Understanding the reasoning behind the rules, makes it easier to follow them. There are severalmain reasons why you are required to follow preoperatory diet before having weight loss surgery.
Pre-op diet helps to control complicated hormone system responsible for causing obesity (hormones are more important than calories, one of such hormones is insulin). When we eat sugar, our pancreas produces one of the most important metabolism hormones – insulin that converts sugar into energy (or fat, when do not use all the produced energy). When we eat too much sugar regularly, insulin levels become elevated, which leads to insulin resistance. That in turn works just like a drug addiction: our body becomes less sensitive to the same amount of insulin; thus, pancreas produces more and more of it to achieve the needed effect; however, when we have more insulin in our blood than sugar, our body tells us to eat some sugar to even out the balance (this is what causes sugar cravings, hunger attacks).
And as soon as we eat sugar, our body produces even more insulin increasing this addiction.
The cycle goes on. Similar process takes place in our brain: sugar triggers the release of dopamine hormone into the same area of the brain that responds to heroin and cocaine. Eating sugar regularly changes your brain so that it becomes tolerant to the sugar, causing you to require more to get the sameeffect. Sugar has also been shown to cause the release of endogenous opioids in the brain, which leads to a rush similar to that experienced when a person injects heroin.
All of this leads to a vicious cycle of cravings and needing more sugar to feel good. In the meantime, all the excess sugar is being stored as fat, slowing you’re your metabolism, and promoting comorbidities such as heart disease, dementia, and cancer to name a few. This is a condition known as pre-diabetes. It is also called metabolic syndrome, insulin resistance, and syndrome X.
The key to weight loss, then, becomes focusing on foods that normalize blood sugar and lower insulin levels. If you eat the same number of calories from broccoli rather than cookies, you will lose weight. If you eat food that spikes your insulin level, you will gain weight. If you eat food that reducesyour insulin level, you will lose weight. This is true even if the food contains exactly the same number of calories or grams of protein, fat, carbohydrates and fiber.
FOR MORE INFORMATION TO GO:
Enlarged liver is a consequence of being overweight (also known as fatty liver disease). Following this diet causes the liver ‘shrink’ in size and softens it, making it easier to move during surgery. During laparoscopic bariatric surgery, the liver has to be lifted out of the way to access the stomach lying beneath it. If the liver is heavy, fatty and immobile, it is harder for the surgeon tosee and gain access to the stomach underneath.
This could be a reason for the surgeon to makeadditional incisions or even cancel a surgery and allow a patient more time to follow the diet to shrink the liver, or changing to open surgery. Open surgery means a larger abdominal scar, which results in longer recovery and increased risks, and of course additional surgery costs. To reduce the size of the liver, it is necessary to follow a diet that is low in carbohydrate, low infat and moderate in protein.
Consider the pre-op diet to be a training that helps your body and mind adjust to the new lifestyle that will follow the surgery. As part of this preparation you may be going through unpleasant sugar detox symptoms and caffeine withdrawal. Sugar and caffeine withdrawal happen when we change our diet not gradually but abruptly, thus consuming less stimulants (such as carbs and caffeinated beverages), which causes head-ache, general weakness, tiredness, mood changes, etc.
You may choose to make diet changes gradually, slowly reducing amount of sugar and caffeine in your diet to avoid unpleasant withdrawal symptoms (if you choose this option, allow an extra week or two for your pre-op diet), or you may choose a cold turkey method (making all the changes abruptly). Regardless which option you choose, you want to allow your body and mind enough time to get prepared for the surgery in order to reduce post-operatory
tiredness and fatigue.
FOR MORE INFORMATION TO GO
Dr. Edwin Guerrero may have certain weight loss requirements for patients with BMI over 50 that will need to be met before surgery. For low and medium BMI patients (with BMI between 30 and 50) there is no specific number of pounds you need to lose during the pre-opdiet, rather concentrate on acquiring healthy eating habits and complete the goals mentioned above.
