Nutrition After Bariatric Surgery

The main purpose of weight loss surgery is to help you reduce the amount of food you are able to eat by decreasing the size of your stomach. However, it doesn't guarantee successful long-term weight loss. Rather, the surgery is simply a tool to help you reach and maintain a healthy body weight. Achieving optimal and permanent weight loss requires commitment to changing old behaviors into healthy lifelong habits.

Nutrition Habits to Follow

Protein First!

Protein deficiency can cause issues such as hair loss, skin problems, swelling, muscle wasting, weakness, poor healing, impaired immunity, and increased risk of infection. Since you will not be able to eat as much, it is important to eat your high protein foods first. Concentrate on lean meat, dried beans, fat free dairy products, tofu, eggs, or egg substitutes. The general recommendation is to consume 60 to 80 grams of protein a day. Even after you are back to eating regular foods, you may not be able to eat this much, so a protein shake or powder will help you reach this goal.

Hydration is Key

You will need 50 to 64 ounces of fluid each day to avoid dehydration. About half of this should be plain water; the other half may be clear liquids or may have a protein supplement added. Each morning, fill a container with your daily water regimen. Then, keep a cup with you and sip all day long, spreading your fluid intake out evenly throughout the day. This will help you drink the needed amount without overfilling your stomach. Sip, don't gulp. Drinking large amounts of liquid quickly may cause nausea and vomiting.

Nutritious Food in Smaller Portions

It is important pre- and post-bariatric surgery to build healthier eating habits. Before surgery, you should begin education to prepare you for your post-op journey and start making changes in your food choices. After your operation, you will only be able to eat small amounts, which will help you lose weight. But it is extremely important to fill the limited space with foods your body needs to be well-nourished and healthy! Otherwise, you may develop nutritional deficiencies that may have a negative impact on your health. Over time, you will be able to eat more and it is possible to stretch your small stomach so that you overeat again—life-long portion control is a must. Work with your dietitian to learn more about portion sizes and how to choose and prepare healthier foods!

Avoid Junk Food

Junk food and overly processed foods usually digest quickly and don't keep you satisfied for long. Generally, junk food is not very nutritious, as it may contain a lot of fat, sugar, and calories. These "empty calories" can add up quickly, causing weight gain. To successfully lose weight and prevent weight gain, you must avoid these foods. That means no cakes, pies, pastries, cookies, doughnuts, muffins, candies, snack chips, fried or greasy foods, or the like. Choose "real food," not processed, food-like substances.

Cook but Don't Fry

Dining out and eating pre-packaged foods makes eating healthily very difficult. Purchase less processed ingredients and prepare your own foods. Think about your knowledge of cooking techniques. If you tend to fry most foods, it's time to explore other ways to cook! If you tend to season everything with fats, like oil, margarine, grease, creamy sauces, and gravies, it's time for some new recipes. Keep an open mind. You may be making big changes, and it takes time. If you don't like something the first time, keep trying it!

Eat Vegetables

Non-starchy vegetables are nutrition powerhouses. They provide lots of nutrients that make us healthy, have very few calories, provide fiber and fill you up—not out. Half of your plate should be covered with non-starchy, low-fat vegetables.

Rethink Your Drink

Sweetened beverages are a source of large amounts of unnecessary calories, and usually add little to no nutritional value. Avoid carbonated soft drinks; sweetened, caffeinated or alcoholic beverages; sports drinks; and juices. Water is always the best beverage choice.

Practice Portion Control

Even if you eat healthy foods, you can consume too many calories if you eat large portions. Learn the appropriate portion of various types of foods and measure out those portions accordingly. You may have learned to take larger portions from your family members, from dining out or elsewhere, but now is the time to re-evaluate what you think is an appropriate amount to eat. Over time, this will become your new norm. Pre-portion foods, use a small plate, and remember: It's OK to leave food on your plate if you get full.

Recommended Vitamin Supplements

Vitamin and mineral deficiencies have been observed in patients after weight loss surgery. Iron, folate, vitamin B12, calcium, and zinc are most affected after gastric sleeve surgery. View a complete list of our recommended vitamin supplements below. They are available over the counter at your local pharmacy. If you have difficulty locating or tolerating any of the supplements, call your dietitian or surgeon for suggestions.

Multivitamin and Mineral Supplements

• Buy only a complete adult multivitamin/mineral supplement with iron.
• The number you need to take each day depends on the individual product. Aim for about 200 percent RDA for iron (36 mg), folic acid (800 mcg) and thiamine (3 mg), and 2 mg of copper. It is best if the multivitamin also contains selenium and zinc.
• If you decide to switch to a pill form after 6 months, soft gels or capsules may be better absorbed than tablets. Do not take MVI in gummy form. Gummies do not usually have all the vitamins and minerals you need.
• If you need to take more than one dose, it may improve absorption to take them at different times of day.

Vitamin B12

• Take 500 to 1,000 mcg sublingual (under your tongue) tablet or liquid once a day.
• Do not buy time release.
• You can take vitamin B12 once a day. You do not need to spread out the doses.

Vitamin D3

• Take 3,000 IU (International Units) of vitamin D3 per day.
• Chewable and liquid D3 vitamins are best absorbed. If you switch to a pill form after six months, soft gels or capsules may be better absorbed than tablets.
• You can take vitamin D3 once a day. You do not need to spread out the doses.

Calcium Citrate (with vitamin D)

• Take 500 to 600 mg of calcium three times per day to equal at least 1,500 mg per day.
• Spread doses out throughout the day to improve absorption.
• Do not take calcium supplements at the same time as your other vitamins. Calcium and iron (in the multivitamin) compete for absorption sites. It is best to take your multivitamin with iron 2 hours apart from your calcium supplement.
• Chewable and liquid calcium supplements are best absorbed. Do not use gummy calcium supplements. Chewy supplements are acceptable, but gummies do not usually contain calcium citrate and are not the best absorbed.
• Choose calcium citrate. Avoid calcium carbonate, calcium triphosphate, oyster shell, bone meal, and so on.

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