Bariatric Diet - All You Need to Know
The right bariatric diet and proper bariatric eating techniques can mean the difference between success and failure. They will help you avoid complications and maximize short and long-term weight loss.
Getting into the right diet plan before surgery and sticking to it is important for 3 reasons…
- The higher your body mass index before surgery, the more likely you are to develop complications. Getting your diet in line well before surgery will bring down your BMI and reduce your risks.
- It gives your body the energy and nutrients it needs to heal from surgery and function properly during extreme weight loss.
- It helps to avoid bariatric surgery complications down the road while maximizing weight loss and maintenance (1).
Conventional wisdom may tell you, “You’re getting bariatric surgery soon, so now’s the time to live it up!” But you must have the complete opposite mentality.
From the moment you begin to seriously consider weight loss surgery, your diet habits should change forever. Consider the months leading up to surgery as a test. You are training yourself to have discipline with food and learning the motivation it will take to reach your goals.
The right bariatric surgeon will help. Part of the process of choosing a good doctor is learning about the dietitian or nutritionist that they partner with or have on staff. The dietitian will talk with you about your diet history and will help you understand what kind of eater you are.
In addition to pointing you towards the bariatric treatment that will mold best to your habits, they will set you on an appropriate pre-bariatric surgery diet.
Their involvement is also important from a financial perspective. Many bariatric insurance providers require that you go through a medically-supervised weight loss program before they approve your surgery.
“…NO one last big unhealthy meal before surgery.”
Your pre-surgery bariatric diet will most likely be high-protein and low-carbohydrate with plenty of fluids. For the two weeks leading up to surgery, you’re bariatric diet will most likely be a liquid one and your daily calories will be at or below 1,000. To ensure you’re getting the right nutrients, your dietitian may also prescribe bariatric vitamins.
A high-protein/low-carbohydrate bariatric diet is important for 3 big reasons…
- Reduces bleeding
- Promotes healing
- Shrinks your liver – an enlarged liver can make surgery more difficult by blocking the surgeon’s view and increase the risk of your liver being damaged during surgery (2).
We’re sorry to say that this means no “one last big unhealthy meal” before surgery.
Your surgeon-recommended dietitian or nutritionist will also have you on a detailed bariatric surgery diet plan for the first several weeks after surgery. Following their advice exactly will promote healing and start you on your permanent (and more enjoyable) bariatric diet while minimizing negative side-effects…
- You’ll only be able to have liquids for the first couple of days following surgery. Hospital meals will probably include broth, water and possibly juice, although you may find that juice upsets your stomach at first.
Your liquid bariatric diet may only be an ounce at first. Yes, an ounce! That’s about the equivalent of two tablespoons.
Starting around week 2, your blender will become an integral part of your meal preparation. Even after you’re completely healed, smoothies and pureed meals will compliment your bariatric diet well and are a great place to include your extra protein if necessary.
If you don’t have a great blender already, we strongly recommend investing in one.
We like the Magic Bullet Set. In addition to whipping, blending or grinding quickly and thoroughly, it makes clean-up easy and includes everything you’ll need to serve your creation or take it to go.
- Adding powdered protein to your bariatric diet will follow your liquid-only diet for a week or two, but the mixture should still be water-like. Certain soups will probably be okay as long as they don’t have any solids in them. During the first week, your doctor will most likely recommend that you sip a few ounces of your liquid meals every hour or so.
- From the 2nd through the 6th weeks your liquid meals will get thicker and thicker (but still completely pureed with no small bits remaining). Solid foods will be out of the question. Eating 4 to 5 three ounce meals a day is normal. Your tiny stomach won’t be able to hold much, so expect to feel full very quickly. Foods appropriate for this stage include cream soups and yogurt-based smoothies.
- As soon as possible, your doctor will have you eating solid foods which will make you feel full sooner. This could happen as soon as the fourth week, although the average patient gets there between 6 and 8 weeks. At that point, your bariatric diet will consist of 3 four-ounce “normal” meals per day.
Introduce foods back slowly to figure out which foods your system can and can’t tolerate. Anything too fibrous, such as raw vegetables, may be too much for your system to handle at first. You’ll need to cook everything well and chew it thoroughly before swallowing.
