Following a healthy, balanced and nutritious diet lifelong after your surgery will support you to achieve the best possible health and weight loss outcomes. It will also minimise the risks of various post operative complications.
Eating habits to follow after surgery
Aim for 3 small meals at regular times every day – use a smaller plate or bowl to support portion control. Follow the “bariatric plate” model:
- Protein - meat, eggs, chicken, fish, pulses, dairy products, tofu should make up half of your plate. Eat these foods first.
- Fruit and vegetables – a quarter of your plate should be veggies and salad as these are low in calories but high in fibre, vitamins and minerals. Eat these foods next.
- Slow-release carbohydrates - whole grains such as whole meal bread, brown rice, potatoes with skin, bulgur wheat, barley etc should fill the last quarter of the plate. Eat these foods last if you still have room.
Aim for a daily protein target of 60-80g per day – resources are available under the patient resources section of this website. Alternatively use an app or check food labels to get familiar with your usual protein intake and increase if you need to. Patients who have had a mini bypass (one anastomosis bypass) have a higher protein target of 80-100g per day.
Aim for 2-3 portions of calcium-rich foods daily (dairy foods, fortified plant alternatives, green leafy veg, fish with small bones, calcium-set tofu).
If you get hungry between meals, plan out some healthy snacks. Choose something rich in protein and/or fibre such as:
- a small pot of high protein yogurt
- a mini cheese e.g. a low fat Babybel
- a boiled egg
- 1-2 teaspoons of peanut butter spread on a couple of apple slices or 1-2 oat cakes
- a piece of fruit
- some veg sticks with a tablespoon of hummus or cottage cheese
Aim for 2 litres of sugar-free, still/not fizzy fluids (e.g. water, no added sugar squash or flavoured water, herbal teas, tea or coffee. Fizzy drinks can make you feel bloated and uncomfortable after surgery, it may also irritate the stomach and make reflux more likely.
Keep your intake of ‘slider foods’ like biscuits, crisps, ice cream, chocolate to a minimum – these foods are high in calories, fat and/or sugar, but don’t fill us up. After surgery, they ‘slide’ down easily and can make it difficult to maintain weight loss if eaten too frequently.
Limit excessive consumption of caffeine as some people find this worsens reflux and/or dumping syndrome – stick to 1-2 cups of coffee per day max
Avoid alcohol completely for 6 months after surgery and then limit to small amounts, keeping to UK recommended limits. Alcohol can increase the risk of stomach ulcers and also is high in ‘empty’ calories so can affect your long term weight balance. Alcohol will also affect you more quickly and at lower amounts compared to before surgery because it more rapidly enters the blood stream – be mindful of your tolerance if you choose to drink alcohol again after the first 6 months.
Bariatric Eating Principles
As well as what you eat after your surgery, how you eat also plays an important role in minimising post-op complications and in supporting long term weight management. We encourage you to practice the following strategies throughout your life post-op.
Follow the 20:20:20:20 rule:
a. Mouthfuls are no bigger than a 20 pence coin
b. Chew 20 times per mouthful
c. Leave 20 seconds between bites
d. Spend no more than 20 minutes eating each meal
Chewing well and eating slowly helps reduce feelings of discomfort or of foods getting stuck, it also reduces the risk of regurgitating food. It will also allow your stomach and brain time to recognise feelings of fullness and satiety, supporting long term portion control.
Stop eating after 20 minutes, or when you feel comfortable – whichever comes first. Do not force yourself to keep eating for 20 minutes if you are starting to feel full up – its best to stop eating at these early signs of fullness to avoid over-eating and risking vomiting or regurgitation. Likewise, end the meal after 20 minutes to ensure that you are not grazing over long periods of time. You can always plan a small, healthy snack if you get hungry between meals.
Separate eating and drinking by 30 minutes on either side. This means that you have enough room in your smaller stomach to eat a small protein rich meal without filling up on liquids. This habit also reduces the risk of dumping syndrome after eating because drinking at the same time can cause food to rush through your stomach and trigger the dumping response
Avoid gulping fluids – aim to always sip slowly. This reduces the risk of regurgitation or vomiting after drinking. Be mindful of your fluid intake on hot days or when exercising and make sure you sip slowly and regularly over the day to avoid getting too thirsty as this can lead to gulping fluids down too quickly
Will there be foods I can’t eat after surgery?
Everyone is different after surgery in terms of the foods they can and cannot manage. However, a lot of patients find some foods more challenging to eat than others, even when they are chewing well and eating slowly. If you manage these foods and textures fine, there is no need to change them, but the table below gives some ideas if you are struggling.
table
| Problematic food |
Reason |
Alternatives to consider |
| Roast meats - any fibrous, dry meat e.g. chicken breast, a tough or stringy chop or steak, processed meats like bacon, sausages, charcuterie |
These textures can be tough and difficult to manage as they lack moisture, making them harder to chew and swallow. This can make the bite of food feel like it is “stuck” in the throat or chest, causing pain and/or vomiting/regurgitation. |
Choose tender cuts of meat which are slow cooked until they fall apart.
Try using minced meat instead.
Eat slow cooked or minced meats in a saucy dish like a stew or curry.
Try softer protein options like scrambled egg, fish or tofu |
| Bread- doughy/ stodgy textures |
Whilst chewing, these can form into a stodgy lump rather than breaking down into small pieces. This can lead to stomach pain and discomfort |
Try: toasting the bread pitta breads or wraps crackers of crispbreads other better tolerated starchy foods like potatoes or grains |
| Stringy vegetables - beans, celery, peas and sweet corn
Fruit with tough skins – apples, pears
|
These may not digest well and may get stuck or feel uncomfortable |
Slice or shred vegetables small.
Cook vegetables until soft.
Peel tough skins off fruit and veg.
Stew fruit (avoid adding sugar) to make a compote. |
