Bariatric Surgery After Care

Bariatric surgery is a type of weight loss surgery that helps people lose weight by reducing the size of the stomach or limiting the absorption of nutrients from food. After a bariatric surgery procedure, it is important to follow the instructions provided by your surgeon and healthcare team to ensure proper healing and maximize the success of the procedure.

Diet after weight loss surgery

You will be given a diet plan to follow after surgery. In general, most people will need to follow a liquid diet for the first few days after the procedure, gradually transitioning to pureed and then solid foods over a period of several weeks. It is important to eat slowly and chew your food well to avoid discomfort and potential blockages.

These vary from person to person, but a typical plan is:

  • First few days – water and fluids (for example, thin soup)
  • First 4 weeks – runny food (for example, yoghurt or puréed food)
  • Week 4 to 6 – soft food (for example, mashed potato)
  • Week 6 onwards – gradually return to a healthy, balanced diet

You will also be advised to:

  • Eat slowly, chew carefully and only eat small amounts at a time – particularly during the early stages of your recovery
  • Avoid, or be careful when eating, foods that could block your stomach, such as soft white bread
  • Take vitamin and mineral supplements
After Bariatric Surgery

Exercise after weight loss surgery

Exercise is an important part of a healthy lifestyle and can help support weight loss and overall health after bariatric surgery. However, it is important to follow the specific exercise recommendations provided by your surgeon and healthcare team to ensure proper healing and minimize the risk of complications.

In general, most people will need to avoid strenuous activity or heavy lifting for at least 2-4 weeks after bariatric surgery to allow their bodies time to heal. After this time, you can generally start to gradually increase your activity level as tolerated.

Here are some general guidelines for starting an exercise program after bariatric surgery

Consult with your healthcare team

Before starting an exercise program, it is important to consult with your surgeon and healthcare team to discuss your specific needs and any potential limitations. They can provide guidance on the types of exercises that are safe for you to perform and any precautions you should take.

Start slowly

After bariatric surgery, it is important to start slowly and gradually increase your activity level as tolerated. This may involve starting with low-impact activities, such as walking, and gradually progressing to more strenuous exercises, such as running or cycling.

Focus on strength training

In addition to cardiovascular exercise, it is important to include strength training in your exercise routine to help build muscle mass and support weight loss.

Stay hydrated

It is important to stay hydrated during and after exercise, especially after bariatric surgery. Be sure to drink plenty of water before, during, and after your workouts.

It is important to listen to your body and stop exercising if you experience any discomfort or pain. If you have any concerns or questions about starting an exercise program after bariatric surgery, it is best to discuss them with your healthcare team.

Follow-up appointments

After weight loss surgery, you’ll be asked to attend regular follow-up appointments for the rest of your life.

These appointments will usually be in a weight loss surgery clinic
for at least the first 2 years, but eventually you may just need
a check-up with a GP once a year.

Follow-up appointments may involve:

  • Blood tests to check your vitamin and mineral levels
  • A physical health check
  • Advice and support about diet and exercise
  • Emotional or psychological support
After Bariatric Surgery

Pregnancy and contraception after weight-loss surgery

Women are usually advised to avoid becoming pregnant during the period of most significant weight loss in the first 12 to 18 months after surgery.
This is because weight-loss surgery can affect your vitamin and mineral levels. If your levels are low while you’re pregnant, there is a risk it could harm your baby.
It’s a good idea to:

  • Use contraception until advised it’s safe to become pregnant – ask your doctor about the best type, as some are not suitable for women who’ve had weight loss surgery (including the contraceptive pill and contraceptive injection)​
  • Speak to your doctor if you become pregnant soon after surgery or you’re planning a pregnancy at any stage after surgery – they can check your vitamin and mineral levels, and advise you about supplements (find out about vitamins and nutrition in pregnancy)

Help and support

Having weight-loss surgery can be physically and emotionally draining.
Support will be provided as part of your follow-up, but you may also find it useful to talk with people who have also had weight-loss surgery.

Post Bariatric Surgery Diet

Making good food choices and eating a balanced diet will help you shed pounds after bariatric surgery and maintain a healthy weight for life.