For RNY or Mini Gastric Bypass patients with high BMI it is very important to burn as much internal (visceral) fat as possible (the unhealthiest fat that surrounds our internal organs). The surgeon will need to pull small intestine in order to perform a bypass, and in order to do that he will need to separate it from the surrounding fat.
All visceral fat has a lot of blood vessels that will need to be cut, thus increasing blood loss during surgery, and scar tissue during healing process. In certain cases, for patients with
BMI over 60 Dr. Edwin Guerrero will recommend to proceed with a gastric sleeve or SADIS, or will make such decision during surgery, if performing a bypass becomes too risky due to the amount of internal fat. This will be discussed with high BMI patients prior tosurgery of course.
If you have diabetes and are treated with medication, you will need to adjust your insulin or medication while following this diet. Please contact your Diabetes Specialist Nurse/Practice Nurse/GP before starting the diet.
FOR MORE INFORMATION
Ideally everyone should start making diet changes described in these instructions the moment they decide to have surgery. You will learn for how long precisely you should strictly follow the diet during your consultation with Dr. Edwin Guerrero. However, our minimum recommendations are:
BMI 61 and over requires at least 6 weeks on a pre-op diet and pre-op
consultation with Dr. Edwin Guerrero. Please do not ignore follow up
consultations, and do not feel as if we were checking on you. We sincerely
want you to succeed and would like to guide you through this process every
step of the way, help you adhere to the diet and benefit from it to be ready
for surgery rather sooner than later.
Important:
Every meal or snack should include protein (it will help you feel full longer as it takes longer to digest and does not cause insulin level spikes).
Main meal = Protein + Vegetables or Greens
Snack = Protein + Low-sugar Fruit
| ALLOWED | AVOID | |
|---|---|---|
| PROTEIN (Choose an option and combine with veggies or greens) *Foods with higher glycemic index (cause insulin level spikes) -eat in moderation | Egg (1 yolk and 2 egg whites per meal) Fish (Tuna, salmon, swordfish, tilapia, sardines) Crab Lobster Shrimp Chicken withouth the skin Turkey without the skin Lean pork Lean beef (ground, steak) Low-fat cheese (cottage, ricotta, mozzarella, cream cheese, feta) Low-fat yogurt, preferably Greek type Tofu Beans* Lentils* Chickpeas | Bacon Sausages Chicken, turkey or pork skin Deep fried foods Yogurth with added sugar Whole Milk |
| VEGETABLES / GREENS *Foods with higher glycemic index (cause insulin level spikes) - eat in moderation | Dark leafy greens (all types such as spinach, kale, lettuce, arugula, purslane, bock choy, etc). Onios Peas Mushrooms Asparaus Arthichokes Peppers (all types) Cauliflower Broccoli Jicama Celery Eggplant Cabbage Brussels spouts Green beans Garlic Fennel Radish Cucumber Pickles Zucchini Summer Squash Pumpkin Sweet potato* Root vegetables such as carrots, beets, yucca and parsnips* Winter squash such as acorn* Tomatoes | Potatoes (incluiding chips, French fries) )Corn (including corn chips, popcorn). |
| CARBS / FRUITS *Foods with higher glycemic index (cause insulin level spikes) - eat in moderation | Berries fresh (blueberries, acai, strawberries, blackberries)(1 cup). Apple Pear Cherries (1 cup) Peach Apricot Plums Pineapple (1 cup) Papaya* (1 cup) Orange* Lemon Limes Kiwi* Melon* (1 cup) Watermelon* (1 cup) Avocado (1/4 piece per day) | Dried fruits such as raisins and prunes Fruit juice Mango Grapes Banana Bread (all types, crackers, pretzels) Rice (all types, rice cakes) Pasta Tortillas (also nachos) Pizza Foods cooked floor/breadcrumbs (white or whole grain) |
