RNY weight loss surgery goals for six weeks to six months

RNYRoux en Y Gastric Bypass (RNY) weight loss surgery patient holding large old baggy jeans

  1. Remember the size of your RNY pouch and don’t overfill it. Solids fill you up, stick in the stomach, and slowly trickle out. Remember, the feeling of “satiety” isn’t instantaneous. As you transition to solid foods, it is better to have a bit less than you think will fill the pouch than to overfill it. If you want the pouch to stretch, overfill it. If you want to vomit, overfill it.
  2. If you cannot tolerate a food today, don’t worry. The typical progression of foods that the stomach will tolerate go from fish, to foul, to beef (swim, fly, walk). If you cannot tolerate something today, try it later.
  3. Cut your food to the size of half a pea and chew it thoroughly. The stoma is a bit less than half an inch, and if something gets stuck in there, then you will either vomit it out, or your gastroenterologist will have to take it out with an endoscope. If you don’t learn to cut up your food and then to chew your food, you will be quite uncomfortable.
  4. Three or four meals a day is the rule. A meal should last no less than five minutes or no more than 30 minutes. Sit down and enjoy the meal. You will be eating a lot less than everyone else in the family, so take your time and enjoy the company.
  5. Do not skip meals. So you are not a breakfast eater and never have been. Learn to eat it. Plan what you will eat, eat high quality protein, and enjoy your food. Snacks happen because of hunger—hunger happens when you have missed a meal. Think—did missing breakfast really work for your weight loss? What you eat in the morning makes you feel full for the afternoon.
  6. Get a smaller plate, a smaller fork, a smaller spoon. You will eat less, you will have smaller portions, and you have to cut it smaller. Using utensils designed for this purpose makes sense. Small portions are a key to weight loss, and now it is enforced.
  7. There is a growing body of evidence that sips of water with your meal will not wash out the food. This may be a myth that is slowly leaving bariatric literature. In a survey of 30 patients who reached their goal with RNY weight loss surgery, and maintained that for at least two years, all of them sipped some liquids with meals. However, none of them “gulped,” their liquids. None of them drank and ate at the same time during the first 12 weeks—the pouch requires different treatment during that time.
  8. Drink a lot before meals. Most RNY weight loss surgery patients complain of constipation, and most constipation comes from not drinking enough. Now, I have never had a patient tell me that I was right. My bariatric patients all say that drink plenty. When they measure what they drink, they find they don’t drink as much as they should. Drinking water or sugar-free liquids also decreases appetite.

RNY weight loss surgery liquid diet – first it sustains you, now we want you to avoid it

For the first six weeks you lived on pureed foods, soups, and liquid drinks. Now that you are eating solids, soups and pureed foods become something to avoid. You may need to go back to soups and pureed foods if you cannot tolerate solids, but that is a separate issue. Solids empty differently than liquids.

Solids provide a sense of fullness that you may have been losing in the last couple of weeks. So, as your stomach can tolerate these solid foods, you will notice a new sense of satiety with smaller portions. Your stomach will grind away at the solids and eventually they will empty into the intestines. Liquids, soups, and many puree foods go passively through the stomach. Strange to think of it but it is kind of a weaning process. You have your teeth back, your stomach is getting ready for solid foods, and it is time to graduate from one, and put the other behind you.