Your bariatric surgeon will advance you through each phase of the post bariatric surgery diet plan — beginning right after surgery — until you’re ready for the final, lifelong phase.

The most important aspect of your clear liquid diet, immediately after bariatric surgery, is to keep well hydrated.

Staying Hydrated

  • Sip liquids constantly. You should have 48–64 ounces (six to eight, 8-ounce cups) of fluids per day.

  • Dilute fruit juices. At first, you may need to dilute fruit juices to avoid nausea or diarrhea.

  • Avoid extremes. It may be helpful to avoid extremely hot or cold liquids until your stomach fully heals, usually around six weeks.

Remember, your stomach is still recovering from bariatric surgery. It’s common to experience nausea or vomiting at this point. Please keep yourself hydrated.

Suggested Choices for a Clear Liquid Diet After Bariatric Surgery

Fruit juices – Diluted or light juices with artificial sweetener. Limit — 2 cups daily, due to calories

  • Apple

  • Grape

  • Cranberry

Broths

  • Clear beef

  • Chicken

  • Vegetable

Others

  • Water

  • Ice chips

  • Decaffeinated coffee or tea

  • Low calorie sports drinks

  • Sugar free:

  • Gelatin

  • Popsicles or frozen juice bars

  • Noncarbonated flavored waters

  • Clear fruit drinks with artificial sweetener

What to Eat During a Full Liquid Diet After Laparoscopic Adjustable Band Bariatric Surgery

During the full liquid diet phase following your lap band surgery:

  • Continue consuming 48–64 total fluid ounces (six to eight, 8-ounce cups) per day.

  • Add the suggested liquids below to your diet.

  • Consume ½ cup of full liquid fluids at each meal.

Suggested Choices for a Full Liquid Diet After Gastric Band Surgery:

  • Beverages

  • Skim milk with protein powder

  • “No added sugar” Carnation® Instant Breakfast®

  • Meal replacement drinks

  • Protein Supplements

  • Begin using protein supplements after each meal to meet your daily protein requirements.

  • Others

  • Fat free yogurt (no added sugar)

  • Strained cream soups

Liquids Between Meals

  • Wait at least 30 minutes after each meal. Then consume an 8 ounce protein supplement or shake followed by 16 ounces of sugar free, clear liquids.

  • Try to spread fluids out over a three-hour period.

  • Stop drinking at least 30 minutes before mealtime.

Remember, your stomach is still recovering from lap band surgery. It’s common to experience nausea or vomiting at this point. Please keep yourself hydrated.

Sample Full Liquid Diet Menu for Phase 2A: After Lap Band Surgery

  • Breakfast: ½ cup protein

  • ½ cup skim milk with either:

  • ½ scoop protein powder

  • ½ cup meal replacement

  • Lunch: ½ cup protein

  • ½ cup fat free yogurt (no added sugar)

  • Dinner: ½ cup protein

  • ½ cup strained, low fat cream soup

Don’t forget your liquids between meals (about 30 minutes after each meal).

Key Goals of the Puréed Food Diet (Phase 2B) After Bariatric Surgery

  • Incorporate high protein foods into your diet, which helps your pouch heal.

  • Women: 50–60 grams of protein

  • Men: 60–70 grams of protein

  • Start taking your chewable vitamin supplement with minerals.

  • Drink plenty of fluids, 48–64 ounces per day.

Meal Plan for Phase 2B: Puréed Diet After Bariatric Surgery

  • Consume three small meals each day.

  • Protein supplements

  • Gastric Bypass Patients: Begin using protein supplements after each meal to meet your daily protein requirements.

  • Laparoscopic Adjustable Gastric Band Patients: Continue using protein supplements as you did in Phase 2A.

  • Liquids between meals

  • Wait at least 30 minutes after each meal. Then consume an 8 ounce protein supplement or shake, followed by 16 ounces of sugar free, clear liquids.

  • Try to spread fluids out over a three-hour period.

  • Stop drinking at least 30 minutes before mealtime.

