Going from Liquids to Solids – Learning to Taste food

Successful Gastric Sleeve surgery patients and thin people taste their food. They don’t gulp down the food.  They savor it so they don’t need as much. Watch the typical obese person eat and many few food rapidly, gulping food down before they have any idea what it tastes like, or before their stomach can tell their brain they have eaten enough. Your days of inhaling meals are over. With Gastric Sleeve surgery if you eat quickly, your meal won’t last for over a minute. So for you to enjoy eating, take small bites and savor the food – describe the flavors, become a food critic.

Eating fast is one of the reasons those stomachs stretch out. Take your time.  Nickel-twenty-twenty.  Nickel sized bites – twenty bites in twenty minutes.

Prescribed Consistency – how to chew to get there:

  • Eat a bite size no larger than a nickel.
  • Relax and chew while mixing your food with saliva.
  • Feel the consistency between your tongue and the roof of your mouth

The above process has an important secondary reward. You will actually taste what you consume instead of inhaling it. Learn to relax, enjoy, and find peace in eating in this way. You’ll be much healthier for it both physically and emotionally. Most importantly, you can eliminate any problems with your Gastric Sleeve surgery.

Gastric Sleeve surgery patients your stomach is like a baby’s.

Your stomach is fresh and new, just like a baby’s.  And just like a baby’s your stomach may not tolerate things right away that it will tolerate later. So, if something doesn’t settle – go back to liquids for a day or two and move forward from there.

This is also a great time to introduce foods that you have never tried before. This is the time to renew your palate – and your second chance in life to free yourself from the foods that got you to be a weight loss surgery patient.

At this point Gastric Sleeve surgery patients can feel great – like they can eat anything. If you learn to chew well as instructed (above) and have a strong constitution, you may be able to consume anything that you want at this point. But, if you had stomach issues and/or problems eating specific things before Gastric Sleeve surgery, you’ll have those same issues afterward only they could temporarily be worse while healing after having Gastric Sleeve surgery. It’s important to keep your trouble foods in mind.

Stomach Indigestion

The last thing in the world you want during the healing phase of Gastric sleeve surgery is stomach gas. You don’t want acid indigestion either. You can eat beans at this point – only if they do not form gas. We’re going to tell you that you can consume things like beans, tuna and vegetables. But only if you had NO problems consuming them before your Gastric Sleeve surgery. If you had problems eating something before Gastric Sleeve surgery, even marginal problems – don’t consume it now. You can have whatever it is you desire – in a few weeks.

Take Gas-X at the first sign you might be forming gas. Don’t wait…

Make a bad food list. Sit down and think about the things that don’t agree with you and list them. We find that people get into trouble in this phase because they feel good. You get out and visit family and friends and that’s good for you. Problems only occur when you are offered something to eat. You’re in a social situation. You’re not thinking and you are offered a delicious thing to eat that you love and maybe one that you know would come back and bite you even if you hadn’t had Gastric Sleeve surgery. You might think you can consume just a little and get around it by chewing and chewing it – and at first it seems that it works! It’s so good that you forgot “Taste and Wait” and you go over the threshold. It won’t hit you right away. But after 20 minutes to 2 hours, it does. Your stomach bloats or knots and you are in serious pain. You will have a very uncomfortable night and may have to go back to a Clear Liquid Diet for a day or two.

You can easily prevent this from happening by listing all the things you’ve ever had even the slightest problem with before Gastric Sleeve surgery and not eating them at all until your stomach has functioned pain free for 3 weeks. So make that list right now. Make that list your Bible. If it’s a big list that you can’t commit to memory, look at it before you eat every time, especially if you are out in a social situation where you might be a little nervous and not thinking.

Use the “taste and wait” method when you add a new food after Gastric Sleeve surgery

Taste and wait applies throughout the healing process of Gastric Sleeve surgery. It should apply afterward also. Your stomach is drastically smaller and may permanently be more sensitive to some things. Each time you add a new thing to consume start by using the “taste and wait” method. No kidding. This will save you some real agony because it forces you to slow down and think about what’s going on inside your stomach as you eat. Again, people typically realize they’ve made a mistake in eating something over 20 minutes after they’ve consumed it. Taste and wait slows you down enough so what might become an emergency that may even require hospitalization is only a small bump in the road. Taste and wait is simple. Take a small bite (the size of your pinky fingernail), chew it as described above and wait 2 minutes to see how it sets. When adding a new food, consume the whole portion that way. You can turn it up gradually by adding more bites after the 2 minute interval (take 2 bites then wait 2 minutes, 3 bites and wait 2 minutes).

The idea behind Gastric Sleeve surgery is that you will be satisfied eating 4 ounces. But it’s easy to out eat Gastric Sleeve surgery because of the delay of satiety inherent in eating in general. Because it’s not your stomach initially being full that makes you feel full. It’s signals from your stomach to your brain that make you feel full and there is a lag time from eating to realizing satiety. Learning to wait after consuming a small portion is the new game you must play (and the one you should have played all your life). Your stomach is very small now. But, again, feeling full never happens right away after you eat. A good way to get in trouble is to think in terms of hunger when you eat. You will still be hungry after eating your 4 ounce portion. But then after waiting a little time, you will be very, very full. The time between eating and satiety is critical for you to understand. It is during this time that people consume more than the portion your stomach was redesigned by your surgeon to take. If you overeat shortly after having Gastric Sleeve surgery, you can break open the sutures holding your stomach together and you will need another emergency operation to fix it. After you have healed from Gastric Sleeve surgery if you overeat, you will slowly stretch your stomach’s capacity and permanently compromise your Gastric Sleeve surgery’s effectiveness.

