Bariatric Surgery
Post-Operative
Nutrition Requirements
and Guidelines
Please contact the bariatric outpatient dietitian, Stacy Smith,
R.D./L.D. if you have questions or to set up a follow-up
appointment at 404.501.5611 or 404.501.7818.
You should schedule a follow-up appointment with the dietitian at
least by week 7 when you start on solid foods or sooner if needed.
Diet Progression Guidelines
***Portion Sizes: You will begin with sips and tablespoons. Your
portion should not exceed ½ cup- 1 cup (4 -8 ounces) per meal
(whether it is liquid or solid) until after 12-18 months.
Liquids cannot be taken with food or protein shakes at any
stage of the diet progression. Follow a 30-60 minute rule (at
least 30 minutes). Do not drink any liquids 30 minutes before a
meal and do not start drinking liquids until 30 minutes after a
meal.
If you drink liquids with your meals it can:
 Stretch your pouch
 Make you sick
 If you are full on liquids, you cannot eat enough
 If you drink too quickly after a meal, it can push food
through too fast
The diet progression is from liquids to solids to help you heal
and to avoid blockages or discomfort. People who adhere to
these guidelines tend to see (and feel) better results.
Phase I: Liquids: (weeks 1-3)
*No carbonated beverages*
You will start on clear liquids after surgery. Clear liquids are
water-based.
Foods Allowed
Clear Liquids: (If you continue on clear liquids past 2 days, you
should add a clear liquid protein supplement)
 Water
 Diluted juice (apple, grape, cranberry)
 Fat-free, low-sodium broth, bouillon or high-protein
broth
 Sugar-free Jell-O
 Sugar-free popsicles
 Ice cubes
 Decaf coffee or tea
 Sugar-free fruit flavored drinks such as Crystal Light
Full Liquids: (includes all clear liquids as well) Start protein
supplement here!
Full liquids are milk-based.
 Skim milk
 Yogurt (thin or drinkable only)
General Guidelines
1. Your portion size is 2-4 ounces or ¼ to ½ cup.
2. Divide meals/snacks into 5 or 6 small feedings per day.
3. Sip slowly. Take 30 minutes or longer to drink each meal/snack.
4. Drink at least 64 ounces of water (fluid) per day. This is in
addition to your meals and snacks.
5. Include a protein supplement daily.
*Note: Most protein supplements will instruct you to put 1 scoop
per 8 ounces of liquid. Since your serving is 4 ounces, it is
recommended to use ½ scoop of protein or make the 8 ounces and
divide it into 2 four-ounce servings.
Measurement Chart
1-1/2 teaspoons = 1/2 tablespoon
3 teaspoons = 1 tablespoon
2 tablespoons = 1 ounce
4 tablespoons = 2 ounces
1/2 cup = 4 ounces
8 tablespoons = 1/2 cup
1 cup = 8 ounces
1 cup = 1/2 pint
2 cups = 1 pint
4 cups = 1 quart
2 pints = 1 quart
1 quart = 32 ounces
2 quarts = 1/2 gallon
4 quarts = 1 gallon
**Sample Menu**
Time
Food/Drink
Amount
7:00 - 7:30 a.m.
4 ounces
8:00 - 9:00 a.m.
skim milk or light vanilla
soy milk
Protein powder
Water
½ scoop
8-12 ounces (as tolerated)
9:30 - 10:00 a.m.
Sugar-free Jell-O
2-4 ounces
10:30 a.m. – 11:30 a.m.
Water
8-12 ounces (as tolerated)
12:00 p.m. - 12:30 p.m.
Skim milk or light vanilla
soy milk
Protein powder
Water
4 ounces
1:00 p.m. – 2:00 p.m.
2:30 p.m. - 3:00 p.m.
Sugar-free popsicle
Water/apple juice
½ scoop
8-12 ounces (as tolerated)
1
1 ounce water, 1 ounce
juice (2 ounces total)
8-12 ounces (as tolerated)
3:30 p.m. - 4:30 p.m.
