How to choose a gastric sleeve surgeon you’ll love
June 10, 2016
Is a gastric sleeve right for me?
August 1, 2016
Having a gastric sleeve is a big deal. If you're not sure what a gastric sleeve diet looks like after surgery, then this is the post for you. Even if you've already had a sleeve, you'll love these simple tips and tricks which will help remind you what to focus on again.
How does a sleeve work?
The sleeve gastrectomy removes a large part of your stomach, creating a small pouch for your food. It helps you to achieve weight loss as it:- Allows you to feel satisfied with a smaller amount of food
- Reduces hunger between meals as it removes the part of the stomach that produces a hunger hormone “ghrelin”
- Assists you in establishing a healthy relationship with food
Achieving success...
Most people will lose approximately 60-70% of your excess body weight (more on that here), but the real aim is to improve your health, reduce risk factors for poor health or your dependence on medications. Studies have shown the most successful candidates are those who have regular follow-ups and make long-term changes to their lifestyle. The main thing is that you have to want to change and want to try to eat well.What's the timeframe I'm looking at?
Pre-surgery
2-6 weeks Very Low Calorie Diet (Optifast) to reduce the fat around your liver and reduce surgical risks.Weeks 1 & 2 After Surgery
Thin fluids only while the stomach heals. Optifast is ideal.Weeks 3 & 4 After Surgery
Smooth purees and gradually increasing the consistency to soft foods as you feel more hungry.Week 5 After Surgery Onwards
Normal healthy foods! When you are tolerating soft foods you may commence a normal healthy diet with lots of variety, focusing on protein, vegetables, dairy and fruit plus supplements. You'll have to get focus on changing your eating habits, too.
The gastric sleeve diet long term: What can I eat?
Most foods fit as part of a healthy gastric sleeve diet! However, the portion sizes will be small. You only need 3 small meals a day (about 1 cup). Use a small plate for main meals and don’t be surprised if you leave food on your plate... it is a good sign. These plates are designed for bariatric surgery and will give you a good visual of portion sizes
Choose good quality foods
As you now eat a limited amount of food each day you need to choose good quality foods for optimum health and nutrition. Your daily diet should be made up of a variety of foods, focusing on high protein like lean meat, fish, poultry, legumes, beans, tofu, dairy products or eggs, and vegetables plus a smaller amount of fruit and wholegrain products. These are the same healthy foods recommended for the general population.Your Daily Checklist
To ensure you are getting the right combination of food groups’ everyday. Aim for…
- Once a day - some fruit (apricot, 1/2 apple or 1/3 banana)
- Twice a day - veggies, salad or legumes
- Three times a day - protein or dairy
- And a few whole grains if you like
- PLUS 1.5-2L water
Gastric sleeve diet no-no's: Cheating the sleeve
It's really important to AVOID calorie-containing liquids, (juices, soft drinks, cordial, alcohol, excess milk etc) and mushy, liquid or meltable foods (like ice cream and chocolate) as regular features in a gastric sleeve diet. The reason? These foods pass through your stomach quickly, giving you too many calories without making you feel full.
Avoid snacking unless hungry, especially on high calorie, low nutrient snacks like chips and biscuits. Always ask “Am I actually hungry?” before you snack. If the answer is "No", then you need to ask what else you can do instead...
How you eat is just as important as what you eat:
- Serve your meals on small cutlery and crockery – entrée or bread & butter plates, yum cha bowls or ramekins and teaspoons or baby forks.
- SIT down & make time for your meal every time you eat.
- Relax and eat slowly. Make your meals last 20-30 minutes, after that time THROW OUT the rest!
- CHEW, CHEW, CHEW!
- SAVOUR each bite: swallow one mouthful before taking another.
- Try eating with your non-dominant hand - you'll be much slower due to incoordination!
- Try an app that helps you slow down: Eat Slower, Bariatric Meal Timer or SlowMow Eating Timer.
- Put your cutlery down between mouthfuls
- Do not drink with meals – do drink plenty of WATER between meals. Leave 30 minutes before and after meals before drinking again.
- LIMIT high calorie, less filling foods and drinks such as excess milk, soft drink, juice or cordial, chocolate, chips, cake, biscuits and ice cream.
Your hunger and fullness signals will feel different to before surgery. Listen carefully to your stomach when eating. On a hunger scale of 0-10 where 0 is absolutely starving and 10 is Christmas Day full, aim to stay between a 3 and 7.
24 Comments
I really like what you have to tell, but most of the YouTube videos are not loud enough.
iI don’t know if its my computer or the videos.
I’m afraid of gaining now that I have l plateau . I’m not feeling full or can’t recognize the feeling.
Thanks so much for your comment Geri. I know – I am going to re-record all of the videos as something was going on with the Facebook recording, I’m sorry! It sounds like you might need to get in touch with your dietitian or psychologist for a little reassurance. It’s a really common fear, but one that needs a bit of a chat to discuss and answer properly. Do you have a team you can book an appointment with?
I can get an appointment with a dietitian. I was thinking that would be helpful. thanks for getting back with me
Great Geri – good luck!
Hi Geri,
On October 20 it will be nine years since I had my sleeve. I don’t feel hunger very often and eat because I know I should. I did gain a little bit back but lately it is coming off again. I don’t know why and I really don’t care. I have been happy with my weight and lifestyle since the op.
Fabulous attitude to have Kerry – it sounds like you’re managing your sleeve really well, especially after 9 years. Being happy with your health and lifestyle is the ultimate goal!
Im really struggling lately with food and exercise. Not getting enough water. Feels like lately its more steps backwards than forward.
