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  • Q&A with Australian Health Practitioners

    Will I have limitations on diet after gastric bypass surgery?

    Related Topic
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  • 2

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    Sally Johnston

    Dietitian, Nutritionist

    The founder of Nutrition for Weight Loss Surgery, Sally has extensive experience in individual counselling, working in the private sector since 2003. She has specialised … View Profile

    In the early post operative stages after gastric bypass surgery it is likely that your surgeon would ask you to follow a liquid, then pureed food diet. These are only short term and after about 4 weeks you should be able to experiment with small serves of soft, normal food.

    Long term after gastric bypass surgery the main limitation on what you can eat is portion size. You will need to serve meals on a small plate, a bread and butter plate size. The technique of eating is also important to ensure you can eat comfortably.

    The following eating technique is important after all forms of weight loss surgery, including gastric bypass:
    - Cut food into small pieces (use a 5 cent piece as a guide)
    - Eat slowly - put cutlery down between mouthfuls to help slow down
    - Chew, chew, chew
    - Allow 20-30 minutes for a meal

    If you follow these guidelines you should be able to eat a wide variety of foods.
    Sally Johnston
    www.yourbariatricdietitian.com.au

  • Chris Fonda

    Dietitian, Nutritionist, Sports Dietitian

    As an Accredited Sports Dietitian, APD and athlete (springboard diver), Chris has both professional and personal experience in sport at the sub-elite and elite level.Chris … View Profile

    I agree completely with Sally here. Just to add, proportions of the plate are also slightly different in those who have had bariatric surgery. Using the bread and butter plate as a guide, half the plate should be of high quality protein (e.g. meat, chicken, fish and eggs), the rest should be salad or free vegetables (veggies that have very little carbohydrate content) with a small proportion of low GI carbohydrates (e.g. corn, rice, pasta, quinoa) to name a few.

    As Sally has already mentioned, its important for those who have undergone bariatric surgery to eat slowly and to chop and chew their food really well. Allowing 20-30 minutes for each main meal is adequate. Eating too fast or not chewing food well enough can cause nausea and vomiting. As a rule think “chop”, “chew”, “knife and fork down” each time you go to eat.

    A great resource to use is the Portion Perfection Plate for Bands and Sleeves. Its a colourful and visual guide to the portions of food someone who has had a band or sleeve can have. You can find this resource at www.greatideas.net.au. Its vital to still have plenty of variety (even if it is in small amounts). But because of the limitations on the amount of food you can eat you may need to consider a multivitamin supplement such as Nutrichew to correct deficiencies.

    Your surgeon should refer you onto a dietitian who specialises in bariatric's, if not you can find and Accredited Practising Dietitian (APD) at www.daa.asn.au

  • Sally Johnston

    Dietitian, Nutritionist

    The founder of Nutrition for Weight Loss Surgery, Sally has extensive experience in individual counselling, working in the private sector since 2003. She has specialised … View Profile

    Just a couple of comments regarding Chris' post. 

    I agree the Portion Perfection Plate for Bands and Sleeves is an excellent tool - we recommend it in our practice for those with a gastric band. Early in the sleeve and even the bypass journey the plate may be a little large, but will likely be appropriate long term. 

    We also recommend Nutrichew for those with a gastric band. However, as the initial question above refers to gastric bypass surgery it is important to note that Nutrichew is not adequate for those who have had a gastric bypass. Far greater supplementation is required and most clinics will have a specific regime they recommend.

  • Arlene is a registered practising dietitian, with a private practice in the Eastern Suburbs of Sydney, and has built a strong business over the last … View Profile

    Yes you will have to be cautious in your eating habits after gastric bypass surgery. Initially after the surgery and then you will  have to maintain better eating habits as a lifestyle. Eating the right foods in the right amounts will ensure your success in losing weight and keeping it off following surgery. Staying physically active will also help you maintain your weight loss. These recommendations provide you with important information to guide your food and
    activity choices after surgery. Your surgeon, nurse or dietitian should give you specific guidelines regarding what and when to eat and how to stay physically active.
    Following surgery, you typically progress through different phases. Every individual progresses at a different pace and some individuals may need to stay in one phase longer than others. The table below briefly explains the phases and their timeframe. However, your surgeon may advance you at a different pace or have you skip certain phases.
    Phase Diet Duration
    1 Clear liquid 2 to 4 days
    2 Full liquid 4 days to 3 weeks
    3 Pureed 2 weeks to 1 month
    4 Soft 1 month to 6 to 8 weeks
    5 Normal Begin at week 8. This will be your lifelong way of eating.
     
