Phase III - Soft Diet Phase (Week 4 to end of Week 6)

As with the other phases of your post-gastric sleeve surgery diet, the timing of when you are able to return to eating solid foods will vary depending on how easily you have made the transition to having a new, smaller stomach. If you tolerated the puree diet well move to a "soft diet" of selected soft foods, while still maintaining your three-meals-a-day guidelines, and then gradually moving to more solid foods. This is the point at which you begin the transition to a permanent diet that focuses on healthy, balanced meals that will keep you satisfied but will facilitate your continued weight loss.

The Essentials of a Soft Diet

This is a new stage of your postoperative diet plan, far less structured and restrictive than previous phases, because by now you have had time to adapt not only to smaller quantities of foods, but also to develop a feeling for more healthy dietary choices. During this phase you will continue to follow the three-meals-a-day routine you established in previous phases, and continue with your protein and nutritional supplements, but now you can begin to experiment with more normal foods. Continue to take small, teaspoon-sized bites of any foods. You'll be eating solid foods now, so remember to chew and chew thoroughly, putting your fork or spoon down between bites to give yourself more time to chew your food completely. Continue to NOT drink liquids with your meals, only between meals.

Remember that the key to making this phase of your diet plan work for you is to consistently eat smaller portions than you did before surgery. We recommend that you use a bread-and-butter size plate rather than a larger plate and that you carefully measure your portions to avoid accidental overeating. Foods that you can begin to experiment with during this phase of your diet include:

• Meats, chicken, and fish – tender chicken, fish, and meats, well-cooked and cut into tiny, bite-sized pieces or minced; tinned salmon, fish, chicken, ham, or tuna canned in spring water.
• Vegetables – any of the vegetables you were permitted while on the Optifast® diet, either steamed, boiled, or broiled or stir-fried without added oils or butter; if these are well-tolerated, you can experiment with other vegetables such as potatoes, sweet potatoes, sweet corn, green peas, and legumes, but only in tiny portions because they are full of calories.
• Milk and dairy products – low-fat milk, cottage cheese, ricotta cheese, low-fat yoghurt.
• Fruits – peeled pears, apples, melons, and other soft fruits; discard the skins, pits, and pith of the fruits.
• Breads and cereals – low-fat crackers, rice, pasta, noodles, Weetabix, and porridge; remember that soft, doughy breads can expand in your stomach and cause discomfort.
• Flavourings – you can use standard herbs and spices, chicken or beef stock, low-fat hummus, and tiny amounts of oil when cooking.

In general, remember the name of this diet step and start with soft foods, limiting yourself to tiny portions of these foods. You can gradually work your way up to more solid foods, such as red meats and salads, if the softer foods are well tolerated. The way to make this diet phase work for you is to choose foods that you really like and take your time chewing and savouring them to enjoy their flavours.

There are still foods that you should avoid

These include hard or stringy meats, fatty meats (such as bacon), chicken skin, and any fried meats. You should also avoid eating raw or tough vegetables such as beans, celery, broccoli stalks, and sweet corn. Stay away from doughy breads and high-fat or sugar-sweetened cereals such as muesli, and if you notice that you have problems digesting pasta, rice, or corn, stop eating them for a while, and wait until you can tolerate them more easily.

Avoid all alcoholic drinks and sugar-sweetened drinks or soft drinks, energy drinks, carbonated beverages, full-fat milk and milk drinks, sweetened juices, sugar, chocolate, sweets, syrups, creamy sauces, and snacks such as potato chips or high-fat crackers. Your goal is to lose weight, after all.

Foods to eat at each meal

This is important because it is a preparation for transitioning to the healthier, more balanced diet you will be maintaining after your recovery period. At each meal, you should make sure that you are eating adequate amounts of lean, low-fat protein to maintain your muscle mass as you lose fat – lean red meats, chicken, or fish 2-3 times a week, low-fat dairy products, tofu, etc. Each meal should include healthy portions of fresh, frozen, or canned vegetables and fruit, and you should remember to eat two or more portions of healthy carbohydrates per day.

Continue to drink 1-1.5 litres of fluids per day between meals. When preparing vegetables or meats, use very minimal amounts of olive oil, margarine, or a cooking spray. Try to avoid using oil as much as possible by grilling, baking, boiling, dry roasting, or stir-frying. If you need to eat out in a restaurant, remember the general rule of thumb is "soft foods," and order only an entrée-size meal.

Also, now that you are eating more solid foods, now is the time to start exercising again, if you haven’t started already. Try to perform a cardiovascular exercise several days a week – walking, biking, aqua-jogging, or swimming.

Above all, try not to slip back into poor eating habits. You can't ever go back to the way you were eating before the sleeve gastrectomy operation, and if you think about it you really don't want to, because that diet caused the obesity you are working to eliminate. This is your opportunity to start eating the types of foods and the quantity of foods that will create a healthier, slimmer you.