Diet advancement
Allowed foods
Duration
Stage 1 – clear
Clear liquids
Examples: protein powder added to any clear liquids, amino acid complex mixed in water, and clear broth or stock (chicken, beef, veal, vegetable mushroom, miso)
Water, unsweetened decaf iced tea, diluted fruit juices, decaffeinated tea/coffee, true lemon beverages, sugar-free Jell-O
Coconut water and sugar‐free popsicles
Day 1–4
(During hospital stay and at home until able to reach goal rate of 3 oz water every 30 min)
Stage 2 – full
Full liquids
Examples: protein drink, fat-free (skim) milk, unsweetened nondairy milk, blended split pea, bean, vegetable, or lentil soup, sugar-free/low-sugar, fat-free/low-fat, or fat-free Greek-style yogurt. Sugar-free pudding thinned with fat-free milk. Unsweetened applesauce, unsweetened pureed fruits, smooth/creamy hot cereal
Day 5–15
Patients may begin to take their bariatric multivitamins and other supplements
Stage 3 – soft
Soft “mush-able” foods
Examples: lentils or split peas, black beans, cannellini beans, red kidney beans, black beans, fat-free refried beans, tofu, banana, peaches, or pears (if canned, no added sugar), sweet potato, cooked carrots, cauliflower, broccoli, string beans, winter squash
Low-fat cottage cheese
Low-fat or fat-free ricotta cheese
Soft scrambled egg or egg whites
Soft well-cooked (Crock-Pot or ground meat) chicken or turkey, Fish (tuna, salmon, crab meat, tilapia)
Day 15–30
Stage 4 – solid
Regular texture bariatric diet
OK to introduce raw vegetables such as salad greens, crunchy fruits such as apples, and nuts/seeds
Day 31-3 mo
Beyond
Solid, low fat/low sugar, high fiber
Typically, OK to decrease high-protein diet and increase dietary fiber per patient goals
Day 90+
Although exceptions may be made in select patients (such as those whose musculoskeletal pain is limiting their mobility), anti-inflammatory medications like ibuprofen and aspirin are avoided because of the increased risk of ulcer formation. Furthermore they are advised to abstain from smoking, especially those who underwent LRYGB due to risk of marginal ulcer formation at the gastrojejunal anastomosis [2].
Activity is limited to ambulation in the first few postoperative weeks. Patients can then slowly increase exercise regimens to incorporate cardiovascular and weight training routines to facilitate weight loss.
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