction or blockage of the gastric bypass channel opening and to allow sufficient time for healing.
Choose 1oz. high protein foods with each meal. Use a blender, food processor, and/or strainer to make
foods a smooth consistency like applesauce. Add a little broth, cream soup, milk or other liquid to cooked
foods to make pureeing easier. Baby foods (stage 1) are convenient on this phase of the diet.

Foods Allowed

Juice
Limit 4-8 oz. per day
grape, apple, cranberry,
pineapple, orange, or grapefruit
juice, Tang, Powerade, Gatorade
AVOID Apricot, peach or pear nectars Alcoholic beverages

Fluids (low-calorie)
At least 48-64 oz.
water, sugar-free flavored water,
coffee, sugar-free hot or cold tea,
Propel, Crystal-Lite, SF Koolaid,
SF popsicles, chicken, beef or
vegetable broth,
diet soda (2-3 weeks after
surgery)
AVOID Regular sodas, beverages
sweetened with sugar, sweet tea,
fruit punch, lemonade, etc.

Meat
HIGH PROTEIN
All meats must be pureed, trim
fat, remove poultry skin. May use
beef, pork or ham, poultry, or fish.
Bake, broil, boil or steam meats
before pureeing.
AVOID Fried meats, spiced meats, fatty
meats (duck, goose, deviled ham,
bacon, sausage, salami, pickled
herring, smoked lunch meats)

Eggs
HIGH PROTEIN
Pureed cooked eggs
(scrambled, poached or boiled)
AVOID Fried Eggs

Cheese
HIGH PROTEI N
Melted cheese, smooth cheese
dips, cottage or ricotta cheese
AVOIDSpicy cheese containing onions
or peppers or those containing
nuts.

Milk & Yogurt
HIGH PROTEIN
2 cups (16 oz) daily
Fat-free or skim, 1% milk or
buttermilk; Soy or lactaid milk;
Sugar-free flavored low-fat or
non-fat smooth yogurt
AVOIDWhole or 2% milk; whole milk
yogurt

Protein supplement
HIGH PROTEI N
To equal ~10-20 grams

Nuts and Seeds
Smooth peanut butter
AVOIDall nuts and seeds; crunchy
peanut butter
Soups and Sauces
Strained soups only, cream
soups, bisques and chowders
AVOIDtomato based soups, bean based
soups or chili, french onion soup

Cereals
Cream of rice, cream of wheat,
strained oatmeal, thin grits
AVOIDHigh fiber cooked or dry cereals

Bread-None
AVOIDBreads and bread products,
crackers, popcorn, snack chips
and pretzels
Potatoes, Pasta and Rice
Pureed or mashed potatoes
(sweet or white), pasta and
noodles, white rice, couscous
Cornmeal, Chow mein noodles
(wheat noodles), brown or wild
rice

Vegetable
All vegetables pureed, low fiber
except on the restricted list
green beans, carrots, squash,
greens, spinach, beets, peas,
canned asparagus
AVOIDHigh fiber, gassy vegetables such
as broccoli, beans, brussel
sprouts, cabbage, corn,
cauliflower, cucumber, onions,
parsnips, green peppers

Fruits
All fruits must be pureed, low
fiber and non citrus
Applesauce, baby jar food fruits
AVOIDAvocado, all berries, cantaloupe,
all dried fruits, fresh dates, fresh
figs, pears, tangerines, citrus
(grapefruit, orange,)

Other
Use in Moderation
Sugar-free or pudding, sugar-free
gelatin, sugar-free or low sugar
fruit whips, sugar-free ice cream
or yogurt
AVOIDIce cream, cakes, pies, candy,
cookies, doughnuts, sweet rolls;
desserts made with coconut,
raisins, nuts

Condiments
Use in Moderation
Salt, mayo, vegetable oils, butter,
margarine, cream, sour cream
butter or pan sprays
All herbs & spices, vinegar
AVOIDPepper, BBQ sauce, chili sauce,
catsup, cocktail sauce, tabasco,
hot sauce, horseradish, mustard

Sample Pureed Menu:
Morning Afternoon Evening
Breakfast
2 Tbsp (1 oz.) pureed egg
2 Tbsp (1 oz.) crm of wheat
Lunch
2 Tbsp (1 oz) puree chicken
2 Tbsp (1 oz.) sweet potato
Dinner
2 Tbsp (1 oz) puree turkey
2 Tbsp (1 oz) puree peaches
Snack 1
1-2 oz cheesy grits
Snack 2
1-2 oz puree chicken salad
Bevarages
1 cup (8oz) fat free milk
16 oz water
Beverages
16 oz Crystal Lite
Protein drink (10 grams)
Beverages
1 cup (8 oz.) fat-free milk
8 oz water
(Total fluids for day = about 64 fluid oz.) (Total protein = 61 grams)
*Take at least 5 minutes to consume 1 oz food or drink.
*Wait 15 minutes before or after meals to begin drinking.