After 6 to 8 weeks or so, you’ll be fully transitioned into your new permanent bariatric diet.
IMPORTANT: For the first few months following surgery you need to be very mindful of avoiding dehydration. Your body will need about 8 cups (1/2 gallon!) per day.
Not getting enough can lead to nausea and persistent vomiting which, in turn, can lead to vitamin deficiencies and put you back in the hospital.
So what should you eat?
A good long-term bariatric diet follows 5 basic principles…
- Eat healthy
- Protein first
- Keep your blood sugar stable
- Drink the right amount of water at the right times
- Don’t snack
“Many patients…actually become repulsed at the thought of unhealthy food after surgery because of how it makes them feel.”
Healthy bariatric eating has two angles… what you eat and how you eat. Here we focus on what you eat. We’ll get into the “how” further down the page.
The creative packaging in the supermarket can make it difficult to distinguish between the healthy and unhealthy foods. In general, your bariatric diet should only consist of FOG foods…
- Farm – The food is raised on a farm (i.e. chicken, turkey, eggs, dairy products)
- Ocean – It comes from the ocean (i.e. fish)
- Ground – It is grown in the ground (i.e. fruits, vegetables, nuts, whole grains) (click here for a great resource about starting a garden and organic gardening)
When possible, avoid anything that was modified by humans in any way. A good rule of thumb can be applied by reading the label… if there are more than 3 to 5 ingredients or if there are any ingredients that you can’t pronounce, don’t buy it.
How you prepare your food is as important as what you buy…
- When cooking, bake, grill, poach or broil…don’t fry.
- Use skim milk instead of whole milk.
- Use chicken or vegetable broth instead of oil.
- Replace oil in recipes with applesauce or yogurt.
- Add spices or lemon juice to add flavor instead of olive oil or butter.
We know, we know… how boring, right?
Give it a shot. Not only will you eventually get used to the change, you will probably start to be turned off by not eating this way.
Many patients have said that after a while they actually became repulsed at the thought of unhealthy food because of how it made them feel compared to their new bariatric diet.
In addition, many patients’ taste for unhealthy food changes after surgery.
Protein is one of the most important nutrients for your body, and you need a lot of it in order to stay healthy… up to 80 grams a day.
With your old stomach, this was no problem. But now that your stomach is down to the size of a golf ball, 80 grams is a big percentage of the available space.
Your body’s going to do all it can to get the adequate amount of protein, so if you’re not eating enough your body will begin to break down muscle. This can cause you to feel nauseous, irritable, weak and tired. If lack of protein intake goes on too long it can ultimately cause general swelling, hair loss and skin problems, worsen your immune system and increase your risk of infection.
So eat you protein first.
It can be found in many foods, including meat, fish, soy and dairy products, legumes and nuts. When you’re picking your protein, be mindful of fat content as many protein sources contain ample amounts of it. Always opt for the lean or low-fat option.
If you’re having a tough time getting enough, it may be necessary to supplement your bariatric diet either every day or as needed. For example, a daily supplement can be taken in the form of a pill or powder, or you can make yourself a protein shake at the end of a low-protein day.
“Stable blood sugar leads to stable hunger and stable relationships.”
Stable blood sugar leads to stable hunger and stable relationships (no mood swings).
In order to keep your blood glucose level in check…
- Avoid simple carbohydrates. Foods with simple carbs include white bread, potatoes, white rice, corn, peas and anything that is obviously full of sugar like candy, ice cream or donuts.
- Eat good carbs in small portions (along with your high amounts of protein), including vegetables, apples and the “brown foods” like whole-grain bread and brown rice. In addition to being good for your blood sugar level, they are often high in fiber which makes you full faster and helps to regulate your bowel movements.
Not just water!
It’s important that you remain hydrated after weight loss surgery… you must drink FLUIDS (preferably, low calorie ones such as unsweetened, caffeine-free herbal tea) but not just water.
If you only drink water, you may develop electrolyte abnormalities such as water intoxication syndrome.
Talk with your team for recommendations specific to you, but usually no more than half of your fluids should be water.
It is also important that you drink a lot of fluids… between 48 and 64 ounces per day. That’s equal to about 8 cups or 1/2 a gallon. This may be tough to do considering the size of your new stomach.
