Nutrition After Bariatric Surgery - Northern Westchester Hospital
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To reach the Bariatric Dietitian:
(914) 242-8359
Nutrition After Bariatric Surgery
After surgery you will need to make changes to your eating patterns. The diet after Bariatric
surgery progresses from a liquid diet to a pureed diet to a soft diet and then a modified regular
diet. The diet progression is designed to allow your body to heal. Initially, it will help you meet
your protein and liquid requirements, and later, to assist you in meeting your nutritional needs.
It is imperative that you follow the diet’s progression and adhere to this regimen to
maximize healing and minimize the risk for unnecessary complications
You will eat smaller portions of food, and happily find that you are satisfied. By eating
nutritious foods, your weight loss will proceed rapidly and safely, and you will avoid
discomfort.
Eat Only One Meal at a Time- Do Not Graze
A "meal" is not just what, and when, you eat but also how you eat. Work up to eating 3 small
protein-rich, meals and up to 3 snacks (optional) per day. Establish a pattern of eating, so
that your body will be accustomed to it, and you do not become excessively hungry. It is best
to make a rule in your mind, designating a time and a place where you eat. When you leave
your designated place for dining, all eating should cease. Think of “closing the kitchen.” Avoid
eating on the run, or mindless eating such as watching TV, working on the computer, or
reading a book. This is KEY to long-term success.
Each Meal Should Contain Protein - You need 60-80 grams protein/day
When you eat, make sure that each and every meal is at least half composed of protein. This
is the main source of irreplaceable building materials, which our bodies require to repair and
maintain our organs, muscle tissue, skin, and hair to name a few. Protein takes longer to
digest and metabolize, thereby making you feel more satisfied. Focus on eating protein first
so you feel full. Duodenal Switch patients - You will need 80-100 grams protein/day.
Eat Slowly
A very important part of eating is enjoying and savoring your food. Take a look at your meal
before eating to see how much you will be putting into your new pouch. Your meals should
last about 20 minutes. Take your time to avoid discomfort and potential nausea.
Chew Your Food Well
You will get more satisfaction and enjoyment from your food, if you chew it thoroughly,
before swallowing. More importantly, your food will be able to empty out of your stomach
through the small opening at the bottom of the pouch and help you feel full and satisfied.
Swallowing food without chewing properly may block the opening, which may result in
vomiting or the inability to eat or drink anything until food is gradually digested.
Red meats are especially difficult to chew completely, and may cause trouble. We therefore
advise you to avoid red meats for the first six months after surgery, and to be especially cautious
when you do try them. It is best to buy cuts of meat such as Filet Mignon, or double-ground
sirloin. Make sure the meat is very moist and not overcooked. Cut your meat in very small pieces,
and chew very carefully and thoroughly. Reheated meat is never well tolerated the next day
because it gets too dried out.
Avoid Eating Sweets and Sugars
Foods that contain sugar can make you feel very strange, especially if you eat them on an
empty stomach. It is best to avoid these types of foods since they are a source of empty
calories and may cause you to become hungrier which can hinder weight loss efforts.Food Guide for Each Post-Operative Stage
Stage I Clear Liquids
Take small sips at a rate of 4 ounces (½ cup) per hour. Do not use a straw!
o Sugar free, calorie free, caffeine free, non-carbonated beverages
o Ice chips, water, diet beverages with less than 40 calories per serving
o Diet Snapple, Crystal Light, Propel, G2 by Gatorade, Vitamin Water Zero
o Clear beef, chicken, turkey or vegetable broth, miso broth
o Sugar-free popsicles and Jello
Stage II Full Liquids
Aim for 3-6 high protein, liquid meals. You will be consuming 4 ounce ‘meals’ every 3-4 hours.
