honesty please...

Hi, Can anyone tell me honestly what you are supposed to eat for the first three months or so after having gastric bypass surgery? I have yet to find anyone who is willing to be honest about the portion size, whether all liquid, or some liquid, how you get all your vitamins etc..., and why don't you become malnourished? or anemic? AND, are you hungry? Finally, what is the expected time, if ever, that one is able to eat "normally" again? I hope someone can help me. I've been researching this online for months now, and so many of you have been incredibly helpful, and this is one of the only things I have yet to see discussed. Thanks ahead of time. Janet S.

Hi Janet, I think the actual eating plan after surgery depends on where you have your surgery. The nutritionist you see as part of the program will give you the food plan and review it with you. Have you selected a surgeon and hospital yet? I had my surgery at NEMC and the first 2 weeks after surgery was full liquids. Believe me, you will be full trying to get in the protein (50 grams) and fluids (48-64 oz). The fluid intake includes the broths, shakes, and other liquids. I could also have a half cup of fat free cottage cheese or eggbeaters on this stage. I was not able to eat that portion size though. I just had my post-op visit and I advanced to the next stage, pureed and moistened foods. I can now have 3 oz of meat (pureed) or fish. I can also have turkey chili also. I have to consume 50-60 grams of protein and at least 64 oz of fluids. I will not advance to the final stage for at least another 4 weeks. Whether you advance depends on how you are doing. The final stage adds fruits, veggies, and starchy foods. The portion sizes are the recommended portion sizes by the ADA. I'm not sure what you mean by "normal". You can eat foods that your body can tolerate as long as they are healthy choices. The choices you make will determine if you keep the weight off for the long haul. Again, the nutritionist in the program you select will review everything with you. If you are afrid that you will never eat solid foods again, that is not true. You won't eat fried, fatty foods or foods high in sugar and calories. But, that's not what you should be eating anyway. I hope this helps some. Sue

Hey Sue, I'm right behind you LapRNY on 9/14 at BMC. Janet this pretty much reflects my post op diet too. I am on Carnation Instant Breakfast(no sugar added) 3 times a day and can have a snack of low carb yogurt or tomato soup mixed with skim milk, same protein and fluid requirements, and hope to be advanced to soft solids tomorrow. Believe me, you are not hungry at this stage and even if you think you are, you are quickly satisfied. I cheated twice once with well chewed cheese from a pizza and once with a meatball from Chickarina soup and boy, was I sorry! I did not vomit, but it was close. My little pouch did not quite know what to do with this unexpected food and it was pretty painful going down. Right now I am getting my fluids in with sf popsicles, SF/FF creamsicles and fudgesicles (which have some protein, too) high protein soups (made with HMR chicken soup or well pureed and strained beans) Chrystal lite which I sip throughout the day, hot decaf tea,clear broth. I tend to like the soups and broth more than the sweet stuff. I have not had any coffe since the day before surgery and don't miss it at all! My taste has also changed, some things just don't appeal to me anymore! The big change is how small this little pouch is. Believe it or not, a too big gulp of very cold water or too large piece of sf jello can be very painful. Sipping, taking small bites and eating slowly are essential. These are all things that would have been helpful habits to change despite surgery, the surgery just forces you to make these behavior changes. Without the behavior changes one could possibly regain weight after surgery. I will not be seeing a full diet with fruits, veggies and starches until at least November 9, but I am sure by then, new habits will have taken hold and Thanksgiving dinner will never be the same, but still enjoyable! Hope this helps! Luann

