After Gastric Sleeve / Bypass Diet

These are general guidelines regarding when to introduce various foods. Everyone is different and may not progress at the same rate.

Day 1 – 2 after surgery:

Clear Liquid Diet
The clear liquid diet means fluids or foods that are liquid at body temperature and can almost be seen through. You will be on a clear liquid diet while you’re in the hospital.
Examples of clear liquid diet (no added sugar/sugar free):

• Clear (diluted) fruit juices without added sugar: apple, grape, white grape, or diet cranberry
• Sugar-free Crystal Light drink mix or popsicles, sugar-free Kool-Aid
• Herbal tea, caffeine-free tea
• Flat diet soda
• Sugar-free popsicles
• Sugar-free gelatin
• Clear broth
• Water

It is best to dilute juices by 50% with water. Avoid citrus juices (orange/grapefruit) and tomato juice for the first three weeks. Coffee and de-caffeinated coffee contain acids, which are irritants to the stomach lining and should be avoided for the first few weeks after surgery.

Day 2-3 Post-Op:

Pureed Diet
You may now begin a pureed diet. This includes all items listed for clear and full liquids, and the items listed for the pureed (blenderized) diet.

• Eat PROTEIN foods first
• Make sure foods are well blended.
• Start slowly. If you do not tolerate pureed foods go back to the liquid diet and try again in a few days.
• Remember to drink liquids between meals, not with meals.
• Continue protein drinks or protein supplements every day.

Examples of pureed diet (sugar-free/no sugar added, low fat):

• Eggs
• Cheese
• Pureed or scrambled eggs or egg substitute or cheese: omelet, melted low-fat cheese, low-fat or non-fat cream cheese, ricotta cheese, very smooth/mashed soft cheese such as mozzarella, string cheese, low-fat or non-fat smooth or small curd cottage cheese
• Meat, fish, poultry, baby food meat or pureed meat or poultry moistened with broth or low-fat gravy
• Blenderized shrimp, scallops or fish
• Pureed tuna or salmon (canned in water) or pureed egg salad with low-fat or non-fat mayonnaise
• Potted meats thinned with broth; smooth deviled ham
• Starches: unsweetened instant oatmeal (strained), cream of wheat or rice, cereal, mashed potatoes or sweet potatoes, smooth polenta, hummus, refried beans
• Low-fat or baked crackers or chips
• Vegetables: baby food vegetables or pureed cooked vegetables (no corn or peas)
• Mashed winter squash, tomato juice or sauce, pureed salsa, marinara
• Soup: Strained, low-fat cream soup made with skim milk; fat-free broth
• Blenderized lentil or split pea soup or chili
• Fruit: baby food fruits (bananas, pears, applesauce, peaches, mango, etc.)
• Unsweetened applesauce (smooth)
• Unsweetened canned fruit: blenderized
• Unsweetened fruit juice (diluted, no sugar added)

Tips to Get Started

Everything that you eat on the pureed diet should be sugar-free or no sugar added, low fat, and blended to the consistency of baby food or smooth applesauce.

• Start with 1 ounce (2 tablespoons) portions – no more than 4 tablespoons at the most.
• Listen to your body and stop eating as soon as you feel full.
• Listen to your body and stop eating as soon as you feel full.
• Continue protein supplements (80 g protein per day from supplement).
• Once you begin to eat pureed foods (which are considered solids) you will want to start differentiating between liquids and solids. Meals should include pureed foods, and so liquids (including protein drinks) should be taken separately from your meals.
• You should eat 3 meals a day with protein drinks between meals.
• Protein drinks containing at least 20 g of protein per serving should be consumed as needed to meet 80 g/day goal.
• Start with a portion size of 1 to 2 tablespoons of pureed food for the first month.
• At first, you may not be able to tolerate this amount. Eat your protein source first, and then if you have room, a small amount of fruit, vegetables or other foods may be consumed.

Day 3 to Week 3 Post-op:

Soft Solid Food Diet
If you have been tolerating pureed foods, you may now begin a soft diet. This includes all items listed for clear and full liquids and pureed diets plus items listed for the soft diet.

Try 1 to 2 new foods a day. This will help you to learn what foods you tolerate.

• Remember your stomach pouch empties more slowly with more solid or dense foods than with liquids, so you will be able to tolerate a smaller quantity of food than you could with liquids.
• Go slowly. If you do not tolerate the trial of soft foods, resume pureed foods and try again in a week.
• Eat protein foods first.
• Avoid foods high in sugar and fat.
• Space meals at about 4-5 hours apart.
• Continue your protein drinks between meals.
• Drink other fluids constantly between meals.

10 Examples of soft diet (no added sugar/sugar-free, low fat)

• Baked fish (no bones)
• Imitation crab meat, baby shrimp
• Bananas
• Canned peaches or pears in water or juice
• Well-cooked vegetables without seeds or skin (no corn or peas)
• Scrambled, poached or hard boiled eggs
• Tuna or egg salad (no onions, celery, pimientos, etc.)
• Finely shaved deli meat
• Baked, grilled or rotisserie chicken
• Moist foods will be better tolerated. Moisten meats with broth, low fat mayonnaise, or low-fat gravy or sauce.
• Fish and seafood proteins are softer and easier to break down than poultry or red meat proteins.
• Reheating foods tends to make them dry out and hard to tolerate.

Common Problem Foods (Avoid for 3 months after surgery)

• Red meat such as steak, roast beef, and pork. Red meat is high in muscle fiber, which is difficult to separate even with a great deal of chewing. Avoid hamburger for one month after surgery.
• Un-toasted bread (Toasted bread may be better-tolerated.), rolls, and biscuits.
• Pasta
• Rice
• Membrane of citrus fruits
• Dried fruits, nuts, popcorn and coconut
• Salads, fresh fruits (except banana) and fresh uncooked vegetables and potato skins

3-6 Weeks Post-op:

All foods previously tolerated, tofu, fish and seafood, thinly sliced deli turkey or ham and other luncheon meats, slices of low fat cheese, unsweetened canned or cooked fruit, potatoes, squash, unsweetened cereal with skim milk or Skim Plus (i.e. Cheerios and Chex), boiled chicken in broth (cut up in small pieces), crisp toast and crackers, beans and peas, and lean, moist ground turkey and beef.

6-8 Weeks Post-op:

Diced poultry (no skin), vegetable burgers, soft cooked vegetables, soft fruits (watermelon, honeydew, peaches and plums), and well cooked pasta.

3 Months Post-op:

Rice, un-toasted bread, lean and moist meat and poultry.

4 Months Post-op:

Veal, crunchy fruits and vegetables including salads.

6 Months Post-op:

Beef and pork (choose poultry and fish more often in view of lower fat content).

The diet should always be high in protein and low in refined carbohydrates (white flour). Preferably, choose protein first, then fruits and vegetables, and then whole grains.

Rapid gastric emptying is a combination of symptoms that occur when an overly large meal, or a meal high in fat or sugar is consumed by a weight loss surgery patient. Most episodes of rapid gastric emptying can be prevented by avoiding eating overly large meals or sugary foods.