Nutrition Guidelines after Gastric Bypass, Gastric Band

Nutrition Guidelines after Gastric Bypass, Gastric Band & Gastric Sleeve Surgery 

The information in this packet will help guide you immediately after your surgery and for 

the months and years to come. The 6 major recommendations are outlined on this page 

and you can find additional details about each recommendation on the following pages. 

The Bariatric Surgery Dietitians are always available to answer questions by phone at 

434-243-9348 and will see you during clinic visits. 

1. Diet Progression 

After 1-2 meals of Phase 1: Clear Liquids, you have advanced to Phase 2: 

Blended/Pureed. 

Continue the Phase 2 Diet until your first clinic appointment after surgery (about 3 weeks) 

when the surgeon and dietitian can evaluate your progress. 

In the Phase 2 Diet, all foods must have a pureed consistency. 

2. High Protein Food Sources 

Your diet after surgery requires 60-70 grams of protein per day. 

High protein foods include low-fat or fat-free dairy foods, beans, eggs, nuts, peanut 

butter, lean meat, fish and poultry. 

There are many protein supplements available. 

3. Low-Sugar & Low-Fat Foods and Beverages 

High-sugar and high-fat foods and beverages will cause unpleasant side effects 

(“Dumping Syndrome”) and make it more difficult for you to lose weight. 

Read food labels to make sure your foods have less than 5 grams Total Fat and less than 

10 grams Sugars per serving. 

All beverages should be sugar-free. 

4. 4-6 Small Meals per Day 

Portion size should be ½ cup or less at every meal. 

Eat slowly and chew each bite well. 

Stop eating as soon as you feel SATISFIED. 

5. 48-64 oz. (6-8 cups) Fluid per Day 

Do not drink from 30 minutes before until 30 minutes after a meal. 

Avoid carbonated beverages and caffeine until Phase 4: Regular Foods. 

6. Vitamins and Minerals 

Taking vitamins every day for the rest of your life is essential to make sure you get all the 

nutrients your body needs. 

o Multivitamin with minerals (Children’s Chewable or Adult Multivitamin): one a day 

o Calcium Citrate with Vitamin D: 

Gastric Bypass: 500 mg twice a day for a total of 1000 mg per day 

Gastric Band/Sleeve: 500 mg once a day 

o Iron (ferrous gluconate): 325 mg twice a day, taken separate from calcium 

Only if you had Gastric Bypass surgery and are a woman still menstruating 

OR your blood work showed low iron levels 

Please save this packet and review it for the best results after your surgery!

1. Diet Progression 

The weight loss surgery diet is divided into four phases. The diet progression is outlined below: 

Phase 1: Clear Liquids (1-2 meals) 

- For 1-2 meals after surgery you will be given clear liquids such as water, broth, a small 

amount of unsweetened juices, diet Jell-O and diet drinks to see how you tolerate eating. 

- Sip slowly and pay attention to your feelings of fullness. 

Phase 2: Blended/Pureed Food (3 weeks) 

- For approximately 3 weeks after surgery, you will need to eat blended or pureed foods. 

- All the food you eat should be the consistency of thin, smooth applesauce or yogurt. 

- Put cooked foods in a blender, then add liquid such as skim milk, broth, fat free gravy or low 

fat creamy soup and blend until smooth. 

- Eating solid foods too soon will put pressure on the staple line and may cause breakage or 

leaking. 

Food Choose Avoid 

Protein and Protein 

Substitutes 

Milk and Milk 

Products 

Fruit and 

Vegetables 

Pureed fish, tuna, poultry, or pork; 

low fat cottage cheese; low-fat or 

non-fat cheese; baby-food meats 

(all types); mashed or pureed tofu; 

pureed egg or egg substitute; 

blended low fat casseroles with 

soft vegetables 

Fat-free (skim) or 1% milk; sugar 

free or low fat yogurt 

(approximately 80 calories per 

serving) 

Applesauce, pureed banana, 

mashed potato or other fruit & 

vegetables without seeds or hulls 

that have been pureed 

Bread and Cereals Hot cereals cooked in milk 

(oatmeal, grits, cream of wheat) 

