Week 3-4 After Surgery: What to eat during the puree phase

During the first 4 weeks after surgery, your stomach is still healing and your sleeve will feel tight, due to swelling. For most people, after 2 weeks on fluids you can start eating pureed food. Some surgeons start this phase a bit earlier, but in our clinic the surgeons would prefer to take it slowly, rather than be sorry.

At around the 2 week mark, you may be starting to feel a bit of appetite return. Don’t panic – this just means that you’re really ready to move onto the puree phase. The swelling in your stomach is reducing so the fluids that have usually kept you full, are moving through your stomach more quickly. Foods with a thicker consistency will keep you satisfied for longer.

What can I eat?

You can enjoy any smooth, soft foods. The texture needs to be similar to “mushy” baby foods – easily “squashable” with a fork. For the first few days, make sure they are blended but after that you should be able to eat foods that aren’t blended as long as they are mushy and you chew them really well so they are puree by the time you swallow them.

The golden rule here is if you wouldn’t feed it to a baby that is just starting to eat food, then you shouldn’t be eating it!

Remember these key points:

• You’ll probably manage about ½ cup (125ml) serves as meals. If you can’t eat this much, especially to start with, don’t worry. Definitely don’t force yourself to finish – it will make you feel uncomfortable.
• Over the two weeks on purees gradually thicken the consistency of the puree (start out quite runny then thicken) rather than increasing the volume.
• Chew well!
• Avoid:
  • Lumps – these may cause a blockage (e.g. vegies that are cooked but raw in the middle).
  • Anything that you can’t squash with a fork – especially white bread, rice, dry meats, raw fruit and raw vegies as they will get stuck
  • Fizzy drinks, alcohol and excess calorie-containing drinks like juice, sugary cordial or milk (unless it is a meal).
  • Drinking with meals – wait 30 minutes before and after meals .
  • Overeating – this will make you feel uncomfortable and put strain your wound as it is still healing.
• Keep taking your multivitamin and fibre and, finally
• Start to get moving again – walking or just getting out and about is a great place to begin. Don’t lift anything heavy or get in a pool until you’ve seen your surgeon and they are happy for you to do so.

How should I eat?

Concentrating on how you eat is REALLY important. If you eat too fast, your mouthfuls are too big, or you eat too much, you’ll likely make yourself uncomfortable and potentially bring up your meal. Instead,

1. Eat slowly: Use a teaspoon, take small mouthfuls (¼ – ½ tsp per mouthful) and rest between.
2. Relax! Take 20 – 30 minutes to enjoy your meals
3. Instead of eating more at meals, thicken the texture of your meals, as the weeks go on.
4. Still hungry? Add a high protein, pureed mid-meal snack if you need it. (Often if you try to hold on, you’ll be starving by your next meal and eat too fast/much)

Some Meal Ideas

BREAKFAST

• Cereal made soggy with milk (eg. 1 Weet-Bix)
• Porridge made on milk (make sure there are no lumps)
• Baked beans
• A soft-poached or soft-boiled egg (be careful of scrambled)
• A fruit & yoghurt/milk smoothie
• Yoghurt +/- some pureed or stewed fruit or mashed banana
• Smooth ricotta or cottage cheese with a little avocado
• A meal replacement shake such as Optifast

LUNCH & DINNER

Aim to make your meal ½ protein and ½ veg

• Pureed meat or chicken casserole/stew or mince made with vegies
• Thick soups (blend really well and make with meat, chicken or legumes for protein)
• Pureed fish, smoked salmon or tinned salmon or tuna in oil (the oil is easier to eat than spring water as it’s more slippery)
• Mashed beans or lentils (e.g dahl or chilli con carne)
• Silken tofu
• Mashed veggies to go with your protein (cook well) – good options are broccoli, cauliflower, sweet potato or pumpkin

SNACKS (only if hungry)

• Pureed or stewed fruit
• A small smoothie with milk or yoghurt and fresh fruit
• A small amount of a meal replacement such as optifast
• A few spoons of yoghurt
• Low-fat dairy desserts e.g. custard or Nestle Diet Crème Caramel
• Diet jelly
• 1-2 tsp of smooth peanut butter
• Hot drinks like tea, coffee or hot chocolate made with milk

A few tips for pureeing:

• Use saucy or well-cooked, soft foods. Avoid stringy and dry foods – these don’t puree well.
• Use a blender or bar-mix to process the food.
• You can use a potato masher or fork for soft vegies – but make sure there are no lumps!
• Freeze in ½ cup portions and reheat for convenient, pre-prepared meals.

**Please remember that this information may not be exactly the same as what your surgeon recommends. Be sure to check with them first, before making any changes to your post op diet.