Eating After Your Gastric Bypass Surgery or Whipple Procedure

This information describes the dietary (eating and drinking) guidelines you will need to follow after your gastric bypass (gastrojejunostomy) or Whipple procedure (pancreaticoduodenectomy).

Your clinical dietitian nutritionist will review this information with you before you leave the hospital. If you have any questions or concerns, or are losing weight after you leave the hospital, call 212-639-7312 to set up an appointment with your clinical dietitian nutritionist.

Dietary Guidelines

After your surgery, the amount of food you can eat at once and the time it takes for food to leave your stomach may change. Because of this, you may need to change the way you eat.

You may also have trouble tolerating foods high in fat, sugar or both.

Follow the guidelines below. You can also use the sample menus at the end of this resource to plan your meals.

Eat smaller meals more often

After surgery, you may feel full more quickly when you eat. This can prevent you from getting enough nutrition. If this happens to you, or if you have nausea or indigestion, try eating smaller meals slowly and more often. For example, try eating 6 half-size meals instead of 3 main meals each day. This will allow you to eat the same amount of food overall, but in smaller portions that will be easier to digest.

Eating small half-size meals may also be helpful if you have nausea (feel like you’re going to throw up) or indigestion.

You may be able to eat larger portions as time passes.

Drink enough liquids

Try to drink around 8 (8-ounce) glasses of liquids each day. This will help you keep from getting dehydrated. If you drink more than 4 ounces of liquids when you eat, you may become too full to finish your meal.

Avoid foods that cause gas

If you’re having bloating or fullness, it may help to limit or avoid foods and drinks that can cause gas. Examples include:

• Broccoli
• Cabbage
• Brussels sprouts
• Cauliflower
• Beans and legumes (lentils, peas, peanuts)
• Fruits that aren’t ripe
• Carbonated drinks, such as sodas and sparkling or seltzer water

Try avoiding these things for the first month after your surgery. If you’re not having symptoms after that time, you can try adding them back to your diet one at a time to see if you can tolerate them.

Include protein in your diet

After surgery, your body needs more protein to help you heal. Good protein sources include:

• Lean beef cuts
  • Eye round roast
  • Top round roast
  • Bottom round roasts
  • Steaks
  • Top sirloin steak
• Chicken or turkey with the skin removed
• Fish
• Low-fat dairy products
• Eggs
• Tofu
• Beans and legumes
• Nuts and nut butters

Start with low-fat foods

Eat low-fat foods right after your surgery. You eat less fat by following the guidelines below.

• Trim any visible fat from meats.
• Bake or broil foods instead of frying them.
• Use only a pat of butter or margarine on toast.
• Limit the amount of butter or oil on vegetables and dressings on salad.
• Avoid heavy gravies and cream sauces.
• Limit snack chips, croissants, doughnuts, and rich desserts like pound cake or cakes with frostings
• Avoid processed meats like hot dogs, sausage, bacon, and bologna

You can gradually increase the amount of fat in your diet to an amount that you can tolerate. See the section below called “Monitor Your Bowel Movements for Changes” for more information.

Monitor Your Bowel Movements for Changes

Problems with fat absorption

Some people have problems absorbing fat after their surgery. This may cause weight loss or make it harder for your body to absorb some vitamins.

You may not be absorbing all the fats you’re eating if you’re having any of the following symptoms:

• Frequent bowel movements
• Bowel movements that float
• Bowel movements that are very light in color, frothy, greasy, or foul smelling

If you have any of these symptoms, ask your doctor if you need to take pancreatic enzyme medication. An example is pancrelipase (Zenpep^®). You can take these medications with your meals to help with digestion.

Lactose intolerance

Lactose intolerance is not being able to digest lactose. Lactose is a sugar found in dairy products. Some people become lactose intolerant after surgery. If you have gas, bloating, or diarrhea after you eat foods with lactose, you may have lactose intolerance.

Milk and buttermilk have a lot of lactose. Ice cream and yogurt can have both high and low amounts of lactose. Hard cheeses like cheddar and parmesan have lower amounts of lactose. Soft cheeses like cottage and ricotta also have lower amounts of lactose.  Some people with mild lactose intolerance can tolerate these lower lactose foods. You can try eating dairy products in smaller amounts with non-dairy products to improve your tolerance.

There are also medications available that can help you digest lactose. One example is lactase (Lactaid^®)

Sometimes, lactose intolerance after surgery will go away. You can try having dairy again in a few months to see if it has improved.

Dumping syndrome

Dumping syndrome is when you have diarrhea (loose bowel movements) after having large amounts of sweets, such as:

• Sugar, honey, and syrup
• Regular (not diet) soda and fruit juices
• Cakes, cookies, and candies

If you think you have dumping syndrome, limit or avoid sugary foods or drinks and try diluting juices with water.

If you have dumping syndrome, it’s especially important to eat smaller meals and drink enough fluids throughout the day.

Sample Menus

The sample menus at the end of this resource have 6 small meals with 4 ounces of liquid at each meal and 8 ounces of liquid between meals. Soup also counts as a liquid.

It’s often helpful to separate liquids from solids. Try drinking liquids between meals instead of during the meal.

Many of the foods on the menus aren’t sugar-free. Use sugar-free or “light” yogurt in place of regular yogurt, limit fruit juices, and dilute fruit juices with water if you:

• Have diabetes
• Have high blood sugar
• Are having dumping syndrome

Foods with an asterisk (*) have lactose. If you’re lactose-intolerant, try lactose-free milk (such as Lactaid) in place of regular milk. You can also take lactase tablets or drops to help you digest dairy products. You can also try a non-dairy option such as unsweetened almond milk or soy milk in place of regular milk.