Suggested Foods Ideas for Puréed Diet After Bariatric Surgery

Protein Sources

  • Yogurt (plain or sugar free, low or nonfat, blended without fruit chunks)

  • Strained cream soups (celery, potato, mushroom, or chicken made with skim milk)

  • Skim milk with ½ scoop protein powder

  • Protein supplements added to food or water for extra protein

  • Mashed cottage cheese (low or nonfat, small curd)

  • Ricotta cheese (low or nonfat)

  • Scrambled eggs or egg substitute

  • Puréed beef, chicken, or turkey

  • Baby food meats

  • White fish (cod, haddock, tilapia, orange roughy) mashed with a fork

  • Canned chicken breast, mashed and moist

  • Canned tuna fish in water, mashed

Grains/starches

  • Cream of wheat or cream of rice

  • Farina

  • Grits

  • Baby oatmeal

  • Mashed potatoes/sweet potatoes

  • Puréed winter squash

Fruits

  • Diluted, 100% fruit juices (apple, grape, cranberry)

  • Light juices sweetened with non-nutritive sweetener

  • Applesauce

  • Mashed bananas or mashed canned fruits in own juices

  • Puréed peaches, apricots, pears, pineapples, melons

Vegetables

  • Tomato juice

  • Diet V-8 Splash® or V-8 Juice®

  • Puréed spinach, carrots, summer squash or green beans

Avoid puréed broccoli, cauliflower, and other fibrous vegetables at this stage.

Sample Menu for Phase 2B: Puréed Diet After Bariatric Surgery

Eat the protein portion of your meal first, and don’t forget your liquids between meals (about 30 minutes after each meal).

Breakfast

  • Protein: 2 tablespoons to ¼ cup scrambled eggs or egg substitute

  • Starch: 2 tablespoons to ¼ cup cream of wheat

Lunch

  • Protein: 2 tablespoons to ¼ cup mashed low fat cottage cheese

  • Fruit: 2 tablespoons to ¼ cup puréed peaches in own juices

Dinner

  • Protein: 2 tablespoons to ¼ cup baked skinless chicken breast (puréed) or mashed canned chicken breast

  • Vegetable: 2 tablespoons to ¼ cup puréed carrots

Liquid meal– If you’re having a liquid meal replacement, soup, or high protein shake:

  • Drink 4 ounces (1/2 cup) over 20 to 30 minutes

  • Try adding mashed, canned chicken or tuna to soup to increase protein content

  • Blend if needed

During this phase after bariatric surgery, you will transition to more solid foods. This may include soft meat, fish, chicken, cereals, cooked vegetables, and canned and fresh fruits.

During the adaptive or soft food diet, continue to:

  • Incorporate high protein foods into your diet and consume them first at meals.

  • Women: 50–60 grams of protein

  • Men: 60–70 grams of protein

  • Take your chewable vitamin supplement with minerals.

  • Drink plenty of fluids, 48–64 ounces (six to eight, 8-ounce cups) per day.

Post-Bariatric Surgery Meal Plan for Phase 3: Adaptive/Soft Foods Diet

  • Consume three small meals each day.

  • Add a variety of low fat, low calorie starches, fruits, and vegetables to your diet, as tolerated.

  • Avoid skins and seeds on fruits and vegetables.

  • Avoid breads.

  • Chew foods thoroughly.

  • Stop eating whenever you feel full.

  • Continue using protein supplements after each meal to meet your daily protein requirements.

  • Liquids between meals

  • Wait at least 30 minutes after each meal. Then consume an 8 ounce protein supplement or shake, followed by 16 ounces of sugar free, clear liquids.

  • Try to spread fluids out over a three-hour period.

  • Stop drinking at least 30 minutes before mealtime.

In addition to the foods listed on the pureed diet, begin introducing the following foods to your diet.

