Disciplined diet before and after weight loss surgery.

The choice to have bariatric surgery is not simple. People suffering from obesity and its complications (high blood pressure, diabetes, heart disease, etc.) make this decision after years of attempting and failing to reduce weight through diet and exercise.

Pre-Op Guidelines

These guidelines are provided to help you prepare for surgery. It’s important to start developing new eating and exercise habits before surgery to help with the transition after surgery. Following these guidelines will give you the best chance for long-term results. You can read through the guidelines below.

Congratulations on your decision to have bariatric surgery!

Is weight-loss surgery safe?

You’ve tried everything. The fad diets. The fad exercises. You’ve even tried the ones that weren’t fads. But nothing has worked. And you’re not just carrying “a few extra pounds.” You’re obese and suffering from a number of other health issues as a result.But there’s still hope. You’ve heard about bariatric surgery and the success it’s brought to so many people in your predicament. You’ve heard about bariatric surgery and the success it’s brought to so many people in your predicament.

You’re just asking yourself one question: “Is it safe?”

It’s very safe if you are in good hands, While every surgery carries some level of risk, the risk of complications from bariatric surgery is very low, and depending on the procedure, surgeon quality, people are usually able to go home the next day. For international patients, we prefer them to stay a night more a few days more just in case.

Aside from electing to have surgery after consulting with a doctor, the most important criterion is a commitment to a lifestyle change that includes eating the appropriate foods in the proper quantities, losing weight, and keeping it off for the rest of your life. That transformation must begin prior to surgery.

For patients with a BMI more than 50, roughly three months before surgery, they should begin altering their diet in conjunction with a dietician and begin reducing weight. Depending on your weight, you may be advised to reduce only 5-10 pounds, or you may be required to lose up to 10% of your body weight if you are really obese.

The better you do at this stage, the higher your chances of success after surgery. As soon as you decide to get surgery, you should begin changing your behavior. Honestly, behavior adjustment accounts for 90% of a patient's success. Surgeons receive 10% of the credit, with the remaining 90% going to the patient.

Nutrition basics

Balancing calories in and calories out

“Calories in” refers to the food and drink you consume and your body absorbs. “Calories out” refers to the calories that are used up. Calories come from all basic food types including fats, carbohydrates, protein and alcohol.

Your body burns calories every minute of every day, so the more active you are, the more calories you burn. If you consume more calories than you burn, you will gain weight. Most adults burn at least 1,500 calories per day, without even trying. So, if you only eat 1,500 calories, you will lose weight.

Fat

Of all foods, fats contain the most calories with nine calories per 1 gram of fat. Our bodies are designed to desire high-calorie foods. Since fats are so packed with calories, you can drastically reduce your calorie intake by reducing the fats you eat.

Carbohydrates

Carbohydrates include sugars (simple carbohydrates) and starches (complex carbohydrates). Carbohydrates have four calories per 1 gram of carbohydrate, which is half of what fats have. However, they can add up quick. Also, you may not feel as full for as long on meals that are mostly carbohydrate compared to meals that have protein and fat in them.

Protein

Protein, like carbohydrates, has four calories per 1 gram of protein. However, protein is more than just calories. Proteins are the building blocks for your muscles and organs that keep your body healthy. An adult needs at least 60-70 grams of protein each day. Protein comes from meat, fish, poultry, eggs and dairy products. Vegetable sources of protein come from beans (soy, pinto, red beans and lentils), tofu, nuts (which are fatty) and whole grains (oatmeal, whole wheat and brown rice). Meals with protein in them tend to help people feel full longer than carbohydrate-only meals or snacks.

Water

Water is essential. When you are trying to lose weight, your body needs large amounts of water to break down waste products. You should try to drink 64 ounces (8 cups) of water or other low-calorie fluid (unsweet tea, non-fat milk, Crystal Light, etc.) per day.

Vitamins and minerals

Different foods have different amounts of vitamins and minerals, which is why it’s important to eat a variety of foods. When you’re losing weight, it’s important to make sure you are getting enough vitamins. After bariatric surgery, people may not absorb all the vitamins and minerals, such as calcium, iron, vitamin B12, as well as they did before having surgery. To help with this, taking a multivitamin with iron is part of our pre-op program, or you can start taking the recommended post-op vitamins for your planned procedure before surgery. This gets you in the habit and lets you get an idea for which ones you like.

