Stage 4 Bariatric Diet:
"Regular Foods"

It’s ok to start adding “regular” solid food on the Stage 4 bariatric diet. However, this does NOT mean you go back to eating the way you ate before surgery!

The goal after surgery isn’t to simply eat smaller portions of the foods that got you TO surgery in the first place.

The goal is to do a total diet and lifestyle overhaul.

The foods and habits you develop as you start to add regular foods back should be the foods/habits you adopt for the rest of your life! So if you STILL haven’t started to practice basic guidelines for good nutrition, NOW is the time. Don’t wait any longer!!

Stage 4 Bariatric Diet

Basic Guidelines for Good Nutrition

  • Establish the time you’ll eat each meal. Example: 8a, 12p, 6p.
  • Continue to drink protein supplements between meals as needed to assure you’re hitting the protein goal (usually 60-80 grams per day)
  • Continue to drink at least 64 ounces of calorie free, non-carbonated beverages daily
  • Plan meals and snacks in advance
  • Learn to meal prep

AND:

  • Shop 1x/wk
  • Shop with a list to prevent unhealthy/impulse purchases
  • “Protein first” nutritional strategy throughout the honeymoon weight loss phase. Remember the “5 R’s.”
  • Sit down when you eat. Eat slowly and mindfully.
  • Include Protein + Produce at all meals: protein + veggies OR protein + fruit (example: cottage cheese + cherry tomatoes  OR cottage cheese + diced apple)

Stage 4 Bariatric Diet

Eat at planned meal times and drink protein shakes in between as needed.

Here's an example:

Portions could range from 1/4 cup - 1 cup per meal  at Phase 4 

8a: Meal- Egg scrambled with onions, mushroom, black beans. 

10:30a: Protein shake

12p: Meal- Tuna pouch with grapes

3a: Protein shake

6p: Meal- Crockpot chicken with steamed broccoli

Food Intolerance is Expected

Even though you’re “allowed” to eat regular food once you reach the Stage 4 bariatric diet, there are going to be regular foods that don’t appeal to you anymore or that you don’t tolerate.

Note: Your surgeon may have a slightly different diet progression, or may name the stages differently.

If you try something (chicken, for example) and have trouble tolerating it, don’t throw the idea away completely. Wait 2-3 weeks, then try reintroducing it again.

Stage 4 Bariatric Diet Food Lists

The following is a list of "regular" healthy foods that you can start to add back in once you're at the final solid foods Stage 4 phase. Think of the list as your grocery list. If it's not on the list, don't buy it!

Pro Tips:

  • Introduce only one new food daily
  • Use moist cooking methods 
  • Take TINY bites and chew food thoroughly, to applesauce consistency
  • Know that you likely will not tolerate everything on the list immediately
  • Portion sizes will be slowly increasing by phase 4 diet. You may be able to tolerate approximately 1/4 - 1 cup per meal

PROTEIN:
  • Fish and Shellfish
  • Low sodium deli meat with less than 3g fat per ounce
  • Chicken breast
  • Turkey breast
  • Ground turkey, chicken or ground beef (93/7% or 99/1%)
  • Jerky: beef, turkey, ostrich, salmon, vegetarian
  • Lean and well-trimmed beef or pork (limit to 1 serving/month)

And any protein from previous diet stages:

  • Eggs
  • Egg whites
  • Egg beaters
  • Beans
  • Lentils
  • Tofu
  • Tempeh
  • Milk: nonfat or 1%
  • Greek yogurt: nonfat or lowfat
  • Plain yogurt: nonfat or lowfat
  • Cottage cheese: nonfat or lowfat  
  • Ricotta cheese: nonfat or lowfat
  • Cheese: nonfat or lowfat  (limit to 1x/day)

VEGETABLES:

Raw

Cooked

TIPS:

Aim to eat more vegetables than fruits in a day

Pair vegetables with protein, like this:

  • Lowfat string cheese + baby carrots
  • Hard boiled egg + sugar snap peas

FRUIT:

Fresh

Frozen (no sugar added)

Canned (in its own juice, no sugar added)

AVOID: Dried fruit, fruit juice.

TIPS:

In the beginning you may find it helpful to peel anything that has a tough skin: (i.e. apple) or thick membrane (i.e. citrus).

Pair fruit with protein like this:

  • Part skim mozzarella string cheese + apple
  • Plain Greek yogurt + berries

QUALITY CARBS:

Sweet potato

Butternut and other winter squash

Old Fashioned Oats

Quinoa  

FATS:

Nuts

Seeds

Olive oil

Avocado

Guacamole

Avoid Refined Carbohydrates

Although these are “regular” foods, choosing refined carbs is a move in the wrong direction… back toward old eating habits.

Also, these foods swell/expand in your stomach, cause discomfort, and feel like they get “stuck.”

Learn to choose “veggie swaps” in place of typical refined carbs:

  • White Bread
  • White Rice
  • Pasta
  • Tortillas
  • Packaged, processed snack foods

Cooking Methods for Stage 4 Bariatric Diet:

  • Use moist cooking methods (especially in the beginning, for better tolerance): Crockpot, Instant Pot, Sous Vide, Poaching
  • Air fry vs pan fry/deep fry
  • Use low fat cooking methods like baking, broiling, grilling, roasting instead of frying or cooking in butter or oil

AND:

  • Use nonstick cooking spray vs oil to prevent sticking
  • Sauté foods in a small amount of broth instead of using butter or oil
  • When making stews or soups, refrigerate and skim hardened fat off the top before reheating

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