Gastric Bypass Diet
Days 1 and 2: Bariatric Clear Liquids
Duration: 2 days
Food consistency: Bariatric clear liquids, which includes clear, non-carbonated, non-
calorie, caffeine-free liquids such as:
o Water
o Crystal Light
o Flavored, sugar free water (Fruit2O, Propel)
o Sugar-free Kool-Aid
o Decaffeinated coffee or tea (iced or hot)
o Low fat broth
o Diet Jell-O
Instructions on First Day:
1. You will sip small amounts of fluid throughout the day.
2. It is important for you to sip these liquids slowly.
3. Do not use a straw as they can make you feel bloated and gassy.
4. As the initial swelling goes down and your pouch heals, fluids will exit the pouch
as if it were going through a funnel.
Instructions on Second Day:
1. If you tolerate small amounts of liquids for approximately 24 hours, you will
advance to larger amounts of the same liquids from Day 1.
2. You will receive a meal tray for breakfast, lunch and dinner.
3. You will also receive these bariatric clear liquids between your meals to help you
drink enough fluid to stay hydrated.
4. It is again important to sip these liquids slowly.
Tips:
• The purpose of this phase is to ensure that you tolerate something in your new
stomach pouch and slowly transition you to larger amounts of liquids
• Unflavored water may be difficult to tolerate initially. The reason why is
unknown; however, putting a slice of orange or lemon into your water can
improve tolerance
• Beverages that contain a lot of sugar, including natural sugar=CALORIES! A lot
of beverages on the market claim to give you energy, provide you with 100% of
the RDA for vitamins, minerals, and antioxidants, but will also increase caloric
intake
• Do not drink carbonated beverages even if they are “flat.” When you swallow
“flat” soda, the trapped air bubbles are released in the pouch and cause additional
gas
Day 3 to 9: Bariatric Full Liquids
Duration: 7 days
Food consistency: A full liquid diet consists of foods that pour off a spoon like soup and
thin cream of wheat. These liquids not only provide fluid to prevent dehydration, but also
supply protein and other nutrients to keep you healthy and with healing.
Instructions:
1. All items should be low in fat and sugar to prevent excessive caloric intake and
improve tolerance.
2. You should start the protein supplements during this phase. Minimum protein
requirements: 60 – 80 grams per day. It is important for you to sip these full
liquids slowly.
3. It is pertinent that you keep track of your protein intake daily to ensure you are
meeting your protein requirements. Protein is essential to help preserve muscle
mass, assist in wound healing, keep your energy level up, and keep your body’s
everyday functions running smoothly.
4. Try adding non-fat dry milk powder to foods to increase the protein content
without adding volume (3 Tablespoons of non-fat dry milk powder = 4 grams of
protein). You can also add unflavored protein powder to food items; i.e. Unjury
(20 grams per scoop) or Beneprotein (6 grams per scoop).
Measuring conversions:
3 tsp=1 TBSP
1 fl oz=30 cc’s
2 TBSP=1 oz=28.3 grams
4 oz=1/2 cup
4 TB=2 oz=1/4 cup
8 oz=1 cup
8 TBSP=4 oz=1/2 cup
4 cups=16 oz=1 pint
8 cups=64 oz=2 quarts
Bariatric Full Liquids
*You should purchase these items before surgery*
Suggested Full Liquids Portion Size Protein Content
See protein supplement See protein supplement
Protein Supplements section section
Skim Milk 1 cup 8 grams
Blended and Strained low 1 cup 6 – 12 grams
fat cream soups (made with
skim milk)
Blended and Strained low 1 cup 4 – 8 grams
fat broth soups
Thin cream of wheat or rice ½ cup 3 grams
(no oatmeal)
No sugar added, fat-free ice ½ cup 2 grams
cream
Full Liquids: Sample Menu
Food Protein Content
• ½ cup thin cream of 7 grams
Breakfast wheat (with 3 T dry
milk powder)
• ½ cup skim milk 4 grams
See protein supplement list
Morning Snack Protein Supplement or check food label
Lunch • 1 cup blended and 16 grams
strained low fat
cream soup (with 3
T dry milk powder)
Afternoon Snack See protein supplement list
Protein Supplement or check food label
Dinner • 1 cup blended and 12 grams
strained low fat
cream soup (with 3
T dry milk powder)
• ½ cup no sugar
added, fat-free ice 2 grams
cream
Evening Snack See protein supplement list
Protein Supplement or check food label
Total protein: 41 grams not including protein supplements
Day 10-30: Bariatric Pureed Foods
Duration: 3 weeks
Food consistency: smooth-blended foods with a consistency of Stage 2 baby foods.
