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Pam German's Weight Loss Journey

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Sample Gastric Bypass Diet.

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Sample Gastric Bypass Diet

This is just a sample diet that my surgeon gave me. I thought Id offer it to pre-ops as a sample of what to expect post-op. Always follow your surgeons advice for post-op diet.

 

 

STAGE 1:          NON-CALORIC CLEAR LIQUIDS

           

Start:   3 days post-operatively, some surgeons require Stage 1 be started in-hospital so adequate fluid consumption can be monitored.

 

            Diet:            Three fluid ounces (90 cc) of sugar-free clear liquids three times daily.

Between these meals you should take three ounces of clear liquids per hour. See page 4 for lists of recommended fluid for Stage 1.

 

Instructions:    Stop sipping as soon as you feel full. Drink slowly; use a 1-oz. medicine cup to measure your fluid intake.

 

 

STAGE 2:          SUGAR-FREE LOW-FAT FULL LIQUIDS

 

            Start:            Usually 48 hours after Stage 1.

 

Diet:    Six small meals per day each consisting of 4 fluid ounces of Sugar-Free Carnation Instant Breakfast (CIB) mixed with skim milk. Drink slowly (sip) over a 1-hour period.

 

Instructions:            1. Continue to record fluid intake at home. Bring this record to your follow-up clinic visits

2. Other high-protein liquids can be substituted for Carnation Instant Breakfast.

    See page 4 for suggestions.

3. Sip high-protein liquids slowly over 1 hour.

4. Between-meal fluids should be non-caloric clear liquids and should not exceed 6 oz. per hour.

5. Goal fluid intake is 48 oz. fluid daily.

6. Take liquid or chewable multivitamin supplements daily.

 

 

STAGE 3:          PUREED FOODS

 

            Start:            Usually 2-3 weeks after discharge.

 

Diet:    Three fluid ounces (6 Tbsp) of high-protein pureed food consumed three times per day. One of these ounces may be pureed vegetable or fruit. Eight fluid ounces of skim milk or Sugar-Free Carnation Instant Breakfast should be taken three times daily between meals. No more than 8 oz of fluid should be taken per hour.

 

(See Suggested Meal Plan for Stage 3 on the next page)


SUGGESTED MEAL PLAN FOR STAGE 3

 

 

 

Meal               Serving Size                           Food                                        Calories                    Protein (gm)

 

Breakfast       2 Tbsp     Pureed Pudding or Yogurt         30                      3                                                             1 Tbsp     Pureed Fruit                    20                   --

 

Snack        8 oz Sugar-Free CIB            150                  15

 

Lunch    2 Tbsp    Pureed Meat                    30                    3

             1 Tbsp            Pureed Vegetable     20               trace

 

Snack        8 oz Sugar-Free CIB            150                  15

 

Dinner   2 Tbsp    Pureed Meat                    30                    3

             1 Tbsp            Pureed Vegetable     20               trace

 

Snack        8 oz Sugar-Free CIB            150                  15

 

                                                   TOTAL  600 kcal     54 gms

 

 

STAGE 4:          SOFT AND SOLID FOOD

 

            Start:            5-6 weeks after surgery.

 

Diet:    Two-three fluid oz (4-6 Tbsp) of high-protein solid food consumed three or four times a day. Eight fluid oz skim milk or Sugar-Free CIB daily between meals (no more than 6 oz/hr).

 

Goal:   At least 48 oz liquid daily, 600 grams protein daily.

 

Instructions:            As with Stage 3.

 

1.      Certain solid foods may not be well tolerated. Many patients have difficulty with meat despite chewing well.

2.      Other foods to avoid include nuts, potato skin, fruit peel, and high-fat, high-calorie foods (including alcohol).

 

 

SUGGESTED MEAL PLAN FOR STAGE 4

 

 

 

Meal               Serving Size                           Food                                        Calories                    Protein (gm)

 

Breakfast        1 Egg, Scrambled                    73                    7

                          Slice Bread, Toasted        34                    1

                 1 tsp  Margarine for Toast            45               trace

                                  Banana                    20               trace

Snack        8 oz Sugar-Free CIB            150                  15

 

Lunch     cup  Plain Chicken Salad            73                    7

                 1 tsp               Mayo                    45               trace

                      3          Crackers                    34                    1

               cup      Applesauce                    20               trace

 

Snack     cup Yogurt, Plain or Skim            90                    8

 

Dinner        1 oz     Fish, Baked with Lemon  73                    7

               cup           Noodles                    34                    1

               cup           Carrots, cooked soft  12                    1

 

Snack     cup       Custard or Sugar-Free CIB            150                    8

 

                                                   TOTAL  853 kcal     56 gms

 

Note: See page 4 for additional high protein foods that may be substituted into Stage 4.

 


RECOMMENDED FLUIDS FOR STAGE 1

AND

FOR BETWEEN MEALS (ALL STAGES)

 

 

Water                                                                           Diet Jello

Tomato or V-8 juice                                      Decaffeinated coffee or tea

Sugar-free popsicles                                                          Bouillon or broth

Unsweetened fruit juice (limit to 8 fl oz daily)            Crystal Light or any other sugar-free beverage

Caffeine-containing beverages (as tolerated)                      Decarbonated flat diet soda

 

 

RECOMMENDED HIGH-PROTEIN FLUIDS FOR STAGES 3 AND 4

 

Type  Serving Size   Calories  Protein (gm)

 

Sugar-free CIB (skim milk)  8 fl oz               150                  15

Plain Yogurt (nonfat, 1% fat)               8 fl oz           110-144             11-13

Skim Milk or Buttermilk 8 fl oz                 90                    8

Sugar free, Low-fat Yogurt               6 fl oz                    90                    7

