Your first diet after weight  loss surgery will be clear liquids. A diet of clear liquids maintains vital body fluids, salts, and minerals; and also gives some energy until you can resume a normal diet. Clear liquids are easily absorbed by the body. This eases the digestive tract into processing food again after the trauma of weight loss surgery.

What is a clear liquid? A good rule-of-thumb is anything you can see through.For example, apple juice is a clear liquid; milk is not. If unsure, check with the physician or registered dietitian. Clear liquids are any transparent drinkable liquid. Like glass, it might have color, but you should still be able to see through it. Usually they contain mostly sugar (or sugar substitute) and water (except for broths and bullion, which are salty). A strict clear liquid diet excludes all solids (even noodles in soup), milk products, and citrus (orange, grapefruit) juices. See Appendix One for examples.

Liquid Diets

—Your weight loss surgeon is not torturing you

Some bariatric surgeons have patients on liquid diets for several weeks after weight loss surgery.Some weight loss surgeons allow patients to eat solids fairly early on, and everyone seems to have a different plan. Who is right? Your bariatric surgeon is. Follow his or her plan, because they have very specific reasons for what they are doing.

Liquids empty from the stomach, or the pouch, differently than solids. You can survive with just liquids for a long time. The rational for liquids is that they won’t stretch the pouch, unless you gulp them. So, sip, sip, and sip.

There are two variations of liquid diets: clear liquids, and full liquids. The appendix shows you the difference. The real question is not what is a liquid; the real question is about coffee. Okay, so I fudge a little bit here, but I do this because of Ira. Ira’s only request was that he be allowed to drink coffee when he left the recovery room—I made a deal that we would call coffee a clear liquid if he would do laps around the nurse’s station. Ira became the world-marathon hospital lapper, and he had his coffee. Now 100 plus pounds later, Ira is a fixture in our weight loss surgery support group, a great encouragement to others—and we love talking about our favorite restaurants in the Big Apple (yup, Peter Lugar Steak House or Cafe Sport in San Francisco).

Most weight loss surgeons who have bariatric patients on prolonged liquid diets are concernedabout the staple line leaking. They want to give the stomach a chance to heal. Liquids do empty well, and it is an easy way to lose weight. The key to healing is getting in the protein. There are varieties of protein drinks available. There are also a lot of recipes for putting tofu in a blender with various things and making great shakes. Unfortunately a lot of “smoothies” are very high in carbohydrates and not terribly appropriate for losing pounds.

Clear Liquids

Controversies with clear liquids

Diabetic bariatric patients show no significant increase in blood sugar when they are started on a clear liquid diet containing sugar following a bariatric operation.

No—you cannot puree a Big Mac

The puree diet and Margaritaville

A blender is important during this phase, as it allows food items to be pureed to the consistency of baby food, yogurt, or applesauce. See Appendix One.

The puree, or blender diet, is meant to allow bariatric surgery patients with a limited capacity to have foods that go down easily without stretching the pouch, or stomach. The puree diet limits the post operative vomiting that bariatric patients might have, and vomiting is the enemy. Vomiting leads to increased incidence of leaks, breakdown of the staple line, and Lap-band slips. A puree diet increases the diversity of food that you can eat and increases protein sources. During this time, a chewable vitamin should be taken.

TIP: A coffee bean grinder works well to grind up pills

Once the pills are ground place them in a teaspoon, add some Splenda and a drop of water. Swallow the medicine and follow it with some water. You can also place the medicine in some apple sauce and take it that way.

Consume six small meals per day

You will transition to three meals per day and a snack, but during this period, it is important to begin regulating your food. Until the first 12 weeks are done, and your weight loss surgeon agrees, do not eat and drink at the same time. We let bariatric patients sip with their food after six weeks and have found no problem with this.