Before moving on to nutrition after sleeve gastrectomy, we should know that sleeve gastrectomy is a surgical procedure that is decided according to the Body Mass Index (BMI) value of the person. The surgery is applied to people who have tried diets before but have not been successful, and the postoperative target is to gain a healthy eating habit.
Although it varies according to the stomach capacity, it is aimed to provide more saturation with much less food than the preoperative period by removing 60-90% of the stomach. After the surgery, a gradual nutrition program is applied under the supervision of a dietician. Although it varies according to the person, after the liquid and puree feeding period is over, the transition to normal nutrition is made by considering the foods that can be tolerated.
The First 3 Days After Surgery
No food or liquid is given on the first day of hospitalization after the operation. The fluid and energy needs of the patient are provided by serum. On the 2nd day following the surgery, the patient will be given colored water (methylene blue) orally to control the leak test. If this test is negative, water intake will be started. If the patient is comfortable with water intake, patients will be discharged from the hospital without removing the drain.
The First 15 Days After Surgery (Liquid Nutrition Period)
After the operation, clear fluids that can be easily consumed in the first 15 days are given, although it varies depending on tolerance. Preferred products in the clear liquid category; water, milk (skim milk and lactose-free milk are preferred), light ayran and kefir, immature fruit juice (freshly squeezed), unsweetened apple, pear and quince compote and drained, grained meat or chicken broth.
However, since these foods do not meet the protein needs of the person, protein powder should be consumed daily in the amount determined by your dietician. In case of insufficient protein intake, muscle loss can be seen while losing weight. This causes sagging. In addition, protein is the most important food group that helps surgical wounds to heal faster and keep you full.
Nutrition and the point to be considered after sleeve gastrectomy is to consume the mentioned foods every half hour. Each meal should be around 100-150 ml and be sipped slowly.
Post-surgery 15-30 DAYS (Puree Nutrition Period)
During this period, pureed foods will be added to your diet on top of milk, buttermilk, chicken and broth. You can benefit from vegetables with high vitamin value except onion and garlic (pumpkin, carrot, broccoli, tomato, eggplant, celery etc.) High carbohydrate ratio potatoes should be consumed rarely. Peeled fruit purees (apple, pear, banana, mango, pineapple, peach, melon, etc.) can be consumed in your snacks, and the daily fluid intake should be at least 1.5 liters during this period.
The most important point to be considered; Solid and liquid foods should not be consumed at the same time, they should be put between them for 30 minutes. This is called the solid-liquid separation rule and must be applied for life.
Transition to Solid Period (1-3 Months)
It is essential to understand that the transition to normal food should be slow during this period. Soups without flour are free. Boiled, grilled or baked meat / chicken / fish can be consumed. However, it is among the most important rules to try each new food you try one by one. You can create a transition plan from the easiest to the most difficult to digest. You should stop consuming foods that touch or have digestive problems for a while and then try again. The most important rule in this period is to chew well.
Normal Nutrition Period (After 3rd Month)
As of the 3rd month after the operation, you should maintain your personalized nutrition plan by providing sufficient protein without interrupting communication with your dietician. You should add every new food you haven’t tried to your diet by observing your tolerance. You and your dietician should decide whether to continue your protein supplement by considering the amount of food you can consume.
Vitamin and Mineral Deficiencies After Gastric Sleeve Surgery
Vitamin and mineral deficiency can also be seen with nutrition and especially the removal of a certain part of the stomach after sleeve gastrectomy. For this reason, you should check your vitamin values with blood tests requested by your doctor at certain periods and use multi-vitamin and mineral supplements.
General Rules in Bariatric Nutrition
- With the nutritional programs applied after bariatric surgery, your new lifestyle will be shaped under the control of a dietician.
- One of the goals of the surgery is to reduce the amount of food you can consume thanks to your small stomach volume.
- At least 20-25 minutes should be reserved for each meal and should be chewed well with food.
- Priority should be given to a diet rich in protein and if necessary, protein supplements should be used. It should be consumed before carbohydrates and fats.
- Small plates, containers, glasses can be preferred to provide portion control more easily.
- While choosing the foods to be consumed, the amount should be determined according to the tolerance.
- Solids and liquids should not be consumed at the same time (solid-liquid separation). Fluid consumption should be stopped half an hour before the main and snacks.
- Eating should be stopped as soon as fullness and satiety is felt while eating.
- To support lean tissue, you should follow a healthy diet program rich in protein and exercise. An average of 30 minutes of aerobic physical activity should be done every day.
- Obesity surgery patients may not be able to meet their fluid needs only with water. Liquid intake is possible with milk, buttermilk, soup, compote and some solid foods that you support with snacks.
- At least 1.5 liters of water should be consumed daily. It should not be forgotten that liquids such as tea, coffee, ayran and soup consumed during the day do not replace water.
- It should not be forgotten that too much fruit, fruit juice, sugar, sugary drinks and foods containing starch will cause dumping syndrome (tremors, dizziness, sweating, etc.) and prevent weight loss in the long term.
- You should stay away from soda, mineral water, carbonated and alcoholic beverages. Consult your dietician for alcohol intake after 6 months.
- Please take 25-30 minutes for main meals and 15 minutes for snacks. When you take solid foods in your mouth, you should chew at least 25-30 times before swallowing.
- Observe your tolerance for every nutrient you have just started and if you cannot tolerate it, take a break for a while.
- Carefully read the label information for all packaged items you purchase. Choose products that are low in sugar, fat and salt.
- The first year after the surgery is the honeymoon period and even if you do not follow the rules, weight loss will occur, but in order to gain a successful and healthy weight and to prevent weight gain, you should put healthy eating habits into your life and make it a lifestyle in the first year.
Weight Loss After Gastric Sleeve Surgery
As in every diet process, weight loss after sleeve gastrectomy varies depending on the person’s initial weight, height, gender, physical activity and genetic structure. The more the person’s starting weight is, the more weight he gives will be at the same rate. For this reason, individuals should not compare themselves with individuals who have undergone surgery.
In general, 10% of the initial weight is lost in the first month after sleeve gastrectomy. Subsequently, a loss of 40-45 kg is observed in 1 year, although it changes depending on the parameters we have listed.
It should not be forgotten that sleeve gastrectomy or any other method is not a magic wand. Especially in the first year, you need to receive healthy nutrition training with a dietician and put these eating habits into your life and make them a lifestyle. Otherwise, problems such as back weight gain may occur in the future.