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Nutrition


A healthy diet is an important part of life after surgery. A healthy diet will help prevent malnutrition after surgery and promote good weight loss and weight maintenance. It is our goal at Missouri Bariatric Services to provide you with the best tools and nutrition education to help support your new lifestyle. On this page you can read about lifestyle changes needed to be successful after weight loss surgery, tips to help you get started with these changes, have access to educational materials provided in our clinic, and read through some frequently asked nutrition-related questions.

Many lifestyle changes must be made after weight loss surgery

  • After surgery, fluids must be consumed between meals, but not with meals. After surgery, stop drinking 30 minutes before a meal and wait at least 30 minutes after a meal to start drinking again. Drinking fluid while eating or immediately after eating will cause the food to leave your pouch making it easier to eat more food at one time or creating the desire to snack later. Either way, it can effect your weight loss or weight maintenance because you eat more food.
  • After surgery you need to drink at least 64 ounces of low-calorie, sugar-free fluid everyday to stay hydrated..
  • Take small bites and chew food at least 10 to 20 times (or more) before swallowing. Food should be the consistency of toothpaste or applesauce before you swallow. This enables you to eat food more comfortable
  • Give up or reduce caffeine intake for life.
    • Switch to decaffeinated coffee and/or tea.
    • No more than 1 to 2 cups of regular coffee and/or tea per day.
  • Do not drink alcoholic beverages for at least one year after surgery. Thereafter, alcohol must be consumed in moderation. Alcohol can cause stomach ulcers, drastically increase your calorie intake, and cause alcohol poisoning if drank in excess.
  • Avoid carbonated beverages for life (including, but not limited to, regular soda, diet soda, and beer). Carbonated beverages place air into the pouch which can cause gas, bloating, and discomfort.
  • You may want to avoid using a straw for a couple of months or until you have trained yourself to sip fluids instead of gulp. Straws cause us to drink faster than normal and can also cause air to enter the pouch, which leads to gas, bloating, and discomfort.
  • Eat three meals every day.
    • Do not snack or graze between meals.
    • Do not skip meals.
  • Take the recommended bariatric specific vitamin and mineral supplements for life. See our recommendations in the "Educational Material."

Learn to eat your meals in this order

  1. Eat lean protein first. The best sources of protein are: fish, seafood, poultry, beef, pork, wild game, eggs, cottage cheese, tofu (other vegetarian meat substitute products) and protein supplements.
  2. Eat non-starchy vegetables second (such as leafy greens, green beans, broccoli, carrots, etc.)
  3. Eat fruit third.
  4. Eat whole grains OR starchy vegetables last.

You must eat adequate protein every day after surgery to avoid protein malnutrition. Goals are:

  • Women need a minimum of 65 grams of protein every day
  • Men need a minimum of 80 grams of protein every day
  • The best sources of protein are: fish, seafood, poultry, beef, pork, wild game, eggs, cottage cheese, and protein supplements.
  • Some other sources of protein can be: beans, lentils, cheese, and nuts, but the primary source of protein in your diet should come from the previous list of proteins.

Tips to prepare for surgery

  • Practice chewing your food 10 to 20 times before swallowing.
  • Drink fluid between meals, but not with meals.
  • Carry a beverage container (like a water bottle) with you at all times.
  • Start eating more vegetables, fruit, and whole grains.
  • Start to identify "trigger" foods. These are foods that you eat when stressed, sad, bored, lonely, etc. Sometimes these are sweet, salty, or high-fat foods.
  • Keep a food dairy.
  • Practice eating 3 meals each day.
  • Work to reduce your caffeine intake from coffee, tea, and soda.
  • If you do not do so already, start taking a multivitamin plus iron and a calcium plus vitamin D supplement every day.
  • Try protein supplements. A complete list of recommended supplements can be found in the "Educational Material" section.
  • Investigate bariatric specific vitamin and mineral supplements to see which is right for you. These supplements are discussed in-depth in preoperative education classes and it is best to wait and purchase them until after your class. Just be sure to purchase them before your surgery.

