Making the decision to undergo weight loss surgery, or bariatric surgery, can be difficult. They may have questions about their life after their procedure, wonder what sort of diet restrictions they will have, and question who will be there to support them before and after surgery.
Washington University bariatric surgeons are partners in their patient’s journey to a healthier lifestyle when the decision to have weight loss surgery has been made. Along with a dedicated, multidisciplinary team of registered dieticians, mental health professionals, physical therapists, and more, a patient will receive a vast range of support in the time leading up to and for years after their weight loss surgery.
What dietary restrictions will I have after surgery?
Immediately after surgery, a patient will need to begin a full liquid diet until their first postoperative visit to prevent surgical complications such as vomiting, dehydration and larger food items from getting trapped in the gastrointestinal tract. Patients must always take small sips of fluids that do not contain added sugar. An approved liquid diet will contain water, skim milk, strained cream soups, low-sodium clear broths, protein shakes, sugar-free drink mixes, and decaf coffee or teas.
After a patient’s first postoperative visit, their care team will guide them to start a pureed diet usually one week after your surgery. Typically, foods in this stage will look like pureed baby food or applesauce. Carrots, green beans, broccoli, cauliflower, potatoes, canned chicken or tuna, cream soups, cottage cheese, and canned fruit can be blended in a food processor until there are no lumps. This dietary stage will last two weeks.
At the start of the fourth week after bariatric surgery, patients can begin to introduce softer foods that are easier to chew, including cooked vegetables that aren’t “stringy,” canned fruit, soft, cooked chicken, fish and eggs are encouraged in this stage. Although foods like bread, rice and bread are soft, they stick together and can cause patients to become nauseated and should be avoided. The soft food diet will last two weeks.
Six weeks after bariatric surgery, patients begin adding other foods such as salads, uncooked vegetables and other meats back into their diet. This is often a “trial-and-error” process that can be made easier by following certain guidelines.
Patients who undergo weight loss surgery must follow certain lifelong guidelines. These guidelines become easier to follow over time and will help patients maintain their health and improve their outcomes after surgery:
- Do not drink liquids for 30 minutes before and for 1 hour after eating. This will push food through a patient’s pouch, cause dumping syndrome, make them hungry faster, and decrease absorption of key nutrients.
- Eat slowly and chew well. A patient should take at least 45-60 minutes to eat meals, even small ones.
- Do not skip meals. Eat three meals and 2 brief healthy snacks per day. Snacks should not exceed 10-15 minutes in duration and consist of healthy food such as high protein foods, fruits, vegetables, or yogurt.
- No sugar! Sugar and high fat foods will cause dumping syndrome. A patient may use artificial sweeteners such as Splenda, Equal, Sweet n’ Low, and Stevia.
- Avoid red meat early in their recovery. Choose poultry and chicken as they are easier to chew and digest. A patient should ensure their meat is not too dry or it may get stuck in their pouch.
- Avoid bread, rice, and pasta, bagels, and dumplings. These items can get stuck in a patient’s pouch causing abdominal pain, nausea, and vomiting.
- Stay away from unhealthy snacks loaded with empty calories. They will hurt a patient’s new eating plan and can and will cause them to gain weight.
- Eat protein first and at every meal. A patient should eat 60 or more grams of protein (from milk, eggs, poultry, fish, beans and legumes) a day to help avoid losing lean muscle tissue.
- Avoid fast food and the drive thru. Fast food is high in fat, calories and salt, and if a patient finds themselves on the road and must eat out, they should make good food choices such as salad or grilled poultry or fish and avoid greasy burgers and fries.
- Make fruits and vegetables a big part of their diet. Fiber from these items will help patients stay full and avoid constipation. They are also a great source of vitamins and nutrients to help them stay healthy after surgery. Choose fresh fruits and vegetables over chips, pretzels and other unhealthy snacks.
- Don’t get too hungry. When patients get too hungry, they often make the wrong dietary choices and eat too fast. This can cause pain, nausea and vomiting.
- Aim for 64 oz of fluids per day. Carry a water bottle and take small sips throughout the day.
How soon can I return to normal activities after bariatric surgery?
Patients who have undergone bariatric surgery are encouraged to “take it easy” and build up their strength after surgery. Walking is good exercise and should be encouraged right after surgery. When a patient returns home, they should walk about 5 minutes every hour. After surgery, going up and down a flight of stairs and riding in a car are allowed. However, doing too much too quickly can lengthen a patient’s recovery time.
Patients are restricted from lifting objects over 10 pounds for the first 4-6 weeks after surgery. Sexual activity is restricted for the first 2-4 weeks after surgery. Patients should not take a bath (showers are okay beginning the day after surgery) or go into a swimming pool for two weeks. While on pain-relieving narcotic prescriptions, patients should not drive or operate heavy machinery. For the first six weeks after surgery, patients should not go golfing, play tennis, do yoga, Pilates, swim, or do any vigorous exercise that uses the core muscles. Additionally, unless consulted by their physician, a patient should not fly on an airplane for four weeks after surgery.
After six weeks, or after a patient has healed internally, they can introduce low-impact exercises into their routine, gradually increasing their intensity and impact over time. Exercise is an important part of maintaining a healthy lifestyle after bariatric surgery and can help patients keep off weight.
Washington University Bariatric Surgeons
Washington University bariatric surgeons J. Chris Eagon, MD and Shaina Eckhouse, MD offer life-changing obesity treatment through minimally invasive laparoscopic procedures, including gastric bypass and sleeve gastrectomy. The Bariatric Surgery Team consults with patients and performs procedures at the Center for Advanced Medicine and Barnes-Jewish West County Hospital.
Prospective patients can visit the team’s website and select a virtual time slot with a Washington University bariatric surgeon that works best for their schedule or complete this online form to hear more about the online seminars from our program coordinators. For additional information, please call (314) 454-7224.