Hi Janet - Eating plans vary a great deal depending on your surgeon. Pre-op, some surgeons require you to lose some weight such as 10 % of your body weight, and almost all insurance companies require a 6 month supervised diet program before they will approve the surgery. For most of us, that's a nutritionist but some people have posted that they go thru their PCP or Weigh****chers, etc for this. Also, some surgeons require several days (even weeks, posters have said) before surgery that they be on a liquid diet and take "go-litely", which is a product that cleans your bowels out . I had my surgery at Baystate Medical Center in Springfield with Dr Munshi. He did not require any liquid diets or weight loss pre-op. His only requirement was not to eat after midnight the day before surgery. Immediately post-op, I was given a list of soft foods by the hospital nutritionist. I had runny mashed potatoes, cream of wheat, sugar free puddings, blended soft meats (couldn't do that, mashed it with a fork instead), sugar free peanut butter. The liquids were water, sugar free jello and sugar free popsicles. Some people are told to supplement this first stage with protien shakes but my nutritionist wanted us to try and get all our nutrients from real food. Some people can't tolerate many foods at this stage so they end up drinking the shakes. This soft food stage lasted 2 weeks, until I had my follow up with the surgeon and his nutritionist. Since everything was going fine for me, the nutritionist told me to slowly introduce new foods to my diet. Of course, she didn't mean go out and eat Big Macs or anything, sensible healthy foods like adding fruits and veggies. She told me to be careful of pasta, rice, sweets, and Chinese foods, as many people have problems with these. We are supposed to eat our protein first, followed by veggies/fruit, then carbs. We're instructed to avoid the "bad" carbs (sweets, white bread) for maximum weight loss. For about 6 weeks after the surgery, I couldn't eat really heavy, fried foods like french fries, etc. Now, I can eat just about anything but the same foods don't appeal to me. Most days, I stick to my nutritionists plan, but sometimes we're at someone's house, a restaraunt, etc. We were at a friend's birthday the other day and I tried a bite of cake. It was almost sickeningly sweet . So I left it alone because I didn't want to get sick . So "normal" changes after time because our tastes change and pre-op, it would take lots of food to satisfy us but now just a tiny bit will fill our pouches . I usually eat 4-5 small meals/snacks a day, usually about 1/2 cup food. Some foods you can eat more of, but the dense protein things such as chicken and tuna fill your pouch faster. Then again, everyone's post-op experience can be different, some people have a hard time with certain foods after. Good luck with your decision. It is a big decision and you're doing the right thing by looking into it carefully . Mea 7/12/04 -58 lbs

Thanks to all *****plied to my post. You were very helpful and enlightening. And, Mea thanks for the encouragement. I too believe this is a huge step and am researching, making notes, and asking a LOT of questions. It was interesting talking to my PCP the other day about it. He said he had no problem with it, but suggested I carefully talk to my family about it. He mentioned how some of his patients who had had the WLS have had family problems after...jealous husbands, jealous kids, family members who think that you are changed both inside and outside due to your surgery. He even reminded me of the fact that my husband is handicapped and might say he would support me, but in the long run may resent it if I am more active and more energetic than he. It sounds a little silly, but in the long run, I think its something to consider as well. Have any of you run into any interference or jealousy due to your weight loss? Janet

Janet, Yes there is some truth to the psychosocial aspects of this WLS. My sister has had it & has done very well & what she tolerated in her husband of 30+ years she does not tolerate any more & is thinking of leaving him. And I think she is finally thinking this way because she feels better about herself & is more confident that she can go it alone. the last kid is finishing up HS in a year so she plans to make the move then. Also, there is a jealousy element whenever someone looses so much weight. I've seen it several times when I have lost a great deal of weight in the past. Usually someone will try to sabbotage your weightloss by telling you it's OK to cheat. Things like that. But it is so worth the weight loss & increase in your health to get rid of husbands & friends who are not good for you. Hope that helps. Donna

This was my doctor's protocol: liquids for 3 weeks following surgery. Liquids include: water s/f Carnation Instant Breakfast s/f popsicles s/f jello s/f kool-aid and like beverages broth flat diet soda tomato or v-8 juice fruit juice (not more than 8 oz/day) gatorade (not more than 8 oz/day) decaffeinated coffee and tea After that comes 4 to 6 weeks of the soft foods diet starting first with: pureed baby meats 2% cottage cheese fat-free ricotta low-fat cheese yogurt mashed potatoes (made with plenty of liquid) cream of wheat (again--make it thin) tofu split pea soup pureed soups skim or 1% milk unsweetened applesauce/pureed fruit refried beans once you find you can tolerate 4 or 5 things on that list, move on to: moist flaky fish (haddock, tuna, salmon) cooked poultry, purred w/ broth canned chicken eggs and egg substitute canned shrimp and crab Then, around 8 weeks you move to solids gradual introduction of solid foods concentrating on low-fat, high protein foods, and including 64 oz of fluids per day.

Janet I was on liquids for the first day and then soft foods for 2 weeks. Within 3 weeks I was eating normally again, but smaller amounts. The only food I don't eat is soft bread, it tends to get stuck in my stoma. I guess is swells up like a sponge in my stomach. I can eat a small steak but it needs to be chewed so much that I tend to go for ground meats or fish. Meatloaf or a hamburg patty is a better choice. They don't require as much time to chew. I take a vitamin every day but since my intestines are not bypassed malnutrition is not an issue. If I ever want or need to eat normally again I can have my surgery "turned off" in just a few minutes. It took me 8 months to reach my goal. My high blood pressure, sleep apnea and diabetes are gone. I have gone from 13 pills a day to 1. Richard