After bariatric surgery: your care guide

1. How should I drink?

• Take small, frequent sips while awake. Do not gulp a full glass or wait until you feel thirsty.
• A common goal is around 2 litres of permitted fluids daily, reached gradually as tolerated. Follow any individual fluid restriction for heart or kidney disease.
• Use a marked bottle or record your intake. Water and nourishing liquids allowed at your stage count towards the total.
• Avoid fizzy drinks, including diet versions, fruit juice, sweetened drinks and alcohol. Choose caffeine-free drinks during early recovery.

2. Your first-month food timetable

This is a common general schedule after uncomplicated sleeve gastrectomy or gastric bypass. Follow your discharge plan if its dates differ. Do not advance while experiencing pain, vomiting or swallowing difficulty.

1. Stage 1

   Liquids

   Completely smooth liquid without pieces, skins or seeds.

   Suitable examples: If only clear liquids are authorised: water and clear low-fat broth. The team determines this brief stage; do not prolong it yourself. Once nourishing liquids are allowed: low-fat or lactose-free milk, a low-sugar protein drink, and blended, strained soup at the permitted consistency.

   Remember: Milk and yoghurt are not clear liquids. Soup containing pieces is unsuitable for the liquid stage.

2. Stage 2

   Smooth purée

   An even yoghurt-like texture without pieces needing chewing.

   Suitable examples: Plain yoghurt without pieces, smoothly blended cottage cheese, or cooked chicken or fish blended with permitted liquid until completely smooth.

   Remember: No pieces of meat or chicken, bread, rice or pasta at this stage.

3. Stage 3

   Soft food

   Moist food that mashes easily with a fork.

   Suitable examples: Soft thoroughly cooked egg, tender boneless fish, soft cheese, and moist tender minced meat as tolerated.

   Remember: Avoid dry or hard foods, skins, seeds, nuts and tough meat.

4. Stage 4

   Gradual return to regular food

   Once your team agrees, introduce one new food at a time in small amounts.

   Suitable examples: Eat protein first, followed by permitted vegetables. Discuss persistent difficulty with a food with your dietitian.

   Remember: Bread, rice and pasta do not return automatically when a stage ends; your nutrition plan sets their timing and portions.

3. Portions and eating technique

• Start very small when beginning purée, for example 1–2 tablespoons, and increase only as tolerated within your team’s portion plan. Stop at the first fullness, pressure or nausea; do not force yourself to finish.
• Take small mouthfuls and chew until smooth. Allow around 20–30 minutes for a meal and sit upright.
• Once eating purée or soft food, do not drink with meals. Wait 30 minutes afterwards before drinking, and spread fluids between meals.
• Prioritise protein. Many plans aim for 60–80 grams daily; your dietitian sets your individual target. This means grams of protein, not the weight of the food itself. Check the protein amount on drink labels.
• Do not deliberately skip meals to speed weight loss. Avoid sugary and high-fat foods. Stop a food that causes pain or vomiting, and contact the team if this recurs.

4. Medicines: what to take and avoid

This explains medicine groups; it is not a prescription. Do not start a medicine because it appears here. Your discharge prescription states what you need, with the dose and duration.

5. Vitamins and supplements

• After sleeve gastrectomy or gastric bypass, supplements and nutritional follow-up continue long term, usually for life. Do not stop because you can eat or have lost weight.
• Your plan may include a bariatric-appropriate multivitamin and mineral supplement, calcium and vitamin D, iron, and vitamin B12. The team sets products, doses and the B12 formulation using your operation and blood results.
• If prescribed both iron and calcium, take them at least 2 hours apart. Do not swap your supplement for gummy vitamins or another product without checking its contents with the team.
• Repeated vomiting with poor intake can cause serious vitamin B1 deficiency. Seek urgent assessment; do not wait for blood tests or a routine visit.

6. Movement, wounds and everyday life

• Take short gentle walks several times daily and build up as able. Avoid prolonged sitting or bed rest. Use prescribed stockings and breathing exercises.
• Avoid heavy lifting, abdominal exercise and gym training until cleared. Do not drive while taking sedating painkillers or if pain prevents safe movement and braking.
• Follow your wound-specific dressing and showering instructions. Do not pick off glue or adhesive or apply unprescribed creams. Avoid swimming and soaking wounds until healed.
• Avoid smoking, shisha and nicotine. For constipation without severe pain or vomiting, discuss treatment with the team; do not assume severe abdominal pain is ordinary constipation.

7. When should I seek help?

8. Follow-up: do not wait for a problem

• Keep the first appointment written on your discharge plan. If none is arranged, call the clinic today.
• Bring your medicine list, fluid and protein records, symptoms, and glucose or blood pressure readings if requested.
• Continue surgical, nutritional and blood-test follow-up. Nutrition and blood tests are usually reviewed several times in year one, then at least annually for life, or more often for your needs.