Cream Soup (skim milk)  8 fl oz               131                    6

Sugar-free Pudding   4 fl oz                    76                    5

Sugar-free Cocoa 1 pkt in 6 fl oz           50                    4

                     

                                                                                                                                                           

                                                                     

RECOMMENDED HIGH-PROTEIN FOODS FOR STAGE 4

 

Type  Serving Size   Calories Protein (gm)

 

White-fleshed fish             3 oz             95-120                  22

Tuna, canned in water         3 oz                    95                  22

Scallops, bay and sea 4 oz raw            100                  19

Part skim hard cheeses      3 oz           150-240             21-24

Cottage cheese, 1% fat                  3 oz                    62                  10

Eggs, whole   2 (large)        158                  12

Egg substitute, liquid       cup               45-90               9-10

Lean chicken or turkey pureed       2 oz                  100                  16

Baby food meats, all types                  3 oz                  105                  12

Peanut butter 2 Tbsp          200                  14


GUIDE FOR PROGRESSION OF DIET

 

 

Some foods may be difficult to tolerate. They may cause discomfort and/or vomiting. It is important to remember while progressing the diet that there are other reasons why vomiting may occur. A specific food should not be avoided because vomiting occurred once after eating. The food should be tried again after waiting several days. The following is a list of foods that may be used as a guide for diet progression.

 

 

 

TYPE OF FOOD

FOODS ALLOWED

FOODS THAT MAY BE DIFFICULT TO TOLERATE

FOODS TO LIMIT IN ORDER TO PROMOTE WEIGHT LOSS

Beverages

Coffee, tea, club soda, diet soda, water, milk

*Decarbonated soda

Milk may not be tolerated. Alternate dairy products may be substituted.

High calorie drinks: whole milk, milk shakes, beer, alcohol, sweetened beverages

Breads

Dry, crisp, or toasted breads, crackers, or chips

Soft, doughy breads that become gummy, breads with nuts, seeds, or dried fruit

Sweet breads, doughnuts or pastries

Cereal

All cooked and dried cereal except those listed under difficult to tolerate

Cereals containing nuts and dried fruit, and very high-fiber cereals

Sugar-sweetened cereals

Dessert

Yogurt, custard, pudding, gelatin, sherbet, ice cream, and crisp cookies

Any dessert containing nuts, dried fruit, seeds or coconut

All

Fats

All

Fried foods with a hard, crusty coating

All

Fruits

Soft, fresh, canned, frozen or cooked fruit

Fruits with a core, seeds or skin: whole citrus fruit

Fruit juices

Meat, Eggs, Cheese

Beef, lamb, veal, lean pork, ham, fish, chicken, turkey, cottage cheese, cheddar type or processed cheese, eggs, smooth peanut butter

Tough meats or those containing gristle. In some cases, beef may not be tolerated

Fried and high fat cuts of meat

Starch

Boiled, mashed or bakes potatoes (without the skin), noodles, and pasta

Potato skins and rice

None

Soups

Cream soups or clear soups

Those with large pieces of meats or vegetables

High fat, cream soups

Vegetables

Soft-cooked, steamed, or canned vegetables

Those with tough, stringy texture, or small seeds

None

Miscellaneous

Nutrasweet products

Popcorn, nuts

 

 

 

 

 

 

 

EXTRA TIPS

 

 

  • Consume meals very slowly (about 10 minutes per ounce). If you feel full, stop at that point until the next meal.

 

  • Do not drink fluids with meals; wait 30 minutes before and after to prevent stretching your pouch. Avoid carbonated liquids unless they are flat. Avoid drinking with a straw. Both of these precautions are to prevent gas from getting trapped beyond the outlet of the pouch.

 

  • Milk intolerance may be due to temporary lactose intolerance. Try Lactaid milk or add 10 drops of Lactaid to a quart of milk.

 

  • Adequate protein intake is essential to avoid losses of lean body mass and promote healing of your incision. Consider protein supplement drinks.

 

  • Never, never, never chew gum!!! If you accidentally swallow it, an endoscopy may be necessary to remove the gum from your pouch. Consider sugar-free breath mints as an alternative to chewing gum.

 

  • Take one chewable multivitamin/mineral supplement daily. Later, you may want to add other supplements such as calcium, B12, and Iron. Have your nutritional levels checked often.

 

  • Do not swallow any pills whole until your surgeon says its ok (usually 4-6 weeks post-op). You can crush the pill and mix it with applesauce. You may also use liquid forms of medications if available.

 

  • Ice cube trays are handy for storing pureed food (each cube section is about 1 fluid ounce).

 

  • Baby warmer trays may be helpful for keeping pureed food warm while it is slowly being eaten.

 

  • Food may be blenderized or you may choose baby food.

 

  • Take small bites and chew well. Chew each bite at least 20 times before swallowing once you transition to solid food.

 

  • A baby spoon or toddler spoon helps you control your bite size.

 

  • Eat a balanced diet as much as possible. Because the amounts of food eaten at each meal will be small, it is important they be of high nutritional value.

 

  • Exercise is important. Make it a part of your daily regimen once your physician consents. Walking in a great form of exercise for new post-op patients.

 

  • When advancing from liquid to pureed or later on to soft food, you may experience problems with vomiting. This occurs with overeating, not chewing well, or mixing liquid and solid food. If you vomit, make sure you are not eating too much at one time and that you are chewing well. Some patients will vomit with certain foods the first time they try them, but may tolerate them at a later date.

 

  • Avoid sugary foods and drinks. If you had Roux-en-Y bypass surgery, eating sugary foods and drinks may lead to dumping syndrome, a condition characterized by abdominal cramps, diarrhea, sweating, rapid heartbeat and a dizzy sensation.

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