Phase 4 – Soft Diet
1-2 oz meals; 3-5 times per day
The soft diet consists non-irritating low residue foods. All foods must be thoroughly chewed to
avoid obstruction or blockage of the gastric bypass channel opening. Include a variety of foods and a good



Juice
Limit 12 oz. per day
grape, apple, cranberry,
pineapple, orange, or grapefruit
juice, Tang, Powerade, Gatorade
AVOIDApricot, peach or pear nectars
√with your doctor about alcoholic beverages

Fluids (low-calorie)
At least 48-64 oz.
Water, sugar-free flavored water,
coffee, sugar-free hot or cold tea,
Propel, Crystal-Lite, SF Koolaid,
SF popsicles, chicken, beef or
vegetable broth,
diet soda (in moderation)
AVOIDRegular sodas, beverages
sweetened with sugar, sweet tea,
fruit punch, lemonade, etc.

Meat
HIGH PROTEIN
(prepare meats with a moist
cooking method to avoid
dry/tough meats)
Trim visible fat from meat;
remove skin from poultry; bake,
broil, boil or steam meats; flakey
fish, dark meat chicken, lean
ground red meat, thin deli meat
AVOIDFried meats, spiced meats, fatty
meats (duck, goose, deviled ham,
bacon, sausage, salami, pickled
herring, smoked lunch meats)

Eggs
HIGH PROTEIN
Eggs; scrambled, poached, over
easy
AVOIDFried Eggs

Cheese
HIGH PROTEIN
Most cheeses and cheese dips,
cottage or ricotta cheese
AVOIDSpicy cheese containing onions
or peppers or those containing nuts.

Milk & Yogurt
HIGH PRTOEIN
2 cups (16 oz) daily
Skim, 1% milk or buttermilk; Soy
or lactaid; Plain or sugar-free
flavored low-fat or non-fat yogurt
AVOIDWhole or 2% milk; whole milk

Protein supplement
HIGH PROTEI N
To equal ~10-20 grams
See supplement list on page 14

Nuts and Seeds
Smooth peanut butter
AVOIDAll nuts and seeds; crunchy
peanut butter

Soups and Sauces
Chicken, beef, turkey noodle or
rice soup, broth, consomme,
vegetable based soups; cream
based soups
AVOIDTomato based soups, bean
based soups, chili, or french
onion soup

Cereal
Low fiber cereals such as Cheerios,
Corn Flakes, Special K, Rice
Krispies, Rice Chex, Corn Chex,
Cream of Wheat, puffed rice, puffed
wheat
Cooked cereals
AVOIDHigh fiber cereals such as Bran
Flakes, Bran Buds, Granola,
Grapenuts, Product 19, Wheaties,
Shredded Wheat, Shredded Bran,
Raisin Bran, Ralston, Total, Wheat or
Bran Chex, Wheat Germ

Bread
½ slice = 1 oz
3 small crackers = 1 oz
(Toasted bread is usually better
tolerated.)
Low fiber breads, bagels, English
muffins, corn bread, dinner rolls,
hamburger & hot dog buns,
matzo, Melba toast, saltine
crackers, plain bread sticks (with
out sesame seeds) plain croutons
AVOIDHigh fiber breads such as whole
wheat, rye, boston brown & those
with nuts or seeds; high fiber
muffins; high fiber whole grain
crackers; popcorn, snack chips
and pretzels

Potatoes, Pasta and Rice
Baked or boiled potatoes (sweet
or white, without the skin); barley,
noodles & pasta, chow mein;
white or brown rice, grits,
cornmeal, hominy, tapioca,
cornstarch, arrowroot
AVOIDWhole grain flours: “whole wheat”
or “whole rye”, wild rice
Potato with skin

Vegetable
Low fiber vegetable (preferably
cooked or canned) asparagus,
green beans, wax beans, beets,
carrots, collards, eggplant,
mushrooms, okra, spinach,
yellow squash, zucchini
AVOIDHigh fiber, grassy vegetables
such as broccoli, beans, brussel
sprouts, cabbage, corn,
cauliflower, cucumber, onions,
parsnips, green peppers,
rutabaga, sauerkraut, scallions,
onions, radishes, tomatoes,
turnips, celery, lettuce

Fruits
Low fiber fruits; non citrus fruits
(see restricted list); peel edible
skins off fruits, soft bananas,
applesauce, caned fruits (citrus
fruits are okay 30 days after
surgery)
AVOIDAvocado, all berries, cantaloupe,
all dried fruits, fresh dates, fresh
figs, pears, tangerines, citrus
(grapefruit, orange)