To make things more difficult, you can’t drink with your meals and need to wait at least an hour after you eat before drinking anything. If you don’t, the liquids will quickly flush the food through your stomach. This can affect digestion, make you feel hungry and lead to weight gain after bariatric surgery.
To meet your liquid intake goals, keep some liquids next to you at all times and sip a little every 15 to 20 minutes outside of meal time. Stay on track by getting a special container, measuring out your daily amount of fluids every morning and putting it in the fridge (or on the counter if you prefer your liquids at room temperature).
Spread your consumption throughout the day so that the container is empty before you go to bed.
Snacking between meals is the quickest way to halt your weight loss progress and to gain your weight back after you hit the low point.
Don’t do it.
By far the best way to keep you honest is to keep a good free diet journal. Plan all of your meals ahead of time. When you go to the grocery store, only buy the foods that you have planned. Then only eat what you’ve planned, when you’ve planned (more on this important tip further down the page).
While it’s very technical and can be a tough read, we highly recommend that you print and review the Bariatric Surgery Nutritional Guidelines from the American Society for Metabolic and Bariatric Surgery (ASMBS). In addition to containing the most recent bariatric diet research for your own knowledge, it’s also a great reference to ensure that your dietitian or nutritionist is up-to-date.
The advice throughout this page – both above and below this section – applies to everyone, regardless of procedure. However, there are certain precautions you’ll need to take depending on which procedure you have.
Click the following to jump to your procedure or scroll down review them all:
Your smaller stomach after gastric sleeve surgery will lead to a couple of important changes in your diet:
- You will feel full much sooner than you did before
- If you eat too quickly, you may have difficulty swallowing. This is the result of food backing up into the esophagus after the stomach pouch has been filled. To avoid this, chew your food thoroughly, eat slowly and eat foods that are more easily digested. This should get better as your pouch stretches over time.
Diarrhea is relatively common after gastric sleeve surgery. Eating a pre-planned gastric sleeve diet will usually get things back to normal, although some patients find that the diarrhea is caused by lactose intolerance (not necessarily caused by surgery, but the new stomach can make lactose intolerance symptoms more prevalent). If that’s the case, you’ll need to avoid dairy products.
See our Gastric Sleeve Diet section for more information.
Just like gastric sleeve surgery, you’ll feel full sooner after eating due to the smaller size of your stomach. You may also lose certain food cravings due to hormonal changes resulting from the surgery.
Most gastric bypass patients (about 80%) will experience dumping syndrome when they eat the wrong foods. Conveniently, the wrong foods are the unhealthy ones, so while dumping syndrome symptoms are unpleasant, they help you keep your gastric bypass diet in check.
While diarrhea does occur for some patients (see Gastric Sleeve Diet section above for recommendations), constipation is more common after gastric bypass and usually means that you need to drink more water.
Due to the malabsorptive component of gastric bypass surgery, your doctors will insist that you take bariatric vitamins for the rest of your life to avoid extremely dangerous vitamin deficiencies.
See our Gastric Bypass Diet section for more information.
The gastric band reduces the amount of food you can eat before feeling full by creating a small stomach "pouch" on the upper portion of your stomach. As a result, you should follow the same precautions as those listed in the gastric sleeve section above.
Unlike the other procedures, the rest of your stomach will still be intact below your band. As a result, drinking water 30 minutes before through 30 minutes after meals will make it even easier to "flush" food through your smaller stomach pouch causing you to eat more than you should.
See our Lap-Band Diet section for more information.
Duodenal switch surgery is so effective due to both reducing the size of the stomach AND through limiting the amount of food that your system absorbs. To offset this lack of absorption, you’ll need to take several different vitamins and supplements every day or risk developing serious, life-threatening vitamin deficiency.
Supplements will likely include:
- Multi-vitamin/mineral supplement
- Fat soluble vitamins (A, D, E, and K) in a ‘dry’ form
- Probiotics (beneficial bacterium found in the intestinal tract)
Routine tests are essential to make sure your body is getting the nutrients it needs.
See our Duodenal Switch Diet section for more information.
