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Hydration and Nutrition after Bariatric Surgery

Congratulations on your recent bariatric surgery! Please use this handout as a reminder of the education you received prior to surgery. It is very important in the early days and weeks following your discharge from the hospital that you focus on your fluid intake to prevent dehydration and potential readmission to the hospital.

Signs and symptoms of dehydration

  • Decreased Urine
  • Dry Mouth
  • Dark Urine
  • Nausea
  • Dizziness
  • Lack of energy
  • Headaches
  • Dry Skin

Your Fluid Goal:

64 ounces (oz) each day*

  • 32 oz of fluid should be from clear liquids without protein or added sugar
  • 32 oz can be from full liquids and protein supplements 

Tips to help reach fluid goals:

  • Keep fluids on hand at all times. If your fluids are not with you, you cannot drink them.
  • Sip fluids slowly throughout the day. Drinking too fast or gulping can cause pain, bloating or other intolerances.
  • Sip fluids frequently throughout the day. You may only be able to drink 4-8 oz of fluid over an hour when first discharged to home. As you heal and the abdominal swelling goes down you will be able to drink more in a shorter period of time. Eventually you should be able to drink 8 oz of fluid in 5-15 minutes. You will not meet your fluid goals if you are not drinking every hour.
  • Have a plan to drink defined amounts of fluid by certain times of the day. For example:
    8 oz of fluid by 10 am, 16 oz by noon, 24 oz by 2pm, 32 oz by 4pm, 40 oz by 6pm, 48 oz by 8 pm and 64 oz by 10 pm.
  • Set alarms as reminders to drink as time can pass quickly and it will be difficult to make up the difference later. You cannot rely on your body to tell you when to eat or drink after surgery as the physical cues will be altered.
  • Track your intake on paper logs or using a smartphone app. This will increase your awareness and make sure you meet your goals.

Remember fluids should be:

  • Caffeine free
  • Sugar free
  • Non-carbonated
  • Alcohol free

Diet Progression

In the Hospital

  • Start slowly sipping on clear liquids provided
  • You will be given a fluid goal while you are in the hospital

At Home

1st Week after Surgery- Full Liquid Diet

  • Fluid Goal- 64 oz a day*
    • Protein Supplements can count towards total fluid intake however you need at least 32 oz of water or other sugar free clear liquids without protein.
  • Protein Goal- 60-100 grams a day as discussed with your dietitian and/or provider
    • Drink 2-4 protein supplements a day depending on supplements chosen.
  • Refer to your “Nutrition Guidelines for Weight Loss Surgery” education packet for additional full liquid/ semi-liquid foods and a sample meal plan.

2nd, 3rd and 4th Week after Surgery- Pureed Diet

  • Continue to focus on fluid intake and protein supplements.
    • 64 oz fluid a day*
    • 60-100 grams protein a day
  • Try one new puree texture food at a time.
  • Try to consume 5-6 small meals/snacks a day. ‘Meals’ or ‘snacks’ may only be a couple tablespoons at a time in the beginning.
  • Try to consume protein foods first during meals and snacks.
  • Sip on fluids between meals. You may drink all the way up to your first bite of food but do not drink and eat at the same time and wait 30 minutes after eating before you resume drinking.
  • Refer to your “Nutrition Guidelines for Weight Loss Surgery” education packet for more information on the Pureed Diet Stage and a sample meal plan.

*Fluid needs are individual and some people may require more fluid to maintain adequate hydration.  Please follow recommendations as discussed with your dietitian or provider.

For more information or to make an appointment, please contact your Nutrition Department:

  • Johns Hopkins Bayview Medical Center call 410-550-0311, Sibley Center for Weight Loss Surgery Outpatient Nutrition, call 202-370-6565.
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