Desserts
All in moderation except those
on restricted list
AVOIDDesserts containing coconut,
nuts, raisins, or seeds; fig bars,fruit cake

Condiments
Use in moderation mild salad
dressing (french, 1000 island), oil
& vinegar, mayo, vegetable oils,
butter, butter sprays, margarine,
cream, sour cream
All herbs & spices, vinegar,
pickles, relishes, A-1 sauce, soy
sauce, teriyaki sauce,
Worcestershire sauce
AVOIDspicy salad dressing (blue
cheese, Cesar, Garlic, Italian,
Roquefort, Russian)
BBQ sauce, chili sauce, catsup,
cocktail sauce, tabasco, hot
sauce, horseradish, mustard

Sample Soft Menu:
*Remember to chew foods thoroughly
Breakfast
2 Tbsp (1 oz) scrambled eggs
2 Tbsp (1 oz) oatmeal with ¼ tsp margarine and Splenda
Beverage
1 cup fat-free milk and 12 oz water, sipped through morning
Mid morning snack
1 oz cheddar cheese
2-3 saltine crackers
Lunch
1 oz sliced deli turkey meat
½ slice bread (toast) with small amount mayonnaise
Beverage
12 oz orange Propel and protein drink (10 grams), sipped through afternoon
Midafternoon snack
2 Tbsp (1 oz.) cottage cheese
2 Tbsp (1 oz.) sliced peach
Dinner
2 Tbsp (1 oz) dark meat chicken
2 Tbsp (1 oz) vegetable medley with ¼ tsp margarine
Beverage
8 oz fat-free milk and 8 oz water sipped through evening
(Total fluids for day = about 60 fluid oz.) (Total protein = 61 grams)
*Take at least 5 minutes to consume 1 oz food or drink
*Wait 15 minutes before or after meals to begin drinking

Phase 5 – Regular Diet--Initially
1-2 oz. meals; 3-5 times per day
Once on the Regular diet, all foods may be eaten except those which cannot be thoroughly chewed or which cause discomfort or irritation. You can begin to try some of the foods that were in the restricted/avoid list like the vegetables or fruits you enjoy, or whole grain foods.

Remember to try one new food at a time so you will be able to identify which foods you may not be tolerating. Also, if you do not tolerate a specific food initially, try again later.

Eat a variety of foods daily (fruits, vegetables and whole grains) and be sure to include a good source of protein with each meal. Continue to choose 2 cups of milk or yogurt daily, and a protein supplement providing about 10-20 grams of protein

Sweets/desserts, fried foods and beverages containing calories should be limited/avoided (except 4-8 oz of
juice or Gatorade or Powerade, if desired)

Sample Regular Menu
Morning Afternoon Evening
Breakfast
2 Tbsp (1 oz.) egg
2 Tbsp (1 oz.) oatmeal
Lunch
2 Tbsp (1 oz) chicken thigh
1 tomato slice
Dinner
2 Tbsp (1 oz) spaghetti/meat
2 Tbsp (1 oz) noodles
Snack 1
1 oz cheese
1-2 slices apple
Snack 2
1 oz chicken salad
1-2 whole grain crackers
Bevarages
1 cup (8oz) fat free milk
16 oz water
Beverages
16 oz Crystal Lite
Protein drink (10 grams)
See page 14
Beverages
1 cup (8 oz.) fat-free milk
8 oz water
(Total fluids for day = about 64 fluid oz.) (Total protein = 61 grams)
*Take at least 5 minutes to consume 1 oz food or drink.
*Wait 15 minutes before or after meals to begin drinking.

Phase 5 – Regular Diet--Eventually
3-4 oz meals; 3 times per day

Once you are tolerating slightly larger meals, the regular diet should consist of three meals per day restricted in volume to 3-4 oz (6-8 Tbsp, or ½ cup total) per meal. However, do not try to force yourself to eat 3-4 oz. if
you are not ready–Listen to your body and stop at the first signs of fullness.

With the larger meals, you should have 2 oz. of high protein foods with each meal, and include a variety of other foods including fruits, vegetables, and whole grains. Continue to consume 1-2 cups of milk daily, however, you will no longer need the protein supplement, unless you are unable to tolerate protein foods or milk.

