Gastric Sleeve Diet

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Gastric Sleeve Diet

The gastric sleeve diet that results in the most weight loss and best health includes:

Pre-op diet starting 3+ weeks before surgery
Post-op diet lasting from 3 days to 4 weeks with a gradual transition from clear liquids to solid foods
Primarily healthy meals with limited snacking
60+ grams of protein per day
2+ liters of low-calorie fluids per day
Strict vitamin regimen

Read and click the sections below for everything you need to know about your new diet after gastric sleeve surgery.

01 GASTRIC SLEEVE PRE-OP DIET

3+ weeks before surgery: Practice long-term diet
2 weeks before surgery: High protein, low sugar, low carbs
1 week before surgery: Stop or change medications
2 days before surgery: Clear liquids only
Surgery day: Nothing to eat or drink

There are three big reasons to start your pre-op gastric sleeve diet at least 3 weeks before surgery:

Lower risk of complications – Eating a healthier diet will cause you to lose weight, and the lower your body mass index on surgery day, the lower your risk of complications. For example, a healthier diet will shrink your liver and reduce your intra-abdominal fat, making it easier for your surgeon to to perform surgery.
Quicker recovery – Eating healthy during the weeks leading up to surgery will optimize your body’s immune system and lead to a quicker recovery.
Ease the transition into your new life – Recovering from surgery and adjusting to your new life will be challenging. Establishing good diet habits as early as possible will simplify the rest of the changes that are coming your way.

Click the sections below to learn more about your gastric sleeve pre-op diet.

1. Pre-Op Food List & Guidelines

Your gastric sleeve pre-op diet should begin at least 3 weeks before surgery. Your surgeon’s guidelines will include the following.

3+ Weeks Before Surgery

Eat as healthy as possible (food that comes directly from the farm or water)
Eat your protein first, and shoot for at least 60 grams of protein per day. To give you an idea about how much protein that is, each of the following equals about 60 grams of protein:
- 3 hard boiled eggs + 4 ounce chicken breast = ~60 grams of protein
- ¾ block of extra-firm tofu + 6 ounces of tempeh = ~60 grams of protein
- 4 ounces of ground beef + smoothie with 1 scoop of whey protein = ~60 grams of protein
Eat small portion sizes (using small bowls and plates will help with this)
Cut food into small pieces
Eat slowly, chew food thoroughly (chew 25 to 30 times with each bite)
No more than 3 small meals per day
Limit snacking (no more than 2 small snacks per day)
Limit high-fat foods
No fibrous foods like asparagus, celery, or broccoli
No starchy foods like rice, pasta, or bread
No greasy or spicy foods
No whole milk products
No sugar
Take a daily multivitamin

2 Weeks Before Surgery

To reduce your risk of complications, start the following 2 weeks before surgery

The entire 3+ Weeks list above
No over-the-counter herbal supplements

1 Week Before Surgery

In addition to the pre-gastric sleeve diet guidelines above, your surgeon will ask you to stop certain medications to reduce the risk of bleeding and stomach problems after surgery. Medications to stop or change may include:

Any arthritis medications
Time-released medications (switch to non-time-released)
NSAIDs (nonsteroidal anti-inflammatory drugs), such as:
- Acetaminophen (Tylenol)
- Aspirin (many brands)
- Ibuprofen (Advil, Motrin)
- Naproxen (Aleve)
Other anticoagulants, such as:
- Enoxaparin (Lovenox)
- Clopidogrel (Plavix)
- Dipyridamole (Persantine)
- Ticlopidine (Ticlid)
- Warfarin (Coumadin)

2 Days Before Surgery

It’s time to clear out your digestive system in preparation for surgery:

No food

Midnight Before Surgery

No food or drinks of any kind

Your digestive system must be completely free of food or liquids during surgery.

This will reduce the risk of inhaling stomach contents which can cause all sorts of problems like serious infection or pneumonia.