Water
5:00 p.m. – 5:30 p.m.
6:00 p.m. - 7:00 p.m.
Skim milk or light vanilla
soy milk
Protein powder
Water
½ scoop
8-12 ounces (as tolerated)
7:30 p.m. - 8:00 p.m.
Strained cream soup
2-4 ounces
8:30 p.m. - 9:30 p.m.
Water
8-12 ounces (as tolerated)
4 ounces
Phase II- Soft/Pureed
Weeks 3-6
**No carbonated beverages**
Foods at this stage need to be an applesauce or mashed potato
consistency. No chewing required. You may use low-fat gravy or
low-sodium broth to grind or puree meats to make them moist.
You may also use baby food if you wish.
General Guidelines
1. **DO NOT take beverages with your meals. You will need to
stop drinking liquids 30-60 minutes before each meal and do not
drink anything for 30-60 minutes after each meal. Drinking
liquids can stretch your pouch and/or cause dumping syndrome.
2. Divide meals and snacks into 5 to 6 small feedings per day.
3. Your portion size is 2-4 ounces of ¼ cup to ½ cup.
4. Eat slowly. Sip slowly.
5. Do not eat sweets or drink sweet beverages.
6. Include protein foods and/or protein supplements at each
meal/snack.
Phase II- Pureed/Soft Phase
FOOD CATEGORY
CHOOSE
DO NOT CHOOSE
BEVERAGE
Decaffeinated coffee or tea,
sugar-free non-carbonated
beverages (Crystal Light,
Sugar-free Kool-Aid, Diet V-8
Splash, etc.)
Sweetened beverages,
carbonated beverages,
beverages containing caffeine,
alcoholic beverages
BREAD & CEREAL
Well-cooked and thinned
oatmeal, cream of rice, cream
of wheat, grits
Breads and all other cereals
Sugar-free gelatin, baby food
fruit or unsweetened pureed
fruit, sugar substitutes, sugarfree jelly and syrup, light
yogurt, sugar-free low-fat
pudding
Jam, jelly, honey, syrup, sugar,
pie, cake, cookies, pastries or
beverages sweetened with
sugar
EGGS
Very soft cooked eggs,
poached, scrambled or soft
boiled
Fried eggs
FATS
NONE
FRUITS & JUICES
All unsweetened fruit juices,
artificially sweetened fruit
drinks, unsweetened baby food
fruits. Juice should be
diluted.
DESSERT &
SWEETS
MEAT, POULTRY,
FISH &
SUBSTITUTES
Baby food beef, chicken, lamb,
liver, pork, turkey and veal,
low-fat cottage cheese, soft
scrambled eggs
Margarine, butter, cream, oils,
salad dressings, mayonnaise,
gravy
Raw or whole fruits
Any others
MILK
Lactose-free, skim or 1% milk, Whole milk, 2% milk, cream,
light yogurt or plain
half and half, regular flavored
unsweetened yogurt, low-fat
yogurt
and sugar-free soy yogurt, rice
milk, soy milk, almond milk
SOUP
Blended vegetable, tomato,
bouillon soups, and low-fat
cream soups
VEGETABLES
Strained vegetable juices,
baby food vegetables or lowfat pureed vegetables, thin
mashed potatoes
SEASONINGS &
MISC.
Mild spices as tolerated, sugar
substitutes
Regular cream soups or soups
with chunky meats
Any other vegetables
Phase II: Soft/Pureed- Sample Menu
Time
7:00 a.m. - 7:30 a.m.
8:00 a.m. - 9:00 a.m.
9:30 a.m. - 10:00 a.m.
10:30 a.m. – 11:30 a.m.
12:00 p.m. - 12:30 p.m.
1:00 p.m. – 2:00 p.m.
2:30 p.m. - 3:00 p.m.
3:30 p.m. - 4:30 p.m.
5:00 p.m. – 5:30 p.m.
6:00 p.m. - 7:00 p.m.
7:30 p.m. - 8:00 p.m.
