Post Surgery

NUTRITION

After bariatric surgery you will need to make changes to your eating patterns. Our bariatric coordinator, surgeon and dietitian will also help you through this process. It is very important to follow the eating and drinking instructions beginning immediately after the operation.

The size of your stomach pouch is about one ounce or one to two tablespoons. At first your capacity will be somewhat limited, so be patient. You may find that two to three teaspoons of food fill you up. This is expected. You may also find that you are able to eat more of one type of food than another. That is okay, too. Over time, your food pouch will stretch. By six months after surgery, it may stretch to eight ounces or one cup. Long term, the size of your pouch is likely to be eight to twelve ounces or 1 to 1½ cups. This will limit the amount of food you can eat at one time.

The surgery is designed to restrict solids, not liquids, so drinking liquids will not make you feel full. You also should not drink liquids during or immediately after meals as they will flush food through the reduced stomach pouch, which means you will not get the prolonged feeling of satiety needed to help you eat less; however, staying hydrated and drinking lots of water throughout the day is important. You will also need to learn to eat slowly and chew your food very thoroughly.

One of the changes that patients often comment about is the concept of wasting food. After surgery your eyes and head still work the same way as they did before. However, because of the new stomach pouch, you will be satisfied with much less. It is critical that you listen to your body’s signals of fullness and not to your eyes that see food left on your plate.

Click HERE to download Holiday No-Splurge Tips
Click HERE to download Nutritional Guidelines & Eating Techniques

WEIGHT LOSS AFTER SURGERY

Food Amount & Selection

It is recommended that you eat only three small meals a day. The primary source of nutrition should be protein. 70 to 75% of all calories consumed should be protein based (eggs, fish, meat, etc). Carbohydrates (bread, potatoes, etc.) should make up only 10 to 20%, and fats (butter, cheese, etc.) only 5 to 15% of the calories that you eat. A diet consisting of 600 to 800 calories and 75 grams of protein should be the goal for the first 6 months. Protein drinks can be helpful to fulfill your protein requirements. There are many to choose from. Look for protein drinks that are low calorie and low sugar and that have a good taste. waist measurement of 35 inches or greater.

You will need to make good food choices and learn to avoid problem foods, such as high-fiber, high-fat, and dry foods, since these are more difficult for the small stomach pouch to digest. Good food choices include fruit and vegetables, lean protein, some bread and cereal, and some dairy products.

Avoid foods which contain sugar; foods that have a concentrated supply of calories with little nutritional value, such as milkshakes, syrups, jam, and pastries, should be avoided as much as possible. Not only will they slow down your weight loss, but they can make you sick! Sugar may cause dumping syndrome in patients who have had the gastric bypass procedure.

Click HERE to download Protein Containing Foods
Click HERE to download information about Dumping Syndrome

Foods That May Be Difficult to Tolerate

  • Bread products
  • Cow milk products
  • Pasta products
  • Fatty foods and fried foods
  • Candy, chocolate, any sugary foods and beverages
  • Carbonated beverages
  • Bran cereal and other bran products
  • Corn, whole beans, and peas
  • Dried fruits and skins of fresh fruit
  • Coconut

Click HERE to download information about Potential Problems & Suggested Dietary Modifications

Foods Texture

All the foods you eat must be of the proper consistency to avoid damage to the sutures and to avoid clogging up the small opening in between your stomach and your intestines.

The diet after surgery progresses from a liquid diet to a pureed diet, then to a soft diet and last to 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, it will 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 of unnecessary complications.

After about two weeks after surgery you should be able to tolerate a small amount of solid foods. These solids will be soft, pureed and/or blenderized. It is very important that you make sure everything is chewed to the consistency of baby food. And finally, but most importantly, you should stop eating as soon as you feel full (no longer hungry).

Click HERE to download Phase I Post Operative Diet: Clear Liquids
Click HERE to download Phase II Post Operative Diet: Full Liquids
Click HERE to download Phase III Post Operative Diet: Pureed Solids
Click HERE to download Phase IV Post Operative Diet: Soft Solids
Click HERE to download Phase V Post Operative Diet: Stabilization


Vitamin Supplements

It is difficult to get all of the essential vitamins and minerals your body needs from the small volume which you will be allowed to eat, so it is important to take vitamin and mineral supplements daily. Not all products are created equal. Bariatric surgery patients not only require higher amounts of vitamins and minerals, but it is essential that they are in the proper forms. Click HERE to purchase a variety of vitamin and protein supplements.


