Here are the recommendations that I follow. They were given  to me by a bariatric program that is a Center of Excellence in Los Angeles, California:

Roux-en-y gastric bypass diet requires each day:

• 80 gm protein per day (preferably low fat sources).
• 1200 mg calcium per day (with 500 mg magnesium and 400 mg vitamin D – both help calcium absorption)
• 2 multivitamins with iron per day
• 500 mcg B12 sublingual
• 6-8 glasses of fluids per day (non-caloric beverages)

Note: What protein a patient can handle varies from patient to patient. I have no problem handling all forms of protein, but beef and tough meats require more chewing.

- Low sugar – Sugar will cause dumping syndrome in most patients, and will slow down weight loss.
- Low fat
- Low carbohydrate
- No bread, rice or pasta for 6 months postop  (These foods tend not to be tolerated well, especially at first because they swell in the stomach)
- No caffeine
- No carbonated beverages
- During the first 6 months after surgery you are recommended to eat no more than 1/4 to 1/2 cup because cut nerve endings may eliminate your ability to tell when you are full.
- Must chew food very carefully, approximately 30 times each bite.

No matter what, always eat protein first. Then eat vegetables and carbohydrates if you have room.

Can you feel full on 1/4 to 1/2 cup of food? Absolutely! Hard to believe but it is true. When you eat solid food, a signal is sent to your brain telling it that you are satisfied. Before surgery, I rarely had this satiety feeling. Now I can feel it on 1/2 cup of food. For someone with a normal stomach, it is hard to imagine this, but remember after gastric bypass, the stomach does not react like a normal stomach. The stomach does expand over time and after a year you may be able to eat 1 to 1 1/2 cups of food.

Note: Different bariatric surgery programs have different requirements. Some allow you to eat anything you want sooner than 6 months. The protein requirements can vary from 60 to 100 gm protein per day. Supplements may vary. Some programs will tell you to take children’s vitamins but these are missing essential vitamins and are not recommended by many programs.

This diet only applies to roux-en-y gastric bypass patients. It does not apply to those who have undergone Lap Band or Duodenal Switch weight loss surgeries. These surgeries have different dietary requirements, because there is no malabsorption with the Lap Band, and there is more protein and fat malabsorption with the duodenal switch than with roux-en-y gastric bypass surgery.

Please consult your bariatric surgeon or nutritionist for the dietary requirements of their program.