Your surgeon will have you on a liquid- and soft-food-only diet for up to 10 days following your procedure: liquid-only for the first few days followed by the slow introduction of soft foods.
After the first 10 days you will likely be allowed to transition into a mostly normal diet along with a daily vitamin and mineral regimen.
Your surgeon may also recommend staying away from “sticky” carbs like pasta which may stick to your balloon and increase your chances of vomiting.
See our Gastric Balloon Diet section for more information.
Because vBloc does not change your anatomy, there are no specific dietary restrictions or a risk of malabsorption (so no need for vitamin supplementation). However, your vBloc device is designed to work in tandem with lifestyle changes, so your nurse or dietitian will work with you to find ways to improve your diet and exercise habits.
See our vBloc Therapy Diet section for more information.
Because you need to chew your food so thoroughly for aspiration to work properly, it can take some effort to make the change to your new eating habits. With this in mind, you will be asked to ease into eating full meals.
See our AspireAssist Diet section for more information.
How you eat is just as important as what you eat, including…
- Where you eat
- Food preparation and weight loss surgery recipes
- Portion sizes
- How fast you eat and how you chew your food
Our Bariatric Eating page covers this all-important topic from soup to nuts.
There are more reasons why people eat other than just being hungry. Sometimes that extra bite tastes just so good.
There are also emotional and psychological reasons why people may eat more than their bodies need them to.
Making things even more complicated, there are also biological reasons why people may overeat.
Sometimes overeating can lead to behavior resembling an addiction. If you are concerned about you or your loved one, there are plenty of resources, online and off, to help you. Visit our page on food addiction to take a food addiction quiz, and to learn more about food addiction and food addiction treatment.
The following 12 tips will keep you moving toward your goal. We recommend that you either print this list or write it down and keep it in a place you go all of the time such as your journal. Read it frequently or, at a minimum, when you go through rough patches…
- Use a free online diet journal to plan and record your meals – if you have to choose two things on this list, this is one of them. As mentioned above, use it to…
- Plan all of your meals ahead of time
- Act as your guide through the grocery store, take it with you (or print your list) and only buy the foods that you have planned
- Only eat what you’ve planned, when you’ve planned
- Set goals and record progress (more on this below)
- Join offline and online support groups and attend them regularly. This is the other of the two most important things to do.
Bariatric surgery patients who participate in support groups have recorded more weight loss and tend to live healthier than patients who don’t.
See our In-person Weight Loss Surgery Support Group page or Online Weight Loss Support Group page for more, including recommendations for which ones to join.
- Set a realistic goal weight. Your bariatric surgeon will work with you to make sure your goals are realistic based on the bariatric surgery procedure you choose. See our Types of Bariatric Surgery page to learn what the average patient loses for each procedure.
- Set monthly goals, document your progress and plan a reward for yourself each time you hit them. This is another great use for your food journal.
Rewards could include treating yourself to a massage or spa day (or get your partner to commit to giving you a massage if you don’t want to spend the money), throwing a little party, having a barbeque or scheduling a weekend trip away. And be disciplined. Only give yourself the reward if you hit your goals. Appropriate goals include…
- Weight loss until you hit your goal weight
- Weight maintenance after you reach your goal weight
- Following your journal’s food plan
- Hitting your weight loss surgery exercise goals each month
- Take your journal and only buy your planned healthy foods
- Don’t shop while you’re hungry
- Since healthier foods tend to cost more, don’t be afraid to shop in bulk and freeze the extras.
The EatSmart™ Digital Nutrition Scale – Professional Food and Nutrient Calculator is our top choice for measuring your meals. It has nutritional information pre-stored for thousands of foods, helps you track your diet by allowing you to save the data from your own foods and allows you to weigh foods up to 11 pounds (about 5 kg).
“I used to eat and eat without really enjoying the food. Sure, I liked it. But it had become habit to eat as much as I could as quickly as I could. After bariatric surgery, for the first time in my life I feel like I really enjoy the food. I eat slowly and savor the taste of every single atom.”
Anonymous Weight Loss Surgery Patient
- Identify and address emotional eating as soon as it arises. Most won’t have a problem with emotional eating after bariatric surgery, but some will.