Contact your Dietitian

Doctors Hospital Weight Loss & Wellness Center

  • Blanca Villarreal, RD, LD - blanca.villarreal@uhsinc.com - 956-693-5026

Laredo Medical Center Weight Loss Program

  • Rosa Cavazos-Lopez, MS, LD, MACP - rosa_cavazoslopez@chs.net - 956-796-2662

Lifestyle Changes

One of the benefits of laparoscopic bariatric surgery is that patients return to normal activity relatively quick after surgery. The length of hospital stay is usually 24-48 hours. It also takes most people about a week to return to work and a month to six weeks to resume strenuous exercising. In the case of open surgery or if there are complications, recovery may take longer.

Bariatric surgery is not a quick fix. It’s an ongoing journey toward weight loss through long-term lifestyle changes. After surgery, the difference in your body makes it physically easier to adjust your eating and lifestyle habits. Fortunately, you will not have to go through the process alone. Our team will follow up with routine check-ups with your surgeon, ongoing band adjustments if necessary, support groups and nutritional classes.

Don’t forget, it is very possible to regain a significant amount of weight if you continue the lifestyle you had before your procedure! You will need to work closely with our team and communicate openly with us.


Exercise Plan

Incorporating regular physical activity into your daily routine is as important as following your nutrition plan. Often patients have been sedentary due to decreased activity tolerance, psychological constraints, and in some cases, physical disabilities. After surgery, aerobic activities, particularly walking and swimming are generally best tolerated. You will need to consult with your surgeon and weight-management team to find out which activity is right for you.

Walking

You should begin walking as early and as often as tolerated immediately after surgery. This should include a 5-10 minute warm-up. Depending on your health, the warm up may be all you can manage early on. Take it slow and gradually increase walking time up to 30-45 minutes of continuous walking daily if possible.

  • Set a 6 week goal for walking time.
  • Don’t worry about speed initially.
  • Once you achieve the 45 minute walking plateau, gradually increase your walking pace.
  • Generally 6 weeks post-op, it is considered safe to perform any exercise (including aerobics, bicycling, strength conditioning, etc.) At this
    point you should begin a strength conditioning program. In addition to the strength benefits, increasing your muscle mass will make them a
    more efficient calorie burner.

Long-Term Exercise Program

  • 30-45 minutes of continuous aerobic activity (walking, swimming, jogging, dancing, biking) 4-5 times per week
  • 2-3 days per week of weight training.

Tips for Better Workouts

  • Make sure you have quality shoes for your chosen activity.
  • Start slowly. Doing too much too soon can lead to injuries.
  • Try new activities. Doing the same thing can lead to plateaus and boredom.
  • Be ready for exercise by eating right throughout the day and by staying hydrated.
  • Always stretch both after you warm up and after your workout!
  • If you’re sore or tired, give yourself extra recovery days if needed.

How to Begin

  • Choose an activity that you enjoy. The best exercise for you is the one you’ll actually do!
  • Start with 2 or 3 days of exercise with a rest day between workouts.
  • Begin with a 5-10 minute warm up of light cardio and stretch the muscles you’ll use during your workout.
  • Increase your pace and intensity to slightly harder than comfortable and exercise as long as you can.
  • Begin where you ARE, not where you want to be. You may only be able to exercise for a few minutes at a time, but that will change quickly if you’re consistent.
  • End each workout with a 5-minute cool down of light cardio and stretch the muscles you’ve worked to improve flexibility and reduce your chances of injury.
  • Each week, increase your workout time by a few minutes until you can work continuously for 30 minutes.
  • For the first few weeks, focus on endurance and conditioning. You have plenty of time to work on your speed and distance!

How Hard Should You Work?

When doing cardio, you should be within your target heart rate (THR) zone. Always be aware of how you feel when you exercise. If you feel dizzy or lightheaded, stop immediately and rest or call your doctor. If you’re not breaking a sweat, speed it up!

Variety will keep your body and your mind challenged, so after the initial conditioning period (about 6 weeks of consistent workouts), vary your workout intensity and time. Each week, do a long slow workout (45-60) minutes at the lower end of your THR and one short one (20-30 minutes) at the higher end of your THR. Your other workouts can be between 30-45 minutes, in the middle of your THR.


Motivation: Key to Success

To work, the surgery needs your active participation. Your success will depend on you and the partnership between you and your medical team. We are here to support you through the changes with personal consultations, support groups and workshops.

If, at any time, you feel overwhelmed or otherwise need more assistance, please contact us. We will be glad to take the necessary steps to refer you to the best possible resolution.

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