| NUTS / SEEDS Choose one option plus a portion of fruit for a snack | Almonds (15 pieces) Walnuts (10) Pecans Brazil nuts (3) Pine nuts (75) Hazelnuts (10) Peanuts (17) Chia seeds (2 table spoons) Sesame seeds (2 table spoons) Macadamia nuts (5) Flaxseed (2 table spoons) Pumpking seeds (2 table spoons) Edamame (1/2 cup) Unsweetened nut butter (2 tables spoons) | Corn nuts Honey roasted nuts Nuts with a sweet or candy coating Sweetened nut butter Granola |
| OPTIONS FOR PROTEIN-RICH SNACKS | • 1 oz reduced-fat cheese 1/2 cup, or a handful, of fruit • 2 oz ligth fruit yogurt mixed 1/4 cup cottage cheese • 2 tables spoons of humus with raw vegetables (handful) • 1/3 cup cottage cheese and 1/2 cup fruit • 1/3 cup cottage cheese mixed with sugar free jell-O • 1 oz reduced fat cheese and 1 oz lean deli meat wrapped in lettuce leaf • 1 oz reduced-fat cheese and 7 olives • 2 oz of Greek yogurt and a cup of strawberries | Potato chips Pretzels Corn chips Popcorn Candy Chocolate Cookies Rice Cakes Crackers Granola bars Ice cream |
| CONDIMENTS | Spices (Mrs. Dash, hot sauce, cinnamon, garlic) Herbs (dill, cilantro, rosemary, parsley) Extracts (vanilla, lemon, almond, hazelnut) Extracts (vanilla, lemon, alomnd, hazelnut) reduced sodium worcestershire sauce Low-sodium soy sauce Vinegars (all varieties) Capers, horseradish, salsa Olive or avocado oil (extra virgin) in moderation Mustard (except sweet mustards) No sugar added pickles and relish Low fat mayonnaise (1 table spoon) | Honey mustard Ketchup Salad dressings (premade contain sugar) |
| SWEETENERS | Stevia (100% organic and without added artificial sweeteners such as sucralose, aspartame or acesulfame) | Refined sugar (white and brown) Corn syrup Honey Maple syrup Agave nectar Artificial sweeteners such as aspartame, acesulfame and sucralose (avoid as much as possible) Sugar alcohol (such as erythritol, xylitol, sorbitol, etc) |
| FLUIDS | Water Tea (preferably herbal or fruit tea) Coffee regular or decaf (must be stopped at least 2 to 4 weeks before surgery) Almond milk unsweetened (not miore than 60 calories per serving) Fruit infused water Other sugar-free drinks (ideally without artificial sweeteners). | Juices (all types, fruit and vegetable) Regular milk Drinks with artificial sweeteners or caffeine (energy drinks) Soda Alcohol Smoothies |
Use the rule of palm to measure your food portions easily without any scales, cups, grams, ounces, etc. No need to count calories either, simply follow this rule.
Your palm determines your protein portions.
Your fist determines your veggie portions.
Your cupped hand determines your carb/fruit portions.
Your thumb determines your fat (nuts/seeds/cheese) portions.
For protein-dense foods like meat, fish, eggs, dairy, or beans, use a palm sized serving.
Note: a palm-sized portion is the same thickness and diameter as your palm. 1 palm-sized portion is recommended with each main meal.
For veggies like broccoli, spinach, salad, carrots, etc. use a fist-sized serving.
Again, a fist-sized portion is the same thickness and diameter as your fist. 1 palm-sized portion is recommended with each main meal.
For carbohydrate-dense foods – fruits – use a cupped hand to determine your serving size. 1 cupped-hand sized portion of carbohydrates with most snacks.
For fat-dense foods – like cheese, nut butters, nuts/seeds – use your entire thumb to determine your serving size. We recommend 1 thumb-sized portion of fats or protein foods high in fat with most snacks.
Breakfast
Option 1: Omelet (1 whole egg + 1 egg white, handful of spinach, table spoon of chopped onions, olive oil, salt and pepper in moderation).
Option 2: Scrambled eggs (1 whole egg + 1 egg white, any fresh mushrooms 4-6
pieces, table spoon of chopped onions, olive oil, salt and pepper in moderation).