Other Sugar free gelatin or popsicles; 

sugar free fat free pudding/custard 

Crunchy peanut butter; 

all others 

Chocolate milk; 

sweetened condensed 

milk; 2% or whole milk; 

ice cream 

All others 

Bread and crunchy 

cereals 

Chewing gum; sweets 

Sample Phase 2 Menu: 

Breakfast 1 package No Sugar Added Carnation Instant Breakfast made 

with 1 cup skim milk & 1/3 cup powdered nonfat milk 

Snack ½ cup cottage cheese 

Lunch ½ cup fat-free refried beans 

1 ounce melted reduced fat cheese 

Snack ½ cup Light yogurt 

Dinner 2 oz meat blended with 1/4 cup low-fat cream soup and 2 Tbsp 

skim milk powder 

This provides approximately 70 grams protein and 800 calories. 


Phase 3: Soft Food (1 week) 

- About 3 weeks after surgery, with your doctor’s approval, you may advance to Phase 3. 

- The general rule is “Can I mash this food with a fork?” to determine if it will be soft enough. 

- Phase 3 of the diet should include about 3 to 4 meals per day. Each meal should not exceed 

4 ounces or ½ cup. 

- You will need to eat and drink slowly. Take small bites and chew very well. 

- Keep in mind that you are “re-educating” your stomach. If you eat too fast, too much, or 

don’t chew enough, you will feel uncomfortable and could vomit. 

Food Choose Avoid 

Protein and Protein 

Substitutes 

Milk and Milk 

Products 

Fruit and 

Vegetables 

Lean soft and moist meats 

including fish, tuna, poultry, or 

pork; low fat cottage cheese, 

low-fat or non-fat cheese; soft 

tofu; eggs or egg substitute; 

soft low fat casseroles with 

soft vegetables 

Fat-free (skim) or 1% milk; 

sugar free or low fat yogurt 

(approximately 80 calories per 

serving) 

Any fruit & vegetables without 

seeds or hulls that have been 

cooked soft; soft 

unsweetened canned fruits or 

vegetables; fresh soft fruit 

Bread and Cereals Hot cereals cooked in milk 

(oatmeal, grits, cream of 

wheat); cold cereal (high 

protein) soaked in milk 

Other Sugar free gelatin or 

popsicles; sugar free fat free 

pudding/custard 

Crunchy peanut butter; 

fried eggs; any meat that 

is dry, tough or chewy. 

Red meat may not be 

tolerated in this phase. 


sweetened condensed 

milk; 2% or whole milk; 

ice cream 

All others – including raw 

vegetables (such as 

salads) and raw crunchy 

fruits (especially those 

with tough skins/ seeds) 

Soft “gummy” bread; 

crunchy cereals; sweet 

cereals 

Chewing gum; sweets 


Breakfast 1 egg with 1 slice reduced fat cheese 

Snack 1/3 banana with 1 Tbsp Natural Peanut Butter 

Lunch 3 oz lean, soft meat (turkey, low-fat ham) with ¼ cup low-fat 

gravy 

¼ cup light canned fruit 

Dinner ¼ cup tuna canned in water with 1 Tbsp light mayo 

¼ cup cooked vegetables 

Snack ½ cup Low-fat cottage cheese 

This provides approximately 70 grams protein and 700 calories. 


Phase 4: Solid Food 

- About 4-6 weeks after your surgery, you may begin to try solid foods, one item at a time to 

test your tolerance to them. 

- Do not worry if you cannot handle foods that you used to eat. Most people experience some 

problems at first with food tolerances, especially with meats and breads. 

- Once you are eating solid foods you can reduce the number of meals that you eat to 3 meals 

per day. Be as regular as possible with meals and meal times. 

- You will always need to get 60-70 grams of protein per day, and if you skip meals you will 

not get in enough protein. 

Food Choose Foods that may be Foods to limit/avoid 

difficult to tolerate for best weight loss 

Protein and Lean meats, eggs or egg Tough meat or meat Fried or breaded meat 

Protein substitute and tofu; with gristle; Some products; fried eggs 

Substitutes regular low fat 

patients do not tolerate 

casseroles or crock pot 

meals 

red meat. 

