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Wednesday, October 30, 2013

How to Eat After Gastric Bypass Surgery

Gastric Bypass surgery (GBP) is a growing elective surgery in America as well as other countries. The diet after surgery varies with each clinic performing the surgery, but there are certain dietary rules to follow to avoid weight gain and malnutrition.

Instructions

    1

    Drink only clear liquids for three days after surgery. Clear liquids are defined as anything liquid at room temperature than is translucent. Examples of liquids allowed on this diet include broth, apple juice, grape juice, water, jello and Popsicles. Sip very slowly, as your stomach is now very small. If you drink too quickly, it could cause vomiting.

    2

    Start eating pureed foods when cleared by your particular surgeon to do so. Pureed means the texture is similar to baby food. Examples of foods allowed on the pureed diet are cottage cheese, scrambled eggs, yogurt, pudding, oatmeal and grits. For the more adventurous gastric bypass patient, the blender can be used to puree anything that will blend. Chicken is easily pureed when combined with a small amount of broth to retain moisture. Very fine tuna or chicken salad is also a popular food choice on this diet, as it is easily digested and high in protein. The protein needs for most patients after gastric bypass range between 75 to 100 g per day. A patient's dietitian or surgeon can calculate the specific needs based on body weight at the time of surgery. Depending on stomach pouch size, meals tend to be around 4 oz. each. It may be less than this immediately following surgery due to swelling. The pureed diet phase typically lasts from 4 to 8 weeks.

    3

    Drink fluids only between meals. A person's stomach is no longer big enough to hold both food and liquids at one time. If a person were to drink during meals after GBP they could potentially become malnourished due to not getting enough food in, or they could stretch out their pouch, causing weight gain in the future. Do not drink fluids 20 minutes prior to eating. After a meal is consumed, wait 30y minutes before drinking again. If it feels as though a piece of food gets stuck on the way down, a tiny sip of water can be taken to move it through. Another important thing to know about fluids is that no fluids with calories should be consumed after GBP unless it is skim milk or a protein shake. Juice, sweet tea and sports drinks are not allowed. They contain too much sugar and could cause dumping syndrome and weight regain. Sugar-free drinks such as Crystal Light, Sugar Free Kool-Aid and unsweet decaffeinated tea are allowed after GBP. Do not drink carbonated drinks after GBP. Caffeine should only be consumed in small amounts, as it can speed up GI tract motility and also exacerbate dehydration.

    4

    Eat a low-sugar, low-fat, high-protein diet after the pureed phase of the diet. A high-protein diet is important because it helps a person who is losing significant amounts of weight retain muscle mass. Protein is crucial in wound healing, and makes a person feel full faster. Foods high in protein include meat, chicken, fish, eggs, beans, protein shakes and protein bars. Protein powder can be found in grocery stores, nutrition specialty shops and pharmacies, and can be added to most foods and drinks to increase protein content.

    5

    Take vitamin and mineral supplements every day after GBP. In general, two chewable multivitamins daily is recommended. A person after GBP needs 200 percent RDA of vitamins and minerals. Calcium is also important to take daily after surgery. The specific type of calcium needs to be calcium citrate. Other types of calcium such as calcium carbonate may not be fully absorbed into the GI tract after the surgery. There are an abundance of bariatric websites available that sell vitamin and mineral supplements for after surgery (see Resources below). The other vitamin that is important to take regularly after surgery is B-12. This vitamin is no longer absorbed from food after the surgery. It is necessary to take it either sublingually (under the tongue) once per day, through a nasal spray once per week, or in a shot form once per month. Bloodwork should be drawn at least every 6 to 12 months to check for any deficiencies. Common nutrient deficiencies after surgery include iron, zinc and vitamin D. If a deficiency is discovered, it is important to replace this with a supplement immediately.

    6

    Do some form of exercise for at least 30 minutes most days of the week after GBP surgery. Exercise is a key factor in maintaining weight loss. There is no specific exercise that is recommended, as each person has their own limitations and abilities. Walking is a good way to exercise, as are videos and lifting weights. As a person loses weight and is more physically capable of activity, exercise level and intensity should increase. Drinking calories is also a very common way people will gain weight after GBP.

    7

    Avoid high-fat foods after GBP surgery. A person who eats fried foods every day will gain weight back regardless of having surgery or not. The calories consumed with a high-fat diet will still affect weight gain after surgery. High-fat foods consist of fried products, pastries, food with butter or cream, and high-fat meats such as ground chuck.

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