Gastric Sleeve Diet - Week 5

Image of consultant bariatric surgeon, Mr Rishi Singhal

Medically reviewed by Prof Rishi Singhal MBBS, MRCS, FRCS, MD  
By Heather Fry BSC (Hons)

What to eat on week 5 of the gastric sleeve diet

Week 5, transition to solid textured foods. Stick to 3 meals with portions of 3-6 tablespoons per meal. Use the 20 technique to eat slowly and avoid discomfort.
Avoid drinking with meals, and focus on calorie-free fluids. Have balanced meals, half protein, a quarter vegetables/salad, and a quarter carbohydrates. This is really the start of learning how to work with your gastric sleeve developing lifelong healthy eating habits to achieve your health and fitness goals. You must leave soft, sloppy food in the past and discover solid textured foods to help you feel satisfied for longer.

What are solid textured foods?

These are foods that often need cutting up with a knife and fork and take some chewing. They will help you feel satisfied more as they take longer to be digested by the body.

How much should I eat each day?

You should be able to have 3 regular meals per day now. Your portion size should still be about 3-6 tablespoons per meal – don’t ever have any more than this. Serve your meals on a 7-inch side plate or a portion control plate.

Will I be able to eat normally?

Once you’ve eaten, you want to feel like you’ve had enough, not hungry but not have an uncomfortable full feeling. You don’t want to feel any discomfort as this means you’ve eaten too much or not eaten the food correctly. As well as your stomach being smaller, there are changes to gut hormones which help you to feel satisfied quicker.

It is important to reduce the frequency of this discomfort as much as possible by following the 20,20,20,20 technique:

  1. Take a 20-pence-sized bite of food.

  2. Chew for 20 seconds. Even though there might not be much to chew in this phase, it is important you still wait this length of time before moving to the next step.

  3. Once swallowed, wait at least 20 seconds before you prepare your next bite.

  4. Repeat the above steps over a period of 20 minutes. Stop before this if you feel you have had enough.

This technique means small amounts of food will be slowly sent down to your stomach and will avoid causing any pain or regurgitation. You will need to continue with this technique in your weight loss journey.

What is the difference between Head hunger and Physical hunger?

Unfortunately, the battle of recognising what is head hunger or physical hunger can still be very difficult following surgery. Surgery does not alter your brain, how you think about food, or how you rely on food to satisfy certain emotions. We hope before your surgery you’ve had time to work on this and begin to recognise certain triggers.

Ready to take the next step?

Physical hunger is felt in your abdomen with a need for food to take away any discomfort, or you might be showing signs of low blood glucose levels and feel lightheaded if you are extremely hungry. Head hunger is felt in your mouth or head. It’s not so much a physical sensation but more of a want rather than a need. You might wander around the kitchen looking for food but nothing really satisfies it, or you might spend a long time looking at a few shelves in the supermarket before you can make your mind up on what to buy. Some people class themselves as an emotional eater – this might also still be present after surgery. It’s important to get the support you need so that these behaviours don’t sabotage your weight loss.

Can I drink with food?

It is very important to keep eating and drinking separately. Drinking with or too close after a meal can cause discomfort and flush your food through quicker, but it also has the potential to cause your stomach to stretch. You can drink up to a meal if you feel this is comfortable, but most people who have had a gastric sleeve wait 30 minutes before eating. You must then wait at least 30 minutes after eating before having a drink. Continue to aim for 2L of fluid per day and focus on calorie-free fluids: Water,  Tea (including fruit and herbal), Coffee,  No added sugar squash, and No added sugar flavoured water. There are some drinks you might enjoy but limit to 1 or 2 per day as they can be high in salt or sugar but low in protein:

• Bovril/Marmite/Oxo

• Light hot chocolate (e.g., Cadbury Highlights, Options)

• Light malted drinks (e.g., Horlicks, Ovaltine)

• 100ml fruit smoothie or fresh fruit juice (diluted 50:50 with water)

What foods should I eat?

You can now reintroduce solid textured foods and have “balanced” meals. You are still going to be aiming for 60-80g of protein per day. Typically, half of your plate will be protein, a quarter of vegetables or salad and a quarter of carbohydrates. Find out your daily calorie intake to lose weight, with our Calorie Deficit Calculator.

Time Liquid Protein content (g)

8.00am

2 poached eggs, 1 grilled tomato and 1 crispbread with a thin spread of butter
16
9.00am -
12:30pm
Water/tea/squash/coffee

1.00am

1 tin tuna with 2 teaspoons of light mayo mixed with ¼ avocado, 1 dessert spoon sweetcorn, 1 inch cucumber (diced), 5 cherry tomatoes (chopped) and 2 dessert spoons of cooked brown pasta
24
1.30pm -
5:00pm
Water/tea/squash/coffee

5.30pm

1 small, sliced chicken breast stir fried with ¼ yellow bell pepper, ¼ red bell pepper, ¼ red onion and 1 tbsp of egg or rice noodles. Drizzle a small amount of sweet chilli sauce.
15
6.30pm -
9:30pm
200ml cow’s milk with 1 heaped tbsp of skimmed milk powder (13g). Warm up and add light malted drink if preferred.
11
Image of consultant bariatric surgeon, Mr Rishi Singhal

All content on this page is reviewed by a multi-disciplinary team lead by Prof Rishi Singhal.

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