​​​​​​​​​​​​​​​​​​​​​​Eating After Gastric Bypass Surgery

You will start with small amounts of these liquids/puréed foods because you will feel full quickly. At first, you will have to eat small amounts frequently. Begin with 2 to 4 ounces at a time, and aim for six meals per day. Eventually, you will be able to eat four to six meals of 4 ounces each.

Eat slowly. It should take 30 minutes to eat and drink 4 ounces (1/2 cup).

Drink Examples

At least 8 cups of caffeine-free, low-calorie liquids should be consumed gradually throughout the day to prevent dehydration. These liquids should be sipped in between meals. Do not drink liquids with meals, and wait 30 to 45 minutes after a meal to begin drinking fluids again.

• Water, or sugar-free or zero-calorie flavored water
• Diet fruit drinks, less than 10 calories per serving
• Decaffeinated tea (limit to 8 ounces/day)
• Decaffeinated coffee (limit to 8 ounces/day)
• Skim milk
• Sugar-free flavored drink mix

Vitamins and Mine​rals

A multivitamin with minerals, which includes iron and zinc, should be taken daily for the rest of your life to prevent hair loss, improve overall nutrition and prevent any nutritional deficiencies. During the first four weeks after surgery, we recommend a chewable vitamin/mineral supplement such as Flintstone's chewable twice a day, and then advance to a pill form of a multivitamin with minerals if you desire.

You will also be required to take a calcium supplement (example: Calcium Citrate 600 milligrams, three times per day) starting during the first month after surgery and a vitamin B12 supplement (example: sublingual B12, 1,000 micrograms, three times per week) starting immediately after surgery. Additional vitamin and mineral supplements will be recommended based on lab results and food intake/tolerance to prevent any nutritional deficiencies.​

Medications may be taken in chewable or pill form four weeks after surgery.​

Food and Drinks to Avoid

Concentrated sugars, high-fat foods, fried foods and alcohol can cause vomiting and/or diarrhea (dumping syndrome) so avoid:

• Candy, including chocolate
• Sweets
  
• Regular soft drinks
• Honey
• Flavored drink mixes
• Molasses
• Cakes
• Preserves
• Sherbet
• Ice cream
• Alcohol (including beer)
• Doughnuts
• Fried foods

Different people have different foods they can and cannot tolerate. Do not be disturbed if you find some foods do not agree with you at first. You may be able to tolerate those foods later.

​Sample Gastric Bypass Liquid/Semiliquid Menu

The menu below is just an example. You will work with your dietitian to learn more about food options. At first, you may have to eat more frequent meals and consume smaller amounts at each meal. Try to take in 24 ounces (3 cups) of nutritious liquids or puréed consistency food every day.

​​Consistency of all food during Stage 2 should be similar to applesauce.

Breakfast: ​6 to 8 ounces no sugar-added Carnation Breakfast Essentials® mixed with skim milk 
​​​Snack: 1/2 cup cottage cheese

Lunch: Blend 1/3 cup fat-free refried beans and 1 ounce of melted fat-free/reduced-fat cheese

Snack: 4 ounces blended light yogurt

Supper: Blend 1/4 cup meat, 1/4 cup low-fat ​​cream soup, 2 tablespoons nonfat skim milk powder

Snack:  1 cup skim milk with 2 tablespoons of nonfat dry milk powder    

Tips for the first four weeks:

1. Keep food records. This will help you monitor your intake and tolerance to foods. Look for patterns of foods tolerated well and foods that are not tolerated well. The records will also be helpful for your dietitian to provide suggestions for better tolerance or nutrient balance.

   Track the following:
   
   1. Time you ate
   2. Type of food (e.g., baked chicken without skin)
   3. Amount eaten (e.g., 1/2 chicken breast or 1/2 cup yogurt)
   4. How your food was prepared (e.g., baked with broth). Be sure to include any butter, oil, grease or margarine that was added to the food.
   5. Grams of protein. Look on food labels, handouts in your patient notebook, the internet or books to determine the total protein intake.
2. Use ice cube trays. Each cube holds about 2 ounces. This will help you control portion sizes. Try preparing reduced-fat cream soups or puréed meats and vegetables and store item in the trays.
3. Limit food to 2 to 4 ounces per meal. Protein comes first.
   
4. Aim for four to six small meals per day.
5. Drink at least 6 to 8 cups (48 to 64 ounces) of fluid per day. ​Liquids should be sipped between meals. Avoid fluids with meals, and wait 30 to 45 minutes after a meal to begin your fluid intake throughout the day.
   

If you are havin​g trouble tolerating puréed food:

1. Try slowing the speed of your eating.
2. Decrease your portion size.

How to blend food:

1. Cut food into small pieces about the size of your thumbnail.
2. Place food in the blender.
3. Add liquid such as skim milk, broth or fat-free gravy to cover the blades.
4. Blend until puréed and smooth like applesauce.
5. Strain out the lumps, seeds or pieces of food.
6. Use spices and seasonings (avoid spicy ones such as hot sauce and cayenne pepper) to add flavor.