You’re not alone Dave! It’s part of life to have not so good periods. The first step is to recognise it which you have! I’d start with water first and foremost – if you get that right it often helps with energy levels and appetite. Keep us posted with how you go.
Thanks for your reply. Definitely need to sort something out. Not a nice feeling at all.
Of course! We also have a great community in the LWAS private group if you need a bit of extra support. Click on the link at the top of the page and it will take you through to the info about it. Best of luck – you can definitely turn it around. 🙂
I had my first visit to the surgeon yesterday. He told me 71% of patients put weight back on with the sleeve. I was horrified but as you wrote in cheating on the sleeve, this may be reasons why.
Hi Jacqui, That’s very strange. The 3-5 year data shows us that the majority of sleeve patients lose >50% of their excess weight which is comparable to that of the bypass. There is definitely some weight regain which is common from the 1 year post op visit to the 5 year post op visit, and some people do regain more weight, but they are outliers and usually not compliant with the recommendations we give for eating habit, food types and exercise habits (this is the “cheating the sleeve” bit). Perhaps your surgeon was just talking about a small amount of weight regain? I’m not sure. Hope this helps, Zoe
I have heard of this ‘stretching of the stomach’. I do not really mind that to a healthy level, as I am just 6 weeks post operation and only eating 1/4 of food per meal. I set my mind to 1 cup per meal when I decided to go for the operation, but 1 cup seems long long away. Any idea, generally how long it takes for the meal sizes to increase so I can add some variety and feel like actually having a meal? Is there a risk of over stretching the stomach too?
Hi Thisara, Great question. Sometime it takes a few months and even up to 6 months before you feel confident and comfortable with eat a bit more. You should be able to increase the variety from around now though. The most important thing is not to push yourself so you feel uncomfortable as that, over a long period of time, is what can stretch the sleeve. I hope this helps, Zoe
Hi ,I am now on my 7 th week after my gastric sleeve , I am really struggling to eat foods other than puréed foods , every time I do I’m vomiting even after
A mouth full , I am finding that I’m still having a shake every day ,
I’ll have home made Greek yoghurt with ,natural gelatin , 1/4 fresh pear,
1/4 Fresh apple ,1/4 of banana and purée it and will have that for lunch or dinner , then I’ll have puréed piece of sweet potato ,a few slices or carrot ,
& a few couple of small pieces of broccoli .
That’s my day of food p.s I am allergic to soy and soy produces so find it hard to find things to eat as well .
Or I’ll have a small hand full of rolled oats and Greek yoghurt for breakfast
And protine shake for lunch and my puréed Vegies for dinner
I still can’t eat much at all some time not even all that .
I struggle drinking all my water , I do have a green tea each day and I put
Electrolytes in my water but never seem to be able to drink it all .
I cough up a lot of flem through the night .
I have lost 15 kg in my 7 weeks but have come to a stand still .
I still have to loose 8 kg to have my spinal surgery , in a 14 weeks time
I wondering because I can’t do exercises or do much at all due to my back .
I’m I eating enough ….is that why I have stopped loosing . I can’t walk much either so it is rather hard .
I would appreciate any suggestions please need your help …I have been waiting 18 mths to have my spinal surgery and done want it put off .
Regards Glenda
Hi Glenda, Thanks for your comment. Unfortunately i can’t give such specific advice as I don’t have all of your information. I would strongly recommend you see you team’s dietitian and surgeon again though as I’m sure they can help you. Best of luck, Zoe
Hi there..
I’m 13 weeks post sleeve and I’m finding I can tolerate most foods.
I do feel grumbling type sensations which feels like hunger. I didn’t feel this before and its nagging me slightly.
I used to practise intermittent fasting per surgery so I am used to ignoring hunger, but it is slightly frustrating to be feeling this so early post op. Do you think this is something that will pass eventually?
I can’t eat big portions thankfully and I have lost a good 45 pounds.
Hi Max, it sounds like you are doing really well. It’s normal to feel some hunger (some people do and some don’t), but check to see if it is physical hunger, thirst or perhaps head hunger. This post about hunger might help you deal with it: https://www.livingwithasleeve.com/still-hungry-sleeve-gastrectomy/ Best of luck! Zoe
Hi Zoe,
I’m having trouble drinking 6 to 8 glasses of water per day, how do you do it when you can only have a sip of two, can I take a few more sips at a time, say 3 or four each time? I’m afraid of stretching my stomach. I’m 4 months post op.
Hi Sonya, you should be able to try to take 3 or 4 sips at a time. At four months post op, try now to drink a little faster and just make sure you stop/slow down immediately if you feel uncomfortable. With a little practice you’ll find what works for you and what is comfortable. It is tricky so keep going! Zoe
Hi Sonya ~
Something that works for me is I take a water bottle with me wherever I go. At a every red light on my way to work, I sip from my water bottle. I refill it and do the same thing as I travel home from work. There are a lot of stop lights (I live in the suburbs of a large city) so during my commute I easily consume more than a liter of water. Good luck!
I love this idea!
Hi Zoe,
Thank you for your website, I use a lot of the information. I am 22 days post op and am having trouble figuring out what to eat and how much. I tried very ground beef last week and I’m not ready for that yet. Chicken and shrimp seem to work the best. 4-5 bites of a chicken breast is the most I can tolerate. Can I have cambell’s cream of broccoli? I’m only getting in about 80-100 calories the past few days and my stomach rumbles. Broth is just not satisfying enough. Any other suggestions? Thank you!
Hi Debbie, depending on your surgeon at this stage you should be on purees or transitioning to soft solids. You’re obviously ready for something more than the fluids though due to the hunger with the broths. This post will explain purees for you. You can also search puree suitable recipes here too – just click the puree recipes tag at the top of the page. Best of luck, I hope this helps!