Bariatric Diets and Their Stages
Bariatric diets are a part of life for those who have undergone any of a number of different types of weight-loss surgeries. Among the most commonly performed surgeries that necessitate diets like these are Laparoscopic Gastric Band and Gastric Bypass Surgeries as well as Sleeve Gastrectomies. Though these surgeries require a fairly intense preparatory period and an equally important recovery diet and routine, they can be instrumental in averting health problems and co-morbidity associated with excessive weight.
This article, in so much as it is focused on bariatric diets, is not intended to address the diet you need to follow in the period before you undergo the surgery, but in the period of days, weeks, and months after surgery. In the period of time after you undergo the surgery and during which you are recovering, following a very carefully crafted diet plan is instrumental to your overall health as well as to the success of the surgery.
After these types of surgeries, you will have a much smaller stomach than you did before, and it is critically important not to stress your stomach with more food than it can handle. Following a meticulously planned out diet can help your stomach to recover, to get used to handling smaller amounts of food, and to help you avoid complications arising from the surgery. Your stomach will not only be smaller after surgery, but much more fragile as it heals, and this will make it less capable of digesting the types, and amount, of food you may have been comfortable eating beforehand.
In addition to being designed to help your stomach heal and to prevent developing complications after surgery, these types of diets are also designed to help you lose weight and to prevent you from gaining any weight as well.
While the actual diet plan you will need to follow is something you should discuss with your doctor or dietitian, you will find that these diets all share some features in common and progress in stages. As stated, the lengths of these stages will vary depending on the type of surgery you have undergone, but there are several defining features that they share in common.
The first stage of diets intended for bariatric surgery patients is a liquid diet, and it will progress in several stages. After the first several stages of the liquid diet are complete you can expect to move onto a pureed diet, followed by what is known as an adaptive diet which consists of soft foods. Each of these stages is intended to prepare your stomach to be able to handle solid foods again, and after you progress through them, you can begin on a stabilization diet.
There are a number of other things that you will find that are built into these diets. Generally speaking, they are high in protein as well as high in supplements and vitamins. In addition, you will find that they are low in fat, carbohydrates, and sugar. While you are following the course of one of these diets, it is advisable for you to stick to the schedule and the meal plan and to avoid alcohol and caffeine, both of which can cause dehydration.
In addition to these physical components of the diet, it is advisable that once you progress past liquid foods, you eat and drink slowly and chew your food thoroughly. Eating too quickly can overload your stomach and push food through to the small intestine before it is ready. If that happens you may experience a condition known as dumping syndrome that can cause nausea, vomiting, and diarrhea, on top of making you feel terribly unwell.
As stated, the duration of the stages of each of these diets will vary in accordance with the type of surgery you have undergone, but you can expect some form of each of them as a part of a bariatric diet. The duration of each, as well as the specifics, are details that you can approach with your physician or dietitian. Without regarding the pre-op diet or portion of preparation, they will progress through a series of five stages which must be observed carefully to proceed safely to the next and to ensure the long term success of the procedure.
Clear Liquid Diet
The first stage of a bariatric diet in the wake of surgery is the portion of the diet that is entirely made up of liquids. Depending on the type of surgery this first stage of the diet may be divided into a clear liquid and full liquid diet in which only clear liquids are allowed in the first portion and other liquids (such as protein shakes) are permitted in the section.
In the first stage of the diet, only clear liquids are allowed and must be taken in very small portions, often fairly frequently throughout the day, such as once every hour. Typically you can take only one or two ounces of liquid per hour, and as the name suggests, only very specific liquids are suitable for this portion of the diet to avoid stressing your stomach.
At this stage, usually only water and other clear, fat-free liquids are permitted as a part of the diet, such as fat-free milk or broth. Sometimes fat-free, clear ‘liquids’ like gelatin are permitted during this stage of recovery. Doctors and surgeons will often only permit liquids like fat-free milk and fat-free broth to be taken sparingly to avoid stressing your stomach, so for the first part of the clear liquid diet most of what you will be ‘eating’ will be water.