The best way is to keep and follow (you guessed it!) offline or online food journals. If you find yourself cheating, make a note of exactly how you felt and what you ate. What happened before you started eating? Did you have a fight? Did you remember something that made you depressed?
Don’t be afraid to ask for help… your dietitian or nutritionist and psychologist see this kind of issue often and can help you work through it. Your support group is also a great place to talk through your problems and learn new ways to overcome them.
Some patients also like to choose a place or a room in their home that they’re “not allowed” to have food, such as the bedroom or porch. Use this room as a safe haven and retreat there when having a rough food day..
- Watch as little regular TV as possible. Research has shown that the more you watch, the more likely you’ll be to get away from your bariatric diet, but not for the reasons you probably think (4).
In actuality, media and advertising are the main culprits.
Can you remember a time when you were casually watching television, not even the slightest thought of food floating through your mind… and out of no where came this giant, juicy Big-Mac with glistening fries and a sweet soda? Before you knew what hit you, you were in the car, on the way to satisfy a media-induced craving… right? You’re not alone!
This can be a tough issue since TV is such a big part of all our lives, but there are numerous activities that can be just as fun… including ones that involve the TV. Here are some ideas along with our picks for the companies that can make it happen…
- Rent movies and documentaries.
- Use a digital video recorder (DVR) to record the shows you like and fast-forward through the commercials. If you don’t have a DVR at home, there’s a good chance that your local cable company will install one for an additional fee.
"View this as an excuse to improve your mind and your relationships."
- Read more books and play games – video games, card games and board games are fun by yourself, with a family member or with a friend. Amazon.com is a great place to get book and game ideas. We challenge you to think of a book they don’t have in stock (new or used).
It’s easy to say, “I won’t be tempted by the media… the high percentages from the research apply to other people.”
But why risk it? In addition to lowering your chances of losing focus, the other activities mentioned above can be more mentally stimulating and are a great excuse to spend quality time with those you care about. If nothing else, view this as an excuse to improve your mind and your relationships!
- Exercise every day. In addition to boosting your metabolism which keeps your body burning those calories, weight loss surgery exercise is a great way to take your mind off of your hunger and to curb your appetite.
It has also been proven to help prevent depression, lower bad cholesterol, increase good cholesterol, improve libido and improve insulin control. Plus, research has proven that it will make you live longer (5)!
Lap band surgery, gastric sleeve surgery and gastric balloon patients may be less likely to have vitamin and mineral deficiency problems than patients undergoing these procedures, but the possibility still exists.>
See our Bariatric Vitamins page for everything you need to know about which vitamins to take for which surgeries and why.
First, let’s talk about what not to eat.
You’ll notice the term “trigger foods” throughout our site. This refers to foods that upset your digestive system (cause digestive issues such as difficulty swallowing, vomiting, diarrhea or constipation).
Be sure to read this page all the way to the bottom – there’s some valuable advice from other patients that you don’t want to miss.
And while you’re reading it, be sure to share your own experiences!
As you transition into your long-term bariatric diet, certain foods will need to be put on the back burner until your stomach is ready for them while others may upset your stomach forever. You may be able to avoid the trigger by reducing their amounts, but there is also the chance you will need to give the food up altogether.
According to the American Society for Metabolic and Bariatric Surgery>, following are the foods may or may not be okay depending on your body and the type of surgery you choose…
Still have questions or concerns about
this page’s topic?
If you finish reading this page and still have questions or concerns, our weight loss surgery community will be happy to help.
- Carbonated beverages
- Soft “doughy” bread
- Tough, dry, red meat
- Other fibrous foods
- Caffeine in moderation
- Alcohol in moderation (more on this in the Alcohol section below)
The following foods should be eliminated from your diet forever…
- Sugar, sugar-containing foods and concentrated sweets
- Fruit juice
- High-saturated fat
- Fried foods>
Food intolerance affects different people in different ways. The first step is to make sure you’re eating the right way (covered on our Bariatric Eating page).
Assuming you’re eating appropriately, the following are foods to keep your eye on. Reduce how much you eat or eliminate them altogether as necessary…
- Milk products give certain patients problems after bariatric surgery which is due to lactose intolerance. Bloating, gas, cramps and diarrhea are common symptoms.