A clean digestive system is especially important for patients with gastroesophageal reflux disease (GERD) or gastric paresis (paralysis of the stomach).

When you brush your teeth before heading to the hospital, rinse and spit out the water (don’t swallow).

2. Pre-Op Drink List & Guidelines

Your gastric sleeve pre-op liquid diet should begin at least 3 weeks before surgery.

3+ Weeks Before Surgery

Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
Sip fluids, don’t gulp
Do not drink anything 30 minutes before, during, or after meals
No sodas or sugary drinks
Limit caffeine

2 Weeks Before Surgery

Start the following to reduce your risk of complications:

The entire 3+ Weeks list above
No caffeinated drinks
No carbonated drinks

2 Days Before Surgery

To clear out your digestive system before surgery:

Drink only sugar-free clear liquids (no thick or pulpy drinks, no caffeinated drinks, no carbonated drinks, and no sugary drinks)

Midnight Before Surgery

No food or drinks of any kind

3. Pre-Op Meal & Drink Plans

2 Weeks Before Surgery

Breakfast: Low-carb, low-sugar protein shake
Lunch: Lean meat and vegetables
Dinner: Lean meat and vegetables

2 Days Before Surgery

Drink only clear caffeine-free, sugar-free fluids, such as

Clear broth (beef, chicken, or vegetable)
Jell-O (sugar free)
Juice without pulp or added sugar (such as apple juice or pulp-free orange juice)
Popsicles (sugar-free)
Tea (caffeine-free, unsweetened)
Water

Midnight Before Surgery

No food or drinks of any kind

4. 3 Habits of Successful Patients: Diet Journal, Support Groups, Exercise

The most successful gastric sleeve patients do more than just change their diet before surgery. They also adopt routines that keep them on track for the long-term, including:

Start a diet journal
Join a gastric sleeve support group
30 minutes of exercise, 5 days per week.

5. Addressing Food Addiction

Gastric sleeve surgery helps with food addiction by:

Reducing the size of your stomach which will make you feel full sooner while eating
Causing your body to secrete fewer hunger-causing hormones, making you feel less hungry.

But for some patients, the addiction still remains strong after surgery. If it’s not addressed ahead of time, food addiction will cause a new patient to overeat, stretch out their smaller gastric sleeve stomach, and cause the patient regain weight.

If you suffer from food addiction, start to address it before moving forward with surgery, including:

Start a food addiction diet
Talk with your doctor about appropriate prescription drugs
Start a medically supervised weight loss program
Seek professional counseling
Join a support group of others who suffer from food addiction

See our Food Addiction Treatment page for more information.

02 GASTRIC SLEEVE POST-OP DIET STAGES

Stage 1: Clear liquids only
Stage 2: Add thicker drinks & smooth foods (no chunks)
Stage 3: Slowly test pureed & soft solid foods
Stage 4: Slowly test solid foods
Time to reach Stage 4: From 3 days to 4 weeks (varies by surgeon)

There are 4 distinct gastric sleeve surgery diet stages:

Stage 1: Clear liquids only
Stage 2: Add thicker drinks & smooth foods (no chunks)
Stage 3: Slowly test pureed & soft solid foods
Stage 4: Slowly test solid foods

Every surgeon has a different philosophy about how much time each stage should last. Some feel that a quicker transition will speed up recovery, while others believe that giving your digestive system time to rest is a better approach. Both methods are effective, so talk with your surgeon about which they feel is right for you.