Instructions:
• Commercial baby foods can be purchased in the grocery store or foods from home
can be blended to this consistency using a blender or food processor.
• If you puree your own foods, the following tips are important to remember:
o All ingredients need to be sugar-free and low-fat
o Cut all food intended to be blended into small pieces
o A small amount of liquid should be added to the food that you are
blending. Do not use water as this will dilute the taste and the nutrients.
Try adding skim milk, V8*, tomato juice*, broth* or fat-free gravy
(* use the low salt variety if you are being treated for high blood pressure)
• Your portion size should be approximately ¼ to ½ cup per meal at this phase.
• It will likely be necessary that you eat at least 3 meals daily and drink at least 2
protein supplements daily to meet your nutritional needs (See list of suggested
protein supplements in the “protein supplement” section of the manual).
• Minimum protein requirement for women: 60 – 70 grams per day.
Minimum protein requirement for men: 70 – 80 grams per day.
• It is important for you to add up your protein intake every day to make sure you
are meeting your protein requirements. Inadequate protein intake can result in
hair loss and improper healing.
• Mild spices, herbs, salt, pepper and small amounts (1 teaspoon) of butter,
margarine, or oil are permitted to add flavor to your meals. Do NOT use sugar,
honey, molasses, or syrups. Sugar substitutes such as Splenda, Equal, and Sweet-
n-Low are acceptable to use throughout this process.
• Aim to drink at least 64 oz of bariatric clear liquids between your meals daily. It
is very important to stop drinking liquids 15 minutes before your meal and to
wait 1 hour after your meal before drinking fluids again.
• The purpose of this phase is to slowly add some texture to the diet while not
overworking the stomach pouch so it can heal properly.
• Advancing to foods with more texture before the 3 weeks have passed may
result in complications such as vomiting or blockage in the pouch. This could
result in readmission to the hospital.
Bariatric Pureed Foods
Suggested Foods Portion Protein Content
Strained baby meat ¼ cup 10 grams
(Stage 2)
Low fat, cottage cheese (small ¼ cup 7 grams
curd)
Low fat, ricotta cheese ¼ cup 7 grams
No sugar added, low fat, ¼ cup 2 grams
smooth-blended yogurt
Smooth-textured whipped ¼ cup 1.5 grams
potatoes
No sugar added puddings ¼ cup 1 gram
made with skim milk
Strained baby vegetables ¼ cup 0.5 grams
(Stage 1 or 2)
Baby applesauce (Stage 1 or 2) ¼ cup 0 grams
Strained baby fruit (Stage 1 or ¼ cup 0 grams
2)
Pureed Vegetables ¼ cup 0-1 grams
Pureed Bananas or other fruits ¼ cup 0 grams
without seeds
Pureed fish tuna, poultry, veal, 1 oz 7 grams
pork, or beef
Pureed egg/egg substitutes or 1 egg or ¼ cup 7 grams
poached egg
Pureed Foods: Sample Menu
Day 1 Day 2 Day 3
8:00 a.m. ½ cup cream of wheat 1 egg pureed 1 scoop protein powder
Add 2 tbsp of fat free milk 1 oz low fat cheese 4 oz fat free milk
2 oz fat free yogurt
1 banana
9:30 a.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
10:30 a.m. 1 scoop protein powder with 8 1 scoop protein powder 1 scoop protein powder
oz fat free milk with 8 oz fat free milk with 8 oz fat free milk
12:00 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
1:00 p.m. 2 oz. pureed ham ¼ cup pureed tuna salad ¼ cup pureed chicken
¼ cup mashed potatoes (made with low-fat mayo) salad (with low fat mayo)
2 tbsp pureed vegetables 2 tbsp pureed fruit 2 tbsp unsweetened
applesauce
2:30 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
3:30 p.m. 1 scoop protein powder with 8 1 scoop protein powder 1 scoop protein powder
oz fat free milk with 8 oz fat free milk with 8 oz fat free milk
5:00 p.m. ½ cup Greek yogurt ¼ cup low fat cottage ¼ cup fat free refried beans
cheese 1 oz low fat cheese
1 tbsp pureed peaches
6:00 p.m. 2 oz pureed chicken ½ cup pureed chili 2 oz pureed shredded beef
2 tbsp pureed carrots 1 oz low fat cheese 1 tbsp fat free gravy
¼ cup mashed potatoes 2 tbsp pureed cauliflower
1 tbsp fat free gravy ¼ cup mashed yams
7:30 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
8:30 p.m. 1 wedge low fat Laughing Cow ½ cup Greek yogurt ½ cup cottage cheese
cheese
4 tbsp unsweetened applesauce
10:00 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
Days 31 to 58: Soft Solid Foods
Duration: 4 weeks
Food Consistency: Soft solids
1. No large pieces of meat
2. No raw vegetables
3. No skins or seeds of fruit
Instructions:
• You should add only one new food at each meal to test your tolerance of that
particular food. Adding too many foods at one time will make it difficult for you
to determine which foods you tolerate and which foods you don’t tolerate
• Limit the total amount of food to no more than ¾ cup to 1 cup per meal.