Sip slowly and STOP when you start feeling full, even if you have not finished your meal.
o All fluids listed above
o Skim milk or light soy milk
o Approved protein shakes (see attached list)
o Nonfat, plain Greek yogurt (Fage, Chobani), Dannon Light n’ Fit yogurt (all flavors)
o Avoid Ensure, Glucerna, Slim Fast and all other non-approved shakes as they are high in
sugar and low in protein
**Duodenal Switch, Gastric Sleeve and Bypass patients must remain on FULL LIQUIDS with the
addition of strained soups for 3 weeks until advancing to thin purees
Stage III Thin Purees
During this very early period limit your intake to foods that roll easily off the back of a spoon, in
very small amounts. This will give your new stomach pouch time to heal properly.
You will increase your clear liquid intake to 64 oz per day. Drink fluids in between meals to
prevent dehydration. Remember “The RULE of 30” - Wait 30 minutes to drink after eating.
Add pureed protein sources as tolerated. Protein sources are encouraged as 3-6 small (bite-sized
portions) meals per day. Chew very well with each bite.
o All well-tolerated liquids listed above
o Cottage cheese, soft tofu
o Baby foods with less than 10 grams sugar per serving (you MUST read the label)
o Scrambled, poached or soft boiled egg
o Pureed soups or egg drop soup (no chunks of meat or vegetables unless pureed)
o Pureed bean dishes
o Unsweetened apple sauce – add protein powder
o Oatmeal thinned with skim milk, grits, cream of wheat – add protein powder
Stage IV Thick Purees
It is still very important to adhere to the guidelines, as your new pouch is still healing and you are
adjusting to a new way of eating. Limit your intake to liquids, and thick pureed foods if all foods
listed above are tolerated. Thick pureed foods mash with the back of a fork. Foods well tolerated
during this period are moist, juicy tender products in small servings of 3-4 oz:
o Pureed or well-cooked soft vegetables and fruits (no skin)
o Pureed dark meat chicken or turkey
o Ground meats with gravy
o White, flaky fish such as sole
o Tuna fish with light mayonnaise
o Egg salad with light mayonnaise
o Use 1 oz medicine cups to measure portions
→ 1st week of thick purees: 2 oz protein + 1 oz fruit/vegetables
→ 2nd week of thick purees: 2 oz protein + 2 oz fruit/vegetables
o Advance diet as tolerated if protein foods agree with you. ALWAYS EAT PROTEIN FIRST!Week 8 Sleeve, Bypass and DS//Week 5 Bands
Tolerance to foods varies from one individual to the next. Gradually, try other sources of protein
such as soy products, dark meat poultry, fish (no shellfish), and lastly, meats. We advise patients
to avoid red meats until their stomach is functioning very well, usually after 3 to 4 months.
Introduce one food at a time in order to rule out intolerance. Keep a journal of what foods you
tolerate and what foods you do not. Your tolerance to a food may improve over time.
o Try only a very small amount of a food at first to see if you tolerate it
o Focus on moisture and texture, slow eating, small bites, and chew your food well
o Do not drink with meals. Wait 30 minutes before and after meals to drink
o Toasted light, whole wheat bread or whole grain crackers (e.g. Wasa Crispbread) may be
added to meals if tolerated
o Raw peeled fruits, raw vegetables and salads may be added to meals if tolerated
o REMEMBER: Always eat PROTEIN FIRST, then fruit/vegetable, and starch last
o Sample meal plans are enclosed
BAND ONLY: After your first fill you must remain on clear liquids for the remainder of the day.
Progress to Stage II the next day, and Stage III the following day.
Fluids
Drink at least 64 ounces of fluid per day, between meals. Recommended beverages are water and
unsweetened, low calorie, non-carbonated drinks. Juices and drinks that are high in calories
could cause dumping and provide very little nutritional value. Here are some tips:
o Do not drink 30 minutes before or after meals
o Sip slowly and carefully
o Sip fluids continually all day long to prevent dehydration
o Avoid drinking from straws - it may cause gas and/or bloating
o Avoid drinking from fountains - it is more difficult to control the volume of your intake
o Eliminate high calorie drinks such as milkshakes, soda, alcoholic beverages and juices.