8:30 p.m. - 9:30 p.m.
Food/Drink
Cream of wheat
Vanilla protein powder
Soft scrambled egg
Water
Skim milk
Chocolate protein
powder
Water
Pureed or baby
food Turkey
Mashed Potatoes
(thinned with milk)
Baby food pears
Water
Skim milk
Strawberry protein
powder
Water
Low-fat Cottage Cheese
Pureed peaches
Water
Sugar-free, fat-free
pudding
Water
Amount
2 ounces
1 /2 scoop
1
8-12 ounces (as
tolerated)
4 ounces
1/2 scoop
8-12 ounces (as
tolerated)
1 ounce (2 Tbsp.)
1 ounce (2 Tbsp.)
2 ounces ( ¼ cup)
8-12 ounces (as
tolerated)
4 ounces
1/2 scoop
8-12 ounces (as
tolerated)
¼ cup
¼ cup
8- 12 ounces (as
tolerated)
½ cup
8-12 ounces (as
tolerated)
Phase III- Solids
Starts at Week 7
**No Carbonated Beverages**
General Guidelines
1. 64 ounces of fluid per day
2. Portion size is ¼ cup to ½ cup increasing to 1 cup as you
progress.
3. Drinks should NOT be taken with meals. (E.g., if you eat cold
cereal, only put enough milk on to wet it). Take liquids in between
meals, following the 30 minute rule (minimum).
4. Include healthy fats (olive oil, etc.) and healthy
carbohydrates (fruits and vegetables). Raw fruits and vegetables
may be difficult to digest; it is recommended to not eat salads
for 2-3 months after surgery.
5. Avoid sweets and sweet beverages. In the past, patients who
have not limited sweets found that they did not lose weight as
well as they should have.
6. CHEW WELL!! Chewing helps to start the digestion process.
You want to chew your food to an applesauce or mashed potato
consistency before swallowing. You should chew your food 15-25
times before swallowing.
Phase III- Solids
FOOD CATEGORY
MILK & MILK
PRODUCTS
CHOOSE
DO NOT CHOOSE
Skim milk, fat-free buttermilk,
low-fat soy milk, low-fat rice
milk, “light” flavored yogurt or
plain yogurt, fat-free cheese or
cheese with less than 3 grams of
fat per serving
Whole or 2% milk, cheese made from
whole milk, flavored yogurt made
from whole milk, flavored milk, ice
cream, milkshakes, half and half,
flavored creamers, smoothies
If lactose intolerant:
Fat-free and lactose-free milk,
low- fat soy, almond or rice milk,
sugar-free soy yogurt, low-fat
soy cheeses
VEGETABLES
FRUITS
Soft and overcooked potatoes,
squash, tomatoes, green beans,
spinach, beets, carrots, English
peas, mushrooms
Unsweetened, cooked or canned
fruits in water or natural juices,
fresh fruit - banana, melons,
pear, peach, kiwi, apple, grapes,
and unsweetened applesauce.
Limit to 1- 2 small servings per
day. Too much fruit or juice may
cause diarrhea and/or slow
weight loss. Dilute juice.
Vegetables prepared with gravy,
fried vegetables, cheese or fat
Once you can tolerate the low fiber
vegetables listed on the left you can
try adding higher fiber vegetables
back to your diet. Remember to
start with cooked vegetables and
introduce new foods one at a time.
broccoli, Brussels sprouts, cabbage,
cauliflower, radishes, asparagus,
celery, sauerkraut, onions, pumpkin,
turnips, okra, beans, peas, corn, and
sweet potatoes
dried fruits, raisins
*Remember nuts, seeds and fruit
and vegetable skins can cause GI
obstructions after surgery if they
are not chewed extremely well.
Phase III- Solids
FOOD CATEGORY
CHOOSE
DO NOT CHOOSE
BREAD
White or whole grain bread or
toast, low-fat crackers, melba
toast, graham crackers
Any other bread. No bagels, biscuits,
cornbread, muffins, pancakes, sweet
rolls, waffles.
