Why Do I Have To Go On A Full Liquid Diet After Bariatric Surgery
During bariatric surgery such as gastric sleeve surgery or gastric bypass surgery, changes are made to your digestive system. Both surgeries reduce the size of your stomach by permanently removing between 70% to 80% of the stomach and leaving you with a small sleeve-like pouch.
In addition, surgeries such as gastric bypass and duodenal switch also make alterations to the digestive system and the way the body processes and absorbs nutrients from food.
After having these changes made to the stomach and digestive system, the body needs time to heal and would not be able to adequately process the foods as it did prior to surgery.
While patients are still in the hospital they are given clear liquids to keep them from becoming dehydrated and also to keep their newly redesigned stomachs from becoming irritated. Now, they will be starting the next phase of easing the digestive system back to work by following a full liquid diet.
When Did I Start The Liquid Diet
During the liquid diet phase of the bariatric process, youll either be allowed full liquids or be requested to stick to clear liquids like broths and liquids that are essentially see through. For me, right after surgery I was required to stick to clear liquids for the first day or two before moving to full liquids. Sometimes this can be required up to a day or two before surgery as well.
Stage : Regular Consistency
This stage starts 4-6 weeks after your procedure, and involves reintroducing regular foods! Start by adding 1-2 new foods per day, avoiding anything that causes gas like broccoli, pepper, onions, and spicy foods. Remember to eat slowly and chew your foods completely before swallowing. Each meal should be about ¾ cup in size, and should not exceed 1 cup. You should continue to honor the 30/30 rule, sipping water in-between meals. Eventually, you will be able to work up to a regular diet, however, here are some foods you should still avoid:
- Rice, pasta, and bread
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Talk With Your Friends And Family About Your Recovery
Once youre home, your friends and family will be your first line of support. Let them know your post-op healing routine. Answer their questions honestly, even if the answer is I dont know. Contact your doctor or nutritionist to answer any questions you cant. Tell your friends and family how they can help you while youre recovering.
With your bariatric liquid diet, you are learning how to take care of the new you. Its the beginning of a whole new way of life that will ensure your continued health. Preparing for these changes before surgery sets you up for success.
NOTE: The particular timeframes and ingredients mentioned in this article are generally correct. However, your specific healing plan may vary. Always consult with your nutritionist when you have questions or concerns or before making any changes to your post-op routine.
What Is The Liquid Diet Before Bariatric Surgery
The liquid diet before bariatric surgery is a liquid-only diet prescribed to patients two weeks before their scheduled surgery date. This diet involves 4 to 5 vitamin-fortified protein shakes every day without any food or additional calories. This diet is essential to maximize your surgical safety and healing following surgery. It also helps kick start weight loss, helps ensure success of the bariatric procedure, and can help patients develop an idea of what their weight loss journey will be like post-surgery.
National best practice guidelines have identified this liquid diet as a clear way to reduce the operative risk associated with large fatty livers. Many patients suffering from obesity develop fatty livers, meaning their liver enlarges due to fatty infiltration as theyve gained weight. Because the liver sits on top of the stomach, a large fatty infiltrated liver can make it much more difficult to access the stomach and introduce unnecessary risk.
The liquid diet is proven to help reduce the size of fatty livers before surgery, producing a much safer operative environment.
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Approved Clear Liquids Leading Up To Surgery
The key to a successful preoperative liquid diet is to keep it low in sugar while maintaining a balance of high protein with healthy fat and carbohydrates. Dietary facts labels will help you identify the sugar content of your food. All protein drinks you chose need to have less than 5 grams of sugar. All other liquid options should not have any added sugar.
Because the pre-op diet does not contain enough nutrients, it is important to take your bariatric multivitamins, calcium, B12, and iron as directed.
Please note: It is not recommended that one tries a liquid diet for long-term weight loss. The specific liquids suggested by your bariatric dietitian are only to follow pre-surgery for recovery purposes.
Bariatric Clear Liquid Diet
You will start a clear liquid diet the first day after your surgery while you are in the hospital. You may drink skim milk, water, chicken or beef broth, or sugar-free gelatin. Do not start this until your surgeon orders this diet.
Your goal is to drink 3 cups of skim milk and 6 cups of water.
Drink your milk before other clear liquids. Sip small amounts slowly throughout the day. Use your check-off sheet to make sure you are meeting your daily goal.
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Diet After Your Surgery
The post-surgery diet plan consists of several stages. How long each stage lasts and what you can eat and drink will be determined by your healthcare provider or dietitian.
All stages stress the importance of controlling your portions. This habit will help you continue to lose weight and prepare you for how youll eat for the rest of your life.
Reason #: Lean Muscle Preservation
During rapid weight loss, its almost impossible not to lose muscle mass. That is particularly true after bariatric surgery.
Malabsorption procedures like the Roux en Y Gastric Bypass and Duodenal Switch are notorious for this.