Puréed baby food can be used instead of blended foods. Only meat (puréed beef, pork, chicken) baby foods contain protein.

Stage ​3: Semisolid Consistency Foods​

Four weeks after surgery with the approval of your surgeon, the dietitian will review guidelines on how to successfully introduce semisolid consistency foods without nausea and vomiting. At this point, you will advance to soft and easily tolerated foods.

Focus on protein first at meals, and avoid foods that are high in fat and sugar, and difficult to digest. You may still need to consume protein from skim milk or supplements as between meal snacks until you are able to tolerate enough semisolid foods to meet your protein needs. Remember to add one new food at a time, and observe your reaction to it.

Food Examples

• Cooked eggs, any type except fried
• Casseroles, such as macaroni and cheese, or tuna with light mayo (limited)
• Chopped lean meat (except red meat)
• Low-fat cottage cheese
• Cooked vegetables (peeled)
• Beans and legumes
• Softened cold cereal (non-sugar coated)
• Hot cereals made with skim milk
• Canned fruits (in their own juices or water)
  
• Skim milk
• Unsweetened instant breakfast
• Canned chicken
• Soft fish
• Shredded or soft, low-fat cheese
  
• Light yogurt
  

Eating Guidelines​

• Eat three small meals and two snacks per day.
• Each meal should not exceed the volume of 6 ounces.
• Eat and drink slowly. Take at least 1/2 hour to eat a meal.
• Take small bites, and chew very well. Sip on liquids during meals if needed only, but don't drink large amounts during meals (limit to 1 ounce of fluid per meal).
• Continue to drink low-calorie liquids between meals – at least 8 cups per day.
• Continue to take the vitamin/mineral supplement everyday and introduce a calcium and vitamin B12 supplement.
• Avoid red meats.
• Avoid raw vegetables and raw fruits with skins at this stage in your diet progression.
• Avoid nuts and popcorn.
• Avoid all fibrous foods (may cause blockage).
• Avoid high-calorie beverages such as soft drinks, juices, milkshakes and protein drinks.
• Keep in mind that you are "re-educating" your stomach. When you eat too fast, too much or don't chew enough, you will feel discomfort and vomit.
  

Sample Semisolid Menu

Breakfast: 1/2 cup oatmeal made with skim milk and 2 tablespoons dry milk powder

Snack: 1 cup skim milk

Lunch: ​​2 ounces of lean meat (such as turkey, low-fat ham), 1 slice of reduced-fat/fat-free cheese, 1/2 whole wheat tortilla, optional: nonfat skim milk powder can be mixed in skim milk to increase protein

Snack: 1/4 cup low-fat cottage cheese with canned (no sugar added) peaches

Supper: 1/3 cup tuna and 1/4 cup cooked vegetables

Snack: 1 cup skim milk with 2 tablespoons non-fat dry milk powder (if needed)

Between meals drink at least 64 ounces (8 cups) of low-calorie liquids slowly during the day.

Stage 4: Low-Fat, Solid Food​

Begin when directed by your physician and dietitian about three months after surgery. Again, add​ one new food at a time, and observe your reaction to it. Add breads last because they tend to form a ball, which will not go through the pouch easily. You can experiment with red meat, raw vegetables and raw fruits with skins. Remember to chew all food very well, and sip limited amounts of liquids with meals, less than one ounce if necessary.

Select a balanced meal plan, choosing foods from all groups in MyPlate. This is the time to develop your lifelong meal plan and exercise routine. Avoid sugar, sweets and desserts. Also avoid high-fat foods such as cream soups, gravy, butter, fried foods and fast foods.

• Dairy products (low-fat milk and light yogurt)
• Beans and legumes
• Fruits and vegetables
• Lean meat and eggs
• Whole wheat bread and whole grain products, such as cereals, brown rice and oatmeal

• Skim or 1 percent milk
• Low-fat cottage cheese
• Low-fat or nonfat yogurt with artificial sweeteners
• Egg whites
• Low-fat cheese
• Oatmeal and Cream of Wheat made with skim milk
• Fish
• Chicken and turkey
• Other lean meats (pork tenderloin, extra lean ground beef)
• Legumes (dried beans)
• Nonfat dry milk powder (added to casseroles, soups, hot cereals, etc.)
• Soy products   

• Olives (healthy fat)
• Nuts (healthy fat)
• Avocados (healthy fat)
• Regular mayonnaise
• Sour cream
• Cream cheese
• Pie crust
• Whole milk
• Butter, margarine
• Hot dogs
• Peanut butter (healthy fat)
• Granola (some are high fat)
• Muffins
• Coleslaw
• Whole milk cheese
• Potato salad, pasta salads
• Snack crackers
• Ice cream
• Shortening, lard
• Fatback
• Regular salad dressings
• Sauces
• Fried foods
  
• Bacon, sausage, bologna
• Potato chips
• Doughnuts
• All oils (use olive or canola oil in moderation)
• Gravy
• Regular soft drinks, high-sugar drinks