A gastric sleeve is a type of bariatric surgery individuals undergo for weight loss. This procedure requires post-surgical dietary changes. If undergoing a procedure such as a gastric sleeve, a registered dietitian and doctor will work with you to progress you through these stages in a way tailored to your individual condition.
Stage 1
This stage is necessary the first days after surgery while patients are still in the hospital. For the first one to two days after surgery, gastric sleeve patients are required to follow a clear liquids diet.
Foods Allowed
Foods allowed on a clear liquids diet include low-calorie, low sugar, clear liquids such as water, ice, tea, broth, sugar-free gelatin, and sugar-free ice pops.
Foods Not Permitted
Foods not permitted on a clear liquids diet include any solid food or liquids you cannot see through such as smoothies and yogurts. Additionally, other beverages to avoid are carbonated, high sugar, caffeinated drinks and alcohol.
Allowable Amount
During stage 1, patients should drink clear liquids in small sips and without the use of a straw. The amount of liquids recommended at this stage is 0.5 to 1 ounce every 20 minutes.
Stage 2
Stage 2 is the initiation of more calorically dense liquids. Stage 2 begins around two days after surgery and can last up to two weeks. In this stage, patients continue consuming clear liquids and introduce thicker, protein-rich fluids.
Allowed Foods
Foods allowed on in stage 2 include clear liquids, protein shakes, cream of wheat, sugar-free carnation instant breakfasts, Greek yogurts, natural apple sauce, sugar-free sherbert, and lactose-free milk.
Disallowed Foods
Foods not permitted in stage 2 are solid or soft foods, soups with chucks, anything with seeds, high sugar liquids, and high dairy liquids.
How Much to Consume
The Nutrition Care Manual recommends gastric sleeve patients consume no more than 25 grams of sugar per serving, and patients should consume 48 to 64 ounces of fluids a day with 24 to 32 ounces coming from clear liquids and 24 to 32 ounces from full liquids.
Stage 3
In the third stage of a gastric sleeve diet, patients slowly progress from thick liquids to solid foods. This is a slow progression based around physician procedures and how a patient tolerates the food.
Pureed Stage
Patients will move from thick liquids to pureed foods around two to three weeks after surgery. In this stage, patients are encouraged to experiment with pureed cooked vegetables, eggs, beans, fish, meats, or soft fruits. Patients should only consume a few tablespoons of pureed food three to six times a day serving as meals and snacks.
Soft Foods
Once patients feel they tolerate pureed foods, they may begin slowly adding in small amounts of soft foods. Patients typically tolerate soft foods four to five weeks after surgery. These can include ground meat, cooked vegetables, peeled fruits with no seeds, and scrambled eggs. Intake recommendations will vary based on doctor, but some recommend 1/4 to 1/2 cup servings and three to four meals a day with liquids in between meals.
Stage 4
The last and final stage is when a gastric sleeve patient progresses to solid food consumption. This occurs around five to six weeks after surgery. In stage 4, solid foods should be introduced slowly, in small amounts, and one-by-one.
Solid Food Recommendations
Patients should begin increasing the variety of food they eat and aim to consume all the food groups. However, it is recommended patients prioritize protein over all other food groups. The Nutrition Care Manual recommends eating 1 to 2 ounces of protein 3 to 5 times a day with fruits and vegetables.
Foods to Avoid
In this stage, and for the duration of the patient's life, foods to avoid include high-fat meats, fried foods, high-sugar foods and drinks, low or skim dairy products, fats and most oils, and simple sugar foods such as candy, cakes, and cookies.
Your Diet and a Gastric Sleeve
Eating patterns for a gastric sleeve can be complicated and overwhelming. Luckily, those that undergo a gastric sleeve procedure have the support of a skilled medical team, which will include a registered dietitian. The above dietary stages will be customized to the individual needs of a gastric sleeve patient to help ensure they heal properly and receive adequate nutrition.
