Gastric Sleeve Post-Op Diet: How To Stay on Track

Your Stomach Needs a Break

After bariatric surgery, your stomach needs time to heal. The natural course of the digestive tract uses a series of muscle contractions that move food through the digestive tract into the stomach, then out of the stomach with the waste being expelled out of the body. These wave-like contractions are temporarily paralyzed while your stomach is healing so your body cannot handle anything at this point but liquids. Expecting your paralyzed healing stomach to handle solids before it is able can result in nausea or  vomiting, or potentially, more serious consequences. This is why it is so important to follow the special diet after vertical sleeve gastrectomy surgery as it allows your body to obtain nutrients while your stomach is adjusting to all the changes.

Potential Stomach Leak

After laparoscopic gastric sleeve surgery, you will have a staple line where the edges of your stomach were sealed together after a section of it was removed. It is critical that this staple line be allowed to heal adequately and become stronger before it is put under any type of pressure. If the staple line were to gap, stomach fluid would seep into the abdominal cavity causing a potentially life-threatening medical emergency that can result in open surgery to correct. Attempting to introduce solid foods, carbonated drinks or alcohol will put your stomach at risk.

Stretching Your Stomach after Gastric Sleeve

Cheating on your post-op gastric sleeve diet can cause your stomach to stretch out permanently. The major benefit of the bariatric surgery tool is to make the stomach smaller, limiting the number of calories patients can consume at each meal and the benefit of feeling “full” longer. If you have just spent weeks on a special diet and have gone through major surgery, would you want it to all be in vain?

Heartburn after Gastric Sleeve Surgery

Attempting to eat solid foods before your stomach can handle them increases your chances of developing reflux and heartburn. It takes your stomach and digestive system longer to process solid foods (about 6 hours) versus liquids (only 2-4 hours). Some patients have reported excruciating chest pains during heartburn episodes.

Post-Op Diet after LSG and ESG Chart

Clear Liquids

All must be sugar-free and low fat, e.g. broth, water, Jello, decaffeinated tea, decaffeinated coffee, sugar-free popsicles, and other sugar-free beverages that do not contain carbonation. Avoid all carbonated beverages, any beverages with sugar, any beverages with caffeine.

Full Liquid Diet

Includes all items listed in the clear liquid diet but also may include thicker liquids and liquids that contain protein, such as:

• non-fat yogurt,
• sugar-free carnation instant breakfast,
• thinned creamed soups that do not contain any chunks,
• soup with very soft noodles,
• sugar-free pudding,
• low sugar very watery oatmeal,
• no sugar added juices diluted 50% with water,
• low sugar applesauce diluted with water, and
• sugar-free, no fat ice cream.

Pureed Foods

Pureed foods are foods that have been put in a blender and resemble the consistency of baby food. As a general rule, this category will contain things like:

• protein shakes made with no sugar almond milk or coconut milk,
• low-fat cottage cheese,
• hummus, soft steamed vegetables,
• soft cheeses,
• ground chicken or very lean ground beef,
• soups,
• scrambled eggs,
• soft steamed fish,
• canned tuna or salmon,
• mashed fruits that are low in sugar,
• and avocados.

Avoid sugar, bread, rice, pasta, and other starchy foods and veggies that cause gas like broccoli, celery, raw leafy greens, and asparagus.

Soft Foods

Foods that can be mashed up with a regular fork without effort are considered soft foods; these are not pureed foods. The goal is low sugar, low fat, protein-rich foods such as tuna, lean ground beef, beans, lentils, and baked fish. Avoid pasta, bread, starchy foods, foods with sugar or high fructose corn syrup, trans fat, and saturated fat.

Solid Foods

This is the final phase of your gastric sleeve diet and the one that will be your new normal. Solid foods include all foods that are low in fat, low in sugar, and are not included on the list of foods to be avoided. It is important that you introduce these solids gradually to avoid issues with constipation, upset stomach, or diarrhea.

What Is the Typical Portion Size after Gastric Sleeve Procedure?

After your surgery, you will not be able to eat as much as you did before. Your mealtime portion size will start at about ½ cup and gradually work up to 1 cup size portions after several months. After your VSG, around 3 months post-op, you will begin to accurately gauge your portions and how much is too much.

How to Ensure Staying on the Right Track?

• Take your recommended supplements – the supplements that are recommended by your surgeon or nutritionist are key elements in your gastric sleeve post-op diet. They will ensure you do not experience deficiencies that can lead to other, more serious issues.
• Do not drink with meals – this takes some getting used to as most of us are historically accustomed to having consumed food and beverages interchangeably during meals. This causes the stomach to stretch and also liquids take up valuable space needed for food to ensure you get enough vitamins and nutrients each day.
• Choose foods that are packed with nutrients, e.g. fish, banana, and apple vs. bread, which is empty (has low nutritional value).
• Do not drink your calories – when you are on a limited calorie diet, you want to make the most of it. Liquids run through our systems faster and do not stick with us. It is wiser to spend your calories on something that will make you feel full longer and will provide more nutritional value.
• Do not rush through your meals and chew your food well – this will ensure easier digestion as well as give your stomach time to indicate that it is full.
• Drink 64 oz of water every day – it is important to stay well hydrated and stop drinking about 30 minutes before each meal.
• Avoid using the microwave to cook or reheat meals – Microwaving tends to dry out food making it harder to chew and digest. It also removes many valuable nutrients that we need from foods.
• Limit alcohol – consuming alcohol after gastric sleeve surgery can put your liver at risk. It converts energy into fat which leads to weight gain.

What Foods Should I NOT Eat After Gastric Sleeve?

Because each individual is different, their tolerance for different types of food after gastric sleeve surgery will vary. Typically, it takes about a year to determine which foods are going to cause problems for you versus which foods you will tolerate very well.

Following is a list of foods that have been reported by patients to be problematic (meaning they experienced discomfort or some type of physical reaction when they consumed these foods after weight loss surgery).

• Starchy foods and carbohydrates like pasta, bread, rice, and oatmeal;
• Fruit and veggies with tough skin like cucumbers and apple, they are best peeled;
• Tough meats like steak, chicken/turkey breast, thick salmon;
• Grilled meat: grilling tends to make things chewy and the outer surface tougher;
• Desserts and sugary drinks are high in fat and sugar, and can also cause dumping. They also are high in calories and can cause crashes and extra cravings afterward.
• Foods with high-fat contents such as fried foods, butter, and high-fat dairy products;
• Snacks (junk foods) like chips or cookies.