Step 8: Post-surgical nutrition

Bariatric surgery may help you meet your weight loss, health, and lifestyle goals. However, once you've undergone bariatric surgery, you'll need to learn some new habits to make sure that you lose weight and keep it off. Remember this is NOT a diet but rather a lifestyle plan and dietary pattern.

Immediately after surgery, you'll be getting fluids through an intravenous line. When tolerated, you'll begin taking small sips of water. If this goes well, you'll be given other liquids, and then slowly advanced to a diet of pureed food. You'll probably leave the hospital on this pureed diet and stay on it for several weeks. This approach will help you feel satisfied without increasing the risk of food obstruction and vomiting. It will also allow you to have more comfort and less stress as you begin eating at each meal.

Regardless of the type of surgery you've had, you'll need to spend some time with a nutritionist to construct a healthy diet plan. You'll be creating a plan for your new life, therefore it is important to follow it permanently for the sake of protecting your health.

You'll need to:

• Learn about appropriate portion sizes. Learn exactly how much you should eat at every meal, because you don't want to overeat. Overeating can cause vomiting. If you continuously overeat and vomit you can cause scarring or stenosis at the site of surgery, or you'll stretch your stomach pouch, which will allow more calories to be taken in and therefore slow or diminish your weight loss. When you begin eating solid food after surgery, you'll probably be able to eat about 1/4 to a 1/2 cup per meal.
• Learn how to eat very, very slowly. You may be advised to time yourself, so that you take at least 30 minutes at each meal. You should chew all solid items extremely thoroughly. This will help prevent the opening between the stomach and the intestine from becoming blocked. It will also help your brain accurately register when you become full, so that you don't accidentally overeat. You should take your fluids first, eat without added fluids, and wait 60 - 90 minutes after your meal before you start taking fluids again.
• Follow a nutritionally sound diet. Your portions will be considerably smaller, and your body may process nutrients differently after surgery. Therefore, make sure that what you eat is highly nutritious. Most nutritionists recommend that bariatric surgery patients follow a low-fat, low-sugar, high-protein diet, consisting of a nutritionally balanced diet program. You will need to take daily multivitamins, iron and calcium supplements indefinitely. You'll need to be checked regularly to make sure that you aren't deficient in these vitamins and minerals (such as iron) and don't have anemia.
• Avoid fats and sugars. Fats and sugars are very high in calories, so they're NOT recommended for anyone who is working to maintain a healthy weight. In fact, if you've had gastric bypass surgery, eating foods that are high in fats or sugars may actually cause a condition called "dumping syndrome." Dumping syndrome will make you feel physically ill, with stomach pain and cramping, vomiting, weakness, shakiness, and sweating.

• Avoid drinking beverages with meals. Your new stomach pouch will only hold food or drink, but not both! Drink water either half an hour before or after meals, but not with meals. Drinking beverages with meals can cause significant symptoms like "dumping." Instead, drink small sips of water regularly throughout the day. Don't drink large amounts at any one time. Avoid carbonated and sugared beverages, which can make you feel bloated and uncomfortable.

Remember that 80 percent of all people who undergo bariatric surgery consider the surgery to have been a success, because they are able to meet and maintain their weight and health goals. The 20 percent who consider the surgery a failure generally have been unable to stay committed to the lifelong dietary plan necessary for success.

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