Milk and Milk Fat-free (skim) or 1% Chocolate milk; 


Products milk; sugar free or low fat sweetened condensed sweetened condensed 

yogurt (approximately 80 milk; 2% or whole milk; milk; 2% or whole milk; 

calories per serving) ice cream 

ice cream 

Fruits Fresh, canned, frozen or Be cautious with apples, Fruits that have added 

cooked fruit 

grapes, or other fruits 

with tough peels or 

skins and dried fruits. 

sugars or sauces 

Vegetables Fresh, canned, frozen or Vegetables with very Fried or breaded 

cooked vegetables tough skins or a lot of 

seeds 

vegetable products 

Bread Dry, coarse, or well- Soft breads that become Sweet breads; danish; 

toasted bread; crispy low gummy; breads with a doughnuts; pastries 

fat crackers or baked lot of nuts and seeds or 

tortillas 

dried fruit 

Cereals All cooked and dried Cereals containing fruits Cereal with added sugar 

cereals without added or nuts 

over 10-15 grams per 

sugar 

serving 

Potatoes, Boiled, mashed or baked Potato skins; rice; Instant noodle dishes 

Rice and potatoes; well cooked noodles 

Pasta whole wheat pasta or 

rice 

Other Sugar free gelatin or Chewing gum; sweets; Fried, salty snack foods; 

popsicles; sugar free fat popcorn; nuts; chili; creamed soups unless 

free pudding/custard extremely spicy foods low fat versions 



Breakfast ½ slice whole wheat toast 

1 scrambled egg 

1 turkey sausage patty 

Lunch 

½ sandwich (1 slice whole wheat toast with 3 thin slices lean 

ham, 1 slice reduced-fat cheese and 1 Tbsp light mayo) 

Dinner 3 ounces grilled chicken breast without skin with ¼ cup 

cooked vegetables sauteed in 1 Tbsp olive oil 

Snack ¼ cup almonds 

This provides approximately 68 grams protein and 1,000 calories. 


2. High Protein Food Sources 

- PROTEIN will be an essential part of your diet after surgery. 

- Protein helps with wound healing, muscle and skin re-growth, and repair, as well as 

preventing hair loss. 

- We recommend a daily protein goal of 60 grams for females and 70 grams for males 

each day. Every meal and snack should have a good source of protein in it. See the list 

below. 

- Sometimes for the first 1-2 weeks after surgery it is helpful to consume a protein supplement 

(as long as it is low in added fats and sugars). See the list below. 

FOODS 

Beans and Nuts 

SERVING SIZE 

GRAMS OF 

PROTEIN 

Fat-free refried beans 

Beans (cooked) 

baked, black, black-eyed peas, 

½ cup 

6 

brown, garbanzo/chick peas, 

kidney, lentils, lima, pinto, white 

½ cup 

7.5 (average) 

Nuts & Seeds 

almonds, cashews, peanuts, 

pistachios, pumpkin seeds, 

sunflower seeds, walnuts 

1 oz. 6.5 (average) 

Hummus ¼ cup 4 

Reduced-fat peanut butter 

Dairy 

2 Tbsp 8 

Skim or 1% milk 

1 cup 

8 

Low-fat/Light yogurt 4-6 oz. 5 

Reduced-fat cheese 1 ounce 7 

Low-fat cottage cheese ½ cup 13 

Sugar-free fat-free instant 

pudding 

½ cup (made with skim milk) 4 

Carnation Instant Breakfast, No 

Sugar Added 

1 packet (made with 1 cup skim milk) 12 

Non-fat milk powder 

Meat and Seafood 

1 Tbsp 1.5 

Egg (scrambled or boiled) 1 large 

6 

Lean Beef (cooked) 1 oz. (3 oz. = size of a deck of cards) 8 

Lean Pork (cooked) 1 oz. (3 oz. = size of a deck of cards) 8 

Lean Chicken (cooked) 1 oz. (3 oz. = size of a deck of cards) 8 

Fish (cooked) 1 oz. (3 oz. = size of a deck of cards) 6 

Tuna (canned) 