Suggested Food Ideas for Phase 3: Adaptive or Soft Food Diet

Protein Sources

  • All varieties of fish and shellfish

  • Turkey breast or chicken breast (chopped, white meat)

  • Low fat deli lunchmeats

  • Sliced or grated low fat cheese (5 grams of fat or less)

  • Hard boiled or poached eggs

  • Soups (dilute with skim milk or add finely minced meats)

Grains/starches

  • Hot cereals

  • Unsweetened cereals softened in skim milk

  • Baked potatoes, sweet potatoes, or yams

  • Boiled pasta, noodles, or white rice

Fruits/vegetables

  • Canned fruit (in own juices or water packed)

  • Soft, fresh fruit without skins (apples, pears, peaches)

  • Bananas

  • Cooked or canned vegetables

  • Avoid raw, fibrous vegetables like broccoli and Brussels sprouts. Avoid skins and seeds.

Sample Menu for Phase 3: Adaptive or Soft Food Diet

Eat the protein portion of your meal first, and don’t forget your liquids between meals (about 30 minutes after each meal).

Breakfast

  • Protein: ¼ cup scrambled eggs or egg substitute

  • Starch: ¼ cup hot cereal

  • Fruit: ¼ cup canned peaches in own juice

  • Fat: 1 teaspoon margarine

Lunch

  • Protein: ¼ cup (1 ounce) deli sliced turkey breast

  • Starch: ¼ cup mashed potatoes

  • Fruit/vegetable: ¼ cup pears or mixed fruit in own juice or light

  • Fat: 1 teaspoon margarine

Dinner

  • Protein: ¼ cup (1 ounce) white fish (no breading)

  • Starch: ¼ cup sweet potato

  • Vegetable: ¼ cup cooked green beans

  • Fat: 1 teaspoon margarine

During this phase, or stage, after your bariatric surgery, you will be able to eat foods of a regular consistency. This does not mean, however, that you can go back to your old eating habits and patterns.

Key Goals of Phase 4: Stabilization Diet

  • Eat three, well balanced, meals each day with calorie free fluids between meals.

  • Avoid empty calories. Since you will only be able to tolerate limited amounts of food at a time, it’s very important to eat nutrient-dense foods.

  • Avoid foods high in sugar or fat that do not contain protein, vitamins, or minerals.

  • Continue taking your vitamin supplement with minerals, since your meals won’t be large enough to meet your daily requirements through food alone.

Meal Plan for Bariatric Surgery Patients in Phase 4: Stabilization Diet

  • Consume three balanced meals each day containing nutrient-rich foods, such as:

  • lean meat, poultry, pork, and fish

  • low fat dairy products

  • low fat starches and whole grains

  • vegetables and fruits

  • These foods contain the energy, protein, vitamins, and minerals that your body needs.

  • If you can’t tolerate the amount of food at one meal, you may have to consume six smaller meals each day.

  • Stop eating whenever you feel full.

  • Protein — You should be able to meet your protein needs through foods. If not, you may need to supplement with protein shakes between meals.

  • Women: 50–60 grams of protein

  • Men: 60–70 grams of protein Gastric Bypass Patients: To meet protein needs, you may have to consume a low calorie protein food between meals.

  • Liquids between meals

  • Wait at least 30 minutes after each meal. Then consume an 8 ounce protein supplement or shake, followed by 16 ounces of sugar free, clear liquids.

  • Try to spread fluids out over a three-hour period.

  • Stop drinking at least 30 minutes before mealtime.

Sample Menu Plan for Phase 4: Stabilization Diet

Eat the protein portion of your meal first, and don’t forget your liquids between meals (about 30 minutes after each meal).

Breakfast

  • Protein: 1 egg or ¼ cup egg substitute

  • Starch: ½ cup hot cereal

  • Fruit: ½ banana

  • Fat: 1 teaspoon margarine

Gastric Bypass Patients: Add 6 ounce light yogurt

Lunch

  • Protein: 2 ounces low fat turkey breast

  • Starch: ½ cup mashed potatoes

  • Vegetable: 1 cup salad

  • Fruit: 1 small orange

  • Fat: 2 tablespoons light dressing

Gastric Bypass Patients: Add 1 reduced fat string cheese

Dinner

  • Protein: 2–3 ounces baked fish

  • Starch: ½ cup cooked rice

  • Vegetable: ½ cup cooked spinach

  • Fruit: ½ cup unsweetened applesauce

  • Fat: 1 teaspoon margarine