Exercise

Begin walking 30 minutes at a time, three times per week. If you are unable to walk due to breathing troubles, joint pain or other limitations, talk with our staff and we’ll discuss other alternatives with you. The goal is to work up to walking five times per week, then adding in more strenuous activity, such as cycling, jogging, swimming and light weight training.

Lifestyle changes and eating guidelines

Many people are in the mindset that they “live to eat,” but we want to change that to “eat to live.” While eating is enjoyable and necessary, eating more than your body needs is harmful. This kind of lifestyle change is difficult with or without surgery, but following these guidelines can help.

Monitor your calories in. Your goal is 1,500 calories per day. Read all labels and measure the food you eat.
Eat a low-fat diet. This means fewer than 30% of your calories should come from fat.
Keep a food journal. Write down everything you eat for one week, then calculate the calories. Each time you plan to visit with the physician or nutritionist, keep a food journal the week leading up to the visit.
Eat three meals per day and don’t skip meals. Skipping meals can make you overeat at your next meal and does not help you lose weight. Some bariatric surgery patients need to eat more than three meals per day, and this is OK as long as they are small meals of nutritious foods and you are not snacking continuously.
Do not eat between meals unless it’s fresh fruit, vegetables or a small portion of a non-fat snack.
Avoid fast food restaurants. If you do go to one, don’t order the combo meals. Your body doesn’t need fries and a sugary drink.
Don’t eat while you drive, work or watch television.
Don’t eat or snack after 9 p.m. Instead, wake up hungry and have a healthy break

BMI Pre-Op Diet Length of Time

30-32 2 days clear liquids only
32-39 1 week including two days clear liquids
40-45 2 week including two days clear liquids
46-49 3 week including two days clear liquids
50-59 6 week including two days clear liquids
60+ 8 week including two days clear liquids

Prehospitalization Instructions

Full Liquid Diet:

As you progress through the pre-operative diet, you'll transition to a full liquid diet, which provides more calories and nutrients than a clear liquid diet. This phase includes creamy soups, protein shakes, milk, yogurt, and strained vegetable or fruit juices. Focus on consuming high-protein liquids to preserve muscle mass and promote satiety while keeping portion sizes small to prevent discomfort.

Pureed Diet:

In the final stage of the pre-operative diet, you'll transition to a pureed diet, which includes foods that have been blended to a smooth consistency. This phase helps prepare your digestive system for the post-operative diet and allows for easier digestion and absorption of nutrients. Pureed foods may include cooked vegetables, lean meats, soft fruits, and cottage cheese. Be sure to monitor portion sizes and avoid foods high in sugar or fat.

14 Days Prior to Surgery

(Regardless of Pre-op Diet Length)

Discontinue ALL vitamins and supplements unless otherwise approved by your surgeon.
Discontinue drinking ALL caffeine 2 weeks prior to your surgery date. Caffeine may cause acid reflux post-op due to the acidity. You may drink decaffeinated coffee/tea. Please ensure to stay hydrated.
Discontinue oral birth control and supplemental hormones ○ IUD'S & IMPLANTS are safe and do not need to be removed
Discontinue the use of alcohol, marijuana, or THC products two weeks prior to surgery. These increase bleeding risk.

7 Days Prior to Surgery

Some medications may need to be discontinued before surgery depending on the instructions of your SURGEON
Specific medications to STOP: Coumadin, ANY ANTICOAGULANTS, OR BLOOD THINNERS Plavix, Aspirin, Ibuprofen, Motrin, Advil, Nuprin, Aleve, or any other non-steroidal anti-inflammatory medication, even baby aspirin and all kinds arthritis medications. As these can all cause stomach irritation and possibly more bleeding postoperatively.

If there are any medications you need to stay on, talk directly with your coordinator to get an ok from your surgeon.

2 Days Prior to Surgery:

Begin Clear Liquid Diet Consume only clear liquids;

Apple kind of or other clear juice without pulp or carbonation. If you get regular juice use 100% real juice and dilute with water, 25% juice/75% water)
Clear broths: Chicken, Vegetable, or Beef.
Water or Flavored Water. ● Sugar-free drinks mostly drink with vitamin and minerals. Sport drinks the ones with high eloctrolite in it would ve been great post and pre op both to add in your regular dailey life.
Sugar-free protein shakes are acceptable.