Alternative Items 

1 oz. (3 oz. = size of a deck of cards) 7 

Egg beaters 

½ cup 

12 

Tofu 3 oz. (size of a deck of cards) 11 

Veggie burger (soy, bean, 

veggie) 

1 burger 11-16 


Protein Supplements 

A protein supplement may be beneficial during the first few weeks after your surgery if you are 

having trouble consuming enough protein from food. A good supplement can help you reach 

your daily protein needs. Follow the package directions for mixing protein supplements with food 

or drinks. 

The following is a list of some appropriate supplements, which provide protein without high 

amounts of sugar: 

Protein Supplement Amount Grams of Protein 

GNC 100% Whey Protein 1 scoop 20 

EAS AdvantEdge 100% Whey 

Protein 

1 scoop 23 

Beneprotein 1 scoop 6 

Carb Solutions Shake Mix 1 scoop 11 

Carnation Instant Breakfast No 1 package with 1 cup skim milk OR 12 

Sugar Added 

1 11oz. Ready-To-Drink bottle 

Designer Whey 1 scoop 18 

Isopure 1 scoop powder 25 

Isopure 1 20 oz. clear drink 40 

Unjury 1 scoop 20 

Twinlab 100% Whey Protein 

Fuel 

1 scoop 25 

Body Fortress Super Advanced 

Whey Protein 

1 scoop 26 

Optimum Nutrition Gold 

Standard 100% Whey 

1 scoop 24 

Protein supplements are available at the following stores: 

GNC 

Target 

Walmart 

The Vitamin Shoppe 

Sam’s Club 

Some drug stores 

Some grocery stores 


3. Low-Sugar & Low-Fat Foods and Beverages 

SUGAR 

- After weight loss surgery you will also need to follow a diet that is LOW IN ADDED SUGARS. 

This will help not only with tolerance to foods/beverages after surgery, but will also help with 

optimal weight loss. 

- Dumping Syndrome: After gastric bypass surgery, some patients experience a 

phenomenon known as “dumping syndrome” after eating concentrated sweets, fatty foods 

and/or drinking fluids with meals. This occurs when food exits the pouch rapidly and “dumps” 

into the intestine. This part of your intestine does not tolerate concentrated foods (sweet or fatty 

foods), so it immediately pulls water out of the rest of the body to dilute the food. It then rapidly 

flows down the remainder of the small intestine; it enters the large intestine (still flowing rapidly) 

and exits via the rectum. Some patients have shared stories about their dumping syndrome, 

describing the sudden onset of diarrhea and have reported having accidents in public places. 

Dumping syndrome can cause not only urgent diarrhea, but often patients will also feel nausea, 

lightheadedness, flushing, and stomach cramps. 

- Read Food Labels: Foods may have hidden sugar, so be sure and read food labels 

carefully. Aim for approximately 10 grams or less of sugar per serving. To prevent dumping 

syndrome you will need to avoid eating sugar and foods containing real sugar. Avoid products 

which list any type of sugar as one of the first three ingredients: including sugar, maple syrup, 

honey, molasses, corn syrup, corn sweeteners, glucose, lactose, maltose, dextrose, sorghum, 

sorbitol or mannitol. 

- Artificial Sweeteners: NutraSweet, Splenda, Sweet and Low and other artificial sweeteners 

are acceptable substitutes for real sugar. They will not cause dumping and will help with weight 

loss and maintenance since they contain very few calories. 

FAT 

- Your food choices will also need to be LOW-FAT. Fat may be difficult to digest or tolerate 

after weight loss surgery, especially fried foods, fast foods and snack foods. Small amounts of 

fats are fine such as those found in lean meats and fish or low fat dairy products and in fact, 

your body needs a certain amount of fat each day. 

- Cooking Methods: Use low-fat cooking methods to prevent adding fat to your foods. Try 

baking, broiling, or grilling and avoid frying foods. 

