Nutrition After Bariatric Surgery: Nutrition and Exercise

The goal of bariatric surgery is to help you become healthy or even reverse damage from being unhealthy for periods of time. You will be healthier than ever before thanks to this surgery, but you must take care of yourself.

One of the most important things you must be aware of is your nutrition choice after bariatric surgery. This article will discuss what to look out for after the surgery has been completed, and how to make sure you are eating healthy.

1. Keep a journal daily. Read all labels

Aim for 800-1200 cal a day
Limit your carbohydrates intake to < 100 grams a day
Protein with every meal > 60 grams a day

2. Eat 3 small meals daily and 2-3 snacks
3. Avoid ALL sugary drinks: (No juices, sodas, sweet tea). NO carbonation should ever be consumed after surgery (even a year out).
5. Do not eat and drink at the same time, wait 30 minutes after eating to begin drinking.
6. Eat small, eat slowly, chew well. Eat from a saucer or small bowl.
7. Walk or exercise 30 minutes a day* minimum, add weights
8. Take vitamins daily- chewable, for life
9. Drink 8+ cups of water
10. Have a friend to call who supports you. Join a support group.

Fatigue is Normal First 2-3 Weeks After Surgery

The first two to three weeks after surgery will leave you extremely tired and lethargic. This is normal but only lasts a few weeks. After the first two to three weeks, you should start to feel like yourself again. You will be able to go back to work and resume normal activities. Be sure to follow the advice of your surgeon. The cost of gastric sleeve surgery is, of course, high so it’s important that you do everything in your power to get the best outcome.

During the first few weeks, all liquids count towards your daily “water goal”. You need to aim for 64 ounces a day, at a minimum. So, if you are drinking a protein shake, count it! If you are drinking Crystal Light, count it! Gatorade Zero is a staple to keep your electrolytes up during this time. Count it!

If you have a particularly busy day or are feeling tired even after the first two to three weeks of recovery, make sure you drink plenty of water. This will keep your body functioning properly and help you have enough energy to finish your day.

Eat Small Meals, Six Times a Day

First off, it is very important that you eat small meals frequently. Eating large meals can lead to vomiting and other gastrointestinal issues, as the body does not have enough time to process food if it is eaten in large amounts. Eating larger amounts will stretch your new stomach, resulting in a failed bariatric surgery.

Your bariatric doctor and surgeon will give you a bariatric food plan prior to surgery and will tweak it after surgery based on how your body is tolerating the many changes. You will likely begin with extremely small amounts of clear liquids for the first day. The following day, you will begin small “shot glass style” cups of protein shakes. The hospital will provide all of that and even monitor how much you are able to intake. You will begin with just an ounce or two and work your way up to 4 ounces of protein shakes every 3 hours.

After a week of liquid diet, you will begin introducing high protein pureed foods. Pureed foods are basically anything you can put in a food processor or blender that forms the consistency of baby food. You can also choose baby food but most of the time, you will need to add protein powder to baby food because it is not high enough in protein.

After the pureed stage, you will move to “soft foods”. Soft foods are foods like eggs, soups, tender chicken, steamed veggies, and basically anything that is high in nutrients and protein but able to be mushed in your mouth. At this stage, you need to be drinking 64 ounces of water, Crystal Light, or Gatorade Zero without counting your protein shakes as part of your “water intake”.

Once you have been released to begin a regular diet (usually around 6 weeks out from your surgery, you will want to stay away from foods that are rough on your stomach. Introduce foods back slowly by taking a small bite at each meal to determine if your stomach will be able to tolerate it.

Eat six times a day. That’s right, the doctor will tell you to eat six times a day after surgery and you should continue that habit even after the surgery has been completed. You can eat small amounts and still eat six times a day, so do not get discouraged. Bariatric doctors will recommend that you eat no more than 1/2 cup every 2-3 hours. You may feel full after eating smaller amounts, but that is completely normal. It is important to be sure you get the nutrition your body needs so be sure to begin your meal with high protein, low sugar, low carb food choices.

If you overeat, you may experience a feeling of being painfully bloated. This is your body saying that it can not handle any more food. Stop eating when you feel full but be sure to set a timer to eat again in 2-3 hours. Be sure to stick to small meals throughout the day.

Proteins

Getting the right amount of protein after bariatric surgery is very important. Most bariatric doctors recommend 60-80 grams of protein for women and sometimes higher for men. Ask your bariatric doctor what your personal protein goal should be. Protein will likely come from protein shakes and protein powders at the beginning. Be sure to avoid high sugar and high carb protein powders and drinks.

Protein is very important after surgery, but remember that you want to aim for lean protein sources. Do not go for very fatty protein sources. You can opt for meatless proteins. Finding protein shakes that you can tolerate is going to be key. You can find 26 great protein shake recipes at https://www.bariatricfoodcoach.com/liquid-recipes-protein-shakes-after-bariatric-surgery/

In-Store Proteins

Protein Supplements

Premier Protein
Premier Clear
Ensure Max Protein 30

Whey Powders

GNC 100% Whey Protein Powder
GNC Lean Shakes
Isopure Whey Protein Isolate
EAS AdvantEdge Carb Control or Lean 15
Muscle Milk Light
Body Fortress Super Advanced Whey Protein
Designer Whey
Pure Protein
Syntrax
Oh Yeah!
Atkin’s – Lift or other

Online

Genpro Musclegen
Syntrax Nectar
Unjury
Believe
Inspire
Optifast

Vitamins are Crucial

When you have gastric bypass and vertical sleeve surgery, your body no longer absorbs the nutrients in food like before. You will need to take extra vitamins for life after this type of weight-loss surgery; make sure that we’re giving them correctly by following these guidelines:

Follow up with the bariatrics team at regular intervals (every three months) so they can test lab values against what’s recommended pre-op versus post-op situation.