Stage 1: Clear liquids only

Begins 1 day post-op to 7 days post-op (varies by surgeon)

Depending on your surgeon, Stage 1 of your gastric sleeve post-op diet will last anywhere from 1 to 7 days and will include:

Clear liquids only
Sip your liquids, no gulping
Do not use a straw or drink from a bottle as this can cause gas bubbles

Drinks should include:

Water or Ice (since you can’t eat anything yet, chewing ice may be more satisfying)
Clear broth (beef, chicken, or vegetable)
Drink mixes (sugar-free), like Crystal Light or Kool-Aid
Jell-O (sugar-free)
Thin juice or drinks without pulp or added sugar (such as apple juice, Propel Water, Powerade Zero, etc.)
Popsicles (sugar-free)
Tea (caffeine-free, unsweetened)

When you return home:

Continue the same clear-liquid-only diet until your surgeon tells you it’s okay to transition to Stage 2
Take all vitamins and supplements recommended by your surgeon.

Other Habits

Maintain your diet journal
Maintain regular support group attendance
Start walking (slowly increase to 30 minutes/day, 5 days per week by Week 3 post-op)

Stage 2: Add thicker drinks & smooth foods (no chunks)

Begins 1 day post-op to 14 days post-op (varies by surgeon)

Your surgeon will confirm that you have no nausea or vomiting before allowing you to begin Stage 2 of your post-op gastric sleeve diet. Stage 2 lasts from one day to 2 weeks, depending on your surgeon, and includes thicker drinks, pureed foods, and small “meals”:

Clear liquids list from Stage 1
Protein shakes
Clear broths (beef, chicken or vegetable)
Cream of Wheat
Cream soups (no chunks)
Carnation Instant Breakfast (sugar free)
Greek Yogurt
Natural applesauce
Sherbet (sugar-free)
Skim or Lactose-Free Milk Products
Thicker sugar-free juices like low-sodium V-8 or pulp-free orange juice
Vitamins and supplements

Remember: No soft or solid food and no drinks with chunks or seeds.

You can also drink clear liquids between meals.

While drinking anything:

Take small sips
Stop immediately as soon as you feel full or feel any pressure

Stage 3: Slowly test pureed & soft solid foods

Begins 2 days post-op to 3 weeks post-op (varies by surgeon)

Stage 3 of your diet after gastric sleeve surgery will last from 1 to 7 days, depending on your surgeon.

This stage allows softer solids, but take it slow!

When you’re ready to start pureed foods, blend water, skim milk, broth, or sugar-free juice with one of the following:

Beans
Cooked vegetables
Eggs
Fish
Ground meats (lean)
Soft fruits

As soon as the pureed foods are going down without a problem, work your way into soft foods like:

Cooked vegetables
Ground meats (lean)
Soft fruits (no seeds or skin)

General post-gastric sleeve diet guidelines during Stage 3 include:

Food

Test one new food at a time to confirm you can tolerate it
Eat as healthy as possible, protein first
60+ grams of protein per day
Small portion sizes
Cut food into small pieces
Eat slowly, chew food thoroughly
No more than 3 small meals per day
Limit snacking (no more than 2 small snacks per day)
Limit high-fat foods
No fibrous foods like asparagus, celery, or broccoli
No starchy foods like rice, pasta, or bread
No greasy or spicy foods
No whole milk products
No sugar
Take your vitamins

Drinks

Plenty of low-calorie fluids (64+ oz [2+ liters] per day)
Sip fluids, don’t gulp
Do not drink anything 30 minutes before, during, or after meals
No sodas or sugary drinks
Limit caffeine

Other Habits

Maintain your diet journal
Maintain regular support group attendance
Slowly transition to more aggressive, muscle-building exercises (30 minutes of exercise, 5 days per week)

Stage 4: Slowly test solid foods

Begins 3 days post-op to 4 weeks post-op (varies by surgeon)

Stage 4 of your post-op gastric sleeve diet will last anywhere from a couple of days to 1 to 2 weeks, depending on your surgeon. During this stage you will complete your slow transition to your “new normal” long-term diet.

Your focus should be on eating your proteins first, in solid form (not protein shakes). Here’s why:

You need 60+ grams of protein to stay healthy, and getting that much can be tough if you fill up on other food first
Liquid protein is okay while you are in healing mode, but switch to solids after recovery. Solids make you feel full sooner while eating and reduce the risk of weight regain.