Snack
Option 1: Small Greek yogurt (sugar-free) with 1 handful of fresh blueberries.
Option 2: Lettuce wrap with two thin slices of turkey breast
Lunch
Option 1: Mixed greens salad (olive oil, salt, pepper, lemon juice for dressing),
grilled chicken breast (1/2 of breast or equal to palm size).
Option 2: Tomato and cucumber salad with shrimps, chickpeas or green peas.
Snack
Option 1: 10-15 almonds, 1⁄2 large apple (or 1 small apple)
Option 2: Two small pieces of cheese, any fruit/fresh berries (1 handful).
Dinner
Option 1: Sautéed broccoli (use onions and garlic, lemon juice, salt and pepper, other spices to add flavor), fried/baked/grilled tilapia (1/2 filet or portion equal to palm size)
Option 2: Grilled beef steak (choose lean meat, palm size portion, no heavy sauce), a handful of drilled asparagus.
Snack (if necessary)
Option 1: A slice of cheese (finger size portion) with 1 mandarin.
Option 2: Two table spoons of hummus with 1 celery stick and 4-5 baby carrots Drink lots of water, herbal/fruit tea, fruit infused water between the meals (but not with meals).
Drink lots of water, herbal/fruit tea, fruit infused water between the meals (but not with meals).
Any type of surgery is a serious procedure that carries certain risks, and a proper preparation is essential for the successful outcome.
Regardless whether you have acid reflux/heartburn or not, start taking Omeprazole (antacid medication) 1 pill of 20mg twice a day (every 12 hours, total dosage 40 mg per day) for two weeks prior to the surgery (the last pill to be taken the evening before surgery) in order to decrease stomach acidity and later acid reflux, nausea, inflammation, and swelling caused by the procedure. Continue taking antacid medication after surgery for at least two months or until acid reflux/heartburn is gone.
Tip: you can purchase a 2-month supply of anti-acid medicine over the counter in Mexico for under $10 USD.
In case you are already taking anti-acids, continue as prescribed by your doctor. If your regular dosage is 40 mg once a day, you may continue. If your regular dosage is 20 mg once a day, increase it to 20 mg twice a day. If you normally use other brands of anti-acids: Omeprazole (Prilosec), Pantoprazole (Pantozol), Esomeprazole (Nexium)), you can continue your prescribed anti acid.
Consult with Dr. Edwin Guerrero about medications you are taking and when they need to be stopped(usually it is discussed during pre-op consultation).
Stop all NSAIDs 7 days prior to surgery (Aspirin, baby low-dose Aspirin, Advil, Aleve, Ibuprofen, Nuprin, or any other non-steroidal anti-inflammatory medication, this includes most arthritis medications). If you are not sure, please check with your physician. For headache or minor pains, you may use Tylenol (including the day of surgery). You may restart some of these medications 7 days after surgery (some medications may be resumed sooner), however consult with your doctor regarding NSAIDS (for example only if you have heart issues you may resume taking Aspirin or other blood thinners 7 days post-op but always after you take an antacid pill (Omeprazole) to protect your stomach, which should be taken daily for at least 2 months after surgery; we highly recommend changing pain medication like Ibuprofen to Tylenol, or Celebrex, or Meloxicam, as Ibuprofen may cause gastritis and ulcers; Ibuprofen and other NSAIDs after WLS can be taken only if absolutely necessary, and always with an antacid pill first to protect your stomach. Ideally you should use Tylenol only. Please always consult with your doctor before you resume certain medication after surgery.
You may stop taking all vitamins when you begin the liquid diet stage, as taking vitamins on an empty stomach or without solid foods may cause nausea.
During the last 3 days before surgery (not including the day of surgery, if surgery is on Monday, the 3 days before include Fri, Sat, Sun) it is required that you follow full-liquid diet. This “liquid stage” can be increased to 5, 7 or more days by Dr. Edwin Guerrero depending on your BMI and duration of the solid food diet stage. Dr. Edwin Guerrero will let you know if you are required to increase the “liquid stage” during your pre-op consultation.