One of the main ways that bariatric surgeons try to minimize the issue is by increasing protein intake on the diet.
It starts with a liquid diet.
Remember that I said the Pre Bariatric Surgery Liquid Diet is a HIGH PROTEIN DIET. Most bariatric surgeons will recommend at least 60-80 grams of protein per day. That number is related to your weight and activity level.
If you work out a lot, you will need a higher concentration of protein in your diet. Consult with your doctor and/or dietitian to see how many grams of protein you should be getting on a daily basis.
Patients with kidney and/or liver disease should be careful how much protein they intake as this can be detrimental to their condition. If you are on dialysis or have liver cirrhosis please consult with your provider before starting the Pre Bariatric Surgery Liquid Diet.
Many patients, especially female patients think that in order to lose weight the need to spend countless hours on a treadmill. Cardio is definitely important but remember to alternate your workout. Lift weights several times a week to preserve and to gain muscle mass.
Work out the big muscle groups like the hamstrings and the back muscles. Use muscle confusion to your advantage by alternating between cardio and weight training.
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Plan Ahead For Success
Leading up to the days you will be participating in the liquid diet, we recommend that you go to the grocery store to stock up on all the items you will need throughout the two weeks. Waiting to buy the protein shakes, gelatin, and broths until the last minute can lead to failure in adhering to the plan. You want to make sure you set yourself up for success from day one.
Start Your Vitamin/mineral Supplements Day 8 After Surgery
Buy chewable or gel cap supplements for best absorption. Do not buy gummy or soft chews.
Vitamins suggested post-bariatric surgery
- Chewable calcium citrate with Vitamin D three times a day
- Chewable complete multivitamin once in morning surgery)
- Vitamin B12, 500 mg tablet once a day
- Vitamin B-complex tablet once a day
- Liquid iron once a day
- Vitamin D3 1000 IU once a day
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Stage I: Clear Liquid Diet
Once the surgery is over, patient must lead his way towards recovery. The ideal food to consume in the first stage of recovery is clear liquid diet. As the name suggests, clear liquid diet consists of clear soups, water, meat stock, chicken stock, unsweetened drinks and some diet beverages that are clear in nature. 2 oz or 3 oz is the maximum limit of clear liquid diet and that too largely depends on tolerance and digestion capacities of the patient. Since the operated stomach is really small in size, the patient has to cope with the new feeling of fullness that comes from eating a limited amount of food items. Clear liquid diet is prescribed for first one or two days after gastric bypass surgery.
A Step In The Right Direction
Preparing for any kind of bariatric procedure involves a lot of information and personal preparation that can all feel very overwhelming. However, its important to keep in mind that rather this is a step in the right direction.
As restrictive as the liquid diet before surgery is, remember that this is you taking back control of your health and your life. After their operations most patients lose between 100-200 pounds of unhealthy body weight or more. Imagine how that would feel! Its time to start living the healthy energetic lifestyle you want, and the pre-op liquid diet before your surgery is the first step.
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Why The Bariatric Liquid Diet Pre
With most bariatric procedures, your surgeon needs to make alterations to the stomach, and possibly the intestines and other organs as well. To make these changes safely, the stomach and intestines must be free of food. Even when no surgical alterations are made, an empty stomach is still required for ideal outcomes.
However, the liquid diet before weight loss surgery usually starts well in advance of the point when it is needed to clear the digestive tract. This is because it is also used to reduce the size of the liver. For many people with obesity, their liver is fatty and enlarged, making it more dangerous to alter the stomach.
Week Two And Three Pureed Foods And Protein Shakes
After 1 to 7 days of drinking clear liquids, you will be given permission to consume liquefied sources of protein. This stage of the post-op diet will usually last for one week .
Because of the patients smaller stomach size, the individual should have several smaller meals throughout the day. Your daily intake should be about 60-70 grams of protein and approximately 64 ounces of clear liquids not counting the fluid in the pureed foods.
Caffeinated and carbonated beverages should not be consumed. Refined sugars and simple carbohydrates should be avoided as well.
Below is a list of the pureed protein sources that are typically allowed by your dietitian or surgeon:
- Protein shakes
- Non-fat cottage cheese
- High protein, low sugar yogurt
Clear liquids should be sipped very slowly, and straws should not be used because they might bring unwanted air into the stomach, which could lead to discomfort.
It is necessary to take one or two multivitamins every day in order to prevent nutrient deficiencies. The multivitamins should be in chewable or liquid form during this time.
It is also important to supplement your diet with calcium citrate the recommended amount will usually be two or three doses with each dose ranging from 400 mg to 600 mg. Calcium citrate supplementation should be separated from the multivitamin dosages by at least two hours. This is because iron and calcium can interfere with each others absorption, leading you to not get the amount that your body needs.
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Bariatric Diet Before Surgery
Why should you lose some pounds before weight loss surgery? Obese people have larger liver due to the excess fat stored in the abdominal region, in and all around the liver.