Educational Materials

The following guidelines and recommendations have been assembled by our staff to help you with pre and post surgery nutrition.

Frequently Asked Questions

  • How long will I be on liquids?
  • Can I have mushy foods on my pre-op liquid diet?
  • Can I have other beverages besides what is listed on the Preoperative Liquid Protein diet?
  • I don't feel very good on my liquid diet, is this normal?
  • What is a clear liquid?
  • How big is my pouch after surgery?
  • When can I stop diluting fruit juice?
  • What is a "slider food?"
  • Can I use baby food on my semi-solid foods diet?
  • Once I finish my diet progression, can I have more kinds of food than what is listed in my book?
  • How many calories, carbohydrates, and fat am I supposed to have?

    How long will I be on liquids?
    4 weeks if you have a gastric bypass or sleeve (2 weeks before surgery and 2 weeks after surgery.) You will be on liquids for 3 weeks if you have a band (2 weeks before surgery and 1 week after surgery). After surgery, it is extremely important to stay on liquids for the recommend time to avoid damaging staple lines or disrupting band placement.

    Can I have mushy foods on my pre-op liquid diet?
    No. The liquid diet is designed to be very low in carbohydrates and fat to force your body to use the fat stores it already has; thus, requiring your body to use the fat in your liver and help shrink it. Maximum fat loss occurs if you avoid any foods.

    Can I have other beverages besides what is listed on the Preoperative Liquid Protein diet?
    No. Other than protein supplements, you should only drink calorie-free, or low-calorie beverages, such as, water, flavored waters, and sugar-free gelatin. Be sure to use skim or 1% milk to help control calorie and fat intake.

    I don't feel very good on my liquid diet, is this normal?
    It is normal for the first 48 to 72 hours on the diet to feel nauseous, have a headache, or become irritable. This will pass as your body becomes accustomed to the change in diet. It is also normal to have loose stools and need to use the restroom frequently during the liquid diet because everything going in is a liquid.

    What is a clear liquid?
    A clear liquid is a translucent fluid. It does not have to be colorless. If you can shine a flash light at the fluid and see the light come through the other side, it is a clear liquid.

    How big is my pouch after surgery?
    Initially, the pouch after gastric bypass will hold about 2 ounces of food (about 1/4 cup) and, generally, by 3-6 months after surgery comfortably holds about 4 ounces of food (about 1/2 cup). After a band reaches it's first "right fit" adjustment, the pouch typically holds 4 to 6 ounces of food. A vertical sleeve gastrectomy pouch also typically holds 4 to 6 ounces of food. Over time some people can comfortably eat up to 8 ounces (1 cup) of food.

    When can I stop diluting fruit juice?
    Drinking regular fruit juice increases one's sugar tolerance and caloric intake; you'll need to continue to dilute fruit juice for life. Dilute fruit juice 50/50 with water. Add more water for a lighter fruit flavor.

    What is a "slider food?"
    A slider food is any food with a soft, mushy texture. These foods "slide" right through your pouch and do not provide a sense of satiety. Examples are: soup, sugar-free gelatin, pudding, ice cream, applesauce, mashed potatoes, and simple white carbohydrates (like pretzels and crackers).These foods should be consumed rarely once you complete your diet progression.

    Can I use baby food on my semi-solid foods diet?
    No, the use of baby food is discouraged. For some reason, people never seem to want to quit using the baby food because it is convenient. Baby food is a slider food.

    Once I finish my diet progression, can I have more kinds of food than what is listed in my book?
    Yes, within reason. You must continue to choose foods and beverages that are sugar-free, have no added sugar, and are low-fat.

    How many calories, carbohydrates, and fat am I supposed to have?
    In the beginning, focus on meeting your protein, fluid, and vitamin and mineral goals. Approximately a year after a gastric bypass, sometimes sooner for gastric band and vertical sleeve patients, a good diet has about 900 to 1100 calories per day with 35 percent to 55 percent of calories from carbohydrates, 25 percent to 35 percent of calories from protein, and 20 percent to 30 percent of calories from fat. Keep an electronic food record to help determine if your diet is meeting these nutrition guidelines.




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