Fruit-infused water, especially with electrolytes, and plenty of water or herbal/fruit tea without sugar, coconut water and other sugar-free fluids are recommended.
We do not recommend chewing gum before or after sugrery as it stimultaes stomach acid production and could cause worse acid relfux after surgery as well as make us feel more hungry.
The purpose of the full liquid diet stage is to cleanse your stomach pouch and bowel from any kinds of solids; to reduce the amount of stomach acid produced, thus decreasing chances of having heart burn issue after surgery; giving your stomach a rest which helps to decrease stomach pouch swelling during the first days of recovery; shrink your liver.
Individuals who undergo gastric sleeve or bypass surgery have reduced ability to absorb vitamins and electrolytes which places them at higher risk of developing nutritional and vitamin deficiencies (especially gastric bypass patients). These deficiencies include, but are not limited to, vitamin A, B, C, D, E, K, folate, calcium, iron, zinc and magnesium.
It is recommended that you BEGIN TAKING VITAMINS AS SOON AS YOU START THE PRE-OP DIET and get into a habit of taking them daily FOR THE REST OF YOUR LIFE.
Stop taking vitamins 3 days before surgery, when you start your liquid diet stage, since taking vitamins on an empty stomach or without solid food may cause nausea.
You will need to purchase the following vitamins:
Note! It is not required to purchase specifically bariatric vitamins (Calcium Citrate, Vitamin B Complex and Probiotics do not need to be a bariatric brand; though they are often better tasting and are higher quality products). You can choose any brand as long as you reach the recommended doses of each vitamin. Keep in mind that standard over the counter (OTC) vitamin brands are formulated to meet the nutritional needs of the general population. As a bariatric patient, your body requires a much higher level of 13 micronutrients that OTC brands will not meet; this is why we recommend using bariatric formulated brands when available.
Below you will find recommendations for each vitamin, brand and dosage.
NO GUMMIE VITAMINS OF ANY KIND AFTER SURGERY!
Dosage:
Bariatric formulated Multivitamin with iron & Vitamin B12: 1 serving daily (each brand has different serving sizes, read the label carefully, one serving may require 1, 2, or 3 pills or capsules per day.)
Non-bariatric multivitamins: 2 serving sizes daily (200 % Recommended Daily
Allowance (RDA)
We recommend capsule presentation, as chewable tablets are often reported byour patients as unpalatable.
| BRAND | name | serving size | Vitamin b12 (mcg) | iron (mg) | vitamin d3 (iu) | average cost/month |
|---|---|---|---|---|---|---|
| ProCare Health | Bariatric Multi-Vitamin with 45 mg Iron | 1 chewable tablet | 1000 | 45 | 3000 | 15 |
| ProCare Health | Bariatric Multi-Vitamin 45 mg Iron | 1 capsule | 1000 | 45 | 3000 | 15 |
| ProCare Health | Bariatric Multi-Vitamin with 18 mg Iron | 1 capsule | 1000 | 18 | 3000 | 20 |
| Bariatric Advantage | Advanced EA Multivitamin | 2 chewable tablets | 1000 | 45 | 3000 | 30 |
| Bariatric Advantage | Ultra-Multivitamin with Iron | 3 capsules | 1000 | 45 | 3000 | 17 |
| Celebrate | Multi-Complete 36 | 2 chewable or 3 capsules | 1000 | 36 | 3000 | 20 |
| Celebrate | Multi-Complete 45 | 2 chewable or 3 capsules | 1000 | 45 | 3000 | 23 |
| Celebrate | Multi-Complete 60 | 2 chewable or 3 capsules | 500 | 60 | 3000 | 24 |
| Opurity | Bypass & Sleeve Optimized - Chewable | 1 chewable tablet | 500 | 18 | 3000 | 10 |
| Opurity | Complete Optimized Multivitamin-multimineral | 2 capsules | 500 | 18 | 3000 | 10 |
Important! If you choose a non-bariatric formulated multivitamin, be sure to either choose multivitamin complex that includes iron, or take iron separately.
