Weight Loss Surgery - Gastric Bypass/Sleeve Gastrectomy: 1 Week Follow-Up

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Hello- this is Nina, the Dietitian. Congratulations, you are 1 week into your journey to a healthier you!!! You body is healing every day and with each new day you should begin to feel better! Working up to your fluid goal of 64 ounces per day can be difficult at first but it can be done. Focus on drinking about 4 ounces every hour for 16 hours and you will get in 64 ounces! To break it down further, try drinking 1 ounce every 15 minutes. Use a timer, your phone alarm, or even a 1 ounce shot glass to measure your fluids. While you are on the pureed/liquid diet for the first month, the most important goal is for you to stay hydrated! Focus on drinking more than eating, and try some high protein liquids to get both fluid and protein in. To help meet your protein requirement of at least 60 grams per day, dry drinking skim milk, nonfat lactaid milk, or unsweet light soy milk. Two 8-oz glasses of nonfat milk count as both 16 oz of fluid and 16 grams of protein.Remember your fluids should be non-carbonated and low calorie. Try water with lemon, lime, or orange to give it some flavor, crystal light or wyler’s light, sugar free kool-aid, fruit 20, propel fitness water, powerade zero, metromint flavored water, and low sodium broth. Low calorie juices like Fuze low carb, minute maid light, diet V8 splash, V8 juice or tomato juice. Remember to limit coffee or tea to 16 ounces or fewer due to interference with vitamin absorption, but unsweet tea, herbal tea, green tea, coffee, and diet snapple help meet fluid requirements. Sugar free popsicles and diet jello are other ways to get in some fluid. Remember to dilute your 100% fruit juice 50/50 with water, and limit to 8 oz per day or 2 fruit servings. If you prefer your milk in pudding form, try sugar free pudding mixed with your own skim milk- somehow the individual servings you can buy premixed leave out the protein! Also during your first month you want to work up to getting in 60 grams of protein. You can do this several ways and you want to be taking bites of foods a few times per day. When you think about planning your meals, think first about what pureed protein foods you will be eating. Try pureed meats like turkey, chicken, beef, fish, tuna, or pork tenderloin that are cooked then blended with broth or water to the consistency of applesauce or baby food. If you prefer, baby food meats work well but can be rather bland, so try adding to a veggie or bean soup and puree in your blender. Flavor your foods with herbs, spices, hot sauce, or even vinegar. Egg beaters added to homemade smoothies help boost protein, and melted low fat or fat free cheese can be added to give blended meats or fat free refried beans some added flavor and protein. Nonfat cottage cheese is great and 2 ounces or ¼ cup counts for a protein serving! Try mixing in your blended fruit for flavor. If you find fat free ricotta cheese, it is great mixed with low sugar tomato sauce and pizza seasoning and microwaved for a lasagna-like treat, or try with some splenda and almond extract for a dessert. Cooked and mashed limas, pintos, black beans, or black eyed peas make a great blended meal and contain fiber which is good for constipation. Another way to eat beans is to try hummus, which is blended chickpeas with garlic and lemon juice. Creamy natural peanut butter eaten right off the spoon or blended in one of your homemade smoothies that has no added sugar carnation instant breakfast is a great treat. Yogurt is a great way to get in protein in an already blended texture food. You want to look for yogurts that say fat free and no added sugar on the label. Yogurt, like fruit, has some natural sugar, so read your ingredient list to determine that there is no sugar added to the product. Some brands that work include: Dannon Light and Fit, Activia Light, Light n’ Fit Carb Control, Low Fat Plain, Stonyfield Farms plain or light, Blue Bunny Light no sugar added, or Breyer’s Light. Nonfat Greek strained yogurt is regular yogurt strained so the liquidy part is drained, while the creamy part with all the protein is left- most have 2 to 3 times as much protein as regular yogurt! Brands called Fage, Oikos, or Chobani can be found at the grocery store. If you feel that you are meeting your protein needs, then move down the food group list to vegetables and then fruits. You want to aim for 2 servings of each. Blended veggies are a great way to get some fiber, and are nice and low in calories! Vegetable juice or tomato juice is the liquefied version that works this month. Fruit needs can be met in the form of 100% fruit juice, diluted half and half with water or try unsweetened applesauce, baby food fruits, or other pureed fruit. After this month when you transition to solid foods, we will probably ask that you stop drinking your calories, so while juice can help meet your fluid needs this month, your surgery is designed to keep you feeling full from solid foods, so when you reach 1 month, you get to eat your fruit!. After you master the meat, meat substitute, milk, vegetable, and fruit categories, there is a little room left over for starch and fat, but not much! The starch group includes things like cream of wheat, oatmeal, and grits, and starchy vegetables like mashed potatoes, sweet potatoes, and squashes. This group is very tempting initially, especially since you got to try some grits while you were in the hospital. The starch group is a good way for you to get in 2 servings of high fiber foods, but only when your protein needs are met. Make sure to add protein to these foods by adding nonfat dried milk powder or low fat cheese to them. Remember that a potato is a nice starchy vegetable, but not when it’s deep fried, made into chips, or mashed with butter, sour cream and heavy cream. Instead, try using fat free sour cream, skim milk, or a dollop of that fat free Greek yogurt to make mashed potatoes. Good luck this month, and remember that it’s most important for you to stay hydrated, take your 2 multivitamins and 500 micrograms of vitamin B12 sublingually, and work on pureed protein-containing foods before anything else! Once you are around 1 month from surgery, You will have a much larger variety of foods to choose from, so it’s good to practice prioritizing your nutritional needs now! Also, remember that your surgery is designed for you to get full quickly on solid foods, but you haven’t tried these yet. The liquids and soupy foods that you eat this month travel through your new anatomy quicker than solid foods will, so remember to eat slowly so that you know when to stop. You should return for a follow up appointment about 1 month after surgery when we will discuss transitioning to a regularly textured diet, adding in calcium citrate supplements, and meal planning with solid foods. Call 843 792 7929 to make your 1 month appointment. See you soon!

Your MUSC Bariatric Surgery Team wants you to be successful and stay in touch.  If you need an appointment, call us at (843) 792-7929 or visit us at www.muschealth.com/weightlosssurgery   


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