Nutrition Guidelines for Patients Having Endoscopic Sleeve Gastroplasty (ESG)
Congratulations on taking an important step toward improving your health! ESG is an innovative procedure that, when combined with healthy eating habits and lasting lifestyle changes, can support successful long-term weight loss.
Daily nutrition goals:
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Protein: 60-80 grams/day.
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Fluids: 64 fluid ounces or more of water or anything else that is sugar-free/day.
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Meals: 4 small meals/day within a 12-hour period.
Before advancing to a regular diet, it is important to follow the graduated diet after your ESG to allow your stomach to heal properly and minimize stress on the sutures. The tissue surrounding the sutures is inflamed and requires time to recover. Eating small, frequent meals helps prevent overfilling the stomach, reduces stretching, and lowers the risk of nausea and vomiting. It is also important to eat slowly, take small bites, and chew your food thoroughly. Drinking plenty of fluids throughout the day is essential to staying hydrated and preventing dehydration.
Diet
Duration
Recommendations
Phase 1: clear liquids
One week
Water, broth, sugar-free beverages, 100% juices (diluted with water), electrolyte drinks, herbal tea*, decaf coffee/tea*, Jell-o, popsicles
*without cream or milk
Phase 2: protein shakes
One week
4 protein shakes/day, in addition to at least 64 fluid ounces of sugar-free liquids a day
Phase 3: Pureed foods
Two weeks
Scrambled eggs, yogurt, cottage cheese, mashed beans/lentils, oatmeal, grits, cream of wheat, applesauce, mashed banana, mashed potatoes/sweet potatoes
Phase 4: soft foods
8 weeks
Continue to include any of the pureed/mushy foods while introducing soft foods such as chicken, flaky fish, turkey, soft tofu, soft cooked vegetables, soft fruits without skin (berries, melons, drained canned fruit)
Return to regular healthy diet 3 months after your procedure
Promoting healthy weight loss by establishing a healthy eating pattern
It is important to continue meeting your daily protein and fluid goals throughout each stage of the diet and as part of your long-term eating habits. Protein is essential for preserving muscle mass and should be included with every meal. Choose lean protein sources, along with fiber-rich fruits and vegetables and healthy fats such as those found in olive oil, and fish. These foods help promote fullness and may reduce the urge to snack between meals.
Aim to eat every 3–4 hours to help manage hunger and prevent grazing. Even if you are not feeling hungry, try to eat at least a small amount of protein. Sip water or other sugar-free beverages between meals rather than with meals, as eating and drinking at the same time can make you feel overly full. Keep in mind that your stomach is much smaller after surgery and cannot hold the same volume of food or fluid as before.
Limit foods and beverages with added sugars, as they may increase appetite and slow weight loss. Artificial sweeteners may be used in moderation, such as up to one packet at a time.
Foods and beverages to avoid 6 months after ESG:
Foods:
Bread, rice, pasta, sugary cereals
Chips, crackers, pretzels
Desserts, candy, cakes, pastries
Fried foods, fast food
Spicy foods
Tough meats/red meats/fatty meats
Nuts, hulls, seeds, popcorn
Beverages:
Alcohol
Carbonation
Caffeine
Beverages with sugar
Physical activity:
Once your surgeon has cleared you to exercise, begin a sustainable physical activity routine. Aim for at least 150 minutes of moderate-intensity exercise each week, such as 30 minutes a day, five days a week. As your fitness improves, gradually increase the intensity, duration, and frequency of your workouts.
Remember, weight-loss success is not measured by the number on the scale alone. As your body composition changes, you may notice reductions in body measurements even when the scale changes slowly. Using a flexible tape measure to track your progress can provide valuable insight into these changes.
Supplement recommendations to help prevent nutrient deficiencies:
After surgery, your smaller stomach will limit the amount of food you can eat, making it more difficult to meet your daily vitamin and mineral needs through diet alone. To help prevent nutrient deficiencies, you will need to take a chewable complete multivitamin and a chewable calcium supplement every day.
Multivitamin and calcium supplement recommendations:
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A complete chewable daily multivitamin that provides at least 18 vitamins and minerals as listed on the Supplement Facts label. Most gummy multivitamins are “partial” formulas, either missing essential nutrients and/or do not meet the required amounts.
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1500mg of calcium citrate, also in chewable form.
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Iron, if anemic.
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Additional vitamin or mineral supplements may be recommended based on your individual lab results.
Multivitamin and calcium supplement recommendations:
-
A complete chewable daily multivitamin that provides at least 18 vitamins and minerals as listed on the Supplement Facts label. Most gummy multivitamins are “partial” formulas, either missing essential nutrients and/or do not meet the required amounts.
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1500mg of calcium citrate, also in chewable form.
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Iron, if anemic.
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Additional vitamin or mineral supplements may be recommended based on your individual lab results.
We’re here to help. Please contact us if you:
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Have persistent vomiting
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Unable to keep fluids, protein shakes, or food down
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Dehydration (dizziness, headache, lightheadedness, dark urine)
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Nausea lasting more than 24 hours
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Severe abdominal pain
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Fever
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Difficulty swallowing
Please make sure you activate your MyChart account so you can communicate with your healthcare team. For appointment scheduling, medical concerns or any questions, please call our office at 443-481-6699.