Weight loss can be slowed down dramatically and even cease
Protein
Protein helps with wound healing, aids in tissue repair, boosts your metabolism, and helps fight
infection. It is important to get 60-80 grams of protein daily. Remember that if you have not
taken in adequate amounts of protein after three weeks, your body will start to break down its
own muscle. This will cause you to feel nauseated and weak - prevention is important!
If the focus of each meal is protein-rich foods, deficiency is very unlikely to occur. Early on, when
you are taking in protein drinks, it is easy to keep track of how much protein you are consuming,
but later, when you are eating regular food, it may be a little more difficult. Use the nutrition
labels as your guide. On the following page is a list of approved protein drinks and where you can
purchase them. Foods that are high in protein and generally well tolerated include:
o Dark meat poultry
o Thin sliced deli meat
o Filet mignon
o Ground lean beef, chicken and turkey
o Canned chicken and tuna
o White flakey fish, salmon, tuna
o Baby shrimp, scallops, gelfite fish, sashimi
o Fat free milk, cottage cheese, low fat cheese and low sugar yogurt
o Scrambled, poached and soft boiled eggs
o Tofu, soy products (read labels - some soy products are very high in calories and low in
protein), veggie burgers, edamame
o BeansRecommended Protein Powders
Questions? Contact the dietitian at
BariatricDietitian@northwell.edu
or call: (914) 242-8359
How to make Bariatric Protein Shakes:
• Use 1 serving of protein powder of choice.
• Mix with 4 OUNCES of skim milk (+4 g protein), light or unsweetened soymilk (+3 g
protein), SkimPlus milk (+5.5 grams protein), or water.
• Coconut milk and almond milk contain very minimal protein. With either, please choose
“Unsweetened.”
Protein (g) Sugar (g)
Product Name Where to Purchase Serving /svg /svg
High Protein Meal
BariatricAdvantage.com 2 scoops 27 0.5
Replacement
*High Protein Meal
CelebrateVitamins.com 2 scoops 27 4
Replacement
*Unjury Unjury.com or Amazon.com 1 scoop 21 3
Protein 20 CelebrateVitamins.com 2 scoop 20 1
ProPerformance 100%
GNC – in stores or GNC.com 1 scoop 24 2
Whey Protein
Optimum Nutrition Gold
GNC – in stores or GNC.com 1 scoop 24 2
Standard 100% Whey
Isopure Zero Carb GNC – in stores or GNC.com 1 scoop 25 0
Quest QuestNutrition.com 1 scoop 23Vitamin/Mineral Guidelines After Surgery
Below are the general guidelines regarding the vitamins and minerals you must take
FOR LIFE after surgery. All vitamins and medications must be chewable or liquid or they
must be crushed, cut, or capsules opened.
Many appropriate vitamins are available at GNC, Vitamin Shoppe, or online stores.
Adjustable
Vitamin/Mineral Gastric Sleeve Duodenal Switch or Gastric Bypass
Gastric Band
Complete Option 1 Option 2
Multivitamin
Take 1x /day
Centrum Chewable Take 2x/ day
Take 2x/ day
Start first day
BariatricAdvantage.com Start first day
home after X
home after surgery Start first day home after
surgery surgery
CelebrateVitamins.com
Take 2-4x /day
Calcium Citrate with Take 2-4x /day Take 2-4x /day
Take 2-4x /day
Vitamin D
1500-2000 mg
Chewable, liquid or 1500-2000 mg 1500-2000 mg Calcium
Calcium Citrate 1500-2000 mg Calcium
crushed and dissolved Calcium Citrate & Citrate
& 750-1000 IU Citrate and
in water. Can cut. 750-1000 IU and
Vitamin D 750-1000 IU Vitamin D
Vitamin D 750-1000 IU Vitamin D
Take separately from
Start first day Start first day home after
Multi or Iron Start first day Start first day home
home after surgery
supplement home after surgery after surgery
surgery
1,000 micrograms 1,000 micrograms (mcg)
(mcg)
Start first day home after
B12
X Start first day surgery
Sublingual or dropper Bariatric Advantage
home after surgery
Advanced Multi EA
Take once a week
Take once a week
Take 2 chewables,
Vitamins A,D,E,K Vitamin A: 10,000 IU to twice a day. (This
In dry form 30,000 IU multivitamin includes
Vitamin D: iron). Can cut.
