Nutrition in the Preoperative Period

Due to the complexity of obesity, the availability of numerous criteria and the importance of lifestyle change after surgery, patients need to be evaluated, monitored and trained by a multidisciplinary team.

Preoperative evaluation of patients should be performed by physicians, psychiatrists and dieticians specializing in bariatric field.

In the evaluation, patients are asked to create a food consumption record about their nutritional history, alcohol use, food preferences and daily energy intake.
During a detailed nutritional evaluation, the dietitian helps patients to prevent nutritional complications after surgery while making corrections to their dietary habits.
Providing some weight loss before surgery helps to minimize these complications.


Nutrition in the Postoperative Period

It is necessary to support the intake of sufficient nutrients to accelerate the tissue healing of the patient after the operation. It is necessary to minimize postoperative reflux, early satiety and dumping syndrome. There should be a transition in their diet in the form of a gradual diet.
The gradual dietary order of bariatric surgery patients should be in the form of clear liquid diet, liquid diet, puree diet, soft diet and standard diet.


Clear liquid diet

The first stage of postoperative nutrition is the clear liquid diet. The body must be supplied with fluids, electrolytes and a limited amount of energy. It is recommended to use a clear liquid diet for 1-2 days. By gradually increasing the stomach volume, approximately 2 liters (8-10 cups) of liquid should be consumed, provided that half of it is water. Consumption should be provided sip by sip. It is necessary to avoid using straws, as the possibility of swallowing air is high, it disturbs the stomach.


Liquid diet

This diet is applied for 2 weeks after postoperative controls. The fiber content of the liquid diet is higher than that of the clear liquid diet.
60-80 g of protein should be met per day.
2000 ml liquid support should be provided.
Recommended liquids;
Water
Lean meat/chicken broth
Fruit juices without sugar
Decaffeinated coffee, light tea
Lactose-free milk, buttermilk, kefir
Sugar-free compote juice
Pudding made from unsweetened skimmed milk
Lactose-free yogurt

Puree period

The puree diet lasts about two weeks. All stages of the liquid diet are also valid during this period. In addition to these;
Low-fat cottage cheese
Eggs (at the first 1-2 days only white part of the egg first and then the boiled egg)
Potato puree
Fruit puree
Well-cooked vegetable purees that do not cause gas (such as zucchini, spinach, fresh beans).
If protein support is not provided sufficiently during the mash period, protein support can be provided under the control of a doctor and dietitian.


Soft diet

This diet is a transition diet. It covers grinding, crushing and mashing. Soft diets are applied at 5,6,7 and 8 weeks after surgery. The target is 60-80 grams of protein per day. Protein supplementation is reduced as protein-derived nutrients increase. Liquids should be avoided during meals and waited for 30 minutes after eating. Spicy, too hot and too cold foods should be avoided.

Standard diet

If everything goes normally after surgery, this diet is started after the 9th week. Target protein intake should be 60-80 g. It can be started with the consumption of raw vegetables such as lettuce and carrots. Three main and three snacks should be taken into consideration and no other meals should be missed. Caffeinated drinks are prohibited for the first four months. It should be stayed away from chilly and spicy foods.