Easy Does It: Diet After Gastric Bypass Surgery

Dr. Christopher McGowan
octubre 28, 2020

Some people think of dieting as an act of willpower, but if you have undergone gastric bypass surgery, there is a hard limit to the amount you can eat at any one time. After surgery, your new stomach can only hold a tiny amount of food. Maintaining a healthy diet after a gastric bypass surgery is an exercise in keeping an eye on quality as well as quantity. What you eat has as large an effect on your health as the raw number of calories you consume in a day.

Gastric bypass surgery is one of the most well-recognized forms of weight loss surgery. In a gastric bypass, a surgeon will separate a small portion of the top of your stomach, sew it into a tiny pouch, and then connect this pouch to a portion of your small intestine. This creates a new route for your digestive tract that bypasses (hence the name) the larger portion of your stomach and the upper part of your duodenum.

The outcome of gastric bypass surgery is a radical reduction in the size of your stomach, which means you simply cannot eat as many calories during a day as you used to. Many people think this is the only difference, but the changes to your digestive tract have profound effects on how your body can digest food. Simply counting calories or grams of fat is not enough after a bariatric surgery. You will need to pay careful attention to exactly what foods you eat, when, and even how you eat them.

Dietary Tips After Gastric Bypass Surgery

After gastric bypass surgery, how you eat is going to be just as important as what you put on your plate. Making sure you chew your food properly can make all the difference between a well-digested meal and one that results in extreme discomfort in your abdomen.

Ensuring you chew food thoroughly is important because your food no longer spends as much time in your stomach and duodenum as it did prior to surgery. Poorly chewed food that is not sufficiently digested when it hits your new, shorter small intestine can put you at higher risk of dumping syndrome, an uncomfortable and dangerous condition where your body simply passes the undigested food along without trying to absorb it. Dumping syndrome can lead to uncomfortable and potentially dangerous malnutrition and diarrhea.

Regardless of how you chew, there are some foods that are going to be better for you after surgery than others. Once you have gotten through the initial recovery phases of clear liquids, broths, smoothies, and pureed foods, your diet will eventually settle out and include proper solid foods. A quick guide is included below to illustrate the kinds of foods that will feature prominently in your diet after weight loss surgery:

  • avocados
  • salmon
  • tuna
  • nuts
  • fruit
  • low-fat grains and starches 
  • coconut oil
  • nut butters
  • low-fat or skim milk
  • eggs
  • vegetables
  • smoothies (filled with fibrous, hard to digest vegetables)

Diet Before Bariatric Surgery

We have touched on how important diet is after a gastric bypass, but the diet you maintain in the weeks leading up to surgery is important as well. If you are a candidate for surgery, your doctor and a dietitian will work with you to begin a high protein diet that is designed to help your body protect as much muscle mass as possible as you begin to cut calories ahead of surgery.

Your main goal of a pre-surgery diet will be to reduce fat around the abdomen, and the liver in particular. Your doctor will also be watching to see if you can maintain the strict requirements of your diet. Signs of binging or purging can cause dramatic shifts in weight before surgery could potentially signal dangerous dietary habits that could put you at extreme risk after surgery.

Diet After Bariatric Surgery

After gastric bypass surgery, your diet will progress in stages. Your digestive tract needs to be allowed to heal, which means you will need to begin on a clear liquid diet and slowly work up to eating solid foods over time. This full process can take more than four months, and you will be working with your doctor or a dietitian for a long time after surgery to ensure you are on the right path going forward.

In the first few days after surgery, you will only be allowed clear liquids. Even then, you will only be allowed to drink a few ounces at a time. Soon, you will begin adding in broth, thin soups, sugar-free gelatin, and skim milk.

Once your doctor is confident your body will be able to handle more substantive foods, you will move on to thicker, pureed foods. At this stage you will begin eating some fruits and vegetables, though you will be avoiding fruits that have a lot of seeds and vegetables that are fibrous and tough. Even when pureed, tough vegetables are still too much for your new stomach to handle at this stage. You may even find that baby foods are great sources of nutritious food your stomach can handle.

You will become a wizard with your blender at this point, as you will likely be eating nothing but pureed foods for several weeks. After you have shown that you are tolerating this diet well, it will be time to move on to soft foods. You will probably still be augmenting your diet with high protein smoothies at this stage, but you will now be able to eat solid protein sources like soft-boiled eggs and ground meat. As you move through this stage you will also be allowed to begin incorporating baked or steamed fish, cottage cheese, and possibly rice. The range of cooked vegetables you will be able to eat will also expand.

The fourth and final stage of your diet is where you settle into the dietary restrictions that will be with you for the rest of your life. At this stage, you will begin introducing solid foods and learning how to prepare and eat a wider range of food. Your list of high protein foods will now expand to include lean meats, provided you are chewing them thoroughly.

What Foods can You not Eat After Gastric Bypass Surgery?