If you find that you are lactose intolerant, you may not have to give milk up all together… give low-fat milk a shot (you should be using low-fat milk and dairy products either way!).
If you still have problems, lactose-free milk, soy products or lactase enzyme pills should do the trick.
- Starches and carbohydrates, when eaten too much, can also block up your digestive system. Keep bread, pasta and rice at levels that your body can manage.
- Certain fruits and vegetables that are more difficult to digest (such as celery, raw vegetables, dried fruits and fruits with skins) may cause problems including vomiting, gas or abdominal cramping.
- Tough meat can get stuck and cause vomiting. Meat is very important to your bariatric diet for the protein that it contains, but you may need to cook it in a way that keeps it soft, choose more tender cuts or chew it more thoroughly before swallowing.
- Soda is generally discouraged but may be acceptable IN MODERATION and only if enjoyed between meals (drinking any liquids during meals will flush your food through your smaller stomach and likely cause you to eat more than you should). See this patient-surgeon dialogue about Soda Safety for more information.
Again, use your food journals to track which foods your body can’t handle.
Many types of bariatric surgery alter the way your digestive system works by either removing part of your stomach, rearranging things or both. As a result, alcohol will have a much different effect on your system after surgery.
Here are the reasons why:
- Your stomach no longer metabolizes the alcohol as well (because part of it is gone or bypassed).
- Most of the alcohol absorption takes place in the small intestines. Rather than being partially absorbed by the stomach, after bariatric surgery most of the alcohol passes quickly into the small intestines.
- The longer the food stays in the stomach, the less drunk you get. This is why you get intoxicated faster on an empty stomach… the alcohol is not slowed down by any food and passes more quickly into the small intestines.
With a smaller and/or bypassed stomach, the alcohol passes through much faster. To make matters worse, you’re not supposed to drink anything during or an hour after meals. As a result, when you drink alcohol you’re always drinking on an (at least partially) empty stomach.
- With procedures that bypass the connection between your stomach and small intestines, there is no regulation of fluids flowing into your small intestine. This is yet another reason alcohol gets there so fast (6).
Several issues can arise if you decide to drink alcohol (7).
First, the sugar and carbohydrates found in alcoholic beverages can derail your daily goals, cause your blood sugar levels to get away from you and cause you to gain back weight.
There are also alcohol-related health issues that you’ll be at greater risk for after surgery (some of which can lead to death), including…
- Acid reflux disease
- Gastric and esophageal cancers
- Heart problems
- Intestinal tract inflammation
- Irreversible brain and nerve damage and potential coma by preventing the appropriate vitamin absorption
- Liver damage
- Neuromuscular and cognitive dysfunction
Finally, with alcohol in you, you are much more likely to give in to food cravings. In addition, you open yourself up to other problems such as drunk driving or behaving in a way that you may regret the next day.
If it all possible, keep things simple… keep alcohol out of your bariatric diet after surgery.
If you absolutely must drink, always be on the safe side…
- Don’t drink any alcohol for at least a few months after surgery.
- Don’t drive after drinking anything (even after small amounts).
- Eat a meal before you drink (remember to wait at least an hour after eating).
- Avoid alcoholic beverages with additional sugars and carbohydrates (such as some mixed drinks and certain kinds of beer).
- As always, make sure you take all of your prescribed bariatric vitamins.
Help & Support – Patient Experiences & Free Online Support Groups
What are YOUR bariatric diet and eating habits? Your advice will be a huge help to other patients and to those deciding whether to have surgery.
Include anything related to your permanent bariatric diet and eating habits, such as…
– Which procedure did you have?
– What are your favorite/regular meals for breakfast, lunch and dinner?
– How much do you eat at each meal?
– Do you snack?
– Do you use a food journal?
– Which foods give you problems?
– How often do you meet with your dietician/nutritionist and what is discussed/reviewed?
– Any tips to make things easier?
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Back to pre-op liquid bariatric diet after weight regain?*
I was 20 stones (280 lbs) pre-op and went down to 13 stones (182 lbs) after my weight loss surgery. But 3 years later I have crawled back up to…
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health-risks-survey-results/. Accessed: October 17, 2009.
[ Last editorial review/modification of this page : 12/06/2016]