Congratulations on making the excellent decision to get your health under control through gastric bypass surgery. You should already see the weight peeling off, and I know how great that feels! Please understand though, that your journey is just beginning.

Remember that weight-loss surgery is not just about losing weight, but an overall improvement in your vitality, health, well-being, and sense of self-worth. This can be done through continued good nutrition and healthy eating. That doesn't mean you can't enjoy eating anymore! It just means we need to change some habits to maximize the benefit of your surgery.

The word "diet" has often had a negative connotation, especially for us foodies. It doesn't have to be that way though- in this article, the word "diet" simply refers to your new healthy way of life!

Let's put together some tips for creating a gastric bypass cookbook you can be happy to follow. You've come this far, now it's time to see it through!

Understanding Your Gastric Bypass Surgery

In order to create an effective gastric bypass cookbook, it's important to have a good understanding of what's been done to your body. Gastric bypass surgery is a procedure that reduces the size of your stomach to just about an ounce when you come right out of surgery. Your new, smaller stomach is then routed directly into the second part of your small intestine, which changes the way you absorb the nutrients that enter into your body.

Gastric bypass surgery helps to speed up your weight loss by:

• limiting the amount of food you can eat in a sitting
• increasing satisfaction after meals
• changing the way you absorb the nutrients in the foods you eat

Your New Pouch

Just after surgery, your new stomach is just about the size of an egg. It doesn't really act as a "stomach" anymore in the traditional sense, so we now call it a "pouch". In general, your pouch may take up to 6-8 weeks to heal. In order to help with the healing process, your doctor will progress you through several diet stages, including:

• Clear Liquids
• Full Liquids
• Pureed Foods
• Soft Foods
• Low Fat/Sugar Solid Foods

In every stage, it is vital that you take steps to care for your pouch. One of the most important things you can do is to eat slowly. It takes some getting used to, but your meals should last you between 30-60 minutes.

You should be taking tiny bites, and chewing them 25-30 times before swallowing. You should also take 1-2 minute breaks between each bite. Remember, we're changing habits here!

Every bariatric doctor has their own way of progressing you through the initial diet stages, so make sure you are following his or her instructions. Eventually, you'll be responsible for finding bariatric-friendly meals to eat on a daily basis. The following are some of my tips and recipe suggestions for each stage of your new diet.

A Few Notes About Fluids

Fluids will always need to be a huge part of your post-op diet. If you're not careful, dehydration can become a real concern after you've had your surgery. It is important to drink at least 64 fl oz of fluids every day, and most of that should be water. Keep the following information in mind when it comes to your post-bariatric surgery fluid intake:

Water- water is the fluid most recommended by doctors when you come home from bariatric surgery. However, some patients have complained that it almost has a "metallic" taste to it right after surgery. If that's the case, try adding a little lemon or lime, or you can dilute it with your favorite non-calorie, non-carbonated drink.

• Juice- while you would think that fresh fruit juice would be safe for any diet, the reality is that it can be dehydrating and even cause dumping syndrome. It's best to avoid juice altogether, but definitely don't drink more than 4-6 fl oz of any kind of juice per day.
• Caffeinated drinks- Caffeinated drinks like tea or coffee are typically discouraged right after surgery because caffeine is a diuretic that does not help when we are trying to stay hydrated. You can get away with decaf, but don't add any cream or sugar!
• Carbonated beverages- Carbonated beverages are a big no-no for a long while after the surgery. The carbonation in the drinks tends to cause gas and bloating, which can already be an issue for some patients when they get home from surgery. It can also cause stretching in your pouch, which you will surely regret.
• Alcohol- When it comes to alcohol, you need to just say no! There are several concerns when it comes to alcohol, including empty calories, altered metabolism, and addiction transfer. It's just not worth the risk!

Stage 1: Clear Liquids

Goals: The dietary goals of this stage are simply to get you ingesting nutrients when you are too weak and too sore to eat, and you likely won't have an appetite anyway.

Instructions: This is the shortest stage of them all, as it begins at the hospital directly after surgery, and ends when you are discharged in 1-3 days following your surgery.

During your stay in the hospital, you are given clear, sugar-free liquids to drink. This includes things like:

• Water
• Beef Broth
• Chicken Broth
• Vegetable Broth

There aren't any "recipes" for this stage, you just have to drink what they give you and get through it. Godspeed!

Stage 2: Full Liquids

Goals: At this stage, you need to drink at least 64 ounces of fluid per day, and somewhere in there you need to somehow include at least 50 grams of protein.

Instructions: This stage is an interesting one because even though all you are ingesting are liquids, the risk of dehydration is quite high. It begins when you get home from surgery and lasts at least a week, and it could be more depending on your surgical center.

This is the stage that will likely make you hate protein shakes, but you MUST find a way! For the most part, you'll be drinking water and "eating" protein shakes. Here is a typical recipe you can use during this stage.

Stage 3: Puree

Goals: At this stage, you are moving past drinking protein shakes all day. That's the good news. The bad news is that you'll be pureeing EVERYTHING, with mixed taste results. The length of this stage varies, so check with your surgical center for details.

Instructions: You're going to put everything through a blender, including:

• Meat
• Turkey
• Chicken

Don't fret though! There are actually some tasty choices at this stage. You can always get away with yogurt or scrambled eggs.

One delicious option is black bean soup. It has a great flavor and it's chock FULL of protein. Search around, there are a lot of yummy options at this stage that you are going to want to add to your gastric bypass cookbook.

Stage 4: Soft Foods

Goals: Move on to foods you actually have to chew. You still want to drink at least 64 ounces of fluids per day and ingest at least 50 grams of protein.

Instructions: This stage will include soft and moist foods that are high in protein. I was personally very happy to get to this stage because A) I HATED eating all the puree, and B) I could finally eat ground beef!

Please note: you must try new foods slowly and deliberately to see how your pouch and your system are going to react to it. I was incredibly excited to eat ground beef, but it took a couple of tries before I could really eat it. Some other options at this stage include:

• Ground chicken
• Ground turkey
• Low-fat cheese
• Chili
• Fish

Basically, this is the stage where you feel like you can finally eat real foods again, and you might even enjoy eating again. Vegetarian chili, Spicy summer beans and sausage, and protein strawberry cheesecake are some must-haves for your gastric bypass cookbook!

Stage 5: Low Fat/Low Sugar Solid Foods

Goals: Maintain a healthy diet of low-sugar, low-fat solid foods.

Instructions: It may take up to 6 to 8 weeks to get to this stage, but it's quite an accomplishment when you do! This is the final stage, which means you'll finally get to eat things like:

• Fruits
• Vegetables
• Starches
• Dairy
• And more!

This is also the stage where you can get yourself into trouble. Make sure you are maintaining a healthy diet and adding only one new food at a time. Just because you can eat more kinds of food doesn't mean you have to go adding them all at once!

Once you've got a good feel for what kinds of food you can tolerate, the sky is the limit for your healthy gastric bypass cookbook. Remember- the key is high protein, low fat/sugar. Some of my personal favorites:

• Breakfast Muffins
• Warm Mexican Chicken Salad
• Shrimp Marinara
• Chicken Crust Pizza
• No Sugar Added Super Fudge Brownies for Dessert! (Really!)

Well now that you've got a start on building your gastric bypass cookbook, you should be able to gain an understanding of what you like and don't like, and what works and doesn't work with your pouch and new system. Remember to listen to the advice of your doctor and dietitian, and move from one stage to the other SLOWLY.

Until next time- happy losing!