Nutritional Requirements

Importance of Protein Intake:

Protein is essential for maintaining muscle mass, supporting wound healing, and preventing malnutrition before and after bariatric surgery. Aim to consume at least 60-80 grams of protein per day from lean sources such as poultry, fish, tofu, eggs, and protein supplements. Incorporate protein-rich foods into each meal and snack to meet your daily requirements.

Vitamins and Supplements:

Following bariatric surgery, your body may have difficulty absorbing certain vitamins and minerals, leading to potential deficiencies. To prevent nutritional deficiencies and support optimal healing, your healthcare team will recommend specific vitamins and supplements to take before and after surgery. These may include a multivitamin, calcium, vitamin D, vitamin B12, and iron supplements. It's essential to follow your healthcare provider's recommendations regarding dosage and timing.

Hydration:

Staying hydrated is crucial for overall health and well-being, especially during the pre-operative period. Aim to drink at least 64 ounces (8 cups) of fluids per day, including water, herbal tea, broth, and sugar-free beverages. Carry a water bottle with you throughout the day to remind yourself to drink regularly and avoid caffeinated

Lifestyle Changes

Behavior Modification Techniques:

Successful long-term weight management requires adopting healthy lifestyle habits. Practice mindful eating by paying attention to hunger and fullness cues, eating slowly, and savoring each bite. Use portion control techniques such as measuring your food and avoiding oversized servings. Additionally, explore stress management strategies such as deep breathing exercises, meditation, or engaging in enjoyable activities to reduce emotional eating.

Physical Activity:

Regular physical activity is essential for maintaining weight loss, improving cardiovascular health, and enhancing overall well-being. Incorporate a combination of aerobic exercises (e.g., walking, cycling, swimming) and strength training exercises (e.g., weightlifting, resistance bands) into your routine. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week, as recommended by national guidelines.

Smoking Cessation and Alcohol Moderation:

Smoking and excessive alcohol consumption can have detrimental effects on your health, particularly after bariatric surgery. Smoking increases the risk of surgical complications, delays wound healing, and exacerbates existing health conditions. If you smoke, consider quitting before surgery to optimize your outcomes. Similarly, limit alcohol intake, as it can contribute to nutrient malabsorption, dehydration, and calorie excess. If you choose to consume alcohol, do so in moderation and avoid carbonated or sugary alcoholic beverages.

Meal Planning and Recipes

Sample Meal Plans: To support your pre-operative dietary goals, we've provided sample meal plans for each stage of the pre-operation diet. These plans offer balanced nutrition, adequate protein, and portion-controlled servings to help you navigate the pre-surgery period with confidence. Feel free to customize these plans according to your preferences and dietary needs.

Nutritious Recipes:

Explore a variety of nutritious and flavorful recipes suitable for the clear liquid, full liquid, and pureed diet stages. From refreshing smoothies and protein-rich soups to creamy purees and soft-textured meals, these recipes are designed to keep you satisfied and nourished throughout your pre-operative journey. Experiment with different ingredients, herbs, and spices to create delicious meals that support your health goals.

Tips for Meal Preparation:

Efficient meal preparation can simplify your pre-operative diet and save you time and effort in the kitchen. Use batch cooking techniques to prepare meals in advance and portion them into individual servings for easy grab-and-go options. Invest in quality storage containers, blender or food processor, and kitchen gadgets to streamline the cooking process. Don't forget to label and date your meals for convenience and food safety.

Support

Counseling and Psychological Support:

Weight loss surgery can evoke a range of emotions, including excitement, anxiety, and uncertainty. Counseling and psychological support services offer a safe space to explore your feelings, address any fears or concerns, and develop coping mechanisms for the pre- and post-operative periods. Work with a qualified therapist or counselor who specializes in bariatric surgery patients to receive personalized support and guidance.

Expand your knowledge and understanding of bariatric surgery by exploring educational resources such as Gigi Lill which cover a wide range of topics, including nutrition, exercise, behavior modification, and emotional well-being.

Conclusion

Congratulations on taking proactive steps towards improving your health and well-being through bariatric surgery. By following the pre-operative diet guidelines outlined in this handbook and embracing lifestyle changes, you're laying a solid foundation for a successful surgical experience and long-term weight management success. Remember to stay committed to your goals, lean on your support network for encouragement, and trust in your ability to achieve lasting transformation. We're here to support you every step of the way on your journey to a healthier, happier you.

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