What to eat and avoid on the gastric sleeve diet

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A gastric sleeve procedure surgically reduces the stomach to about 15 percent of its previous size. The operation helps people who have it to feel fuller faster and greatly reduces overeating.

After surgery, a person must follow a strict diet that enables the body to recover and adjust to a smaller stomach size.

Surgery recipients will need to eat smaller and more frequent meals for the rest of their lives. Here is what someone can expect from the gastric sleeve diet.

Fast facts on gastric sleeve surgery and diet:

• Gastric sleeve surgery is so-called because the stomach resembles a sleeve afterward.
• The reduced stomach size makes it difficult for someone to overeat.
• The surgery's success depends on a person's willingness to stick to a healthy lifestyle.
• The gastric sleeve diet follows four distinct phases for getting back to a healthful eating pattern.

What are the basics?

Gastric sleeve surgery will make overeating difficult.

In gastric sleeve surgery, a surgeon reduces the stomach to a sleeve-like shape by removing much of the stomach.

The surgery is irreversible and can help people lose 60 percent or more of their excess body weight.

It also reduces the body's ability to produce a hunger hormone called ghrelin.

This lets most people feel hungry less often after their surgery.

The gastric sleeve diet is a multiphase diet designed to prepare people for surgery, help them recover, and transition to a lifetime of healthful eating.

People who cannot have gastric sleeve surgery or want to try lifestyle remedies before considering it may be interested in trying the gastric sleeve diet.

However, research from 2011 and published in the journal Obesity Surgery, suggests that gastric sleeve surgery causes nutritional deficits.

So, rather than trying the gastric sleeve diet, someone might want to consider reducing their portion sizes and sticking only to healthy foods first.

Phases of the gastric sleeve diet

The four phases progress so that people can transition to a solid food diet that they will eat for the rest of their lives. Some doctors also require a special pre-operation diet to optimize health ahead of the surgery.

Every individual should discuss details of a healthful pre-operation diet with their doctor since the right diet varies from person to person.

Phase 1

Phase 1 of the gastric sleeve diet usually lasts for about a week after surgery. During this time, people should consume only clear liquids.

Remaining well hydrated following surgery can speed the healing process and help with symptoms, such as nausea and vomiting.

While it can be hard to stick to a clear liquid diet, most people feel little or no hunger in the days immediately following their surgery. They should also avoid consuming:

• caffeinated drinks, such as tea and coffee
• sugary drinks, such as fruit juice
• carbonated drinks
• soda

Instead, people should drink sugar-free clear liquids. In addition to at least 8 glasses of water per day, a clear liquid diet can include:

• jello
• broth
• decaf tea or coffee
• sugar-free popsicles

Phase 2

In phase 2, a sugar-free protein powder should be added to the diet.

A week to 10 days following surgery, most people who have had gastric sleeve surgery begin to get hungry again.

During this stage, they switch to a fuller liquid diet that is rich in protein. The goal should be to eat a variety of healthful nutrients but to avoid sugary foods and foods with low nutritional value.

Foods to avoid should include:

• sugary foods
• high-fat foods, such as whole-milk yogurt
• chunky foods, such as vegetable soup

Someone on Phase 2 should continue drinking lots of water and incorporate protein into their diet, by drinking a protein powder. The protein powder should be sugar-free and mixed with clear or full liquid.

The aim should be to consume 20 grams (g) of protein each day. Intake should be limited to ½ cup of liquid per meal. Sugar-free foods can include the following:

• very thin soups, including creamed soups
• sugar-free pudding, ice cream, or sorbet
• diluted juice
• instant breakfasts with no added sugar
• very soft noodles in soup
• sugar-free non-fat ice cream or yogurt
• low-sugar applesauce diluted with water

Towards the end of the second week or at the beginning of the third week, it is safe for someone to begin adding thicker, pureed foods. They should continue avoiding sugar and high-fat foods.

In addition to the foods that were safe to eat earlier, it is now safe to consume:

• Greek yogurt
• thinned oatmeal
• mashed sweet potatoes
• mashed potatoes
• canned, pureed chicken or tuna
• baby foods
• smoothies and pureed foods, as long as it has low or no sugar
• scrambled eggs
• pureed whitefish

During this stage, people should aim for 60 g to 80 g of protein per day. Greek yogurt, eggs, and fish are rich in protein. To feel full and to ensure adequate protein intake, protein can be eaten as the first part of the meal.

Each meal should include no more than ½ cup of liquids, meaning it will be necessary to eat many small meals.

Phase 3

The transition to phase 3 may include adding nutrient-dense soft foods, such as scrambled eggs.

People who have had gastric sleeve surgery transition to soft foods during phase 3 of their diet regimen.

They must continue eating 60 g to 80 g of protein each day and remain well hydrated. It is safe to eat everything on the pureed foods diet but avoid eating:

• sugary foods
• bread
• skin and seeds from vegetables and fruits
• fatty foods, especially oils and butter
• tough, raw vegetables
• white pasta and rice

High-protein, nutrient-dense soft foods support feelings of fullness and speed recovery. Some options include:

• low-fat deli meat
• soft fish
• low-fat cheese
• eggs, including scrambled, poached, or hard-boiled
• softened vegetables
• soups, including those with some chunks

It is necessary to continue drinking a daily protein shake and to limit caffeine to just 1 to 2 cups of coffee per day if allowed by a doctor.

Phase 4: Transitioning to solids

About 4 weeks after surgery, it is safe for someone to transition to solid foods. People interested in trying a gastric sleeve diet can adopt stage 4 to try to lose weight.

Everyone should continue drinking a protein shake, and get 60 g to 80 g of protein per day. They must ensure they remain hydrated but stop drinking 30 minutes before their meals.

Taking a daily bariatric multivitamin, as recommended by a doctor, can also be part of this phase. The regimen should center on sticking to three small meals per day and two small snacks. Again, snacking on sugary or processed, low-fiber foods should be avoided.

Foods to eat

It is now safe for a person to eat most types of foods. They should continue eating protein-rich foods from phase 3, as well as foods, such as:

• low-fat cottage cheese
• fish
• lean meats
• vegetables
• small quantities of fruit

Foods to avoid

Avoid getting calories from drinks. This makes people feel less satisfied than solid food does and can cause nutritional deficits. Some other foods to avoid should include:

• bread and white grains
• sugary snacks
• packaged foods, such as potato chips
• cooking oils
• fried foods
• sodas
• desserts
• very high-calorie foods

Takeaway

People should talk to a doctor about when it is safe to resume exercise after gastric sleeve surgery. Regular exercise can support weight loss, as well as reducing the health effects of obesity.

Weight loss may be slow at first after gastric sleeve surgery, but over a year or two, it is possible to attain a healthy weight.