American obesity rates have continued to grow, increasing markedly since 1980. Between 1980 and 2004, the rate of obesity among adults increased from 15% to 33%. This increase has led researchers to declare that obesity is now an epidemic in the United States. Fifteen million Americans are currently morbidly obese, with a BMI over 35.

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What will I be able to eat after bariatric surgery? Will I have to eat mushy foods for the rest of my life? When can I have salad? When can I have popcorn? These are all common questions from pre-ops or new post-ops.

While each bariatric surgeon has specific recommendations for dietary progression, the ASMBS has published recommendations for post-operative care. I have also included notes on my surgeon’s recommendations. Please do not take these as medical advice. You should follow your surgeon’s plan. The information in this post is intended only to give an idea of what to expect from a typical post-surgery plan.

• Clear liquid diet: Many surgeons use a clear liquid diet as the first step following bariatric surgery. However, there is some evidence that this step may not be warranted. The ASMBS recommends following a clear liquid diet for one to two days. My surgeon’s recommendations included a clear liquid diet for one week following a post-operative leak test. On his plan, I could have sugarfree jello, diluted 100% fruit juice, and clear protein supplements, such as Isopure Zero Carb.
• Full liquid diet: A full liquid diet includes milk, milk products, and other liquids, such as protein shakes. According to the ASMBS, “the calories and nutrients provided by full liquid diets that include protein supplements can closely approximate the needs of surgical weight loss patients.” During the full liquid diet, patients should focus on fluids and protein intake. Common food choices on the full liquid diet include protein shakes, sugarfree puddings, no-sugar-added applesauce and yogurt, as well as all choices from the clear liquid diet. The ASMBS recommends a full liquid diet for ten to fourteen days. My surgeon’s recommendations included a one-week full liquid phase. I relied almost entirely on protein shakes and yogurt, specifically Greek yogurt.
• Pureed diet: A pureed diet consists of foods that are blended or liquefied with fluid. Consistency should range from that of a milkshake to mashed potatoes. Pureed diets also include scrambled eggs and canned fish, such as tuna. The pureed stage increases tolerance for more solid foods and fiber. Some pureed diets include soft fruits and vegetables, but the emphasis should remain on protein-rich foods. Protein supplements from the full liquid phase should be continued so as to meet protein requirements. The ASMBS recommends following a pureed diet for ten to fourteen days or longer. I followed a pureed diet for one-week, per my surgeon’s recommendations. Some of my favorite foods on the pureed diet were tuna salad, which I made in a mini food processor to achieve puree consistency and Eggface’s Ricotta Bake (available here).
• Mechanically altered soft diet: The ASMBS recommends a mechanically altered soft diet as a way to incorporate more solid foods that still require minimal chewing and will pass easily through the digestive system. This diet is similar to a traditional diet, but the required texture is achieved by chopping, grinding, flaking, or pureeing foods. The ASMBS recommends following a mechanically altered soft diet for at least two weeks. My surgeon did not require a mechanically altered soft diet. However, I was cautious in my diet progression and modified many traditional foods in the early days.
• Regular diet: Following the progression, patients may resume a regular diet, though the focus should continue to be on protein-rich foods. I resumed a regular diet approximately three weeks after surgery, per my surgeon’s recommendations.

In their recommendations, the ASMBS also includes a list of foods for which they recommend avoiding or delaying reintroduction:

• Avoid: sugar, sugar-containing foods, concentrated sweets; carbonated beverages (possibly delay); fruit juice; high-saturated fat, fried foods; doughy breads, pasta, rice (possibly delay); tough, dry, red meat (possibly delay); caffeine (possibly delay, then consume in moderation); alcohol (possibly delay, then consume in moderation)
• Delay Reintroduction: carbonated beverages (possibly avoid); doughy breads, pasta, rice (possibly avoid); nuts, popcorn, fibrous foods; caffeine (possibly avoid); alcohol (possibly avoid)

Please, remember to head your doctor’s dietary recommendations. A modified diet is recommended following bariatric surgery for a reason. The digestive system is healing following bariatric surgery, and prematurely advancing your diet risks injury.

Source:

American Society for Metabolic and Bariatric Surgery (2008) ASMBS allied health nutritional guidelines for the surgical weight loss patient. Surgery for Obesity and Related Diseases, 4, S73-S108.