General Dietary Rules of a Gastric Bypass Diet

• While this diet includes all 5 food groups, it is best to start each meal with high-protein foods, like lean meats or milk.

• Eat small, frequent meals throughout the day. This is essential as your stomach pouch is too small to hold large meals.

• Each meal or snack should be small.

• Eat and drink slowly. Allow up to 1 hour to finish your meals and snacks.

• Take small bites and chew all food thoroughly.

• Avoid extra liquids during meals. Your new stomach pouch may not be big enough to hold fluids and food at the same time.

• Add one new food at a time and observe your reaction to it. Add breads last because they tend to form a ball, which will not pass easily through your new stomach pouch.

• You can add red meat, raw vegetables, and raw fruits with skins back into your diet.

• Learn to read labels on food for fat content. Aim for no more than 35 grams of fat per day.

• Foods which are best avoided on a gastric bypass diet include:
  - High-sugar carbs, including carbonated or regular beverages or sodas.
  - Fried foods
  - High-fat fast foods, including snack chips, candy, chocolate or cookies.
  - Caffeine-containing drinks like tea, coffee or chocolate.
  - Citrus fruits such as orange, grapefruit, lemon, or lime.
  - Sugar foods like white/brown sugar, syrup, molasses, jelly, desserts, jams.
  - Alcohol

• At every stage of the gastric bypass diet, it is important to prevent dehydration by drinking enough fluids. Drink at least 6 cups of healthy liquids between meals. If you suffer from vomiting or diarrhea, you should drink more to replace lost fluid.

• Follow carefully the instructions of your dietitian regarding the type and amount of daily vitamin and mineral supplements you need to take.

Protein in the Gastric Bypass Diet

Protein is the nutrient that the body uses to build new tissue. Protein is important, especially to heal after surgery and to help prevent hair loss. Many patients experience some hair loss two to four months after stomach bypass surgery as a result of poor protein, iron, and zinc intake as well as some medications, rapid weight loss within the first few months, experiencing shock, and having a long surgery. To maintain nutrition eat more protein foods like:

- Skim or 1% milk
- Low-fat cottage cheese
- Low-fat or non-fat yogurt with artificial sweeteners
- Egg whites
- Low-fat cheese
- Oatmeal and cream of wheat made with skim milk
- Fish
- Chicken and turkey (poultry)
- Other lean meats (pork tenderloin, extra lean ground beef)
- Non-fat dry milk powder (added to casseroles, soups, hot cereals, etc.)

Fat in the Gastric Bypass Diet

Fatty foods may be difficult to digest after stomach bypass surgery. Excessive fat delays emptying of the stomach and may cause gastric reflux, a back-up of stomach acid and food into the esophagus causing heartburn. Fat may also cause diarrhea, nausea, or stomach discomfort. High-fat, fried foods and fatty meats are common offenders. To help with weight loss and then to maintain your weight loss, limit your fat intake to no more than about 35 grams of fat/day and avoid the following high fat foods and beverages except in small amounts:

Olives, nuts, avocados, regular mayonnaise, sour cream, cream cheese, pie crust, whole milk, butter, margarine, peanut butter, granola, muffins, cole slaw, potato salad, whole milk cheese, snack crackers, ice cream, shortening, lard, regular salad dressings, sauces, fried foods, bacon, sausage, bologna, potato chips, doughnuts, all oils, gravy, regular sodas, Kool-Aid, etc.

Sugary Foods and Refined Carbohydrates in the Gastric Bypass Diet

Sugary food include: candy, cookies, ice cream, milkshakes or slushes, soda pop, sweetened juices or gelatin, and most desserts. The gastric bypass diet is low in these sweet and sugary foods for a number of reasons. First, these foods are high in calories and fat. Even in small amounts, they can make weight loss difficult. Second, eating sweet or sugary foods promotes "dumping syndrome," a gastric reaction which can occur after the stomach bypass operation and which causes unpleasant side-effects with symptoms such as nausea, diarrhea, and feeling faint. Finally, most sweet and sugary food options are "empty-calorie" foods - meaning, they provide calories but no nutrition. And since calories are so restricted on a long term stomach bypass diet, it is important that nutrient-dense foods become an eating priority.

Fiber in the Gastric Bypass Diet

Dietary fiber, found in foods like bran, popcorn, raw vegetables, and dried beans, is also restricted on the gastric bypass diet. There is less space in the stomach to hold these bulky foods, and less gastric acid available to digest them. Some kinds of fiber can block the stomach pouch, or block the narrow opening into the small intestine.