• The purpose of this phase is to slowly incorporate more texture into your diet
before advancing to a full textured diet, thus assessing your tolerance to various
foods.
• Advancing to foods with more texture before this 4 week period may result in
complications such as vomiting or blockage in the pouch. This could result in
readmission to the hospital.
Soft Solid Foods
Suggested Soft Foods Portion Protein Content
Low-fat cheese 1 ounce 7 grams
Finely ground meats 1 ounce 7 grams
Flaked fish (haddock, 1 ounce 7 grams
tilapia, orange roughy)
Eggs 1 egg 7 grams
Egg Substitutes ¼ cup 7 grams
Canned tuna in water ¼ cup 7 grams
Baked Potato (no skin) ¼ cup 1.5 grams
Oatmeal ¼ cup 1.5 grams
Squash, acorn or butternut ¼ cup 1.5 grams
Whole grain pasta ¼ cup 1.5 grams
Whole wheat crackers 3–4 1.5 grams
Whole wheat toast ½ slice 1.5 grams
Low sugar cereal ¼ cup 1 gram
Cooked vegetables ¼ cup 0.5 grams
Canned fruits in water ¼ cup 0 grams
Sample Menu for Phase 5
Day 1 Day 2 Day 3
8:00 a.m. 1 scrambled egg 1/3 cup oatmeal 1 egg or ¼ egg substitute
1 slice toast 1 slice toast 1 slice low-fat cheese-
2 tsp low-fat margarine make into an omelet
9:30 a.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
10:30 a.m. 1 scoop protein powder with 1 scoop protein powder with 8 1 scoop protein powder
8 oz fat free milk oz fat free milk with 8 oz fat free milk
12:00 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
1:00 p.m. 1 oz of low-fat cheese 1 slice whole wheat bread ¼ cup chicken salad (with
melted over ¼ - ½ cup pasta (toasted) low fat mayo)
1 tbsp marinara sauce 1 slice low fat cheese 1 slice toast
¼ cup cooked broccoli 1 oz chipped low fat deli meat ¼ cup unsweetened
(example-turkey, chicken, applesauce
ham)
2:30 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
3:30 p.m. ½ cup Greek yogurt 4 All Bran crackers with 1 ½ cup low fat cottage
wedge Laughing Cow cheese cheese
6:00 p.m. ¼ of a large baked potato (no ¼ cup chicken and rice ¼ cup fat free refried beans
skin) casserole 1 oz lean ground beef
¼ cup Chili ¼ cup soft cooked green beans 1 oz low fat cheese
1 tbsp light sour cream 1 peach half (canned in water) ½ of a 6” soft tortilla
7:30 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
8:30 p.m. 2 oz of tuna ½ cup Greek yogurt 1 hard boiled egg
1 tsp low-fat/fat-free mayo
3 whole wheat crackers
10:00 p.m. 8-12 oz clear liquid 8-12 oz clear liquid 8-12 oz clear liquid
Unrestricted Textures
• If you tolerate soft solids for 4 weeks, you can slowly advance your diet to regular
textures. At this time, you should tolerate most foods.
