4 Stages of Eating After Bariatric Surgery

If you’re considering undergoing bariatric surgery, or have already scheduled your procedure day, it’s time to start preparing for your recovery. The biggest changes you’ll have to make are to your diet. For years I've posted bariatric friendly recipes here, but neglected those first few formative weeks immediately post-surgery.  I’ve outlined what you can expect during four different stages of eating after your bariatric surgery:

Note that the duration of each stage is an estimate and not written in stone,  If you progress to a new stage and find you are not comfortable, step back for a few days or even a week, then try again.

STAGE 1: CLEAR LIQUIDS

Starting the day after your surgery, you will start a clear liquid diet, continuing for about 4-5 days. During this time, you should try your best to work up to about 3 ounces of clear fluids a day every 30 minutes. This might be difficult right after your procedure, but it will continue to get easier and feel more comfortable! During this time, drink slowly and do not drink liquids out of a straw or chew gum, as these can lead to gas and bloating. Some examples of liquids to try during this stage are:

• Diluted apple juice
• Lemon water
• Vegetable broth
• Lemon-Lime Gatorade G2
• Sugar-free citrus gelatin
• Pedialyte Popsicles

You should also be adding diluted protein shakes to your diet. Use a combination of ½ protein shake and ½ water.

STAGE 2: FULL LIQUIDS

You can advance to stage two of your diet after about 4-5 days and after you have been able to tolerate 48 ounces of clear liquids a day. This stage will involve foods that are mushy or have a consistency similar to yogurt, and will continue for about 7-10 days. Try to eat every 3-4 hours, being sure not to skip any meals. Each of these meals should be about ½ cup or two ounces in size. You should still be drinking a minimum of 48-64 ounces of fluids during this time as well. Examples of foods you can eat during this stage include:

• Greek or nondairy yogurt
• Oatmeal or cream of wheat
• Unsweetened applesauce
• Black beans, lentils, or fat-free refined beans (blended)
• Pea soup, cream of mushroom soup, etc.
• Mashed banana
• Cottage cheese (add a little seasoning or fruit puree for flavor)

You should continue drinking protein shakes between meals with a goal of 80-100 grams of protein a day. You can begin mixing protein with unsweetened almond or soy milk, but avoid cow’s milk. You should also begin your vitamins and minerals on day 5 of this stage, adding one new vitamin per day.

STAGE 3: SOFT AND MOIST FOODS

This stage of your diet will begin about 2 weeks after your surgery and your follow up appointment with Dr. Balsama, lasting 2 full weeks. These foods should be easy to pull apart with a fork, and each meal should be about ½ cup or 4 ounces in size. However, you should stop eating as soon as you’re full, even if this amount has not been reached! Examples of soft foods to eat during this stage are:
Lean proteins like slow cooked chicken or pork

• Canned chicken, tuna, or crab
• Soft cooked eggs
• Chili or stew
• Salmon, trout, or other flakey fish
• Refried beans, mashed lentils, chickpeas, and tofu
• Soft, low-fat cheeses
• Over-cooked vegetables like zucchini, squash, cauliflower, or mushrooms
• Soft fruits like melons, peaches, and avocados

Continue to sip fluids between meals but remember the 30/30/30 rule: Do not drink 30 minutes before or after a meal and chew each bite 30 times. Continue your daily protein drink and minerals as well.

STAGE 4: REGULAR CONSISTENCY

This stage starts 4-6 weeks after your procedure, and involves reintroducing regular foods! Congratulations!!  With thay said, remember to take this stage VERY slowly.  This is where you can hurt yourself by going too fast.  You'll understand when you get your first case of "foamies" - trust me on this.  GO SLOW... Start by adding 1-2 new foods per day, avoiding anything that causes gas like broccoli, pepper, onions, and spicy foods. Remember to eat slowly and chew your foods completely before swallowing (at least 30 times). Each meal should be about ¾ cup (6 ounces) in size, and should not exceed 1 cup. You should continue to honor the 30/30/30 rule, sipping water in-between (but not DURING) meals. Eventually, you will be able to work up to a regular diet.

However, here are some foods you should still avoid:

• Rice, pasta, and bread
• Alcohol
• Carbonated drinks
• Dry meats
• Fruit with thick skin
• Fried foods
• Added sugars
• Baked goods
• Oils

When you get to this stage, go exploring the rest of the blog.  There are plenty of tasty foods that both you and your family can enjoy!

Chicken Lettuce Wraps (like PF Chang's )

PF Chang's is most assuredly NOT a chinese restaurant, but that doesn't stop the wide ranging chain from producing some DELICIOUS food!  Of course, we have to be careful of the sauces, oils, etc.. that they use, but this dish is completely compatible with the post-surgery bariatric lifestyle.  Really simple and quick if you have ground chicken. Takes a bit longer if you debone and chop it yourself (I'm cheap, so I do!)

And they are SOOOO GOOOD!!!!

INGREDIENTS:

• 1 tablespoon olive oil
• 1 pound ground chicken
• 2 cloves garlic, minced
• 1 onion, diced
• 1/4 cup hoisin sauce
• 2 tablespoons soy sauce
• 1 tablespoon rice wine vinegar
• 1 tablespoon freshly grated ginger (powdered in the bottle if you must)
• 1 tablespoon Sriracha, optional ( I serve it on the side)
• 1 (8-ounce) can whole water chestnuts, drained and diced
• 2 green onions, thinly sliced
• Kosher salt and freshly ground black pepper, to taste
• 1 head butter lettuce

DIRECTIONS:

1. Heat olive oil in a saucepan over medium high heat. Add ground chicken and cook until browned, about 3-5 minutes, making sure to crumble the chicken as it cooks; drain excess fat.
2. Stir in garlic, onion, hoisin sauce, soy sauce, rice wine vinegar, ginger and Sriracha until onions have become translucent, about 1-2 minutes.
3. Stir in chestnuts and green onions until tender, about 1-2 minutes; season with salt and pepper, to taste.
4. To serve, spoon several tablespoons of the chicken mixture into the center of a lettuce leaf, taco-style.

Chocolate Almond Macaroons

 

I was working at a client several years ago when one of my team took some vacation time in Paris.  On his return he treated us to some macaroons he picked up a small patisserie.  I was post-surgery at that point, so I resisted - for almost an hour!!  What I bit into snapped - then exploded into a million flavor filled pieces.

Sometimes now I want a cookie and nothing else will do... soooo...  I eat a cookie (or several) of my version of those macaroons.  Perhaps the best tasting cookies I've ever eaten.

2 cups almonds (or almond meal)
1 cup sugar equivalent sweetener (your choice)
1/4 teaspoon ground cinnamon
1/8 teaspoon salt
2 eggs
1/4 teaspoon almond extract
3/4 cup chopped semisweet chocolate
sliced almonds for top of cookies

Grind the almonds in a food processor with the sugar, cinnamon and salt until finely ground. You can also use almond meal if you like, just make sure you use 2 fully packed cups.

Add the eggs and extract to the mixture and incorporate.

Shave the chocolate with a knife (I use 4 squares of Trader Joe's Belgian 72% chocolate). Add to the mix.

Preheat oven to 350F and line 2 big baking sheets w/ parchment paper.

With wet hands, roll the dough into 1" balls and place on cookie sheet.  I use a cookie scoop for consistency.

Sprinkle some sliced almonds on top.

Bake for 12-13 minutes. The cookies will puff up nicely.

Remove immediately to a cooling rack with a thin spatula.

These are light and airy and delicious!