Iron (100 % RDA) use one the following types:
Note! Always allow at least 2 hours between Calcium Citrate and Iron (or multivitamins that include iron) for better absorption. If ferrous sulfate has unacceptable side effects (nausea or stomach pain), ferrous gluconate is a possible alternative for patients who cannot tolerate ferrous sulfate. Be aware that iron intake will cause dark stools, it is normal.
| BRAND | name | serving size | B1 (Thiamin) (mg) | average cost/month |
|---|---|---|---|---|
| Kirkland | Super B-Complex with Electrolytes | 1 tablet | 100 | 2 |
| Celebrate | Vitamin B-50 Complex | 1 capsule | 50 | 4 |
| Now | Vitamin B-100 | 1 capsule | 100 | 4 |
| Source Naturals | Vitamin B-50 Complex | 1 tablet | 50 | 4 |
| Twin Lab | Stress B-Complex Capsules with Vitamin C | 2 capsules | 50 | 5 |
| Bariatric Advantage | Vitamin B-50 Complex | 2 capsules | 50 | 7 |
Note! All bariatric formulated multivitamins include the recommended dosage of vitamin B12. If your non-bariatric multivitamin brand does not include B12 or the dosage is low, be sure to take it separately as B12 or part of B-Complex. See the recommended daily dosage below:
Vitamin B12 (Cobalamin) use one of the options:
*500 – 1000 mcg per day (ideally sublingual dissolvable pills or liquid form)
* 1000 mcg twice a month by injection (only if necessary)
Your lab values will be high when taking this amount of B vitamins. We expect this high lab value; taking the B complex helps prevent a deficiency. We will adjust your intake based on your post-op lab work that is recommended 3, 6, 12, and 24 months post-op.
B-vitamins can be taken on an empty stomach, all others should be taken with a meal.
Dosage:
Calcium Citrate 1500-2000 mg/day – Vitamin D3 800-2000 UI /day
Divide this into 2-3 servings per day to reach the daily recommended dosage and for better absorption.
Choose a brand that contains Calcium Citrate and vitamin D3. Avoid Calcium Carbonate or Calcium Caltrate.
Remember: separate the multivitamin with iron from calcium citrate by 2+ hours for maximum absorption.
| BRAND | name | serving size | Spacing | Calcium citrate (mg) | Vitamin D (IU) | average cost/month |
|---|---|---|---|---|---|---|
| Pro Care Health | UpCal D Powdered Calcium Citrate | 1 scoop or packet | 1 scoop or packet, 3x/day | 500 | 500 | 18 |
| Kirkland | Calcium citrate with Vit D | 2 tablets | 2 tablets 3x/day | 500 | 800 | 9 |
| Celebrate | Calcium Plus 500 | 1 chewable tablet | 1 tablet, 3x/day | 500 | 333 | 22 |
| Bariatric Advantage | Calcium Citrate Chewy Bites | 1 chewy bite | 1 chewy bite, 3x/day | 500 | 500 | 30 |
| Blue Bonnet | Liquid Calcium Magnesium Citrate + Vitamin D3 | 1 Tbsp. | 1 Tbsp., 2x/day | 600 | 400 | 25 |
| Citracal | Maximum Plus Calcium Citrate + D3 | 2 caplets | 2 caplets, 2x/day | 630 | 500 | 18 |
| Nutriton | Calcium Citrate w with D3 | 2 tables | 2 tables 2x/day | 700 | 400 | 7 |
| Opurity | Calcium-Citrate Plus-Chewable | 4 tablets | 2 tablets 2x/day | 1200 | 800 | 14 |
If possible, give preference to Calcium brand that contains Magnesium,
otherwise take Magnesium separately.
Magnesium Citrate Dosage: 400 – 500 mg per day
We recommend that you start taking Omega 3 (fish oil) during your pre-op diet and resume as soon as you can tolerate it after surgery, preferably 2- or 3-months post-op.