• It is best to start with the softer raw fruits and vegetables, such as bananas,
melons, and tomatoes and work up to the harder, more fibrous raw fruits and
vegetables, such as oranges, apples and carrots. At first, you may want to peel off
any tough skins. As you proceed with different food textures, you will likely be
able to consume unpeeled foods.
• Toast bread to improve tolerance.
• Limit your intake to no more than 1 cup per meal. You may not be able to eat this
much, so eat until you are satisfied without exceeding a cup.
• You should add only one new food at each meal to test your tolerance of that
particular food. Adding too many foods at one time will make it difficult to
determine which foods you tolerate and which foods you don’t tolerate
• As always, choose foods that are low in sugar and fat.
Sample Menu
Menu Protein Content
Breakfast • ½ cup cottage 14 grams
cheese
• ¼ cup peaches 0 grams
• ¼ cup oatmeal 1.5 grams
Morning snack • bariatric clear 0 grams
liquids
• protein supplement See protein supplement list
as needed or check food label
Lunch • 1 oz low fat ham 7 grams
• 1 oz low fat cheese 7 grams
• 1 slice of toast 3 grams
• ½ banana 0 grams
• ¼ cup yogurt 2 grams
Afternoon Snack • bariatric clear 0 grams
liquids
• protein supplement See protein supplement list
as needed or check food label
Dinner • 2 oz chicken 14 grams
• ¼ cup rice 1.5 grams
• ½ cup salad 0.5 grams
• ½ small apple 0 grams
Evening Snack • bariatric clear 0 grams
liquids
• protein supplement See protein supplement list
as needed or check food label
General Diet Tips for Success
• It is recommend that you consume 3 meals daily (approximately 1 cup in volume
for each meal), and limit snacking in between meals. If you snack throughout
the day, make sure you choose foods that are moderately-high in protein and
calorie controlled.
• Stop eating with indications of fullness. It can take up to 20 minutes for your
brain to register that your stomach is full. When you feel a pressure in the center
of your abdomen, just below your rib cage, this is your body telling you to stop
eating. If you experience pain after consuming food, you may have eaten too
much or too quickly.
• Minimum protein requirement for women: 60 – 70 grams per day.
Minimum protein requirement for men: 70 – 80 grams per day.
• It is important for you to add up your protein intake every day to ensure that you
are meeting your protein requirements. Inadequate protein intake can result in
hair loss.
• Drink at least 64 oz of fluids daily. Be sure to stop drinking fluids 15 minutes
before your meal and wait 1 hour after your meal before you start drinking
liquids again.
• Mild spices, herbs, salt, and pepper are permitted to add taste. Do NOT use
sugar, honey, molasses, and syrups. Sugar substitutes such as Splenda, Equal, and
Sweet-n-Low are acceptable to use.
• Read Food labels. Avoid high sugar foods, such as sweets, juices, and sodas.
Aim for no more than 10-15 grams of sugar per serving of food in one sitting.
Also avoid foods that are high in fat, such as greasy or fried foods. Choose foods
with less than 5 grams of total fat per serving.
• Incorporate an exercise regimen into your daily routine. Exercise will not
only help you to meet your weight loss goal, but it is also important for over-all
health. Aim for 30-60 minutes per day of moderate physical activity, most days
of the week.
Gastric Bypass Vitamin and Mineral Supplements
Because you will absorb nutrients differently after surgery, daily vitamin and mineral
supplementation is required FOR THE REST OF YOUR LIFE. Vitamin supplements
need to be chewable, crushable, dissolvable, or liquid so that they don’t cause a blockage
in the pouch. You will need to take several doses of vitamins each day. Your dietitian
can help you to develop a dosing schedule if you need assistance.
The following is a list of the REQUIRED vitamins and minerals:
1) Calcium Citrate: You must take at least 1500 mg of calcium citrate per day.