Bariatric Advantage 800-2,000 IU
ADEK combination Vitamin E: Start first day home
X X
formula or Multivitamin 100-800 IU after surgery
with added ADEK: Vitamin K:
120- 450 mcg OR-------------------
BariatricAdvantage.com Start 3 weeks after
surgery Celebrate Multi-ADEK
Iron Take 3 chewables,
DO NOT take with 2 iron tablets a day each once a day. This
milk, tea, coffee, containing 50-65 mg of multivitamin does NOT
calcium supplements elemental iron OR 300 mg contain iron; you must
or antacids (wait 2 X X per day iron gluconate or take a separate iron
hours) iron sulfate supplement (same
Start 3 weeks after dosage as listed in
Try Slo-Fe if iron surgery as prescribed ‘Option 1’).
causes stomach upset
Start first day home
Zinc after surgery
Bariatric Advantage 50 mg/day
Zinc 50 with copper, X X Dissolve tablets in water -
CVS brand, Nature DO NOT swallow tablets
Made, Nature’s BountyLabel Reading for Healthy Meal Planning
Remember!
• 3,500 calories = 1 pound of body fat
• Fiber and protein keep you full
• Always read labels. 1 bottle of ‘no sugar
Nutrition
added’ juice can still have 320 calories!
Facts
Serving Size Serving Size ½ cup (114g)
Take note of the amount of food shown as a Servings Per Container 4 serving. This
may not be the amount you are eating, but it is the amount
containing the nutrient values listed. Amount Per Serving
Calories Calories 90 Calories
• Calories = Energy from Fat 30
• Too much energy = weight gain
• Eating less calories = weight loss
% Daily
Total and Saturated Fat Value*
• Excess fat, including ‘healthy fats,’ can mean
excess calories, resulting in weight gain Total Fat 3g
• A low fat diet recommended to reduce the
risk of heart disease Saturated Fat 0g
• Choose meats, dairy, and convenience foods with less than 2 grams of saturated fat per
serving
Protein
• Builds muscle, keeps you full
• Found in meat, fish, poultry, low fat dairy, eggs, and legumes
Carbohydrate/Sugars
• Carbohydrates are found in starches and sweets
• Keep SUGARS 3g per serving
• Bypass and duodenal switch patients: To avoid dumping syndrome and minimize excess
calories, keep sugars at 5 grams or less per meal
• Avoid foods with sugar as one of the first three ingredients. Sugar can also be called:
sucrose, dextrose, fructose, glucose, corn syrup, high fructose corn syrup, honey, barley
malt, maple syrup, molasses, rice syrup, cane juice, etc.
Dietary Fiber
• Found in whole grains – 100% whole wheat grains, fruits and vegetables
• Forms a ‘gel’ during digestion and takes longer to break down, keeping you full for longer
• Prevents constipation, lowers cholesterol, and maintains normal blood sugars
• 100% Whole grains contain more vitamins and minerals than white bread, crackers, etc.
