Gastric Sleeve Diet Discussion

I just read Ultimate Gastric Sleeve Success: A Practical Patient Guide to Help Maximize Your Weight Loss Results by Dr Duc Vuong. I’d recommend this book for all bariatric patients, because he embraces a whole foods approach to recovery and establishing new eating habits. It is totally worth the $8 Kindle version.

While I love his EAT REAL FOOD mantra, the book is biased towards an Asian diet. He never addresses anything dairy other than to say “only baby cows should drink milk”, which is in line with his Asian background. He also does not address taking medications – as in, when can you take pills again, etc.

The first chapters of the book are very informative about how the surgery is done, with diagrams, which I love. I think for any bariatric patient, this book is A MUST READ. It definitely goes against the crappy diets handed out by the “nutritionists” who work with bariatric surgeons. Every diet I’ve seen has been absolute CRAP. Geeze, no wonder everyone loses their hair if they only eat fruit smoothies and yogurt for eight weeks! The diet given to me was boring, fruit based and asked for WAY too much protein: 80 grams a day!! WHAT?! I don’t eat that now! That is a LOT of protein, and unless you can eat whey powder straight, it’s doubtful you’ll get that much down. I’m aiming for 40-50gm.

Another very important point that Dr Vuong addresses is “mushy food syndrome”. This is when a bariatric patient continues to eat mushy foods long past the time needed for the stomach to heal. By continuing to eat mushy foods, you not only are not helping your new stomach to work properly, but you are not getting satiety because these foods slide right through your pouch. You eat more and this can undo your weight loss. It’s important to start eating real protein as soon as possible after your sleeve surgery. Dr Vuong goes into rating foods on texture, which I think is an INVALUABLE thing for bariatric patients to learn.

I disagree with his hatred of chicken, however. He also hates on pork and beef and recommends never ever eating anything but fish. Again, his Asian bias is displayed. I think chicken is a staple for most Americans and there is nothing wrong with chicken as your protein. Pork and beef should not be eaten more than 1-2 times a week anyway, so restricting those makes sense.

I DO agree that fish is softer than chicken, so eating fish to start out with solid protein is a great idea.

Dr Vuong completely ignores dairy products in his recommendations. Again, Asian bias. I think that yogurt absolutely has a place in recovery to replenish gut flora. I don’t drink milk, so I probably won’t be using it myself, but I don’t think that using milk in smoothies is a bad thing at all. Milk has protein, which is a prime ingredient for recovering bariatric patients. I plan to use Silk, a soy milk that is fortified with calcium and protein. I also have soft cheese (SOFT cheese, not hard cheese in slices or blocks.) in my soft foods list, because I love cheese and I can make a soup, or eat some goat cheese or pimento cheese if I want it. I also love cottage cheese, so that is also on my soft foods list. Let’s not forget that cheese is also high in protein.

What I’ve found, overall, when reading about bariatric diets, is that there is about a million different ideas on what you should do. The typical diet handed out by so called dieticians is a generic, fruit based diet that really doesn’t address anyone’s dietary needs. I’ve seen the exact same diet given to diabetics (high carb for DIABETICS!!). I think that this generic diet is given with the assumption that you’ve been sitting around eating junk food and drinking sodas all your life and that is why you’re fat. I see lots of assumptions from Drs and dieticians, who tend to think that you must eat really shitty foods to be fat. Which is absolutely NOT true. I eat a great diet and I exercise regularly thankyouverymuch. I do get a little bent out of shape when I consistently see these biases towards bariatric patients.

Furthermore, I think it is a damn shame that fat shaming extends to the very industry that is supposed to be helping people lose the weight in the first place.

I think that bariatric patients need to eat nutrient dense vegetables and protein powder until they can manage solid proteins. Fruits contain lots of sugars and have little nutritional value, IMO. I am not a person who eats much fruit to begin with nor do I eat lots of sweet stuff in general. I simply cannot tolerate a diet that is sweet and fruity. Ick. It makes more sense to me to eat as low carb as possible from the get-go, since that is how you should eat to maintain your weight loss. It’s too bad that 90% of what I’ve seen on forums, sites and books is conflicting and biased towards bland, uninspired, high carb foods and omg no fats. Low fat is good, yes, but not at the expense of eating high carb fruit all day long. I actually feel that bariatric recovery patients should not worry about fats since they are calorie dense. When you can only eat a cup of food a day (in recovery), you need every calorie you can get. And NO, I do not subscribe to the idea that if you let one gram of fat pass your lips you’ll go back to eating like before. Why? Because your stomach is now about 1/6 of it’s original size, that’s why. It’s damned hard to overeat when you are recovering from sleeve surgery!

Again, I feel that pretty much every bit of “official” advice (Dr, Nurse, nutritionist) is based on the assumption that if you’re fat, you got that way because you have no idea how to eat. Perhaps that is so for some patients, but I doubt it’s true for the majority. If you learn one thing while you’re fat, it’s how to count calories and what foods are “bad”. Honey, I can tell you the calorie and fat counts of pretty much any food you name. WE GET IT. I resent being given these diet rules that have no basis in reality. They are given to “wean” you off of eating real food with the notion that if you have anything other than crappy smoothies you’ll immediately order Papa Johns and eat the whole thing. This bias that if you eat anything other than nonfat yogurt and berries you’ll “relapse” into being fat is really annoying.

