DIET FOUR STAGES – Ontario Bariatric Clinic

The Four Stages of Gastric Sleeve Diet:

Stage 1: Bariatric Surgery Clears:

In the hospital you will receive 2-4 meals of clear, sugar free liquids, along with a high protein shake. It will begin immediately after surgery or after the results of your “swallow test” are back. Your surgeon will ask you to start the following diet at least 2 weeks before surgery:

Drink water, caffeine free coffee and tea, broth, sugar-free jello, and Gatorade.
Try to sip fluids at the rate of 1 to 2 Tbsp. (15 -30 mls) every 15 minutes.
No straw no carbs no carbonated: Sipping fluids out of bottles or straws may cause gas. Gas is already a problem after surgery so you will not want to make it worse.
Protein Shakes: These must be high protein (20-40 grams/serving) AND low in sugar (less than 5 grams/serving). You must read product labels to determine the nutritional value. There are 2 types of protein shakes: Pre-mixed and powders mixed with milk.
Directions for powders: Add protein powder by the scoop/tablespoon to 8 oz Skim Milk or Fat Free Lactaid daily. You may choose to drink your shake in 2-4 servings.
After surgery you will need at least 60 grams of protein a day: In order to meet your protein needs, protein shakes such as the ones listed above will supplement your meal plans. Once you are able to get enough protein from your food, you will not need to continue using protein shakes on a daily basis.
Gatorade can be used in the hospital and should be discontinued when you return home. If you experience diarrhea or vomiting, Gatorade can be used during that time to help rehydrate.

Stage 2: Bariatric Surgery Full Fluid:

After one week from your surgery date, you will progress to a diet composed mainly of milk products, low in fat and with no sugar. You will remain on this diet until you follow-up with your MD one week later.

You can have foods like sugar-free pudding, low fat yogurt, thin creamed soups, and sugar-free sorbet. You can sip about 60ml (about a quarter cup) each hour. Slowly increase the amounts according to your tolerability
You can also continue to drink the clear liquids from Stage 1.
It is up to you to control how much you consume. Continue with the high protein liquid shake in order to consume 60 grams or more of protein every day.

Stage 3: Bariatric Surgery Pureed Foods:

If you tolerate the Stage 2 well, you may start Stage 3 with the consult of your MD/Dietitian one week later.

Blenderized meat and poultry, soft poached eggs.
Low fat cottage cheese, sugar free puddings.
Unsweetened applesauce, pureed canned peaches ( not in syrup), mashed ripe bananas.
Blended soft cooked vegetables, or overcooked and mashed with a fork.
Oatmeal, Cream of wheat.

Stage 4: Bariatric Surgery Soft and Semi-Solid Diet”

If you can tolerate the items in Stage 3, then after the third week post-surgery, you will gradually advance to soft diet and semi-solids once you meet with your MD. This is a modified diet with emphasized lean protein, well-cooked fruits/vegetables, and whole grains, while it de-emphasizes fat and sugar.

This diet is very individualized. It is normal to experience intolerances. Try to reintroduce that food a week later while focusing on eating slowly, chewing thoroughly, and not overeating.
You will eventually be able to tolerate a variety of foods from each of the 4 food groups.

Example of Soft Diet

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The Four Stages of Gastric Sleeve Diet:

Stage 1: Bariatric Surgery Clears:

Stage 2: Bariatric Surgery Full Fluid:

Stage 3: Bariatric Surgery Pureed Foods:

Stage 4: Bariatric Surgery Soft and Semi-Solid Diet”

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