Foods to avoid: Foods > 6-10 g sugar per serving
Here is a list of popular foods that are filled with empty calories that can prevent weight loss and
can cause both delayed and early dumping:
Ice cream; pudding; sweetened, fruited or frozen yogurt; dried fruits; candied fruit; canned
or frozen fruit in heavy syrup; 100% fruit juice; sugar coated or sweetened cereal; sweet
rolls; doughnuts; muffins; sports drinks or vitamin water; lemonade; sweetened iced tea;
regular soda; popsicles; cakes and cookies; pies; jelly, jam, and preservesFoods To Choose and Avoid
Food Groups Well Tolerated Not Well Tolerated
These foods (especially meat and These foods may be more difficult to
protein) are moist, tender, soft, digest or may block the gastric outlet
runny, thinly sliced in a sauce, due to their tough, dry, fibrous, or
gravy or light mayonnaise; and doughy texture
easily pass through the outlet
when well chewed
Protein
Poultry and Dark meat chicken, thin sliced White breast meat, pork chops lean
meat turkey, ham, veal, thin sliced meat, burgers, ground meat, beef
medium rare filet mignon, chili, Too fibrous, dry, chewy
brisket, chicken salad from the can
Fish White flaky fish, salmon, tuna, Any fried or breaded Fish steaks,
baby shrimp lobster, crab, shellfish
Scallops, gefilte fish, sushi/sashimi Too rubbery
(no rice), thin sliced seared tuna,
shrimp cocktail
Dairy Low fat milk, 1% cottage cheese, Fruit on the Bottom yogurt, cottage
low fat cheese, light/ sugar free cheese blends. (These may cause
yogurt, fat free ricotta dumping in bypass patients due to
high sugar content)
Eggs Soft boiled, poached, soft Hard boiled, omelet
scrambled Too rubbery
Soy products Tofu, soy analog meat/ chicken, N/a
edamame
Legumes All beans Beans may cause gas pain
Vegetables
Colorful and All well cooked vegetables, No stalks, or woody stems,
green leafy chopped salads, crisp baby Poorly chewed salads or veggies
spinach, cucumber, tomato, Too fibrous, stringy, difficult to
pickles, collards chew
Asparagus tips, broccoli florets,
peppers
Fruit
Berries, peeled fruit, grapes Fruit skins – blocks stoma, dried
fruits, fruit juice- too sweet/ sugary
Starches
*Choose Cream of wheat, old fashioned Doughy, gummy bread, rice, pasta,
foods with > oatmeal, 3-4 whole wheat tortilla, bagels, rolls, Italian bread
3 grams fiber crackers, whole grain cereal (Kashi Expands and blocks stoma
per serving brand), light wheat toast (40
calories per serving)
Starchy Yams, potatoes, peas, carrots, Corn
vegetables legumesSample Menus
Stage I Clear Liquids
Instructions
1. Sip fluids slowly without use of a straw as they can make you feel bloated and gassy
2. You are not expected to finish everything on your tray
3. Stop eating if you feel a slight pressure or fullness in the chest area to avoid pain or
vomiting
4. As the initial swelling goes down and your pouch heals, fluids will exit the pouch as if it
were going through a funnel
5. Aim to drink 4 oz (½ cup) of fluid per hour every hour you are awake
Acceptable Fluid Choices - Diet or less than Poor Fluid Choices - Too high in sugar,
40 calories per 8 oz serving, not carbonated calories, carbonation, or caffeine
o Sugar free, calorie free, caffeine free, o Alcohol
non-carbonated beverages o Diet or Regular Sodas
o Ice chips, water, water with a slice of o Carbonated or “flat” beverages
lemon or orange o Carbonated water
o Diet Snapple, Crystal Light, Propel, G2 o Vitamin Water, Gatorade, Powerade
by Gatorade, Vitamin Water Zero o Regular fruit juice (apple, grape,
