What is Gastric Sleeve Surgery?

Gastric sleeve surgery, medically known as sleeve gastrectomy , is a bariatric surgery procedure that involves removing approximately 80% of the stomach and reducing it to a tube-shaped shape. This reduces stomach volume and reduces ghrelin, the hunger hormone. This allows patients to eat less and feel full more quickly.

Who is Suitable for Gastric Sleeve Surgery?

Gastric sleeve surgery is suitable for the following people:

• Those with a Body Mass Index (BMI) ≥40
• Those with a BMI between 35 and 40 and health problems such as diabetes, hypertension, and sleep apnea
• Those who cannot lose weight permanently despite diet and exercise

Why is Nutrition Important After Gastric Sleeve Surgery?

Proper nutrition is vital, as stomach volume decreases significantly after surgery. Improper nutrition:

• May slow down weight loss
• It can cause problems such as nausea and vomiting.
• May cause vitamin and mineral deficiencies

Therefore, a nutrition plan implemented under the supervision of a dietitian ensures both healthy weight loss and preservation of quality of life.

Nutritional Steps After Gastric Sleeve Surgery

1. Stage: Clear Liquid Period (First 1–3 Days): To rest the stomach and start the healing process.

What can be consumed:

• This
• Unsalted meat/chicken broth
• Herbal tea
• Sugar-free compote water
• Fluids that provide electrolyte balance

Carbonated drinks, fruit juices and dairy products are not consumed.

2. Stage: Full Liquid Period (Days 4–14): Ensuring adequate fluid and protein intake.

What can be consumed:

• Lactose-free milk, kefir
• Sugar-free protein shake
• Soup (strained, without chunks)
• Ayran
• Compote
• Protein-fortified drinks

Target: At least 60-80 grams of protein per day.

3. Stage: Puree Period (3rd – 4th Week): Gradually switching to semi-solid foods.

What can be consumed:

• Vegetable purees
• Yogurt
• cottage cheese
• Boiled chicken and fish (blended)
• boiled eggs
• Soft fruits such as bananas and avocados (with doctor's approval)

Spicy, fatty and fibrous foods are not recommended.

4. Stage: Soft Solid Foods (5th – 6th Week): Preparation for the transition to normal nutrition.

What can be consumed:

• Grilled chicken, turkey
• Boiled vegetables
• Low-fat ground meat
• Cheese varieties
• Soft fruits
• Egg dishes

5. Stage: Normal Healthy Eating (After Week 6): Developing permanent healthy eating habits.

Nutritional principles:

• Prioritize protein at every meal
• Small portions, eat slowly
• If there is no need for a snack, it is not made.
• Avoid sugar, processed foods, and fried foods
• Drink 1.5–2 liters of water daily (not with meals)

The Most Common Nutritional Mistakes

• Eating fast food
• Not getting enough protein
• Consuming food + water at the same time
• Returning to fizzy and sugary drinks early
• Skipping vitamin supplements

Nutrition Tips After Gastric Sleeve Surgery

• Chew the bites 20-30 times and swallow.
• Leave at least 2 hours between each meal
• Drinking water 30 minutes before and after meals
• Have regular check-ups with a dietitian
• Weigh yourself weekly to track your weight loss
• Daily protein intake of at least 60–80 grams
• Eating slowly and chewing thoroughly
• 3 main meals instead of snacks
• Water consumption of approximately 2 liters per day

Things to Avoid

• Carbonated, sugary, and processed foods
• Eating fast and taking large bites
• Consuming food + liquid at the same time
• Alcohol, cigarettes and high-caffeine drinks

Which Vitamins Should Be Taken After Gastric Sleeve Surgery?

After surgery, the stomach's absorption capacity decreases. Therefore, the following vitamins should be used regularly. Blood tests should be performed every 3-6 months to detect deficiencies.

• Multivitamin
• Vitamin B12
• Iron
• Calcium
• Vitamin D

Nutritional Problems After Gastric Sleeve Surgery

Inadequate Protein Intake: Protein both prevents muscle loss and increases feelings of fullness. 60–80 grams of protein per day is recommended after surgery. Many patients struggle to reach this amount during the liquid and puree phase.

Results:

• Muscle loss
• Weakness, fatigue
• Hair loss
• Prolonged healing process

Inadequate Fluid Consumption: Because the stomach volume has shrunk, patients often cannot drink enough water. Because fluids cannot be consumed with meals, water consumption is neglected.

Results:

• Dehydration (dehydration)
• Constipation
• Concentration disorder
• Dizziness and weakness

Vitamin and Mineral Deficiencies: After gastric sleeve surgery, the absorption of vitamins and minerals such as B12 , vitamin D, iron, and calcium may decrease. If supplements are not taken regularly, serious deficiencies can occur.

The most common deficiencies:

• B12 : Numbness, forgetfulness, fatigue
• Iron: Anemia, headache, weakness
• Vitamin D/Calcium: Bone pain, risk of osteoporosis

Dumping Syndrome (Rapid Gastric Emptying): Although rare, after gastric sleeve surgery, some patients experience sugary and fatty foods rapidly leaving the stomach and passing into the intestines. This is called dumping syndrome .

Symptoms:

• Sweating
• rapid heartbeat
• Nausea
• Stomach ache
• Diarrhea

Constipation: Constipation is common during the feeding period due to lack of fluids, lack of fiber and inactivity.

Solution:

• Consume plenty of water
• Gradually switch to high-fiber foods
• Light exercise (walking, etc.)

Food Intolerances: After surgery, you may experience intolerance to certain foods. Milk and dairy products, eggs, and some meat products can upset your stomach.

Symptoms:

• Swelling
• Gas
• Nausea
• stomach ache

Eating Disorders and Emotional Eating: Some patients, even if their stomach volume is reduced, resort to overeating to cope with emotions like stress, anxiety, and depression . This not only stalls weight loss but also causes psychological harm.

Difficulty with Portion Control: Despite their shrunken stomachs, some patients find it difficult to control their portions. Eating quickly and taking large bites can strain the stomach.

Results:

• Vomiting
• stomach ache
• Inability to lose weight

Recommendations for Preventing Nutritional Problems After Gastric Sleeve Surgery

• Eating slowly, consciously, and in small portions
• Tracking daily protein and water intake
• Not neglecting multivitamins and supplements
• Avoiding sugary, fatty and high-calorie foods
• Going to dietician and doctor check-ups regularly

Private Magnet Hospital – April 2025