Nutritional Counseling

Salad Eating after Bariatric Surgery is often something that scares people away from surgery. There is a misconception that you will never be able to eat "normally" again. That is simply not true. The goal is to have you eating small healthy meals that will provide you with the right balance of foods.

We have a dietitian on staff to guide you both before and after surgery. We can schedule follow up visits in combination with your doctor visits.

Obviously we do not encourage fast foods or foods high in sugar or fat. That is not to say that on special occasions you may never have a bite of cake. The idea is to limit it to special occasions and to eat in moderation. Keep in mind that some Gastric Bypass or Sleeve patients with Dumping Syndrome may never be able to tolerate sugars.

Learning to eat well is a process that takes a period of trial and error before it is mastered. Most of us have had years of eating too quickly, not chewing our food and mixing food with liquids. Changing these habits takes time. Some helpful hints are to use a toddler spoon and fork. That way you can only take small bites. Put your fork or spoon down in between bites. Do not eat "on the go" or under stressful situations, but rather look for a quiet, peaceful place where you can focus on your meal and the time it should take to eat it. Be mindful to chew your food, until it is pureed in your mouth, before swallowing.

Remember that the size of your "new" stomach (pouch), as well as the opening from the pouch to the small intestine, is much smaller than before surgery. Because your stomach size is smaller, you must eat and drink differently. The following is a list of things that will happen after surgery:

All patients will progress through the 5 stages of the diet. Gastric Band patients progress more quickly through the stages than Gastric Bypass patients.
It is very important that you progress through the stages exactly as prescribed. Advancing too quickly can lead to serious consequences such as pouch disruption and delayed leak.
DO NOT eat solid foods before the appropriate time!
Your stomach will only be able to hold a few ounces of food at any one time.
Beverages cannot be consumed with meals.
Large pieces of food will not pass easily through the stoma (opening from pouch to intestine). You will need to choose soft foods and chew foods very well when your diet progresses to regular texture.
Eat slowly. It should take at least 30 minutes to eat a meal.
Food will empty from the stomach much slower than before the surgery. Because of this, you will feel full quickly and will stay satisfied longer.
Start slowly and introduce one new food at a time.
STOP eating if you feel pain, fullness, discomfort, nausea or vomiting. Occasional vomiting is common and food intolerances vary on an individual basis. If a food is not tolerated, reintroduce it a week later.
You may experience changes in taste and appetite.
You may not feel hungry or want to eat, but it is important to eat at regular intervals in order to recover from surgery and stay healthy.

Do Not Eat fatty foods

Avoid high fat foods and foods with added sugar. These foods can cause Dumping Syndrome in Gastric Bypass or Sleeve patients.
Protein is the most important type of food for your continued safe and healthy weight loss. Protein is essential for healing and ensures muscle mass maintenance during weight loss. Insufficient protein intake can result in impaired healing, hair loss, muscle wasting, dry and scaly skin, and poor resistance to infection.
Consumption of starches (Bread, Pasta, Rice and Potatoes) should be limited. This can result in increased calories and fat storage.

Eat fresh fruit

You should increase your intake of fruits and vegetables. Re-introduce raw vegetables slowly. Make sure to chew very well. Fruits and vegetables with peels and citrus fruits may not be tolerated at first.
Drink at least 6-8 cups (48-64oz) of low calorie fluids daily to prevent dehydration.
No drinking from straws or carbonated beverages. This can cause excess gas to enter the stomach pouch, causing extreme discomfort.
Gastric Bypass and Sleeve patients need to supplement their diets with a multivitamin plus iron, vitamin B-12, and calcium with vitamin D for the rest of their lives.
Gastric Band patients need to supplement their diets with a multivitamin for the rest of their lives. Calcium with vitamin D is recommended.

Helpful tips:

Do not lie down after eating or drinking.
Stop drinking at least 20 minutes before consuming a meal and wait until at least 20 minutes after to resume drinking. Combining food and liquids together can result in bloating.
Try not to eat for 3 hours prior to bedtime. This helps with digestion and prevents regurgitation.
Eat a balanced diet as much as possible. Because the amount of food eaten at each meal will be small, it is important that they be high in nutritional value.
If you plan your meals ahead of time and have the ingredients on hand, you are less likely to make poor food choices.
It is best to prepare your own foods so you know exactly what you are eating. If a recipe yields too much food, you can either divide the recipe in half, or freeze leftovers in small containers to save for other meals.
Use a thermos or chill your glasses in the freezer to keep your protein supplement cool while you are drinking it.
Add some variety to your protein supplement by purchasing sugar free syrups (available at Vitalady.com) or adding 2 drops of McCormick Imitation Extracts.
Sometimes trapped gas can cause chest discomfort. You may try using Gas-X to relieve the pain. If it persists you must contact your doctor.
REMEMBER to take your vitamins and supplements!
Ice cube trays are handy for storing pureed food (each cube section is about 1 fl oz).
Baby warmer trays may be helpful for keeping pureed food warm while it is slowly being eaten.
Colace (Docusate Sodium) is good for CONSTIPATION. You do not need a prescription. You should first make sure you are drinking enough water and eating enough fiber. For extreme cases you may take Milk of Magnesia.
Do not swallow any pills whole. They may be crushed and mixed with sugar free applesauce. You may also use liquid forms of medication, if available.
If you are having trouble tolerating food, you may substitute solid or pureed foods with a protein shake.
When advancing from liquid to puree or later on to soft food, you may experience problems with vomiting. This occurs with overeating, not chewing well or mixing liquid and solid food. If you do vomit, make sure you are not eating too much at one time and that you are chewing well. You must call your doctor if it persists.
Food intolerances will vary on an individual basis. If you have a problem with a new food, wait several days before trying it again. Record any recurrent problems with new foods in a food diary. Bring this to your next visit with the physician and/or dietician.
Alcohol may be consumed on occasion, however, it is very high in calories and sugar, and may cause Dumping Syndrome.
Remember that the dietitian is here to help you. Utilize her for all your nutritional needs. There are a number of books that focus on menus for bariatric surgery patients. In addition, support groups can provide a wealth of knowledge on what does or doesn't work at various diet stages.