- Added Fat: A healthy, low-fat food can be made unhealthy from added fat. Be careful of the 

following ways that fat can be added to food: salad dressing, butter, sauces, gravies, 

mayonnaise, cheese, and nuts. 

- Read Food Labels: Read food labels for TOTAL FAT content. Total fat should be around 

5 grams per serving as an average. 

**** NOTE: If a food is labeled “Low-fat” it does not necessarily mean it is also low in sugar and 

vice-versa. So, it is important to read the entire food label. 


4. 4-6 Small Meals per Day 

- The diet has been designed to be gentle on your “new” stomach, to ensure proper healing of 

the staple line, and to help you to avoid overeating. 

- A normal stomach can hold approximately 4-6 cups at a time. After surgery your stomach 

pouch will only be able to handle about ½ cup! 

o You will need to GO SLOW! 

o It is important to chew your foods well, eat very slowly and pay attention to how you 

are feeling. Stop eating as soon as you feel full. 

5. 48-64 oz. (6-8 cups) Fluid per Day 

- Weight loss surgery patients need to drink AT LEAST 6-8 cups of LOW calorie fluids per 

day to prevent dehydration. (See list below.) 

- Do not drink fluids for 30 minutes before meals, during meals, or for 30 minutes after a meal. 

o Drinking too close to a meal may overfill the stomach pouch and cause vomiting. It 

can also cause the food to be washed through the intestines too quickly and may 

cause Dumping Syndrome or may leave you feeling hungry more quickly. 

- Sip slowly, but consistently between meals. 

- You may not be able to tolerate carbonated beverages or caffeine until you are in Phase 4. 

Beverages to Choose: 

WATER is best!! 

Flavored Water (Fruit2O, Sparkling) 

Crystal Light 

Wyler’s 

Juices Minute Maid Light 

Diet Juices 

Diet V8 Splash 

Sports Drinks Gatorade G2 

Propel 

Vitamin Water Zero 

Powerade Zero 

Soft Drinks Diet soft drinks 

“Zero” soft drinks 

Coffee & Tea Diet Iced Tea 

Unsweetened Tea 

Coffee with sugar-free, fat-free creamer and sweetener 

Milk Skim or 1% milk 

Light Soymilk 

Other Sugar-free Kool-Aid 

Sugar-free, fat-free hot chocolate 

Diet Snapple 

Fuze 

**If a beverage is “sugar-free” or “diet”, it is a good choice for you! 

**Sweeteners can be used: Equal, Sweet N Low, Splenda, Stevia, NutraSweet 


6. Vitamins and Minerals 

- It is critical that you take vitamins every day for the rest of your life after any weight loss 

surgery. You will not be able to meet your daily requirements for vitamins and minerals with 

food because of malabsorption after gastric bypass surgery and because you will not be able 

to eat a lot of food with any weight loss surgery. 

Daily Vitamin Regimen 

Complete Multiple 

Vitamin With 

Minerals 

500mg Calcium 

with Vit D 

1000mg Calcium 

Citrate with Vit D 

Gastric Bypass ** 

Gastric Band & 

Gastric Sleeve 

** Iron only needs to be taken by menstruating females and those who are anemic. 

Iron should be in the form of ferrous gluconate or ferrous fumarate. 

Notes: 

Avoid Mens formula vitamins and “Silver” vitamins for those over 50 years 

old…these typically do not contain iron. 

Calcium should be taken in 500mg doses. So, if you need 1000mg daily, you 

will need to take calcium 2 times a day. 

Avoid taking iron and calcium at the same time since they cannot both be 

absorbed at the same time. 

Gastric Bypass Daily Supplements Example 

At Breakfast: Take 1 multivitamin and 2 calcium tablets. 

At Lunch: Take 2 iron tablets (if needed). 

At Dinner: Take 2 calcium tablets. 

Gastric Band & Sleeve Daily Supplements Example 

At Breakfast: Take 1 multivitamin. 

At Dinner: Take 2 calcium tablets. 

Iron

Nutrition Guidelines after Gastric Bypass, Gastric Band

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