Give preference to brands that source fish oil from non-farmed wild species. If you are allergic to fish, use capsules with flaxseed oil, also a great source of Omega 3.
Omega-3 Dosage: 2000 mg per day (with meal).
After weight loss surgery, the balance between “good” and “bad” bacteria may become altered. This is due to disruption of your GI tract, as well as the use of antibiotics after surgery to help prevent infection. While antibiotics can help keep harmful bacteria under control, they can also wipe out the good bacteria in your body. The number and type of intestinal bacteria is regulated by both intestinal motility and gastric acid
secretion, which are both altered with the weight loss surgery (WLS). Probiotics will also help vitamin B12 absorption and will help decrease intestinal inflammation and other
types of discomfort that often follow WLS.
| BRAND | name | serving size | Average cost/month |
|---|---|---|---|
| Align Probiotic (Bifidobacterium) | B. Infantis 35624 | 1 capsule | 22 |
| Culturelle (Lactobacillus) | Digestive Health | 1 capsule | 17 |
| Bariatric Advantage | Chewable Floravantage Probiotic | 2 chewable tablets | 29 |
| Celebrate | Balance Probiotic | 1 capsule | 28 |
| Garden of Life (16 different strains) | Primal Defense ULTRA Ultimate Probiotic Formula | 1 capsule | 10 |
| Klaire Labs | Ther-Biotic complete | 1 capsule | 21 |
| Mega Foods | Mega Flora | 1 capsule | 15 |
| Nature Made | Digestive Probiotics Advanced | 2 capsules | 21 |
| Nutrition Now PB8 | Immune support probiotic | 1 capsule | 9 |
There are many over the counter probiotics available, most of them contain only one strain of bacteria. Probiotics with at least 5 billion colony forming units (CFUs) per dose that contain at least seven strains of probiotics appear to be the most effective. Probiotics are most effective when taken with meals (unless the label states otherwise). Probiotics come in many forms, including pills, powders, liquids, capsules, and chewable tablets.
| time | Example 1 First 2 months post op | Example 2 2 - 3+ months post op | Example 3 If extra iron is needed |
|---|---|---|---|
| 7:00 am (breakfast) | Calcium citrate w/Vit D3 (1 chewy bite - 500 mg) Magnesium Citrate (500 mg) | Bariatric Multivitamin (1 capsule) B-complex (1 capsule) Probiotic (1 capsule) | Calcium citrate w/Vit D3 (1 chewy bite - 500 mg) Magnesium Citrate (500 mg) |
| 10:00 am | Bariatric Multivitamin (2 chewable tablets) | Bariatric Multivitamin (1 capsule) B-complex (1 capsule) Probiotic (1 capsule) | |
| 12:00 pm (lunch) | Calcium citrate w/Vit D3 ( 1 chewy bite - 500mg) B-complex (1 capsule) Probiotic (2 chewable tablets) | Calcium citrate w/Vit D3 (2 caplets - 630mg) Magnesium Citrate (500 mg) | Calcium citrate w/Vit D3 (1 chewy bite - 500mg) |
| 3:00pm | Iron with Vitamin C (1 capsule) * | ||
| 6:00pm (dinner) | Calcium citrate w/Vit D3 * (1 chewy bite -500 mg) | Calcium citrate w/Vit D3 (2 caplets -630mg) | Calcium citrate w/Vit D3 (1 chewy bite -500mg) |
*3rd Calcium intake is recommended for bypass patients only or women after menopause after either gastric sleeve or bypass.
*Extra iron (additionally to multivitamins with iron) only if needed after having lab work done to
confirm iron deficiency.
Note! You may take vitamins throughout the day at your convenience (make your own schedule), as long as you do not take Calcium and iron (or multivitamins that contain iron) at the same time.
At BOSCEN Weight Loss, we specialize in top-quality bariatric surgery and are committed to outstanding patient care.