A between meal snack may be needed if there is a long time between meals—limit in size to 1-2 oz and
include a high protein food.
Sample Regular Menu (3-4 oz. meals):
Breakfast
1 egg w/cheese
½ slice whole wheat toast
Beverage
8 oz fat-free milk, and 12 oz water, sipped through morning
Lunch
1 oz. deli sliced turkey
1 oz. cottage cheese
1oz. macaroni salad
1 oz. tomato slices
Beverage
12 oz Iced tea with Splenda and 8 oz. water, sipped through afternoon
Dinner
2 oz. ham sliced thin
1 oz broccoli with ¼ tsp margarine
1 oz. fruit cocktail
Beverage
8 oz fat-free milk and 12 oz black cherry Propel sipped through evening
(Total fluids for day = 60 fluid oz.) (Total protein = 58 grams)
*Chew foods thoroughly
*Take at least 5 minutes to consume 1 oz food or drink
*Wait 15 minutes before or after meals to begin drinking

Protein
After gastric bypass surgery, your protein needs are increased because you are healing, however you can’t eat as much, and you may not be absorbing protein as well.

To aid in healing, keep the immune system running well, and minimize the loss of lean body mass (muscles,organs, etc.) as you are losing weight, a good source of protein should be included with every meal.

After surgery, aim for at least 60 grams of protein daily. To meet this, you will need a combination of food and protein supplements. Once you are healed, 45-60 grams of protein is a good goal and can be met through food alone. Taking more protein supplements than you need may result in added calories that can slow weight loss.

Food sources of protein are the best choice as they contain not only protein, but many other vitamins and minerals that are important for good health. Whenever possible, use food sources of protein. Vary your choices of protein foods for the best nutrition value.

Protein supplements are needed in the first phases after surgery to meet your protein needs. Choose wisely—choose the ones that give the most protein for the least amount of calories. A protein supplement with 20 grams of protein should have 120 or less calories. You can choose ready mixed beverages, or flavored or unflavored powders to mix with your own beverage.

If you mix a protein powder with milk, make sure to count that as your milk and protein intake, so your calorie intake will not be too high.
Decrease and then discontinue protein supplements as the size of your meals increase, unless you are not tolerating other protein foods.

• Contact your doctor if you have a medical concern such as vomiting, pain when eating meals,
lasting pain, fever, etc.
• Dumping Syndrome: Symptoms may include: nausea, weakness, sweating, faintness, cramping,
rapid heart rate, and diarrhea. Often related to intake of concentrated sweets so you may find
yourself eating fewer sweets or choosing sugar-free items more often to avoid this feeling.
• Adequate fluid intake (48-64 oz per day) is necessary to prevent dehydration and constipation and
to decrease risk of kidney stones. Use containers that help you reach this goal, such as 20 oz water
bottles–drink 3 per day and you’ve had 60 oz of fluid. Once the bottle is empty you can fill with any
calorie-free fluid.
• Freeze water bottles–the water will stay cold as you sip it slowly through the day.
• An increase in appetite or hunger may be noticed by some individuals about 10 to 14 days after
surgery. During this time most patients feel water intake is improved and easier to consume.
• Never eat on the run. Avoid eating while standing or in the kitchen. Set a place setting and sit
down to eat your meals–you’re worth it!
• Avoid distractions when eating such as TV or reading. This will help you concentrate on your meal
to chew thoroughly and identify the “full” signal.
• Measure foods in the beginning and learn what your meal size should look like on your plate. Then
periodically afterward measure your foods to “check yourself” and avoid gradually increasing portions.
• Attend support groups!
• Exercise daily! Walking is a wonderful exercise that’s easy and inexpensive. Once your surgeon
approves, weights or other muscle-toning exercises will be helpful to maintain lean body mass and
help with long-term weight loss and maintenance.
• Remember: Weight loss surgery is a tool to lose the weight that has been so difficult in the past for
you to lose. To maintain the weight loss, behavior and dietary changes are necessary. Ask for help
when you need it!

Steps you can take while waiting for surgery:
1. Read “Eating for the New You” several times and share it with others who will be helping in your care
after surgery.
2. Switch to calorie-free beverages and practice drinking slowly–1 oz in 5 minutes.
3. Practice eating meals without drinking.
4. Eat protein foods with each meal; smaller portions; variety of foods
5. Sample different protein supplements (see page 14) to determine which ones you would use.
6. Enjoy your meals free from distractions.
7. Practice concentrating on the food you eat and chewing thoroughly
8. Time yourself--Take at least 20 minutes to eat your meal (1 plate of food).
9. Grocery shop before you have surgery so that you will already have the food/drinks/equipment you
need when you return home from the hospital.
10. Eliminate caffeine for the week before surgery to avoid the “withdrawal” headache after surgery.
11. Begin taking a daily multivitamin to ensure your body is ready for surgery.
12. Walk or engage in other exercise activity if able to prepare your body for surgery.
13. Attend a support group.
14. Call to register for Pre-Op Education and Nutrition Class after you have been approved for surgery.
Good luck:D