Cauliflower Mash from Producergirl Productions on Vimeo.

Gastric Sleeve- your eyes are bigger than your stomach

Seriously – it is true.  At first, even though we make your stomach to where it holds about 1/2 cup of food, at first you may only be able to take a tablespoon or two. Take a 4 ounce condiment cup with you. Right after your Gastric Sleeve surgery your surgeon will tell you exactly what your new stomach’s capacity will be. The largest capacity is 4 ounces. But it might be a little less or a little more. After the doctor tells you what it is, use a graduated cup to measure it using mashed cauliflower (recipe here). Take the precisely measured amount of mashed cauliflower and put it into a 4 ounce condiment cup. If your stomach’s capacity is a little more than 4 ounces, there will be a little mound above the lip of the cup. If it is less, the top of the food will be at a line beneath the lip of the cup. Exactly memorize the visual of that level in the 4 ounce condiment cup. Your 4 ounce condiment cup is a measurement tool you can take with you to parties, restaurants and your friend’s house. You fill it with each course and snack you want to eat to the exact predetermined visual level – and that’s all you consume.

You can buy 4 ounce disposable condiment cups very cheaply (they have them on Amazon). These cups will easily fit into a purse or pocket and they come with covers so you can keep them clean prior to use. Here’s how you use them. If you go out to eat, take a little of each thing you want to eat off your plate and put it into the cup – making certain the level is exact or a little less than the predetermined portion (see above). Put the rest of it in a take home box and don’t even think about it except for another meal (breakfast, lunch or dinner only). If you are at a buffet, put your food on a plate and take it back to your table to measure. When you’re done eating – you just throw the cup away.

Eat at home if you can – right now you can’t bank on things prepared by others being soft enough. So don’t eat out unless there is no other choice.

Gastric Sleeve surgery soft food diet – for 7 days (Start 3 weeks after surgery)

Only eat things that can be chewed completely to the “Prescribed Consistency” as described in the first paragraph above. Think baby food.  In fact some people will buy some jars of baby food during this time — why? Because it is the right portion.  You will need some salt and pepper for it.

Poultry and red meat can have semi solids that people tend to chew to a point and then just swallow whole. Tough fat, gristle and veins in red meat, gristle and skin in chicken are among the things you can’t eat now. You can consume anything that can be chewed to the consistency described above. But, this must be done within reason. For example, you could chew soft pickled Jalapeno peppers to the “Prescribed Consistency” and some of you may even be able to eat them at this point. But most of you will want to avoid hot and spicy right now. Hard things such as nuts are obviously not a good choice now too.

This is not a time for salad or fibrous raw vegetables or fruit with large membranes: cabbage, celery, asparagus, lettuce, whole oranges and grapefruit, pineapple, grapes. Cabbage and asparagus can be cooked very soft and if you cook them soft they can be consumed.

Don’t eat high glycemic foods: potatoes, sugar, rice, pasta and breads. These are the things that make you fat and cause diabetes and heart disease.

Eat three meals a day – try and get 15 grams of protein per meal. You may need to use liquid protein or shakes.

We require that you start only one new food at a time

Obviously if you start many new things at once and have a bad result, you can’t know which one is the culprit.

You are transitioning from the “Full Liquid Diet” to soft food. You will eat “Full Liquid Diet” food while adding soft things once at a time. Again, soft foods are any thing that can be completely chewed to the “Prescribed Consistency” (above). Remember, your stomach has been halved, and so It may permanently be more constrictive from here on out. You need to learn to eat to facilitate things moving through your stomach. The process of “Taste and Wait” should be applied to all new things in question for the rest of your life.

Suggested soft foods for Gastric Sleeve patients:

