Nutritionist Meeting and New Food Diet

My first appointment before surgery includes meeting with a Nutritionist/Dietitian. I only have to attend one appointment whereas those who have the gastric bypass surgery for weight loss have several appointments. I will briefly go over the stages of how I am supposed to eat after the surgery based off of the information from this appointment.

One week before surgery: begin liquid high-protein diet. This includes drinking protein shakes. I opt for Slim Fast High Protein. I need to consume about 70 grams of protein and about 900 calories a day. No more solid food.

Stage 1: Post-op Day 1 & 2, this occurs while in the hospital. Once the barium swallow x-ray is completed and there are no leaks in the new surgical connection, you can progress to this stage. Only clear liquids. Non-carbonated. No calories. No sugar. No caffeine. Allowed to sip 2-3 oz. of water per hour.

Stage 2: Post-op day 3 (discharge diet). Clear liquids combined with full liquids. Clear liquids include no sugar or artificially sweetened liquids. Salty liquids are encouraged. Full liquids include protein-rich liquids. At this stage you are supposed to consume 48-64 oz. of liquid but are only allowed to sip 3-4 oz. per hour. This total amount should be split between clear and full so I should be consuming 24-32 oz. of clear liquids and 24-32 oz. of full liquids.

Stage 3: 2 weeks post-op. Increase clear liquids to 64+ oz. daily. Replace full liquids with protein-rich foods. These must be soft, moist, diced, ground, or pureed. Only a couple of tablespoons of food are tolerated at each meal. Eat 3-6 times a day. Examples of food at this stage are eggs, deli meat, fish, cottage cheese, yogurt, and refried beans. Also at this stage you are no longer allowed to drink with your meals. You must stop drinking ½ hour before you eat and then do not drink anything else until ½ hour after you stop eating. This is a new lifetime rule. This is because the liquid can move the food too quickly through the new pouch and your body will not be able to absorb the nutrients from the food you are eating. Too much liquid can also cause discomfort. You need to give the body the longest amount of time to absorb the nutrients because in a gastric bypass patient, the new intestinal route bypasses the duodenum and first part of the jejunum which is mainly responsible for absorbing most of the nutrients from the food that is eaten.

Stage 3: 4 weeks post-op. Continue advancing diet as tolerated. If you can eat high-protein foods and tolerate them, you can start adding well-cooked soft vegetables and fruit. You must always eat protein first before eating anything else.  At this stage, about 2 oz. (or less) of food is consumed, also new lifetime rule. At this stage, you aren't allowed to consume rice, bread, and pasta.

Stage 4: 6 weeks post-op and beyond. Advance diet as tolerated to healthy solid foods. Diet must consist of healthy, adequate protein, fruits, vegetables, and whole grains. 60 grams of protein a day must be consumed while only eating 2 oz. of food at each sitting. I am allowed to add grains and starches back in at this point as long as they are whole grain and I am not losing any more weight.

I leave this appointment a little overwhelmed with all the new information. It is not a matter of if I can do this, but can I make this commitment to change my life forever? I again begin to weigh in my mind what is worse, following this new food plan or being sick every day.