Diet After Bariatric Surgery: Our 35-Day Program for Sleeve, Bypass and SASI

After bariatric surgery at our center in Amman, every patient follows the same written diet program for the first 35 days, whatever the operation: gastric sleeve, gastric bypass, mini gastric bypass, SASI, re-sleeve or revision gastric bypass. The program has three stages. Days 1 to 7: clear liquids. Days 8 to 25: thick liquids made in a blender. Days 26 to 35: mashed food with small pieces of cooked vegetables.

For the full 35 days the program does not allow meat, chicken, fish, bread, dates or salad. Each stage has a table with the type of food, the amount and examples, plus a short list of rules. This page publishes those tables exactly as we hand them to patients at discharge.

If you had surgery somewhere else, your own surgeon's written plan comes first. Programs differ between centers, and the plan you were given is built on your operation and your file.

The stages move in one direction: from clear liquids, to blended liquids, to mashed food. The table below is the whole program on one screen. The sections that follow give each stage in detail.

After day 35 you move to the next stage with guidance from the center's dietitian.

Length: the first 7 days after surgery. Type of food: clear liquids.

Stage 1 rules

• Natural juice is best. If you use a packaged juice, choose one with no added sugar.
• You can use honey or sugar, up to 2 small teaspoons a day.
• Avoid thick soups such as lentil soup and freekeh soup in this stage.
• Avoid citrus juices such as orange and lemon, and avoid berry, pineapple, guava, strawberry and banana juices.
• Avoid fizzy drinks for 6 months.
• Avoid peppers of every kind for 2 months.
• Avoid stock cubes and ready-made instant soups (such as Maggi). Homemade broth is better.
• Jell-O counts as a clear liquid and is allowed.

Sip slowly. Small, frequent sips through the day sit better in a new stomach than a full cup at once.

Length: 17 days, from day 8 to day 25 after surgery. Type of food: thick liquids, made in a blender.

Stage 2 rules

• You can use sugar or honey, up to 2 small teaspoons a day.
• Avoid sweetened packaged juices. Use natural juice or juice with no added sugar.
• Skim milk is allowed. If it gives you gas, stop it and use laban (plain drinking yogurt) or Activia Light instead.
• Twice a week, you can have one serving of Jell-O, custard or muhallabia (milk pudding) in place of one cup of juice.

Everything in this stage goes through the blender until it is smooth, with no pieces. If a soup is too thick to drink easily, thin it with a little broth.

Length: from day 26 to day 35 after surgery, 10 days. Type of food: mashed food, with small pieces of vegetables.

Stage 3 rules

• No meat, chicken, fish, bread, dates or salad for the full 35 days.
• You can have the white of one boiled egg, once, during these 10 days.
• Citrus juices are allowed in this stage. Stop them if they cause acidity or heartburn.

Cut vegetables into very small pieces and cook them until soft. Chew every bite well, and stop at the first feeling of fullness.

This table gathers every restriction in the program in one place.

The operations differ in how they reduce the stomach or reroute food. They share one thing in the first weeks: staple lines or new connections that need time to heal, and a small stomach that needs a slow change in texture and amount. That is why the center uses the same 35-day program after each of them.

After revision surgery, the surgeon sometimes adds an instruction based on what was found during the operation. When that happens, you receive it in writing before you leave the hospital.

In stages 1 and 2 almost everything you take is a liquid, yet some patients still get dehydrated because they are afraid to drink or simply forget. Keep a cup or bottle with you, and take small sips through the whole day: water, broth, the allowed juices and herbal drinks.

Signs of dehydration

• Little urine, or dark urine.
• Dizziness when you stand, headache, or unusual tiredness.
• Dry mouth and lips.
• Constipation.

If you cannot keep fluids down because of vomiting, or the signs are severe, contact the center straight away.

Stage 1: homemade clear vegetable broth

Simmer vegetables such as zucchini, carrot and onion in water with a little salt, then strain the broth well and sip it warm. It is a better choice than stock cubes and instant soups. Chicken or meat broth is made the same way, and you drink only the strained liquid, with no pieces.

Stage 2: blended lentil or oat soup

Cook lentils or oats with vegetables until very soft, then blend until completely smooth. Thin with broth if it is heavy. Mixed vegetable soup and blended potato are made the same way.

Stage 3: roasted vegetables, molokhia and mashed potato

Cut zucchini, carrot and potato into very small pieces and roast them until soft, or sauté vegetables in a little oil. Molokhia and mashed potato are allowed, as are 2 tablespoons of rice, cornflakes with milk, or ka'ak with tea. Serve molokhia without pieces of meat or chicken, because both stay off the menu for the full 35 days.

Nausea

Usually caused by drinking too fast or too much at once. Slow down and sip. If nausea keeps coming back, message the center's dietitian.

Gas after milk

If skim milk gives you gas in stage 2, replace it with laban or Activia Light, as the program allows.

Acidity and heartburn

If citrus juice causes acidity or heartburn in stage 3, stop it. Keep avoiding peppers for 2 months.

Constipation

Common while intake is small. Keep up your fluids and walk every day. Do not start laxatives on your own; ask the medical team.

Food that feels stuck

Can happen in stage 3 when pieces are too big or you eat too fast. Stop, wait, and next time cut smaller pieces and chew longer.

Every patient leaves the hospital with discharge medicines and supplement instructions that fit the operation and the blood tests. Supplements differ between operations: the needs after a bypass or SASI are not always the same as after a sleeve. Do not start or stop a supplement on your own.

For the general picture, read vitamins after weight loss surgery, and always take the doses written for you.

The cost of surgery at the center includes visits to the center and free follow-up with the center's dietitian for two years. The dietitian checks how you are doing with the program, answers questions at each stage, and adjusts the instructions if your case needs it.

If you live outside Jordan, you stay in contact with us after you travel: with the center's dietitian and with the doctor, and we answer whatever you need. See cost and packages for what the package includes.

Contact the center on WhatsApp +962 7 9570 2800.

Some symptoms need urgent assessment after any bariatric operation. Go to the emergency department or call the surgical team straight away if:

• Your temperature is above 38 °C (100.4 °F).
• You have severe or worsening abdominal pain, or pain in the left shoulder.
• Your heart is racing or you are short of breath.
• You vomit repeatedly and cannot keep fluids down.
• You vomit blood or pass black stool.
• You show signs of severe dehydration, such as very little urine or marked dizziness.
• You have pain or swelling in a leg, which can be a sign of a clot.
• You cannot swallow at all.

Contact the center soon, not urgently, if you cannot tolerate the next stage despite trying, if constipation lasts several days, or if nausea or heartburn keeps returning while you follow the program.

These answers come from the center's written 35-day program. If your surgeon gave you different written instructions, follow those.