  • Vegetables – only consume those that can be cooked to a soft consistency. Broccoli, cauliflower, carrots and leafy greens can be cooked to a point they fall apart. Kale, mustard greens, collard greens, cabbage and broccoli are cruciferous leafy greens. They, along with spinach and Swiss Card, are the healthiest things you can eat. All of them can be cooked to the point they fall apart and so are the best choice for post surgery Gastric Sleeve patients. Squash is good. Especially zucchini and yellow squash. But some squashes have a thick skin. In this case as with all things that have tough or hard sections – cut it off. Think in terms of amputating the hard stuff. In example you can eat green beans cooked soft, but be sure to cut off the stems on either end. Tomatoes are very soft (although they are technically a fruit).
  • Fruit – as with vegetables, some fruits have very thin skins and some have thick skins. Cut thick skins off – peel it. Watch out for pits and seeds – get rid of them. A peeled and seeded apple is delicious and very easy to chew and digest. Peeled Pears are good too! Citrus fruits have stringy pulp. We prefer that you juice them for awhile. Strawberries and blueberries are wonderfully soft. Raspberries and Blackberries can have very soft seeds and some can have large hard seeds. So be wary of them. If you find a large or hard seed in your mouth – spit it out. You should be able to find them every time by chewing to the “Prescribed Consistency.” Some fruit can be hard or soft depending on how ripe it is. Let hard fruit ripen on your window sill for a day or two until it is soft. Doesn’t a nice soft ripe banana sound good right now?
  • Fish – should be your top choice for protein – it is the healthiest. To start, you may want to eat soft flakey fish such as flounder. Ask your grocer which fish they have that will be soft after cooking. The trick to keeping any meat or fish soft and chewable is to not overcook it. Salmon may be the healthiest protein there is. Poached salmon may be a wonderfully delicate meal for you to try. You can eat canned tuna. But be careful. Tuna is dry and granular. Don’t forget the “Taste and Wait” method.
  • Poultry – dark meat is moister and softer than white. Overcooking poultry, especially white meat can result in it becoming dry and granular. Remove the skin and feel for gristle while you chew.
  • Red Meat – get soft boneless cuts. Beef has a wider range of consistencies than poultry. So ask your butcher to give you the softest cuts without bones, veins and gristle. On the other hand, we need to point out that the most tender meat is located around the bone. We worry about people absent mindedly consuming a large piece of cartilage, or worse a sharp piece of bone left by the butcher’s saw or clever. But if you are a person who lives in the moment, capable of being fully involved in the chewing method required to achieve the “Prescribed Consistency,” consume that delicious soft meat. It will be the softest and easiest red meat to digest (and most delicious). Just be careful. First, try and pick the bad stuff out and then chew slowly to the “Prescribed Consistency.”
  • Eggs – scrambled, cooked ever so softly. Eggs will become stringy and almost granular if overcooked. There are two tricks to cooking soft scrambled eggs. The first trick is whisking them thoroughly and vigorously before cooking. This brings air into the eggs which guarantees they’ll be soft and fluffy. The second trick is to cook them just to the point they become solid and no more.
  • Other foods – hummus, soft cheese, cottage cheese, hot cereal (i.e. oatmeal cooked very soft).
  • Beans – they have a lot of fiber and so are very good for you. They also are a great mix of protein and low glycemic carbs. The problem with beans is…gas. You don’t want your stomach to blow up like a balloon just yet. These should already be on your “bad foods” list if you already know they form gas in you. But just in case we thought we’d mention them again. You can find canned beans and some of them are even organic. However you prepare them canned or cooked from dry, they must be cooked almost to mush. Beans have skins that can be very tough and that must be softened. Even canned beans should be cooked further if the skins are tough. So always test if you can chew the skins to the “Prescribed Consistency” as described above. Then if the skins are tough, spit them out and cook the heck out of them until you can. Eat beans only if they don’t form gas in you.

The advantages of Sous Vide cooking for Gastric Sleeve patients

Dr. Terry Simpson is the Sous Vide weight loss surgeon! For years he has pioneered using this advanced form of French cooking for Gastric Sleeve surgery patients. Why is that? Because Sous vide is done under vacuum at the lowest temperature possible, making it the slowest cooking method there is. What does that mean for the things you eat? Sous Vide cooks things more soft and tender than any other way. Overcooked things become tough and so can cause problems for Gastric Sleeve surgery patients (especially chicken). So it’s easy to understand why Sous Vide is absolutely the best method of cooking for Gastric Sleeve patients (chicken is especially delicious). But the best feature of Sous Vide cooking is flavor. Being cooked under vacuum causes spices to diffuse into every molecule. Take broccoli for example. Right after Gastric Sleeve surgery, we want you to cook all your vegetables so they are mush – easy to chew and digest. After Sous Vide, the best thing to use to do that is a double boiler.

But even in a double boiler which retains the nutrition at a much higher level than boiling, you lose vitamins and flavor. Cooking at the lowest temperature helps contain the nutrition. But, food that is vacuum sealed can’t lose any of its nutrition and flavor – there’s no place for it to go but back into the food. Broccoli cooked soft in a double boiler won’t have the flavor of fresh uncooked broccoli – it’s just plain cooked out of it. Broccoli cooked Sous Vide tastes like fresh uncooked broccoli but it’s cooked softer than any other way. ALL the flavor is sealed in. So Gastric Sleeve patients don’t have to lose any flavor or nutrition at all while eating the softest food possible. This is how things are cooked in the very best of the finest restaurants in the world. Once costing thousands of dollars, Sous Vide ovens can be had for about as little as a good microwave.

Dr. Simpson has become a gourmet Sous Vide chef just for his Gastric Sleeve surgery patients. So he has multitudes of recipes just for you. It’s a no-brainer for Gastric Sleeve surgery patients. Steak, chicken, seafood and vegetables – everything tastes much better cooked Sous Vide. Let Dr. Simpson show you what real (and very affordable) gourmet eating is! Go to terrysimpson.com to see Dr. Simpson’s world of recipes that are certain to satisfy everyone in your family – dieters and non-dieters alike.