    Plan ahead for the types and amounts of food you will eat after your surgery. You will only be able to eat very small amounts initially (1 to 2 tablespoons), so it’s important to choose your foods wisely. The following tips will help you get enough nutrition from a limited amount of food. Eventually your stomach will be able to hold ½ to ¾ cup of food; however, the same guidelines apply. Drink liquids 30 minutes before meals or 30 minutes after meals, not during meals. Eat protein first. It is essential that you get enough protein for healing, nutrition and to prevent loss of lean muscle mass. You will need a minimum of 50 grams of protein every day. Protein is found in many foods. Eat balanced meals. A balanced meal includes vegetables, fruits and whole grains. These foods are higher in fibre, which will help keep you feeling satisfied. Eating foods in this category can also reduce constipation. Eat three meals each day. Avoid foods that are high in sugar or fat. Eat foods with less than 10 grams of sugar per serving. Choose low-fat foods with 3 grams of fat or less per serving. Take small bites and chew food well. The outlet from your new stomach pouch is very small. Foods that are not chewed well may block this area, which causes nausea and/or vomiting. Eat slowly. Eating quickly doesn’t allow time for your brain to signal you are satisfied, so you are likely to eat more than you need. You should spend at least 20 minutes eating at each meal. Avoid eating at the computer or in front of the TV. Sit at the table so you can pay attention to your body’s hunger cues. Stop eating when you feel satisfied. If you continue to eat after you feel
    satisfied, you may experience nausea, vomiting and/or pain, in addition to stretching your stomach pouch. Drink at least 6 to 8 cups of non-calorie liquids between meals.
    Foods that may be difficult to tolerate
    Tough meats, beef
    Fruits or vegetables with peels/skins (e.g., apples, grapes, potatoes, corn)
    Gaseous vegetables (e.g., broccoli, cauliflower, cabbage, Brussels sprouts)
    Soft-textured breads (toasting bread increases tolerance)
    Rice and pasta
    Milk and dairy products
    Fried foods
    Dried fruits, nuts, seeds, popcorn
    Raw vegetables
    Stringy foods, such as celery or asparagus
    Carbonated beverages

  • Vangel Rizos

    HealthShare Member

    There is an effective weight loss diet to follow after stomach surgery as some have mentioned.  You will also be told to exercise .     
    Surgery, should only be done after you have tried for a few years of doing it naturally with diet and exercise.  If you are considering stomach surgery and then you will be restricted to do the post diet and exercise.  Why dont you try this same post  diet and exercise before surgery ?  It might make you realise what your going to go through.  This is an effective  weight loss diet, and exercise plan,   and see if you can stick to it without surgery, and lose wieght without the torture of this type of surgery.  You will also see if it will work for you,   it might not.  You might then realise what a difficult method it is and if it dosnt work, then reconsider the surgery and not waste your time ( this method with take 12 -24 months) and money, and your health.  This surgery has a low success rate and many patents complain about its side effects and tell me its the worst thing they ever did. Its like all those ladies that have boob jobs then regret it.  
    Living with this surgery is hard and its the worst form of torture I know of.   Natural diet and exercise is much easier, you can have the occasional  “ off the diet food ”  and you dont get as much saggy skin after the excess weight has gone,  as you do with surgery. 

    I suggest you dont have stomach surgery!  I never recommend it.  I have seen hundreds of  people  that have had it and most are disappointed, they always say the same thing,“If I knew I had to eat and exercise like this before surgery I would not have had it.”   Keep seeing others till you can get a natural easy program, and some real help, who cares for you and supports you every day.  Find a buddy to lose weight together with and report to each other every day say at 10am.    Weight loss is not hard, many people do it on there own,  some  need a good system, caring,  understanding and accountability.  There are to many weight systems out there that just want your money,  and after they got your money, don't really care, until you are ready to pay again. 

    (1) Eat and drink less hi calorie foods, Eat more veggies and salad,  ( tomatoes, string beans, peas, corn, etc.  5 + portions a day )  
    (2)  Exercise more, at home,  ( if your obese 90+ minutes a day. )  

    I only see obese and overweight. 

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