You just had bariatric surgery and are home from the hospital - now what? Before surgery and as you were getting discharged, you were given detailed instructions on what to do for your diet until you are seen in your bariatric surgeon's office again. However, many patients find themselves overwhelmed with information and still unsure where to start. Now is the time that all the practiced behaviors of eating slow, taking small sips, staying hydrated, and focusing on protein become real.

Hydration

One of the most important things after any surgery is hydration. Dehydration can happen very easily after surgery for several reasons. One-third of all post-op emergency room visits are related to dehydration¹. The ASMBS recommends that patients consume enough fluids throughout the day to maintain adequate hydration (at least 1.5L per day²). Throughout your entire post-op experience, make sure you are taking small sips of fluids all day. You can even play around with the temperature of your fluids to help you increase your intake.

Stages of Food Advancement After Surgery

Typically, you will follow a specific diet progression for the first 6 weeks that will take you from liquids to solids slowly. The progression is needed to promote hydration, reduce nausea/vomiting, reduce complications, and allow you to get comfortable with behavioral changes³. When it comes to the diet stages and length of each stage, you’ll find that every surgeon will have their own preferences, and it's important to follow their guidelines. Following are some diet stages you might find. If you are ever unsure what to do, call your surgeon’s office to clarify instructions. 

1. Clear Liquid: A clear liquid diet consists of liquids that are see-through. This is what you will most likely find yourself on while in the hospital. The most important fluid is water, but you may also be allowed to drink some decaf tea (iced or hot), sugar-free Jell-O, decaf black coffee, sugar-free popsicles, Crystal Light, low-calorie sports drinks, clear protein shakes, and broths. 
2. Full Liquid: A full liquid diet will include beverages that are thin enough to drink through a straw, but do not have to be see-through anymore. This can include meal replacement shakes, milks, strained cream soups, and thin yogurts.
3. Pureed Foods: Pureed foods should be the consistency of baby food. Some commonly allowed foods are soft scrambled eggs, cottage cheese, canned fruits in water, mashed up vegetables, and ricotta cheese.
4. Soft Foods: During this stage, you should be able to start adding in soft, flakey fishes, cooked vegetables, skinless fruits, and sweet potatoes.
5. Solid Foods: Solid food is the final stage. This is where you will start focusing on your well-balanced meals with solid proteins. Solid proteins will include foods you need to cut with a knife, like chicken. You can also start to slowly add in fibrous fruits and vegetables. It’s helpful to add one new food at a time and listen to your body as you go. 

Keep in mind: each day after your surgery, you will feel more and more like yourself. No matter how great you’re feeling, follow your diet progression as instructed by your bariatric surgeon, as this will allow you long-term success.

References:

1. Dagan, Shiri Sherf, et al. “Nutritional Recommendations for Adult Bariatric Surgery Patients: Clinical Practice.” Advances in Nutrition: An International Review Journal, vol. 8, no. 2, 2017, pp. 382–394., doi:10.3945/an.116.014258.
2. Mechanick, Jeffrey I. “AACE/TOS/ASMBS/OMA/ASA 2019 Guidelines.” Endocrine Practice, vol. 25, no. 12, 2019, doi:10.4158/GL-2019-0406.GL.
3. Parrott, Julie M., et al. “The Optimal Nutritional Programme for Bariatric and Metabolic Surgery.” Current Obesity Reports, 2020, doi:10.1007/s13679-020-00384-z.

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