Bariatric surgery, also called weight loss surgery, helps morbidly obese patients lose significant amounts of weight and reduce their risk of developing Type 2 diabetes, osteoarthritis, high blood pressure and sleep apnea. For long-term weight loss success, patients must follow their surgeons' instructions about diet and exercise carefully. The first step is to learn to eat differently by following a four-stage diet progression during the first eight to 10 weeks.
Bariatric Surgery
Bariatric surgery procedures help with weight loss in several ways. The most commonly performed bariatric procedure, the gastric bypass, restricts the size of the stomach and rearranges the digestive system to block calorie absorption. Adjustable gastric banding procedures reduce the stomach to a tiny pouch to limit the amount of food eaten at one sitting. The biliopancreatic bypass diversion -- BPD -- permanently removes part of the stomach and reroutes the digestive system.
Diet Progression
Surgeons' guidelines vary somewhat, but most instruct their patients to follow a post-operative diet plan that progresses from clear liquids to solid foods over a period of about eight weeks, according to Linda Aills, R.D., lead researcher in a study published in the September 2008 issue of "Surgery for Obesity and Related Diseases." Stage I, clear liquids, lasts 24 to 48 hours. Stage II, full liquids, takes 10 to 14 days, followed by 10 to 14 days of pureed foods and about 14 days of soft foods.
Stage 2 Principles
Stage II, called the full liquid diet, allows foods that are liquid at room temperature. To avoid problems with healing and digestion, liquids cannot contain carbonation, caffeine, alcohol, or high levels -- more than 5g per serving -- of fat or sugar, according to Highland Hospital. Patients should focus on protein-rich, nutrient-dense foods to maintain optimum levels of nutrition.
Allowed Foods
In Stage II, patients should drink plenty of clear fluids such as water, broth, herbal tea and sugar-free gelatin to prevent dehydration. Permitted full liquids include sugar-free pudding, skim milk, yogurt, strained cream soup, creamed cereals and protein shakes, according to Aills. Soft, pureed and solid foods are not permitted at this stage.
Sample Meal Plan
Highland Hospital suggests six meals a day, plus at least two, 8 oz. servings of water or other clear liquids to prevent dehydration. At four hour intervals, three times a day, drink an 8 oz. serving of a low fat, low sugar, high protein supplement over a one hour period. Alternate these meals with small portions -- one-quarter to one-half c. each -- of strained cream soup, skim milk, broth mixed with protein powder, yogurt or pudding.
References
- Weight-Control Information Network: Bariatric Surgery for Severe Obesity
- Duke Health: The Recommended Diet Following Bariatric Surgery
- Highland Hospital: Postoperative Bariatric Diets
- "Surgery for Obesity and Related Diseases 4"; ASMBS Allied Health Nutritional Guidelines for the Surgical Weight Loss Patients; Linda Aills, R.D.; Jeanne Blankenship, M.S., R.D.; Cynthia Buffington, Ph.D.; et al; September 2008
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