Long term diet after DS?

[ClareLynn 153]

I saw the dietician for a pre-op consultation about how to eat after the surgery. The booklet she gave me has 3 stages: liquid, mushy and then "general" diet (which starts after 1 month). I have gotten the impression from posts here that there may be a stage after this?

For example, there are some foods that are prohibited in the stage 3 general diet that she gave me, and I want to understand if those are "don't eat them until healed and you test to see if it works for you in some small portion" or "never eat them ever again". Some of the things to avoid are: raw fruit, fruit skin, raw carrot, whole green Beans, any starches (rice, bread, pasta).

I was wondering if anyone has a link to what a good diet/food list looks like for someone in maintenance after a duodenal switch? I wanted to make meal plans for each phase and get a better understanding what to expect before I have surgery, when I'm still feeling okay and have energy to plan. 😊

[Arabesque 6,449]

Many post op plans are pretty similar regardless of surgery. With my sleeve I had to follow 2 weeks liquids, 2 weeks purées (think sloppy no real chewing), 2 weeks soft (still pretty moist only a few chews needed) then slowly introduce more dense food as able. Certain foods were not allowed for a period of time & others not while I was losing.

You may find you have to keep food pretty moist (think sauces, gravies, etc.) for a while. Your tummy can be pretty sensitive to begin too & foods you previously ate you can’t yet. Plus it’s not unusual for your sense of taste & smell to change temporarily. Some have trouble with things like eggs & chicken. It’s trial & error but don’t give up a food, just try it again later and if you need to stay at a stage longer that’s fine - we heal & recover differently.

The best place to start is with the the list of allowed foods provided by your surgical team. They’ve been chosen so they don’t stress your healing & sensitive tummy & altered digestive system. You may still have issues with some or you may not.

Raw fruit & vegetables, fruit skin, etc. are too coarse for your digestive system at first. The reason for no rice, bread, Pasta is two fold. One to cut out processed empty calorie, low nutrition, starchy carbs from your diet while losing (many add these back in moderation in maintenance). And secondly because they swell & fill your much smaller tummy before you can get your Protein in. Protein is key. Always protein first.

Most eating plans while you’re losing are low fat, low carb, high protein. This is the time you also start exploring how you want to eat in the future. You try new ingredients, cooking styles, try alternative protein & nutritional sources. You’ll find you become very focussed on the nutritional value of what you eat.

If you’re not sure about what you can eat & when have a conversation with your dietician. I saw my dietician every fortnight until about 4 months into maintenance then COVID hit but I could call her at any time I needed. We would discuss foods I had added to my diet, how I managed them & what I wanted to try next. She would sometimes suggest alternatives or suggest I wait or go slowly with some things.

Good luck.

[NovaLuna 709]

Most of the stuff not in stage 3 diet tend to be things they want you to not eat for the first 6-12 months. I was told no bread, Pasta, or rice at all until 1 year post op. But then I learned I had a wheat allergy that developed after surgery (3% chance. they don't warn you about it because it's unlikely to happen, but my luck sucks). So when I eat bread or pasta it has to be gluten free (though I eat chickpea pasta noodles because of the Protein. I only have gluten free pasta for any slow cooker pasta recipes because chickpea noodles are for quick dishes, not for dishes that have to simmer because they end up with an odd after taste). I also eat cauliflower rice instead of regular rice because it's low carb and I just prefer it. I actually have yet to try regular rice post op (I'm 21 months post op with the Loop Duodenal Switch/SADI-S/SIPS surgery).

I'm technically not really in maintenance yet, but I'm borderline. I've only lost 1 pound this month, 1 last month, 1 the month before that etc. so I feel like I'm really close to maintenance, but still losing. Just super slooooow lol. But I'm eating more at what I consider a sustainable diet to just maintain my weight loss instead of actively trying to lose more. If I do lose more then great, if I don't then that's fine too because I've reached a weight that I'm happy at. I consume around 1300-1400 calories a day and have a minimum of 80g of protein (which my surgeon told me was my minimum daily protein intake). My daily diet is very different then yours will be I'd imagine, as I have food allergies (wheat allergy, high fructose corn Syrup allergy, and I'm lactose intolerant. I had the other two issues before the surgery, but the wheat was a new one. I also developed an outright allergy to NSAIDS after surgery too, which sucks because I have arthritis).

Really the diet for the DS and say... Gastric Bypass is pretty much the same long term except in protein requirements and the amount of Vitamins that you'll need. If your dietician/nutritionist deals with gastric bypass patients and isn't positive about long term requirements I was told by my surgeon that it's pretty much the same just DS patients females need a minimum of 80-100g of protein a day and men require 100+g minimum of protein a day while it's quite a bit less for GB patients.

[ClareLynn 153]

Thanks! That helps me understand better about phase 3 vs. long term diet.

I have another 3 appointments scheduled with the dietician for post-op every month. So I'll make sure to write down these questions and bring them to her. She's the bariatric dietician for the hospital so I'm sure that she knows her stuff. It's just that she focused on "what you need to know for pre-surgery" and not so much on the larger long term picture.

I'm sorry that you developed an allergy after the surgery! I already have a gluten intolerance so I think now's the time to just write off wheat for good. I definitely do not want anything stretching out my new stomach. I didn't realize that those foods swell up.