Multi-Vitamin and Mineral Supplements

Take chewable supplements. Chewable supplements are vitamins and mineral pills you can chew. Your new small stomach pouch cannot break down a hard vitamin pill. Your bariatric doctor will likely have you begin with chewable or liquid bariatric vitamins. As the stomach heals, your doctor will release you to taking capsules. Taking capsules before your doctor gives you the go-ahead can result in them getting lodged in your new pouch. Be sure to listen to the doctor’s advice.
Vitamins should be taken at least 1 hour before a meal to give them a chance to dissolve and get into your system. Taking large pills with a meal can prevent them from dissolving and absorbing into your system. Also, drinking large amounts of liquids while taking pills may dilute the amount of vitamins in your system.
Take 2 complete multivitamins and mineral chewable per day. “Complete” means they contain 100% of the recommended daily value for most essential vitamins and minerals. Gummy vitamins usually are not complete. If you are taking a specially formulated bariatric supplement, then follow the dosing guidelines on the package.
Some multi-vitamin and mineral pills have iron and some do not. You will need a separate iron supplement if your multi does not have enough iron.
Take the 2 multi-vitamin and mineral supplements at different times.

Calcium

Take chewable calcium or crush a non-chewable calcium supplement.
Take calcium citrate or tricalcium phosphate. You will not absorb calcium carbonate very well after bariatric surgery. Read the label carefully to make sure you are getting the right type of calcium. Some brand names sound like they would contain calcium citrate but they do not.
You need 1200-1500mg of calcium per day. Some of this should come from low-fat and low-sugar foods. Here is a list of high calcium foods:
300mg – 1 cup milk or plain yogurt, ½ cup ricotta cheese, 1oz Swiss cheese, ½ cup tofu, 3oz canned sardines with bones
200mg – 1oz natural cheese
150mg – 1 pack fortified oats or grits, ½ cup low-sugar pudding, 3oz canned salmon with bones
100mg – 1oz almonds (23), ½ cup low-sugar ice cream or frozen yogurt, ½ cup white beans
50mg – ½ cup of most dried beans, ½ cup cottage cheese, 1 tbsp. dry milk powder
Most patients will still need 3 daily calcium citrate or tricalcium phosphate supplements to get enough calcium. Do not take them all at the same time.

Vitamin D

Take a chewable vitamin D or crush a non-chewable vitamin D pill.
Patients should start out taking 3000 international units of vitamin D per day. Some of this will be in your multivitamin and mineral and some will be in the calcium supplements. Read your supplement labels and decide how much extra vitamin D you need to take.
Your doctor will check your blood level of vitamin D and change the amount of vitamin D you have to take to keep it at the right level.

Iron

Take a chewable or liquid iron supplement. Iron drops for babies can work well. Place on the back of the tongue or mix it with water so it doesn’t stain your teeth.
The recommendations are to get 45-60mg of iron per day. There may already be iron in your multivitamin and mineral which often contain 18mg per pill

All of these supplements can be purchased at your local drugstore or grocery. You can also purchase supplements that are specially made for patients who have had bariatric surgery. These are available on the internet or by phone from:

Bariatric Advantage
oPurity Vitamins
Procare Health
Unjury
Celebrate
Bariatric Fusion

No matter where you plan to get your supplements, always read the labels to make sure you are getting the correct amounts of the nutrients you need.

Vitamins are a vital part of care after bariatric surgery. Bariatric vitamins are required for LIFE! Be sure you will be able to afford vitamins for the rest of your life. Most bariatric doctors will ask for you to come back for labs to verify that your body is receiving and absorbing the necessary vitamins to remain healthy.

If you are taking medication, be sure to speak with your bariatric doctor before adjusting your dosage.

Exercise after Bariatric Surgery

After bariatric surgery, exercise is key to having a healthy and fulfilling life. However, there are certain precautions that must be taken into account when it comes to exercising after you have gotten bariatric surgery.

The first thing you need to do is meet with your doctor and discuss your options. Depending on the type of surgery and procedures you’ve had, your doctor may approve or prohibit certain exercises. It’s important to begin walking as quickly after surgery as you can. Walk every day even when you may not feel like it.

Intense exercising and lifting more than 5-10 lbs is not recommended for at least 6 weeks. You can talk to your surgeon about their specific recommendations for you.

Walking is an excellent option because it can be done at any time, anywhere. Just make sure you have the ok from your doctor. If you don’t feel comfortable with walking, try swimming or biking instead (after your incisions completely heal).

Exercise is an essential part of a healthy lifestyle. It doesn’t matter what type of exercise you enjoy, just find something that appeals to you and do it regularly. If you have other people at home, all having fun doing exercise together can be a wonderful bonding experience.

Take things slowly and carefully to prevent injuries. Do not do any exercises that cause discomfort or pain. It is normal to feel fatigued when you first begin exercising after bariatric surgery, but this should eventually go away.

No matter what your status is with weight loss and exercise, you need to continue eating healthy and exercising regularly to maintain the results of your bariatric surgery.

Having a healthy life is possible after weight loss surgery! You just have to make some changes and stick to them.