I think anyone going on this journey should prep lots of different kinds of foods that YOU LIKE before you go under the knife. I am prepping about a dozen different veggie purees that can be made into soup or used as is. I’m freezing them in 1 cup portions for easy thawing. I’m assuming that I’ll only eat about 1/4 cup of anything at a time, hence the small portions. I am using lots of flavours in my purees, from Asian to Indian to Korean and beyond. Onions and garlic are in EVERYTHING. I see no reason to compromise on flavour just because I have to eat pureed foods. Hummus is also a smooth and tasty thing that’s on my list.

The base recipe for these purees and a Carrot Ginger soup recipe are here.

I hope this info helps someone else getting gastric sleeve or any bariatric surgery.

Base Recipe for Pureed Veg & Soups

I refuse to believe that you have to eat nothing but protein shakes and fruit smoothies for 2 months – as the diet plan from the nutritionist indicated. Just because you can’t eat much, does not mean that you have to eat flavourless goo. I don’t eat a lot of fruit in the first place, so I can’t see me being into it after surgery. I will be using Silk fortified soy milk since it has protein and calcium added. I have no idea what I’ll be able to eat after the gastric sleeve, but by the gods, I want to have delicious savoury options at the ready. I’m sure I’ll tire of sweet things since I don’t eat sweets much now.

These are recipes for bariatric diet weeks 3-4, which is pureed soups. You can use any root vegetable you like: carrot, potato, parsnip, celeriac. It will also work with tomatoes, spinach, broccoli, butternut squash, mushrooms and roasted red pepper. Actually, this same recipe will work for soft foods weeks 4-8, just reduce the liquid and you’ll have pureed veg. Weeks 1-2 are clear liquids, so I think anyone can figure out BROTH. I will suggest getting some beef bone broth from a Korean grocery if you have one. And miso soup would be good, too.

You’ll need flavourless whey protein to add to everything you eat. I’d make the puree/soup, then add the protein only to your serving to keep it from affecting the overall texture of the puree/soup. I am making purees and freezing them for quick and easy prep when I get back home. I’m also making lots and lots of homemade chicken stock to try to boost the protein content as much as possible.

The key to making any of these purees is the NutriBullet. GET ONE. If you are getting any sort of bariatric surgery and must follow a pureed diet, the NutriBullet will do everything you need. You can do smoothies, sure, but this thing makes veg into a beautiful smooth puree, which is perfect for soups or soft foods. Today I made Carrot & Ginger puree with coconut milk:


Carrot & Ginger Puree/Soup with Coconut Milk

1# carrots, scrubbed (no need to peel), sliced
1 medium white onion, med dice
1 Tbl garlic paste
2 Tbl ginger paste (These pastes are Indian items. I highly recommend them for these purees.)
2 cups +/- chicken stock
1/4 cup coconut milk (Sometimes called cream. NOT coconut water!)

In a 2 qt saucepan, add a bit of EVOO to the bottom and put over med hi heat. Toss in carrots and onions and cook for about 5 minutes – do not brown. Add in garlic and ginger, and enough stock to just cover the veg and cook at a fast simmer for about 15 minutes, until carrots and onions are soft. Take off the heat and check S/P. Puree the veg in the NutriBullet. Add coconut milk to the puree and stir in. Leave as is for puree or add more chicken stock to thin down to a soup.

The base for about 1 quart of puree is just this:
1# Veg, sliced or diced
1 Onion, diced
1 Tbl Garlic, minced or use paste
2 cups +/- chicken or beef stock

Cook until soft, check seasoning, puree. That’s it. If you’re freezing, do NOT add any dairy. You can add that when you make the soup. All these can be made with soy milk and veg stock or water if you’re vegan.

And don’t forget to add your plain whey protein when you eat. Assuming a 1/4 cup serving, one recipe should give you about 16 servings! The protein doesn’t add any significant flavour. I am using Vitacost whey protein which is really good: 18gm protein per scoop for plain; 22gm protein per scoop for flavoured. They have all the chewable vitamins you need, too.

NOTE! DO NOT MICROWAVE protein powder! It’s fine spun into smoothies, but other than that, protein powder can be tricky. The key is to make the soup, get your hot portion, then stir in the powder. It dissolves best in hot liquid. If you microwave the powder, it poofs up and coagulates. NOT appealing.

Ideas (going from the base puree and adding flavours):
Potatoes with Mexican crema
Parsnips with pepper and cream
Celeriac with shallots
Tomatoes (use Italian crushed) add basil and cream if desired (could need some sugar if toms are acidic)
Spinach (use frozen chopped) add nutmeg and cream
Broccoli with balsamic vinegar OR Mexican crema
Butternut squash with coconut milk
Mushrooms with sherry, nutmeg and cream
Roasted red pepper with basil and cream

I hope these recipes will help others who have gotten bariatric surgery! Flavour forever! XO