o Diet cranberry or other diet juices (Sample Menu Thin Puree - A 4 oz approved protein shake may be substituted for any meal
Breakfast Lunch Snack Dinner
Day 1 4 oz approved ¼ cup cauliflower 4 oz approved 2 oz mashed beans,
protein shake pureed with 2 Tbsp. protein shake pureed with 1 oz low
(see list) lowfat milk, & 1 oz. (see list) fat shredded cheese
lowfat cheese & 1 T. salsa
Day 2 2 oz 1% cottage 3 oz Healthy Choice 4 oz approved 4 oz split pea soup
cheese pureed with Hearty Chicken protein shake blended with 1 scoop
¼ cup peaches soup, blenderized (see list) unflavored protein
(canned in juice) powder
Day 3 1 poached egg 3 oz tomato soup 4 oz approved 2 oz mashed
1 oz thin oatmeal blended with 1 oz. protein shake yam/potato blended
made with skim milk silken tofu (see list) with 1 oz yogurt
Day 4 3 oz thin cream of 4 oz. pureed black 4 oz approved 4 oz Healthy Choice
wheat blended with bean soup protein shake Hearty Chicken
2 T. mashed banana (see list) soup, pureed
Day 5 4 oz approved 3 oz skim ricotta 4 oz approved 4 oz egg drop soup,
protein shake cheese blended with protein shake blenderized
blended with ¼ 2 Tbsp skim milk, (see list)
small frozen banana vanilla extract and 1
pkt Splenda
Day 6 1 scrambled egg 3 oz 1% cottage 4 oz approved 2 oz dark meat
1 oz pureed salsa cheese blended with protein shake chicken pureed in 2
(or non-chunky) 1 oz unsweetened (see list) oz chicken broth
applesauce
Day 7 4 oz thin high ¼ cup mashed 4 oz approved 3 oz fat free Greek
protein oatmeal cauliflower blended protein shake yogurt with 1 tsp.
(add 1 scoop protein with 2 Tbsp. Milk (see list) Sugar-free jelly
powder) and 1 Laughing Cow
cheese
Day 8 4 oz approved 3 oz. Greek yogurt 4 oz approved 3 oz miso soup
protein shake blended with 2 Tbsp. protein shake blended with
blended with 2-3 Pureed fruit (see list) 2 Tbsp well-cooked
frozen strawberries broccoli florets
Day 9 3 oz thin high 3 oz. Cottage cheese 4 oz approved 3oz split pea soup
protein oatmeal blended with 2 Tbsp. protein shake blended with 2 Tbsp.
(with added protein applesauce (see list) tofu
powder) with 2
Tbsp. Greek yogurt
Day 3 oz thin cream of 4 oz Healthy Choice 4 oz approved 2 oz 1% cottage
10 wheat Hearty Chicken protein shake cheese
2 Tbsp. applesauce soup, pureed (see list) 1 oz unsweetened
applesauce
Day 1 scrambled egg 3 oz thin high 4 oz approved 3 oz. Silken tofu
11 with 2 Tbsp. well- protein oatmeal protein shake with 2 Tbsp. Cooked
cooked pureed (with added protein (see list) squash, blenderized
spinach powder) with 2 T
Pureed banana
Day 4 oz approved 4 oz Healthy Choice 4 oz approved 2 oz. Unjury Chicken
12 protein shake Hearty Chicken protein shake soup blended with 2
blended with ¼ soup, pureed (see list) oz. well-cooked
small frozen banana string beansStage IV Thick Purees
Instructions
1. Food can be mashed with the back of a fork, without requiring a knife
2. You should still blenderize food if it cannot be mashed with the back of your fork
3. Continue to prioritize by eating protein first followed by the vegetables/fruit, and starch
4. Use your 1 oz medicine cup to measure your food
5. 1st week Portions: 1-2 oz protein + 1 oz vegetable/fruit at meals
6. 2nd week Portions: 2 oz protein + 2 oz vegetable/fruit at meals
7. Take small ½ teaspoon sized bites of food. Chew food 20 times prior to swallowing
8. You can substitute a 4 oz protein shake for any meal
9. Wait 30 minutes to drink after a meal
Sample Menu 1st week Thick Puree- 1-2 oz protein + 1 oz vegetable/fruit at meals
Breakfast Lunch Snack Dinner