Other points to keep in mind include:

Stage 3 guidelines above
Test one food at a time to make sure you can tolerate it
Eat healthy “whole” foods (foods from the farm or water; avoid processed foods)
Eat slowly and chew thoroughly
No starchy foods like rice, bread, and pasta
No whole milk products
64+ oz (2+ liters) of fluids spread throughout the day
No drinking 30 minutes before or after meals

03 LONG-TERM GASTRIC SLEEVE DIET

Differences from before surgery
Foods you’ll eat or avoid
Liquids you’ll drink or avoid
Tips to stay on track

Differences from Before Surgery

Once you’ve fully transitioned into your new diet after gastric sleeve surgery, you:

Will experience significant and rapid weight loss and health improvement
Will feel less hungry – your smaller stomach will secrete fewer hunger-causing hormones.
Will feel full sooner while eating – your smaller stomach will hold much less food.
Will be much more diligent about healthy eating and drinking – Eating and drinking correctly will help you avoid side effects like nausea, vomiting, and diarrhea and prevent your stomach from stretching out and causing weight regain. See the sections below for more information about appropriate foods and liquids.
May have difficulty swallowing if you eat too quickly – this is the result of food backing up into the esophagus after the stomach pouch has been filled. Chew your food thoroughly, eat slowly, and eat foods that are more easily digested. If you experience this issue, it should get better as your pouch stretches over time.
May need to avoid dairy – If you are currently lactose intolerant, symptoms after surgery will probably become more prevalent. This is easily addressed by avoiding dairy products.

Click the sections below to learn about your long-term diet after gastric sleeve surgery.

Foods You’ll Eat Or Avoid

We’ve included sample gastric sleeve diet plans further down the page. Generally speaking, here’s what you should eat (or not eat) to lose the most weight, avoid side effects, and prevent weight regain:

Types of Foods to Eat

Eat protein first, then fruits and vegetables, then whole grains
Eat 60+ grams of protein per day
Eat whole foods (directly from the farm or water)
Limit processed foods
Limit high-fat foods
Take your vitamins (see the Vitamins section below)

Types of Foods to Avoid

No fibrous foods like asparagus, celery, or broccoli
No starchy foods like rice, pasta, or bread
No greasy or spicy foods
No whole milk products
No sugar

How to Eat

How you eat is just as important as what you eat. Successful patients stick to these gastric sleeve diet guidelines:

No more than 3 small meals per day
Limit snacking (no more than 1 small snack per day)
Small portion sizes
Cut food into small pieces
Eat slowly, chew food thoroughly (25 to 30 chews with each bite of food)
Do NOT overeat – this will permanently stretch out your stomach and lead to weight regain. As a general guideline, eat until you feel 80% full.

Liquids You’ll Drink Or Avoid

Liquids are often overlooked as a part of the gastric sleeve diet, but poor liquid choices can cause just as many problems as poor food choices.

Types of Liquids to Drink

Plenty of low-calorie fluids 2+ liters per day)
Limit caffeine

Types of Liquids to Avoid

No sodas
No sugary drinks
No alcohol (or very limited quantities)

How to Drink

Sip fluids, don’t gulp
Do not drink anything 30 minutes before, during, or after meals

Tips to Stay On Track

Successful gastric sleeve patients need plenty of support and encouragement from family, friends, and other patients in order to maximizing weight loss and avoid side effects.

