Weight loss surgery, whether it is gastric bypass or a gastric sleeve, is not a procedure to take lightly. If you’ve been approved for one of these operations, you are very brave. You’ve probably tried many ways to get a handle on your weight, and are now able to choose this option.
(If you are not scheduled for a weight loss surgery, it is not recommended following the kind of diet required for the procedure. It is a drastic diet and is for preparing the body for surgery and recovering afterwards).
Before the surgery
Preparing for weight loss surgery is an important task. You have to make sure your body is ready to undergo a drastic change in the way it processes food. Anytime you are scheduled for a surgery, you can have to follow certain dietary restrictions. But with weight loss surgery, it can a bigger deal.
Diet for your liver
Your diet before the surgery is designed to cause you to lose weight. It’s not only your total weight that your doctor is concerned with, but the state of your liver. When a person is very overweight, their liver has also gained weight. This is called fatty liver disease. Fat cells can form around the liver and inside the liver. This diminishes the effectiveness of the liver and also causes it to grow in size.
Normally, this is a problem. But it becomes a bigger issue when dealing with surgery of the stomach. Your liver sits right up against your stomach, and your surgeon will actually have to move it out of the way when performing bypass surgery. Even for a healthy liver, this process has its risks.
When you lose weight quickly with the pre-surgery diet, your liver can actually shrink in size very fast. If you don’t lose enough weight before the surgery, your surgery could be postponed. But if you’ve lost the weight your doctor was looking for, your liver has decreased in size and it’s safer for you to have the operation.
Pre surgery diet
So what does the diet right before surgery look like? (Again, always follow your doctor’s advice over anything else)
Your doctor might put you on a diet as soon as you’re approved to have the operation, which can be months away. This diet is designed to help you lose weight in a controlled way. And you can actually lose weight pretty fast. Because your body is heavier, it also requires more calories to keep it at that weight. Let’s say your doctor had you cut your calorie intake to 1200 per day.
Since your body needed anywhere from 3000 to 5000 calories a day to maintain the weight, you would see significant weight loss in a short amount of time. Fifty pounds in a few months is not unheard-of. A person who needs 2000 calories per day could go on a 1200 calorie diet, but they would not see the same results.
The pre-surgery diet is typically high in protein and low in fat and carbs. In fact, it’s really high in protein. Between 70 and 120 grams, daily. You’d most likely be drinking protein shakes in addition to eating lean sources of protein like chicken breast and fish.
Two weeks before surgery
Once you get within two weeks of surgery, your doctor will have more specific instructions for you to follow. This mostly entails cutting all carbs from your diet and only eating lean meats and vegetables. Some operations may require you to bring it down to just liquid foods, including protein shakes. You’re allowed to drink sugar-free and non-carbonated drinks. You’ll have to exercise portion control because this stretch of the diet can require even less calories than before.
Two days before surgery
It’s common for doctors to require a clear liquid diet of all patients undergoing invasive surgery. With a gastric bypass or sleeve, it is even more crucial. Clear liquids include anything that is liquid at room temperature and not cloudy.
Some examples are: apple juice, clear broths, Jell-O, water, and popsicles (sugar free). You might be able to have one protein shake at this stage. The best thing to do is to sip your meals slowly. You’ll be hungry, but you have to get through this stage to have the surgery. The requirements are always changing, however, which is why it’s important for you to talk to your doctor. Some types of surgery will let you drink carb-rich liquids up to a couple hours before the operation.
Way to go! You made it through the surgery. The hard part is over (well, one of them at least). You’ve worked hard to get this far, to lose the weight, get your liver in shape, and undergo a difficult surgery. Now is not the time to go backwards.
Your system is fragile after surgery. Even though you can feel hungry, you can’t eat more than a few spoonfuls of something at a time. If you do, you could risk vomiting or other negative reactions. If you have the ability to stick to the post-op diet, you’ll minimize the chances of post-surgery complications.
After surgery, the first stage is another round of liquids. It’s based around the clear liquid diet but may have some modifications per your doctor. This stage can last about a week. If you had gastric bypass surgery, you may not feel hungry (which would make this stage easier). The reason is that the surgery has removed the part of your stomach which produces the hormone ghrelin. Ghrelin is responsible for making you feel hungry, and with it gone, you’ll have a better time coping with the restricted diet.
Back to shakes and soft-serve
We don’t mean soft-serve ice cream. When your doctor gives you the OK, this stage introduces pureed foods. Like baby food. But you can make your own purees, since baby food can taste pretty bad. Things that are too fibrous to blend into a puree should be avoided (kale, broccoli). Since you have a smaller stomach now, you’ll get full fast. But you can also eat more times during the day, even twice as often as you did before. Just be sure that each time you eat, you control how fast you eat and don’t overeat. Overeating is really easy with a smaller stomach.
Mashed potatoes are ok, as long as they don’t contain any dairy in them (dairy can be tough on your digestive system). Another thing that can be tough on digestion is spicy foods, so it’s a good idea to stay away from those.
When you are trying a new food for the first time post-op, introduce it little-by-little into your diet. Try to only introduce one new thing at a time, and give yourself time to see how you feel.
Experiment with different purees, and see what you like. Don’t be afraid to try pureed chicken. Since you are eating fewer calories, you need to make sure that you’re getting as much protein as you can get. And protein can be hard to get while on a liquid or soft-serve diet. This stage can last a few weeks, so be patient and wait for your doctor to give you the go-ahead to move on.
Soft foods, finally
Now’s the time for you to enjoy the act of chewing again (there’s nothing like biting into something tasty when you’re hungry). As before, your stomach is still a smaller size so you need to go-slow and make sure everything stays down ok. During these post-op stages, your doctor will also forbid you to drink carbonated drinks. Carbonation can cause bloating.
If your stomach bloats too soon after surgery, it can cause nasty complications. But even months down the road, the danger is still there. Our stomachs are very stretchy, and if you stretch yours enough you might destroy the appetite controlling benefits of your surgery (that’s way worse than forgetting to wear your retainer at night).
Some examples of soft foods you can eat during this stage are: cooked white fish, cooked yams, ground meat (stay away from red meat), soft-boiled eggs, bananas, and anything else you can mash around. Your stomach is still getting used to this new arrangement, so give it time to get the hang of things.
Back to regular foods
After a week or two with soft foods, you’ve graduated to normal foods again. Congratulations, you made it! You still have a ways to go, though. You have to start this stage slowly, adding foods in one at a time. You also have to chop up or completely chew each bite, because large pieces of food can cause an obstruction in your stomach.
You should still avoid foods that are hard to digest, like fibrous vegetables, red meat, pork, and dairy products. Since you still have a ways to go to lose all the weight you need to, you are always going to have to stay with a high-protein, low-fat, vegetable focused diet. But with the right focus and determination, you can experience the full benefits of weight loss surgery.