Day 1 4 oz approved 1-2 oz tuna 3 oz light yogurt 1-2 oz crustless
protein shake (see 1 tbsp low fat mayo 1 oz blueberries quiche
list) 1oz cooked broccoli
florets mashed
1 tsp margarine
Day 2 3 oz light yogurt 1-2 oz egg salad 4 oz approved 1-2 oz tender fish
1 oz mashed 1 tbsp low fat mayo protein shake (see 1oz mashed cooked
blueberries list) carrots
1 tsp margarine
Day 3 1-2 oz 1% cottage 3 oz soup 4 oz approved 1-2 egg frittata
cheese 1 oz mashed string protein shake (see 1 oz sweet potato
1 oz canned peaches beans list) mashed
packed in water 1 tsp margarine
(mashed)
Day 4 1-2 poached eggs 1-2 oz fat free 1-2 oz light, skim 4 oz powdered
refried beans ricotta cheese potato leek soup
1 oz tomato salsa 1 drop of vanilla made with nonfat
extract, 1 pkt milk
Splenda, cinnamon
Day 5 1 pkt Kashi oatmeal 4 oz 98% Fat Free 4 oz approved 1-2 oz tuna
made with 4 oz skim Healthy Choice Soup protein shake (see 1 tbsp low fat mayo
milk – cream of broccoli, list) 1oz cooked spinach,
mushroom, or blenderized
chicken
Sample Menu 2nd week Thick Puree- 2 oz protein + 2 oz vegetable/fruit at meals
Breakfast Lunch Snack Dinner
Day 1 2-3 oz Cream of 2 oz egg salad w/ 1 4 oz approved 2 oz poached cod
Wheat tbsp low fat mayo protein shake (see 2 oz baked potato
4 oz of nonfat milk 2 oz applesauce list) 1 tsp substitute
butter
Day 2 1 scrambled egg 2 oz tuna salad w/ 4 oz approved 2 oz tender fish
1 oz melted low fat lowfat mayo protein shake (see 2 oz mashed cooked
cheese 2oz tomatoes list) carrots
2oz salsa chopped 1 tsp margarine
Day 3 2 oz 1% 4 oz soup 4 oz approved 2 egg frittata
cottage cheese 2 oz peas protein shake (see 2 oz chopped
2 oz blueberries list) veggies
1 tsp margarineDay 4 2 poached eggs 2 oz fat free refried 2 oz light, skim 2 oz baked potato
beans ricotta cheese 1 oz shredded low
2 oz avocado Drop of vanilla fat cheese
extract, 1 pkt 1 oz plain yogurt
Splenda, cinnamon 1 tsp bacon bits
Day 5 1 pkt Kashi oatmeal 2 oz poached cod 4 oz approved 2 oz dark meat
made with 4 oz skim 1 oz chopped protein shake (see chicken salad
milk stewed tomato list) 1 tbsp low fat mayo
2 oz creamed
spinach
Day 6 4 oz approved 4 oz fat free Healthy 4 oz light yogurt 2 oz veggie chili
protein shake (see Choice soup 2 oz melted
list) 2 wheat thin shredded cheese
crackers
Week 8 Sleeves, Bypass and DS//Week 5 Bands
Instructions
1. This diet consists of bulkier, more textured foods which require more cutting and chewing
2. As you add more foods and textures into your diet, you may be able to tolerate a certain
food one week and not the next. Try to reintroduce that particular food into you regimen a
week or two later. Individuals advance differently during this stage
3. Keeping a food journal will help you define which foods you tolerate
4. Preventing food from getting “stuck” in the pouch or gastric outlet depends on the food’s
texture and moisture, and how well you are able to chew it
5. Protein needs to be especially moist and tender enough so that once chewed, the food will
easily exit the gastric outlet
6. Reheated meat is never well tolerated the next day because it gets too dried out
7. Eat no more than 3 small meals and up to 3 snacks (optional) per day
Sample Menu- A 4 oz approved protein shake may be substituted for any meal
Breakfast Lunch Dinner
Day 1 1-2 scrambled eggs 2 oz tuna salad 4 oz chicken noodle soup
1 oz shredded low fat 1 tbsp low fat mayo 1 oz sweet potato
cheese 2 oz baby spinach 1 tsp butter
Day 2 2-3 oz old fashioned oats 3 thin slices of Healthy 2-3 oz cooked salmon
3 tbsp blueberries Choice ham 1 tsp butter
