After bariatric surgery your life for the next few weeks is going to be focused on your body adjusting to your new stomach and gently working it back toward normal food.  Making sure you stomach heals is the most important thing that needs to happen during this period so you should know what to expect and the guidelines that will need to be followed including following the 4 diet stages after your gastric sleeve surgery.

4 Diet Stages After Gastric Sleeve Surgery 

To make the transition successful each individual will follow a controlled diet consisting of four main food stages: Full Liquid, Pureed Food, Soft Food and Regular Food. Each stage is important to follow correctly, eating the right foods.  Sticking to each stages’ time line to ensure your new stomach adjusts will help guarantee no future medical or discomfort issues. Not following the different stages and cheating on your post-op diet can cause diarrhea, dehydration, constipation, bowel obstruction, or a very serious gastric leak, so stick to the diet.

Week 1 & 2 After Surgery -  Full Liquid Diet

Goals: 64 oz fluids, 60-80 grams of protein

The very first day after surgery if you have no nausea and vomiting you will follow a clear liquid diet.  During this first day you must sip fluids consistently all day.  The goal should be 4-8 ounces of liquid per hour for a total of at least 64 ounces of clear liquid per day.  Some recommendations for sugar-free clear liquids are:

• Isopure protein water provides 40g of protein per bottle
• Clear broth or bouillon - chicken, beef, or vegetable
• Diet Jello
• Sugar-free popsicles, sugar-free Italian Ice and sugar-free sherbet
• Water
• 100% fruit juice (limit to 4 oz.)

After the first day you can begin to consuming other liquids that aren’t strictly considered clear.  The goal should be to drink at least 64 ounces of liquid per day but additionally add in other items for protein.  All items listed in the clear liquid diet can still be consumed plus the additional items can be added:

• Propel water, Gatorade G2 (low calorie), Powerade Zero (low calorie)
• 1% Milk, Skim milk or lactose free skim milk
• Soy Milk
• Protein drinks / shakes (60-80g per day)
• Low-fat creamed soups - thinned with no chunks
• Non-fat, sugar-free yogurt or Greek yogurt (must be smooth, no chunks)
• Sugar-free / fat-free pudding
• Decaf coffee or tea
• Sugar-free drinks that are not carbonated
• Vegetable and fruit juices (V8, Low calorie fruit juice, etc.)

There are some liquids that are not recommended and should be avoided:

• Soda
• Alcohol
• Carbonated beverages
• Whole Milk
• Caffeinated beverages including coffee, tea and energy drinks
• Sugary drinks of any kind

The full liquid list is a restrictive list in the first two weeks and is pretty limiting.  You will however get through it and need to follow it closely to ensure your stomach heals. One bright spot is that most patients have very little desire to eat. The hunger hormone ghrelin is almost non-existent after surgery due to part of the stomach that produces the majority of ghrelin is removed during surgery.  Also checkout our gastric sleeve liquid diet plan for additional options to make this phases easier and more enjoyable.

Week 3 & 4 After Surgery -  Pureed Diet

Goals: 64 oz fluids, 60-80 grams of protein

3-4 Meals per day, never more than 4oz (½ cup) meal size, first 1-2 oz protein

After being on only liquids for two weeks your body will be ready to start eating something more substantial and by the third week your stomach has healed enough to handle some pureed food.

You now will be able to eat around 2-4 ounces or pureed food per meal.  Everything should be blended to the consistency of applesauce, so having a blender or food processor will be needed.  You still need to be careful to limit sugars and fats but think of this as the stage as the one that begins to prepare your stomach back to solid foods (Check out our Pureed Diet Plan to see different options and weekly meal plans. The goals for this stage are:

• Get your 60 - 80 grams of protein per day
• Chew slowly and completely, taking small bites
• Still get 64 oz of fluid per day to prevent dehydration
• Avoid starchy foods like white rice, pasta and breads

Some foods may taste differently and will be tolerated differently than they were before your surgery. You may find that dairy products are harder to digest. It’s helpful to  introduce new foods back into your diet slowly so you can identify new tolerances and see how your stomach reacts..

By doing this you’ll be able to identify foods that are causing gas, stomach upset, and/or diarrhea.

During this phase you can eat anything from the previous stage plus begin eating some food with substance including:

• Low-fat or nonfat cottage cheese
• Egg whites or egg substitute, scrambled
• Pureed meats: beef, chicken, turkey and fish
• No sugar applesauce
• Pureed fruit and vegetables (soft fruits, soft cooked vegetables)
• Baby foods (no chunks)
• Fat free refried beans
• Mashed Potatoes
• Cream of Wheat, oatmeal, Malt-O-Meal, grits
• 1 protein shake per day. You can now blend them with yogurt or non-fat milk.
• Almond milk or coconut milk
• Hummus
• Soups
• Canned tuna and salmon (you can add low fat mayo). Great source of protein.

You should avoid the following foods:

• Smoothies are ok but usually high in sugar so limit your consumption..
• Sugar
• Starchy foods like pasta, rice and bread.
• Fibrous vegetables like celery, broccoli, asparagus, raw leafy greens.
• Nuts & snack mixes
• Chips and crackers

Week 5 After Surgery - Soft Diet

Goals: 64 oz fluids, 60-80 grams of protein.  Eat 3 Meals a day and 2 snacks.

After going through the Puree phase your stomach is now ready for the next stage of slowly going back onto regular soft food. On the soft food diet you are allowed all the things in the previous two stages plus now foods that are a little more harder to digest and closer to their normal consistency.  Remember during this stage you still need to really chew thoroughly and take small bites. Ideally you should consume no more than 2 ounces of meat and 1 once of other food for a meal and 1-2 ounces for snacks.  Choose foods that are high in protein, moderate to low carbohydrates and moderate to low fat for best results (See our complete liquid, pureed and soft meal plans to keep your recovery diet on track.). You now may add the following foods back into your diet:

• Chopped lean, moist meats, poultry and fish
• Soft cheeses – limit these, they are typically high in fat.
• Soft cooked vegetables (no skin, seeds or strings)
• Soft canned fruits (no added sugar, not in syrup, juice drained)

Items still to be avoided:

• Beans (These foods can still cause abdominal discomfort)
• Trail mix, crackers, chips, nuts
• Sodas or sugary drinks
• Fried foods
• Fibrous vegetables (i.e. celery and asparagus)
• Candy, Dessert
• Pastas and other high carbohydrate, low nutrient foods (pizza).
• Whole milk and other whole milk dairy foods.
• Raw vegetables
• High fat meats

Week 6 After Surgery - Regular Diet

Goals: 64 oz fluids, 60-80 grams of protein.  Eat 3 Meals a day and 2 snacks.

Reaching the last stage is a real milestone as have now almost all foods are once again able to be consumed.  All food from the earlier stages can be eaten.  The following foods are now available to be eased back into your diet (Make sure to check out all your options and easy meal plans in our Whole Food Diet Plans) :

• All meats (best if moistly cooked)
• All fruits
• All vegetables
• Beans
• All starches and grains
• Caffeine ( limit to 2 -16oz. Cups of coffee or tea per day)

Things to avoid until the three month period:

• Limit nuts and other course food stuffs
• Avoid sodas and carbonated beverages ( sugar and can cause stomach discomfort)
• Avoid alcohol

Things to remember to be successful

• Ease foods back in slowly and progress as your stomach tolerates it
• Eat 3 meals per day
• Meals should take 20-30 minutes
• Chew foods thoroughly
• Eat slowly
• Small bites of food, the size of a black bean
• Do not drink with meals and fill up too fast with liquid
• Be mindful and stop eating when full
• Try to eat a balanced diet