The most highly recommended tips from successful patients include:

Start and maintain a diet journal to:
- Set goals and record progress
- Plan your meals ahead of time
- Use as your guide at the grocery store – take your journal with you (or print your list) and only buy the foods that you have planned
- Prevent gastric sleeve post-op diet cheating

Join and regularly attend a support group to address:

Weight loss – Regular weight loss support group attendees lose as much as 12% more excess weight than patients who do not attend support groups
Fear before surgery
Questions about the future
Diet challenges
Temptations and how to overcome them
Impatience or frustration regarding how quickly the weight is coming off
How to interact with the world in your new body
Relationship changes at home and work
Depression relating to your new diet and changes to existing relationships

Other top patient tips for the best diet after gastric sleeve surgery include:

Keep your blood sugar stable – stable blood sugar leads to stable hunger and stable relationships (no mood swings). In order to keep your blood glucose level in check:
- Avoid simple carbohydrates. Foods with simple carbs include white bread, potatoes, white rice, corn, peas, and anything that is obviously full of sugar like candy, ice cream, or donuts.
- Eat good carbs in small portions (along with high amounts of protein), including vegetables, apples, and the “brown foods” like whole-grain bread and brown rice. In addition to being good for your blood sugar level, good carb sources are often high in fiber which makes you feel full faster and helps to regulate your bowel movements

Don’t snack – Snacking between meals is the quickest way to halt your weight loss progress and to gain back weight. Either don’t snack at all or limit it to one small healthy snack per day.
Grocery shop the right way:
- Take your journal and only buy your planned healthy foods
- Don’t shop while you’re hungry
- Since healthier foods tend to cost more, don’t be afraid to shop in bulk and freeze the extras.
Measure your meals with a scale – Don’t guesstimate. Overweight people underestimate their calorie content per meal by as much as 22%, so use a food scale to ensure you are eating the proper amounts.
Use small plates and small utensils. At only 4 ounces per meal, using your old plates could lead you to add more just because the new portion sizes feel so tiny in comparison. Smaller plates and utensils will help train your mind to feel okay with the smaller portion sizes.
Avoid alcohol. Several problems can arise if you decide to drink alcohol after gastric sleeve surgery. The sugar and carbohydrates found in alcoholic beverages can derail your daily goals, cause your blood sugar levels to get away from you, and cause you to gain back weight. Alcohol will also make you much more likely to give in to food cravings which can also lead to weight regain.

04 VITAMINS & SUPPLEMENTS

Multivitamin
Calcium
Folate (folic acid)
Iron
Vitamin D

The post-op diet for gastric sleeve patients includes a strict vitamin regimen for the rest of your life. It is designed to offset the fewer nutrients you are getting from your smaller gastric sleeve meals.

Click below for more information about each vitamin you will take.

Multivitamin: Full Body Health

A daily multivitamin with mineral supplements will help prevent hair loss and general nutrition problems.

1 to 2 per day
Chewable and liquid versions are best
At least 200% of the Recommended Dietary Allowance (RDA) of iron, folic acid, thiamine, copper, selenium, and zinc

Calcium: Bone Health

Calcium citrate supplements will keep your bones strong after gastric sleeve surgery.

Must be calcium citrate (NOT other forms of calcium)
500 – 600 mg doses
Take 3 times per day forever
Chewable and liquid versions are best
Try to find one that includes Vitamin D

Folate (folic acid): Cardiovascular Health

Patients who don’t get enough folate are at a higher risk of anemia (low red blood cell count or hemoglobin).

For some patients, the folic acid found in a good multivitamin is not enough. Many surgeons do not prescribe extra folate, so ask them to test your folate levels as time goes on to be on the safe side.

Iron: Cardiovascular Health

Patients low on iron are more likely to have a stroke, heart attack, or other blood-related problems.

The iron found in a good multivitamin is not enough for some patients. Ask your surgeon to watch your iron levels to avoid any problems.

Vitamin D: Full Body Health

Without enough Vitamin D, you’re at risk of developing rickets (a weakening of the bones, muscles, and teeth).

Chewable or liquid forms are best
3,000 International Units per day
Take with food
Take 2 hours apart from any Iron supplement (including a multivitamin that contains iron)

Talk with your surgeon to be sure, but you may be able to find a calcium supplement that fulfills your Vitamin D requirements.

05 SAMPLE GASTRIC SLEEVE DIETS