After gastric bypass surgery, you will no longer be able to eat some foods including tough meats, carbs such as breads and pastas, crunchy foods like pretzels, and fried foods. You will also not be allowed to drink carbonated beverages and alcohol.  A few of the most common banned foods are:

  • white breads and pastas
  • tough meat
  • carbonated beverages
  • alcoholic drinks
  • many deserts and sweets
  • some fibrous, stringy vegetables
  • caffeinated coffee and tea

Raw vegetables, for the most part, are going to be a thing of the past. The time it takes for your digestive system to break down fibrous or tough vegetables is simply no longer available after gastric bypass. You still need the nutritional value found in vegetables, so cooked or pureed vegetables are going to be the way to go. If a kale smoothie sounds like a good time, then you are going to be in good shape after surgery.

All of us have a food or two that would be heartbreaking to no longer be able to eat, and sadly it is likely you might find some favorite foods on the naughty list after weight loss surgery. Your new digestive tract cannot handle foods the same way it used to, and there are some foods that are simply a no-go. Not everyone’s body is the same, and though you will start out with a lengthy list of banned and approved foods, over time your dietitian will work with you to find out what foods you can and cannot tolerate.

You will quickly learn which new foods work for you and which do not. Diarrhea, nausea, vomiting, and abdominal pain are all common symptoms of eating food that does not agree with your new digestive system. Paying attention to what you eat and what is introduced into your new diet will help you quickly identify any problem foods as you encounter them. 

Why do Gastric Bypass Patients Lose Weight so Fast?

There is little mystery about why gastric bypass patients lose so much weight after surgery. You can typically only eat 300-600 calories a day for the first few weeks and months after surgery, and for the rest of your life you will be unable to eat as much as you used to.

The simple effect of drastically cutting the amount of calories your body can absorb in a day is part of the reason you lose weight, but the kinds of foods you can eat also play a role. Sweets, bread, pastas, carbonated beverages, fried foods, and several other foods are almost certain to be off limits after a bariatric surgery.

These high-carb and high-fat foods make up a large portion of the unhealthy calories many people take in on a regular basis. Eliminating unhealthy foods from your diet helps to ensure that the few calories you are taking in are the healthiest ones possible. Moving to a low-carb, low-fat diet will help eliminate many of the most problematic foods for weight loss.

Tips on Supplements

After bariatric surgery, your sudden reduction in caloric intake means you will need to add vitamins and minerals back into your diet that you are now no longer getting from your food. This is particularly important in the first days after surgery while you are on a liquid diet. Even after you have become accustomed to solid food again, you will still need to be taking daily multivitamin and mineral supplements to ensure your body has the nutrients it needs.

The list of supplements you will need to take on a daily basis is quite long. You will need to break down any pills you take by crushing them or breaking them into tiny fragments to ensure your body can absorb them efficiently. An alternative is finding chewable vitamins so that, as with your food, you can do your new stomach a favor and begin the process of breaking down what you eat before it heads down your esophagus.

Lifestyle Changes After Your Surgery

One of the most striking changes you will need to make is how often you eat and drink. Due to the small size of your new stomach, it is not recommended that you drink during meals. If, like most people, you consume a large portion of your daily fluid intake while you eat, you are going to need to develop some new habits. Remembering to sip water throughout the day is crucial to staying hydrated.

Eating habits can have a large effect on our daily lives. With your new rules to live by after a surgery, the timing, consistency, and content of your meals will force some changes to your lifestyle. To stick to your diet plan, you will need to eat many small meals a day, most of which are going to involve more preparation than you needed before surgery.

Possible Complications of the Surgery

Gastric bypass is by no means a silver bullet in the fight against excess body weight. It is true that many patients who undergo gastric bypass do lose the majority of their excess weight in the first year or so after surgery, but as many as 20% of those people will regain much or all of that weight over the next 10 years. Often, this can occur as a result of failure to follow diet guidelines set out for you after your surgery. 

A more serious complication can arise as a result of long term nutrient deficiency. The average American is rarely at risk for serious malnutrition given how much food we eat. After gastric bypass, however, the extreme reduction in caloric intake can mean you are at serious risk of not getting enough nutrients out of the food you eat. 

The serious, and possibly lethal, consequences of malnutrition can take a long time to manifest, and could take a long time to reverse once they have been identified. This is one of the main reasons to be sure you have a good relationship with a team of doctors and dietitians who can work with you long after your surgery to ensure you stay healthy. 

This risk is also one of the reasons non-surgical weight loss procedures such as ORBERA®, or endoscopic sleeve gastroplasty (ESG) exist. At True You Weight Loss, we consistently advocate for and perform these minimally invasive, and sometimes reversible procedures. Patients who undergo these procedures often experience similar weight loss to those who undergo gastric bypass surgery, but without the high risk of serious consequences that accompany gastric bypass surgery. 

If you are interested in learning more about alternatives to gastric bypass surgery, solicitar una consulta today at True You Weight Loss. Whether you have already had gastric bypass surgery and want to learn more about how to live and eat with your new stomach, or you are contemplating surgery but want to know more about the risks and alternatives, we have the answers you are looking for.

Dr. Christopher McGowan
Dr. Christopher McGowan
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