4 oz nonfat milk 1 slice tomato 1-2 oz peas and carrots
1 slice light wheat toast
Day 3 2 oz 1% cottage cheese 3 thin slices deli turkey 2-3 oz boiled beans
2 oz canned pears in water 1 slice tomato 1 oz low fat cheese
1 slice light wheat toast 4 wheat thins crisps
dijonnaise
Day 4 ½ slice whole grain toast 2-3 oz egg salad 2 oz pork tenderloin
1 tbsp peanut butter 1 tbsp low fat mayo 1 oz applesauce
¼ small banana sliced 1 slice lettuce and tomato 1-2 oz asparagus tips
3 melba crackers
Day 5 4 oz skim ricotta cheese 2-3 oz blended chicken 2-3 oz baby shrimp salad
3 tbsp blueberries salad 1 tbsp light mayo
1 pkt Splenda 2 oz chopped green lettuce 1-2 oz cooked broccoli
¼ tsp vanilla extract, and tomato
cinnamon
Day 6 2 oz shredded wheat cereal 4 oz 3-bean salad 2 oz flounder
4 oz skim milk 2 oz mango salsa
1 oz sliced strawberriesBasic Rules for LIFE after Surgery
• Rule of 30
→ Do not drink any liquids for 30 minutes before or after a meal
→ HINT: Avoid having a beverage on the table when eating a meal
• Each meal should last 20 minutes to eat no more than 3-4 oz food
→ Pause between each bite
→ Swallow to allow the food to settle in the pouch
→ Your pouch is about the size of a golf ball so it fills up quickly. It is very easy to
have “one bite too many” which may result in pain or vomiting
• Eat protein first - You need 60-80 grams protein/day!
→ Approved protein supplements are recommended to help you meet your goals
• Avoid ‘empty’ calories that have no nutritional value
→ Even though you may not always experience ‘dumping syndrome,’ too much fruit,
fruit juice, sugars, soft drinks and refined starches will slow down your weight loss
• Avoid ALL fried, oily or fatty foods
→ These foods empty rapidly from your stomach into your small intestine, which can
cause ‘dumping syndrome’ and also interfere with your long-term weight loss
• “Full” feels different
→ You will not feel “belly fullness,” but rather pressure or discomfort in the chest
area. Some experience hiccups and sneezing as “fullness” approaches
→ Listen to your body - When in doubt, wait it out!
• Read Food Labels
→ Look for foods with Sugars 3g per serving
• Join A Support Group
→ Northern Westchester Hospital hosts a monthly group - see NWH website for details
• Exercise
→ To preserve lean muscle mass and speed up your metabolism
• Keep yourself hydrated
→ Aim for 64 oz or 2 quarts per day of water or other unsweetened, low-calorie, non-
carbonated, decaffeinated drinks (e.g. crystal light, herbal tea, etc)
• Always take your vitamin and mineral supplements as directed
→ You will need to continue your vitamin and mineral protocol throughout life to
maintain optimum health and prevent deficienciesPrepare Your Home for Weight Loss Surgery
We suggest you purchase the following items before your surgery so that you will be
prepared when you arrive home.
1. Set of measuring cups and spoons
2. Food scale
3. Food strainer - to strain chunks of meat and vegetables out of soups
4. Blender
5. Kitchen timer - meals should last NO MORE than 20 minutes
6. Toddler bowls and utensils
7. 1-quart water bottle - fill at least 2x/day (64 oz) to ensure adequate
hydration
8. 1-oz medicine cups to portion food
9. Notebook for food diary (or download and print at: www.eatwellct.com)
10. Vitamin supplements
11. Protein supplements - try a few brands before surgery to see what you like
Where to Purchase
Bed Bath and Beyond (www.bedbathbeyond.com), Target (www.target.com),
Walmart (www.walmart.com), Kmart (www.kmart.com)You can also read