CEREAL
Cereal without sugar (i.e., Corn or
Rice Chex, Cheerios, Special K,
Rice Krispies or Cornflakes)
Bran cereals, shredded wheat, and
coarse cereals are higher in fiber and
may be tolerated better if eaten in
small portions and only after other
cereals are tolerated well.
PASTA AND RICE
Low-fat and well cooked pasta,
soft yolk-less pasta and noodles,
and well cooked rice. Pasta “sits
heavy” in the first few weeks
after your pureed diet so make
sure to eat small portions at a
time. Sauces should be
vegetable based and low in fat.
Creamy or high-fat sauces, uncooked
pasta, buttery pastas, regular canned
or frozen pasta dishes
BEVERAGES
Decaffeinated coffee and tea,
small amounts of unsweetened
fruit juice, mineral water,
vegetable juices, and sugar-free
fruit flavored drinks (Crystal
Light, Minute Maid Light, Sugarfree Kool-Aid, Diet V-8 Splash)
Any beverage with added sugar,
alcoholic beverages, or beverages
containing caffeine or carbonation.
SOUPS
Bouillon, broth with soft noodles,
vegetable soup, and most soups
without chunky meat. Choose any
soup which contains foods you can
tolerate. Consider soup as a
liquid and do not mix it with
solid foods. Cream soups should
be low-fat.
Regular cream soups, soups with large
chunks of tough meat. Chili with
beans and lean meat should be added
only after you can tolerate high fiber
vegetables.
Phase III- Solids
FOOD CATEGORY
CHOOSE
DO NOT CHOOSE
FATS
Small amounts of margarine (1
tsp.), canola, olive or peanut oil,
peanut butter, reduced-fat
mayonnaise
Butter, regular mayonnaise, bacon,
bacon fat, gravy, fried foods
SWEETS
Small servings occasionally of a
plain dessert, such as graham
crackers, reduced-fat vanilla
wafers, sugar-free pudding or
Jell-O, sugar-free popsicles
Candy bars, cake (with or without
icing), pie, pastries, sodas. All refined
sugar.
SEASONINGS & MISC.
Ketchup, mustard, mild salsa
(small amounts), soy sauce, mild
herbs/spices for seasoning
MEAT, FISH,
POULTRY, EGGS
Scrambled or soft boiled eggs,
ground lean meats (without skin),
cooked lean ham, canned fish or
chicken in water, cooked fish
filet, lean deli meats
Fatty meats, beef unless very finely
ground and chewed well, tough or
over-cooked meats, meats canned in
oil, fried meats, turkey or chicken
with skin
Phase III-Solids
Sample Menu
Time
7:00 a.m. - 7:30 a.m.
8:00 a.m. - 9:00 a.m.
9:30 a.m. -10:00 a.m.
10:30 a.m. – 11:30 a.m.
12:00 p.m. - 12:30 p.m.
1:00 p.m. – 2:00 p.m.
2:30 p.m. -3:00 p.m.
3:30 p.m. - 4:30 p.m.
5:00 p.m. – 5:30 p.m.
6:00 p.m. - 7:00 p.m.
7:30 p.m. - 8:00 p.m.
8:30 p.m. - 9:30 p.m.
Food/Drink
scrambled egg with
protein powder
peaches
Water
Skim milk
Chocolate protein
powder
Water
Turkey
Mashed Potatoes
Green beans
Water
Skim milk
Strawberry protein
powder
Water
Tuna salad with FF mayo
Crackers
Water
Sugar-free, fat-free
pudding
Protein powder
Water
Amount
1
½ scoop
¼ cup
8-12 ounces (as
tolerated)
4 ounces
½ scoop
8-12 ounces (as
tolerated)
1 ounce
¼ cup
1 ounce
8-12 ounces (as
tolerated)
4 ounces
½ scoop
8-12 ounces (as
tolerated)
¼ cup
2 crackers
8- 12 ounces (as
tolerated)
½ cup
½ scoop
8-12 ounces (as
tolerated)