Post Op Puree Soft Food Diet

Stage Three – Regular Consistency Foods

This stage is reflective of how you will eat “regularly” as a person who has had Bariatric Surgery. It is important to consume at least three balanced, nutrient dense meals while always focusing on getting enough protein daily. It is still recommended to introduce new foods or new textures of foods back into your diet slowly; always try only one new food at a meal.

Common problem foods:

• Red meat (steak, roast beef, pork) – the muscle fiber of these foods may still be too difficult to chew enough and break down in your mouth to pass through the stoma

• Untoasted breads rolls, biscuits – try toasting for better tolerance

• Pasta

• Rice

• Membranes or citrus fruits

• No raw fish

• Dried fruits, nuts, popcorn, coconut

• Raw fruits and vegetables – salads, skins of fruit or vegetable

Points to remember…

• Chew your foods well
  • Make sure to get to an apple sauce consistency before swallowing
• Eat Slowly
  • Eating too fast can cause discomfort, nausea or vomiting
• No more than 4 ounces per meal (half should come from proteins)
  • Use small Tupperware/Pyrex or ramekins to help with measuring servings
• Stop as soon as you are full
  • Listen to your hunger and satiety cues
• Only one new food at a time
  • If you do not tolerate something; leave it alone for a couple days before you try it again
• Keep hydrated – goal of 64 ounces per day
  • You can set an alarm clock on your cell phone and have it go off every 15-30 minutes to remind you to drink.
• Eat and Drink separately
  • Wait 30 minutes after eating before drinking fluids.
• Protein, Protein, Protein – goal of 60 grams per day minimum
  • Use protein supplements or protein snacks between meals to help reach this goal
• Walk daily
  • Increase physical activity as able/recommended by the surgeon
• Take your Vitamins!

Foods to AVOID:

• Sticky foods: soft bread, sweet rice, macaroni and cheese, high fat melted cheese, custard.

• High fat and high sugar foods: fried foods, greasy foods, butter, margarine, regular mayonnaise, sour cream, regular cream cheese, whole milk, half and half, ice cream, cakes, cookies, pies and other desserts, bacon, sausage, regular luncheon meats, regular potato and tortilla chips, heavy cream and salty gravy and sauces.

• Refined and processed foods: canned foods with lots of sodium, white breads and pastas made with refined white flour, packaged high-calorie snack foods, like chips and cheese snacks, high-fat convenience foods like cans of ravioli, high calorie frozen foods (pizza rolls, poppers, breaded meats), packaged cakes and cookies, boxed meal mixes (hamburger helper), sugary breakfast cereals, processed meats.

• Other: Based on individual tolerance, you may need to avoid stringy foods like raw celery and asparagus stalks as these may block the stoma. Cruciferous vegetables like cabbage, broccoli and cauliflower may also cause gas in some individuals, so try them in small amounts first. Avoid shredded coconut as it is not easily digested.

Your New Lifestyle

Your new eating habits should center on healthy food choices to reach your weight loss and maintain this goal for many years after surgery. Eat a balanced diet including lean protein, vegetables, fruits, low-fat dairy and whole grains ensure you are getting all the nutrition you need to stay healthy. It is still important to avoid and limit high sugar and high fat foods. Tolerance and portions of foods can change as the years pass which can contribute to old, unhealthier habits. Your gastric bypass is a tool to help you with weight loss but diet and exercise will continue to be your best defense in preventing weight regain years after surgery.

Bariatric Plate Example:

Plate Size (5 inches)

Goals for a Lifetime of Success

• Always eat your protein foods first.

• Continue to drink minimum of 64 oz. of sugar-free fluids daily (water or a calorie-free beverage is preferred).

• Develop healthy eating habits.

• Eat only when hungry and stop at first sign of fullness.

• Eat three small healthy meals a day. Some people may require 1-2 small high protein, sugar-free snacks between meals.

• Follow low-fat, sugar-free guidelines.

• Chew your food thoroughly. This will aid in digestion and food tolerance.

• Remember to take the recommended bariatric surgery vitamins for life.

• Exercise daily 30-45 minutes or as instructed by the bariatric nurse or physician.

• Attend support groups.

Plateaus

Plateaus are common and almost inevitable with any weight loss journey. You may find yourself at a stand still on the scale despite your continued efforts with healthy nutrition and physical activity. This can be very frustrating and discouraging. For some people, this can happen at the 6 or 12 month mark but for others this can happen more frequently. There is no way to determine when a plateau may happen and everyone will experience something a little different.

When you experience a plateau, the first step is to examine your diet and physical activity. Ask yourself if you are still practicing the habits that helped you lose weight initially. Are you eating 3 meals per day; getting enough protein; listening to your hunger and fullness ques; measuring your foods? Are you still making time for physical activity? It may be time to change things up to “shock” your body and jump start your weight loss again. Try new foods or recipes and activities to help keep you on track and prevent boredom.

Weight Regain

The possibility of weight regain typically rears it head about 2-5 years after surgery. The best strategy is to recognize the gain early and examine the possibility for the regain. One challenge may be your body’s natural ability to adapt after surgery. The amount of calories you absorb from your meals now is greater than what you could absorb for the first year after surgery. Another challenge may be an increase in your pouch (stomach) size. The stomach is a muscle and capable of stretching when increased amounts of food are consumed over time. This is also a good time to look at your daily habits. Similar to weight loss plateaus, take a look at your diet and physical activity. Have you been less aware of your food choices? Have you put off exercising? Are you “grazing” on food all day? Remember, weight loss surgery only stops you from overeating in a moment. Make sure to follow up with the doctor and clinic as we are here to help prevent and tackle these challenges with you.

Follow Up

Follow up is an important aspect of weight loss surgery. It is important to have your blood work done every year to determine if you have any vitamin/mineral deficiencies and monitor labs such as cholesterol, triglycerides or blood sugar levels. Follow up can also help keep you accountable to your new lifestyle. If you move, it is important to establish care with a bariatric center in your new location. Ask the doctor for recommendations.

Stage 3 Regular Foods Sample Menu: