At this point, most of you are eating mostly solids. There is less anxiety and more pleasure involved with eating. A few of you will forget why you had Gastric Sleeve surgery. You’re into eating again. Keep in mind that your stomach is just at the point of becoming fully healed. You still may be able to damage your stomach by overfilling it with solids or liquids. It’s still and will always be very important that you only eat the prescribed amount of solids and liquid your stomach has been redesigned to hold. We’d hate to see you get to this point only to destroy your new stomach and require an emergency operation.

Now you have to keep the reason you had Gastric Sleeve surgery in mind. You are either going to learn how to consume less or you are going to slowly stretch your stomach to the point you will start gaining weight again. When people overeat, it is frequently done compulsively. It’s a feeding frenzy – fueled by mania. Right now you feel good about being able to eat again and now is the time you have to kill that mania and keep the reality of eating in mind. As we’ve told you, your stomach is full way before you get the signal from the brain that you are full. You will overeat every time if you rely on a feeling of fullness to stop you from eating. This is the basic truth about eating and it applies to everyone, with or without Gastric Sleeve surgery. Not realizing this is why you became overweight in the first place.

Gastric Sleeve surgery is a new start for you. It’s just like getting your automobile fixed after a wreck. If you drive your car or your Gastric Sleeve surgery the same way you did before the wreck, you’ll destroy it again. There is nothing in this world that works automatically. You have to choose your destiny. Before Gastric Sleeve surgery, over your lifetime you stretched your stomach from a normal size to so large that you could consume several meals in one sitting. Now you are at ground zero again. Better, your stomach is actually much smaller than a normal stomach. You have an opportunity rarely if ever experienced in life. You can start over. Know that the mistake you made was choosing to eat until you felt full. When you do that, you’ve consumed way too much – you have stretched your stomach. Each time you stretch it, you enlarge the cavern of your stomach increasing its capacity and your hunger between meals. We are telling you now, don’t stretch it at all. The way to do that is to never eat until you feel full. Trust that fullness or satiety will occur about 20 minutes after consuming the portion prescribed to you by your surgeon. Gastric Sleeve surgery will not fail you if you choose a destiny for success. Choose the destiny of being a thin, healthy person over a person living only to eat. The choice is up to you. Remember, it is a life choice that never goes away for anyone.

Dr. Simpson will give you one-on-one nutritional guidance at each of your appointments. He personally or his very experienced nutritionist will be reviewing your menus and lists every step of the way.

Full soft food diet for Gastric Sleeve surgery patients – for 1 week

Over the last few days, your diet has been based on the “Full Liquid Diet” and you’ve been testing and adding (transitioning to) “Soft Foods.” Now for a little while we want you to consume soft solids exclusively and keep adding more of them to your diet. We know we may have gotten you addicted to shakes and that they are a convenient way for you to eat lightly with full protein and nutrition. But for us to make certain your healing is complete and to promote it, for the next week we want you to concentrate on consuming soft solids exclusively. The goal is to condition your stomach so it fully accepts eating solids. So the game is exactly the same except that the basis of this diet is all soft solids – no liquids. Please reread “Stage 3 – Transition to Soft Food Diet” and continue to strictly follow the rules about consuming soft solids for 7 more days.

Note about protein shakes and drinks – A few of you may be vegetarians or on a given day you may not have gotten enough protein. In those cases, please do supplement protein with a shake or drink. If you are not a vegetarian, please try and steer more toward solids for this week. The goal for this week is reintroducing your stomach to digesting solids.

Transitioning to healthy (regular) meals after the full soft food diet

First off, you need know that there is no regular food if you were consuming mostly junk prior to having Gastric Sleeve surgery. You can’t eat garbage anymore. You just won’t get enough nutrition. If you were not consuming junk food before your Gastric Sleeve surgery, there is a good chance that you would not have needed the procedure in the first place. So most of you are attempting to eat real meals for the first time or for the first time in a long time. White bread or sandwich buns, a sliver of nitrite laden sandwich meat or ground beef, and processed cheese has virtually no nutritional value. A person consuming such things is literally starving their body by eating.  Eating empty calories is the best way to open the door for disease. You can get away with it as a kid. But as you age, your body will not be able to compensate for it. Think about it.  If you consume things that are empty of nutrition, what is your body going to want afterward? – more food. That’s how consuming junk food works and that’s how Americans get overweight. Further, while we tell you to take vitamins as insurance against disease – most vitamins are eliminated from your body and never absorbed. To be healthy you have to eat real things with vegetables being king.

You can’t eat junk and live a long healthy life – can’t be done. Now that your stomach capacity is limited you must concentrate on balanced good meals. Don’t feel bad about that. It’s a fact proven by many, many studies that the less you eat the longer you’ll live. So if you work with it, your Gastric Sleeve surgery can extend your life…by many years. Not just longevity but quality of life can be dramatically improved. You’ll be able to walk longer, think, see, and hear better and your love life may be extended too. You need to eat this way with or without Gastric Sleeve surgery – it’s past time to face that. Up until this point, bad diet has beaten you and would have cut you down. Now you have the most powerful tool in the world to help you beat your eating issues. Don’t feel bad. It’s time to celebrate. Celebrate by living well. That’s what we want you to do. Celebrate by resolving to the lifestyle necessary to live.

The point is that many of you are going to start consuming things that you didn’t eat before having Gastric Sleeve surgery. Good things, but food that you may have little experience with. Bad diet items are typically high glycemic and so they digest quickly delivering a huge load of sugar that instantly resolves to fat. Many of you are used to consuming such things that digest quickly and easily. You’ve got to stop and think about the new healthy things you want to eat now. Good food takes more time and energy to digest. Speed of digestion is the difference between a low glycemic load (non-fattening) and a high glycemic load (very fattening). So given that good food digests much more slowly than the processed things you may have been eating all your life before Gastric Sleeve surgery, you have to realize – you are in a new world. So act like you landed on a new and marvelously interesting planet. Enjoy it…but proceed with caution. When you run into a new species (food) take time to get to know it. Realize that new things may look good at first but may end up biting you. Slow exposure is the key to assimilating new species into your new world, and what we’re saying is that for you right now they may all be new. Fortunately you can’t eat that much. So there is not one reason (in the world) for you to eat compulsively and quickly. There is not one reason in the world for you to not take your time and introduce new species of food with caution and deliberation. Because if you don’t, your meal will last less than a minute. So what are the rules of survival on your new planet?

  1. Chew to the “Prescribed Consistency”
  2. “Taste and wait”

Follow these 2 very easy to execute rules and you may never have one problem with your Gastric Sleeve surgery in the short run. Over the long run there is a third and forth rule if you want to be thin AND healthy. You must consume nutritionally rich foods and balance your diet. The process of getting full nutrition has many aspects with the main considerations being:

  1. Protein
  2. Fiber
  3. Vitamins and minerals

Because you are going to be eating much less you need to make everything you consume count. If you want to be healthy, gone are your days of eating empty calories.


Most Gastric Sleeve surgery patients are not vegetarian. As we have said, before having Gastric Sleeve surgery many of our patients ate low quality protein in fast food. High glycemic carbs (bread and potatoes) included in all fast food are addictive so they ate a lot of low quality protein. Because they were eating so much in general they got the protein necessary for life even though it was low quality. Now after Gastric Sleeve surgery you will be limited to an ounce or two of protein per meal. You can’t get enough protein. So now you’ve got to consume only high quality protein. A half of a McDonald’s burger patty is not going to cut it. Whey protein isolate is excellent because it contains a full battery of amino acids, an element of protein that may be lacking in vegetable protein sources. It is also very concentrated. So you might be able to reduce the serving size. You only want to get 15 grams of protein per meal. Because your body can only absorb 15 grams at one time.

You might think that it’s okay to consume extra protein – but it’s not. Kidneys are one of the organs that can wear out. Extra protein is eliminated through the kidneys and can overload them. So if your protein supplement gives you 30 grams per serving – cut it in half. This way you can make more room for vegetables which contain fiber and vitamins. A few modern unflavored protein powders have become so refined that they can be mixed in water without changing its consistency. In other words, with the protein powder in it, the water retains the consistency of water without many carbs or calories. That will give you even more room for healthier things such as vitamin and fiber rich vegetables (and some fruit).

Whey protein isolate must be consumed rather than whey protein concentrate by Gastric Sleeve surgery patients. Whey is a byproduct from the manufacture of cheese – it’s dairy. Many people are lactose intolerant. Whey protein isolate has the lactose microfiltered out of it. So it is way more digestible than whey protein concentrate which will form stomach gas in many people.


Fiber promotes healthy intestinal function. Fiber also helps to make you feel full. The importance of fiber relative to healthy bowel function cannot be overstated. Healthy bowel movements remove toxins from your system. Diverticulitis, pockets or cavities in the walls of the lower intestine can result because of constipation. These cavities or Diverticula can become chronically infected. As you age, a lack of fiber will shorten and damage your life. Many of our patients have never consumed enough fiber prior to having Gastric Sleeve surgery. Because it’s just not present in the junk they ate. The vitamin rich vegetables we suggest you concentrate on eating (below) are your best source of fiber. But you are eating a reduced portion size. The recommended daily fiber intake for women is 25 grams, for men 38 grams. Most people don’t even get half of that. If after you analyze your diet you find you are not getting enough fiber, you may want to supplement it. Do not use powdered fiber such as Metamucil or similar generic products. They expand after ingestion and so can cause a Gastric Sleeve surgery patient a world of hurt. Only use premixed liquid fiber – fiber you don’t mix. Take an eighth of the recommended dose or less and be sure to use the “Taste and Wait” method. But this time wait 2 hours. Repeat however many times a day you need to get the dose you want. All fiber can cause serious bloating.

Vitamins and minerals

Live “Plant Strong.” Vitamins and mineral supplements are an advantage of modern times. But as we have said, they are not a replacement for real food. Many people believe that most disease can be avoided and even cured by consuming vitamin rich meals. As we have said the leafy greens: kale, mustard greens, collard greens, cabbage, broccoli, spinach and Swiss card are the most vitamin packed things you can eat. Most of these foods are also a good source of fiber. The world is your oyster when it comes to vegetables. Cauliflower, all the squashes, carrots, all the oriental vegetables, tomatoes are fantastic tasting and are also packed with the vitamins you need. Fruit also has a lot of vitamins. But not as much as vegetables. Fruit has sugar in it and so is a higher glycemic carb (it’s more fattening). We are being pretty stringent here. You have to have some dessert. High quality well ripened fruit (such as orchard peaches) is the most pleasurable thing you can eat. Apples are an exceptional fruit proven to be unusually healthful. They can be eaten as frequently as vegetables.

It is recommended that Gastric Sleeve surgery patients take a multivitamin supplement. Cheap vitamins may not be absorbed by your body and so may do nothing but tax your liver. Wal-Mart is not where you want to get your multivitamin. You can get good vitamins very inexpensively online (try Swanson Health Products). Again, Liquid vitamins are going to be easiest on your new stomach. If you can afford vitamins made from real food they are by far the best as they are the easiest for your body to assimilate. Now Foods is a better than average supplement producer geared for people on a budget. They make respectable quality liquid vitamins as well as liquid protein. Some vitamins are stupid in that they cost way too much. But generally with vitamins you get what you pay for.

Gastric Sleeve surgery patients should research everything they eat

To really be healthy with or without Gastric sleeve surgery, you need to research the things you consume. The most important thing a person should know may be what they are eating.


You can also get reference tools. “The Complete Book of Food Counts: The Book That Counts It All” is a $10 book that tells you the calories, protein, carbohydrates, fat, cholesterol, sodium and fiber in raw and popular processed foods. Get a book like this. Look up all the things you eat and get rid of the ones low in protein or fiber. Depending on your health condition, you might also want to might want to lessen your intake of high carbs, fat, cholesterol and sodium. Gosh, if only this book listed the glycemic load for each food it really would be “The Complete Book.” Actually glycemic load is the most important thing a dieter should know about. So you should get a book for that too. “The Low GI Shopper’s Guide to GI Values: The Authoritative Source of Glycemic Index Values for More than 1,200 Foods” is another $10 book that tells you the glycemic load for many processed and raw foods. You might be saying to yourself, “I don’t need that. I know what is fattening.” Do you? Did you know that watermelon has a glycemic load of 76? A high glycemic load is 70 or above. So watermelon is fattening. Did you know that?

“The Complete Book of Food Counts” and “The Low GI Shopper’s Guide to GI Values” are small reference books designed to be taken with you when grocery shopping. So when you decide to add a new thing to your Gastric Sleeve surgery diet, you can easily look it up and know precisely what its nutritional value is. That’s what we want you to do for every thing you consume (with or without Gastric Sleeve surgery).

There are lots of books about nutrition that tell you the vitamin and mineral content in food. Your capacity to eat has become drastically reduced. So you can’t consume empty calories anymore. After having Gastric Sleeve surgery you must make certain everything you eat contributes to the nutrition your body needs to thrive and remain disease free. Not just because you had Gastric Sleeve surgery.  This is a requirement for healthy living. A good book about nutrition is a book about juicing written by The Juice Lady (Cherie Calbom). “The Juice Lady’s Guide To Juicing for Health” is unlike any other book on nutrition. Most nutrition books go on and on over hundreds of pages beating the same subject to death. Good nutrition is not that complicated but most authors make it so in order to get 300 pages for their book. In one eleven page chapter, “Basic Guidelines for the Juice Lady’s Health and Healing Diet” she outlines what you need to understand about diet.

One of the most powerful things about this book is how it is organized. Every human ailment has its own chapter. In those chapters, she tells you exactly which vegetables and practices will heal that ailment. Every chapter is complete onto itself so you don’t have to do tiresome cross referencing back and forth within the book. You just add those specific healing foodstuffs to her basic guidelines and you have a diet precisely customized for you. If you’ve been overweight for a long time, prior to having Gastric Sleeve surgery you probably have health issues (comorbidities) because of it. Modern medications stop symptoms – they do not reverse or cure disease. Proper nutrition is the only way to reverse and cure disease. This book tells you exactly how to do that.

Juicing for Gastric Sleeve surgery patients

The most powerful thing about The Juice Lady’s book is juicing. Unlike a blender, juicing removes most of the solids in vegetable and fruit juices. The result is very low calorie, relatively easy to digest, condensed nutrition. You can more than triple the amount of nutrition you get from vegetables and fruit over just eating it. With most the solids removed, vegetables become much easier for you to eat and digest. The solids that remain in juiced vegetables contain soluble fiber that you may need. But if you strain your juice you can make it clear liquid that’s even easier to digest if you have digestion problems. The main advantage of juicing for Gastric Sleeve surgery patients is that it condenses vegetables so you may be able to consume more protein. Earlier in this writing we tell you about the best vitamins being made from real food (instead of chemicals). They are very expensive. Juicing is many levels above real food vitamins and you buy everything you need to do it in the produce department at your local grocery store. Juicing delivers the highest level of nutrition possible at a very low cost. Juicers can be very inexpensive. You don’t have to buy a juicer to have Gastric Sleeve surgery. But please consider the advantages for Gastric Sleeve surgery and your health.

We could have just listed foods here and tell you to eat this or that. But there are too many choices as everybody’s tastes are different. These books cover many possible paths for you to choose to obtain the goal of healthy and healing nutrition after having Gastric Sleeve surgery. They give unlimited options when it might seem there are few. The two reference books are small in size and are tools to optimize nutrition that can be carried and used whenever you shop.

How Gastric Sleeve surgery patients should eat at restaurants

We prefer our Gastric Sleeve surgery patients do all their own cooking. But we realize the time will come that you must eat at a restaurant. At this point, you’ve tested many foods and those are the ones you should eat in the restaurant too. Don’t start a new food in a restaurant if you can avoid it – and do avoid it. They’re not going to cook for optimal digestion as you will at home. So even things you’ve tested with “Taste and Wait” can have a different consistency in a restaurant. So in restaurants use “Taste and Wait” even on familiar things you have already tested. That’s not hard to do because restaurant eating is frequently a social event. Take a bite and shoot the breeze for 2 – 3 minutes. No one will notice because they’ll be talking too. If a restaurant serves you a tough cut of meat, dry chicken, stringy eggs or anything that’s not soft and easy to eat – send it back to the chef and have them make something new that you can eat. Don’t be shy. They are supposed to be professionals. Don’t be timid and eat something that can hurt you.

After a little time, you will become very used to your new stomach and you will forget it. Eating will become second nature as it was before you had Gastric Sleeve surgery.  It might take a year or two to get to that point. But at that point if you listen to these directions and go to support meetings you will be a much thinner, healthier person and loving it.