The following advice is designed to reduce the likelihood of any complications following surgery. It is therefore very important that you follow this advice closely. There are 4 stages. Do not be tempted to skip stages or rush things. The advice is designed to help you get all the nutrients you need while helping the wounds heal in your digestive system and helping you recover from surgery.
We recommend that you spend between 1-2 weeks in each stage but you must spend a minimum of 1 week on each stage. You should be led by your body and how you are feeling. Do not try to copy or follow anyone else who has had a sleeve gastrectomy; everyone is different. If you progress too quickly and then struggle, go back to the previous stage for a few days more. You should aim to be eating ‘normal’ foods approximately 2 months after your operation.
Immediately after your surgery, once your surgeon has advised that you may sip freely, start taking your calcium and multivitamins/mineral supplements and commence Stage One (as below).
All drinks should be smooth (no bits or lumps) and should be able to be sucked through a straw.
Breakfast
Fruit smoothie (200 mL)
Mid-morning
Fruit juice (200 mL)
Lunch
Complan or Build-Up or glass semi-skimmed milk including 2 tablespoons skimmed
Mid afternoon
Slimfast (200 mL)
Dinner
Fortified soup (200 mL)
Supper
Build-Up or Complan (200 mL)
(Plus tea/coffee/sugar-free squash etc. in between)
When you feel ready, move on to Stage 2
It is still important to avoid lumps at this stage. Make sure foods are blended well.
Breakfast
Virtually fat free yoghurt/fromage frais, Soggy weetabix or ready brek (runny); Homemade fruit smoothie (made with yoghurt)
Mid-morning
Blended tinned fruit (unsweetened); Virtually fat free yoghurt/fromage frais; Sugar-free Angel delight/custard
Lunch
An example would be one of the following:
Mid afternoon
As mid-morning
Dinner
As lunch
When you feel ready, move on to Stage 3
The texture you are aiming for now is mashed food you could eat with just a fork or spoon.
1 of the following options:
Rice pudding, yoghurt, fromage frais, stewed or soft tinned fruit, cottage cheese, sugar-free mousse/whipped/custard
Now aim for 3 meals a day and 1-2 small snacks. The long term aim is to have 3 tea plate sized meals a day, with nutritious snacks such as a piece of fruit or yoghurt in between.
You do not need to add any extra liquid calories or additional protein any more. You no longer need to have extra milk, skimmed milk powder, fruit juice or Slimfast.
You may not be hungry due to changes in hormone levels resulting from your operation. It is still important to have 3 meals a day – you need the nutrients! It might be tempting to skip meals if you aren’t hungry as a way to speed up weight loss but this will result in you becoming malnourished or developing unhelpful eating behaviors. Hair loss can result as a consequence of undernourishment after weight loss surgery. This is usually a sign of general undernourishment as opposed to a specific vitamin or mineral deficiency. For this reason, you should be aiming to eat a healthy balanced diet in the long-term after your operation. If you are struggling to eat all of your meal, eat the protein portion of the meal first, then the carbohydrate portion followed by the vegetables.
Following is some advice to help with your weight loss journey:
As your diet becomes more solid and you progress through the stages, it is still important to maintain your fluid intake. Suitable choices would include water, no-added sugar squash, tea and coffee and up to 1/2 a liter skimmed/semi-skimmed milk per day. Avoid fizzy drinks as these may cause discomfort. You should not drink with your meals. You may find this difficult at first particularly if you are used to drinking with your meals. However, your new stomach is not big enough to cope with this anymore and if you do eat and drink together, you may vomit. Aim to wait 30 minutes after a meal before drinking.
You may find it difficult to tolerate some foods, and this varies from person to person. Common foods known to cause problems may be dry meat, soft white bread, rice, stringy or very fibrous vegetables, sweet corn, nuts, dried fruit, pips and seeds. Avoid these until you have established yourself on your solid diet and always try foods cautiously. If you don’t tolerate a food, try it again in a few weeks’ time. There is a lot of adaptation in the first few months. It is highly likely you will manage it with time.
Remember that alcohol is very high in calories (particularly alco-pops and stronger wines or lagers) and contains no nutrients. It can also stimulate appetite – another reason not to drink frequently.
Avoiding foods high in fat and sugar will also help you stick to a healthy diet and optimize your long term weight loss.
Whilst it is not essential, you may wish to take a multi vitamin and mineral supplement in the initial period after your surgery. The reason for this is that during this time you may only manage very small portions and your diet may not be able to provide all the nutrients that you require. As you progress through the stages and start to get into a routine with your meals you should no longer need this supplementation.
Vomiting: You should not expect to be sick after a sleeve gastrectomy. If you are, it is likely you have either:
Ask yourself if any of these could be likely causes and try to avoid repeating the ‘mistake’ at the next meal.
If you continue to be sick and it can’t be explained by the above, you should contact your surgeon or GP.
Constipation: If you are suffering with this, check to see if you are drinking enough fluid. You should have at least 2½ liters a day. Try to choose more high fiber foods such as wholegrain products, fruit and vegetables. Regular exercise will also help to alleviate constipation. If constipation persists then you can safely take laxatives such as Resource Optifiber, milk of magnesia or Senna.
What to do if food gets stuck? This may happen if you have eaten a food that was too solid, eaten too fast or too much, or as a result of eating certain ‘problem’ foods. This will feel uncomfortable and you may wretch or vomit. It usually resolves itself, but you can try repeatedly swallowing small quantities of cold sparkling water or Diet Coke, as the fizz may help to dislodge the lump. If the trouble persists, please contact your GP or if out of hours, accident and emergency.