Depending on the nature of your surgery and on your needs, your doctor may divide your clear liquid diet up into two phases, the latter part of which will be called a full liquid diet. In that phase, you will begin taking supplements like protein shakes that are still liquid but contain more nutrients. Otherwise, once the clear liquid portion of the diet is complete, you will proceed to the second phase, the pureed diet.
Once you have passed through the clear diet phase, you can progress onto the pureed diet, where you will still be taking liquids, so to speak, but will introduce new nutrients to your recovering stomach to help with the recovery process. Just as you were taking smaller serving sizes during the clear liquid phase of the diet, in the pureed phase you will still be taking smaller serving sizes, and frequently throughout the day.
During this phase of the diet, you will still be taking a lot of clear liquid as a part of your diet that will punctuate the other pureed meals. It is important that pureed foods have a very fine consistency and that there are no solid pieces in the mix. For this reason, meals like protein shakes are very popular options for meals during the pureed phase. In addition to protein shakes your doctor might recommend you take pureed egg whites or pureed, non-fat, soft cheeses, as these foods are high in protein and low in fat.
When you are in this phase of the diet it is also important for you to take supplements and vitamins in order to make sure that you are getting the necessary nutrients your body needs that are not currently coming in from food.
Soft or Adaptive Diet
After you have finished with the adaptive diet portion of the bariatric diet, you can progress onto the soft or adaptive portion. This stage of the diet is intended to reintroduce solid, though soft, foods to your stomach to get your stomach ready to handle real solid foods again.
As a general rule, you will still be avoiding foods that have a lot of fat, sugar, and carbs, instead opting for soft meats and nutrient-rich cooked vegetables to take the place of the pureed foods you were eating previously.
You’ll still be taking small portions as a part of several small meals throughout the day, and you’ll still be punctuating those meals with an intake of liquids, as with the pureed diet. As previously, you may find foods like egg whites and non-fat soft cheeses recommended as a part of the soft or adaptive phase of the diet, along with lean poultry, fish along with soft (usually cooked) vegetables like potatoes, carrots, avocados, and green beans.
As you will still be on a largely restricted diet, it is equally important that you continue to take vitamins and dietary supplements to ensure that your body is getting the nutrients it needs that are not coming from food.
Stabilization Diet - Solid Foods
The stabilization portion of the diet reintroduces real, regular food and is intended to prepare you to take up more solid foods once more. It does not mean, however, that you can suddenly eat anything you want. Although you will have more freedom with what you can take, there are restrictions on the diet you should follow for the rest of your life. You should consult with your doctor, but as a general rule, you should avoid high fat and high sugar foods, cutting out all refined sugar if possible.
Because your stomach is still recovering from surgery and extremely sensitive, you should not try to reintroduce it to too much at once. Some will suggest only reintroducing one new food a day at most to see how your stomach responds to it.
You should focus on nutrient-dense foods since the idea here is to get as much of your nutrients from food as possible, as well as to normalize your diet. When you are on this portion of the diet, it is still critically important that you chew your food thoroughly so that it reaches your stomach in a manageable consistency.
While you will still be taking a lot of clear liquid each day as a part of this portion of the diet, it is still important to separate your clear liquids from your foods. Use them to punctuate the time between meals and do not take them at the same time.
Dumping syndrome, mentioned above, can occur during this portion of the diet if you are not diligent about the quantity of the food you eat, what you eat together, and how quickly you eat. Eat slowly, chew your food well, and do not eat food high in fat, carbs, or sugars. In addition, there are a number of foods that are difficult to digest that you should generally avoid; consult your doctor for more information.
As you can see, there are a number of restrictive guidelines that you will need to follow in the weeks and months immediately following your surgery, as well as for the rest of your life. Your eating habits will have to change, that’s true, and there are many stories of unpleasant bariatric diets out there - but the belief that bariatric eating and foods have to be unsatisfying, unsavory or flavorless is a myth.
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