DO NOT TAKE PRODUCTS THAT CONTAIN CALCIUM CARBONATE, such as
Viactiv, Tums, and Caltrate. These products need stomach acid to be activated, and
patients who have had gastric bypass surgery will not be able to absorb these products
very well. The following is a list of suggested chewable/liquid calcium citrate products:
Vitamin Brand Amount per Tab Availability
Bariatric Advantage 400 mg/tab www.bariatricadvantage.com
Calcium Citrate (4 chews per day)
Lifetime Calcium Citrate 750mg/1 teaspoon Vitamin World
(2 tsp per day)
Building Blocks 1000mg/6 capsules www.bbvitamins.com
(8-9capsules/day)
Puritan’s Pride Calcium 200 mg/tab www.Puritan.com
Citrate (8 capsules per day)
Celebrate Vitamins 1000mg/4 capsules www.celebratevitamins.com
(6 capsules/day)
2) Iron: Most menstruating women and/or individuals with history of anemia will be
required to take iron. You must take 50-100 mg of iron per day. If you have problems
tolerating this, you can try a slow release formula such as Slow Fe. The following is a list
of suggested iron products:
Vitamin Brand Amount per Tab Availability
Bariatric Advantage Iron 29 mg/tab (2-3 per day) BariatricAdvantage.com
FerroSequels (crushed) 50 mg/tab (1-2 per day) Any drug store
Ferretts 106 mg/tab (1 per day) Any drug store
3) Vitamin B12: You must take 500 mcg of vitamin B12 per day. You will take the
sublingual form (put it under the tongue to dissolve) as it is better absorbed by the body.
If the brand of Vitamin B12 you choose comes in 1000 mcg increments, take half of the
vitamin everyday, or take 1000 mcg every other day.
4) Multivitamin: You must take two daily multivitamin supplements equivalent to
Centrum, and they MUST be in the form of chewable or liquid (examples – Flintstones or
Centrum chewable gummies).
Vitamin Tips:
• You should begin taking these vitamins and minerals when you start your pureed
diet.
• To avoid nausea, do not take vitamins and minerals on an empty stomach,
especially iron.
• If the iron causes nausea or stomach upset, you can try a less nauseating form of
iron called “slow Fe”.
• Do not take calcium and iron at the same time; take at least 4 hours apart.
• Do not take vitamins and minerals with tea, coffee, or cola.
• It is recommended that you start using these supplements prior to surgery to help
you get used to the schedule and build up your system.
Vitamin/Mineral Result of Deficiency
Calcium Weak and brittle bones
Iron Anemia, fatigue, dizziness, infection,
inadequate blood stores, low blood count
Vitamin B12 Tingling of hands and feet, nerve damage,
trouble walking, paralysis, pernicious anemia
Protein Supplements
Using protein supplements is sometimes the only way bariatric patients can meet their
protein needs during the first few months after surgery. It is important to choose protein
supplements that are high in protein and low in sugar. SELECT SUPPLEMENTS
THAT CONTAIN LESS THAN 5 GRAMS OF SUGAR PER SERVING.
The supplements listed below are appropriate for your use. There are many additional
supplements available.
Protein
Content per
Product Kcal/serving serving (gm) Type of protein Availability
EAS 100 15 Milk protein concentrate, GNC
AdvantEdge Calcium caseinate, Whey www.allstarthealth.com
CHO control Protein Isolate
Bariatric 140 22 Whey protein isolate www.bariatricadvantage.c
Advantage om
Designer Whey 100 17.5 Whey protein isolate GNC
Protein Vitamin World
• Aspartame- Fitness Mania
free Giant grocery store
• Lactose-free
Unjury 100 20 Whey protein isolate Unjury.com
• Lactose-free (1-800-517-5111)
AchievOne 120 20 Milk protein concentrate www.store.bariatriceating.
Ready to Drink com (1-800-255-2690)
Zero Carb 160 40 Whey protein Isolate Fitness Mania
Isopure Protein
Drink
• Aspartame-
free
• Lactose-free
Nectar protein 90 23 Whey Protein Isolate www.store.bariatriceating.
com (1-800-255-2690)
Fitness Mania
Procel 110 20 Whey Protein www.globalhp.com
• Aspartame- Concentrate and Lecithin
free
• Lactose-free
• Unflavored
Atkins Ready to 170 20 Calcium Caseinate, Milk www.atkins.com
Drink Shake Protein Concentrate Grocery Store
GNC Soy 60 13 Isolate Soy Protein GNC
Protein www.gnc.com
(unflavored/uns
weetened)
ProBlend 135 27 Whey Protein GNC
Concentrate, Whey www.nutripeak.com
Isolate Calcium Caseinate