Even if the laparoscopic procedure is minimal invasive, during the surgery, the bariatric surgeon has to move apart the liver. If that organ is too large complications may occur.
In order to lower any risk, your dietitian will prescribe you a specific bariatric diet before surgery high in protein and based on liquid food. Usually the pre-op diet allows you to consume up to 1200 calories a day.
Find A Support And Accountability System
We recommend that bariatric patients find a support system it can be friends, family, or a group of current/past patients at your bariatric clinic. By enlisting support, you are not only holding yourself accountable, but others are holding you accountable. We have seen it first hand patients who decide to do it all on their own are not as successful with their weight loss as those are who find support.
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Review Your Bariatric Liquid Diet Plan In Detail
Go over your full liquid diet with your nutritionist. Read through the bariatric liquid diet recipes. Ask any questions you have like: Can frozen fruit be used in place of fresh fruit in the protein shake recipes?, What should I do if I miss a mealtime? or What plant-based products are good substitutes for milk and whey-based protein powders?
The Most Important Thing About The Liquid Phase After Bariatric Surgery
HYDRATION is still the most important thing. Yes, even more than protein. Its true that you do get liquid in when you have a protein drink however many programs dont count protein shakes towards your water goal.
Because eventually the protein shakes will be taken out of your diet as you move towards food protein. When you move towards food protein, time is taken away from drinking . Thus, we tend to prefer you are able to feasibly get all your water in without relying on shakes to do so!
Once again, programs do differ, but I count water as anything that is not carbonated, not caffeinated and less than 15 calories per 8 ounces.
For a fully load blog about how much water you need after bariatric surgery, what counts as water and how to get more water, !
Also, here is a blog post about the power of hydration in the bariatric lifestyle. This is part of my 10 Day Habit series that focuses on the habits of most successful patients!
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Week 4 And 5 Soft Foods
This stage of the diet will allow for a very gradual reintroduction of soft foods into your diet. This stage usually lasts about 1 or 2 weeks.
If a food can be easily mashed with a fork, or a spoon, then it is probably a candidate for stage three of the post-op gastric bypass diet. This portion of the diet will likely include soft meats and cooked vegetables.
The nutrient goals will remain the same as in stage two. 60+ grams of protein and 64+ ounces of fluid is recommended daily. The serving size of protein in stage three should be about 1 to 2 ounces and youll likely have 3 to 6 small meals.
Stage three, like stage two, focuses on high-quality lean protein sources. While stage 3 continues to focus on high-quality lean protein sources, up to three servings of soft vegetables may also be allowed a tiny portion of fat may also be permitted .
Recommendations for the protein sources in this stage of the diet will probably include several of the following items:
Meat, Dairy, and Eggs
You will still need to take your multivitamin and two to three 400-600 mg doses of calcium citrate .
Your dietitian may recommend you take 3,000 IU of Vitamin D3 total per day, which will likely be found in your bariatric specific multivitamin and calcium. It is important to make sure you are taking at least 12 mg of thiamin and at least 350 mcg of vitamin B12, luckily these doses are provided in most bariatric specific multivitamins.
Stage : Soft Foods Diet
Youll probably eat nothing but puréed food for several weeks. Once your doctor decides youre ready, you can start building soft, easy-to-chew foods into your diet. These may include:
- soft-boiled eggs
- baked or steamed white fish
- canned fruits, such as peaches or pears
It is important to eat small bites. Eat a little at a time and practice good portion control.
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Stage Iii: Semi Liquid Diet
As the name suggests, foods that are given during this stage should consist of yogurt or mashed potato like consistency. This stage is also called pureed liquid diet. Similar to full liquid diet, you may provide high protein foods to the recovering patients. Foods like scrambled eggs, cooked vegetables, canned fruits, etc. can be provided in limited quantities. Blended form of lean meats and lean fish is also recommended for this stage of post surgery diet for gastric bypass. Once this stage is over, the patients are provided with soft foods.
Every Bariatric Program Does It A Little Differently
Every program differs on the pre-op and early post-op diet phases after bariatric surgery. Of course, the natural question is but why?
Surgeons, dietitians and nurses compare research as well as their patient outcomes to develop what they feel is the best approach. Thus, there are different approaches.
Some programs will require weight loss before surgery both as a way to shrink the size of the liver as well as help prepare the patient for the changes to come.
Other programs wont require weight loss but will instead have you do a structured diet 1-2 weeks before your surgery date. Sometimes this diet depends on your BMI going into surgery. I have worked in clinics that have patients with a BMI over 50 go on a liquid diet for a week before surgery.
My personal preference is to avoid a liquid diet before surgery becauseyoull have one after surgery! While your surgeon will determine the course of action for you, my take on the matter is to make changes needed for post-op success during your pre-op months. This will help transition you into the post-op habits and youll likely see weight loss!
Regardless if you have liquids before surgery or before AND after surgery, below is a large list of ideas to keep variety in your liquids.
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