Preparations and dietary advice

Blood samples and weight

Pharmaceuticals and other purchases

Low calorie diet

Two weeks before the surgery, your calorie intake should be reduced to 800 calories per day. Regular food is acceptable, but strictly avoid fast carbohydrates such as sugar, rice, pasta, potatoes, bread, and sweets. Further information can be found on our website under “Diet & Advice”. Formula diets like Modifast, Allevo, or Naturdiet are also suitable.

Examples of meals with 200 kcal:

• Omelette made with 2 eggs and a small salad
• Tuna in water (200 grams) + salad + 1 tbsp oil
• Cottage cheese (200 grams), flavored with 1/2 sliced orange or grapefruit
• Salmon fillet (100 g) pan-fried or oven-baked with carrots, parsnip, and celeriac
• 1 dl frozen soybeans in chicken broth
• Chicken fillet (150 g) with spinach. Season with garlic/chili
• 5 sliced strawberries with 2 dl plain yogurt (3%)
• 3 dl Kelda soup, any flavor

You may drink the following without restriction:

• Coffee or tea, without milk or sugar.
• Water flavored with cucumber, orange, lemon, or apple.

Plan travel and accomodation

You should not drive during the first few days after your surgery, as you may feel tired during the initial healing phase. Therefore, it is important that you plan your means of transportation before the surgery.

You will stay at the clinic the night following the surgery. If you live nearby, you may be able to go home the next day. For long-distance patients, an additional night’s stay at Quality Hotel Ekoxen is recommended. For self-paying patients, this stay is arranged by us.

For patients referred through the regional healthcare system, please contact your region of residence for questions regarding travel and accommodation.

For long-distance self-paying patients, we cover both travel and hotel accommodation, including hotel stay for one accompanying person. Read more about this here: We cover travel and accommodation.

Preoperative preparations

• Shower with Descutan® the evening before and morning of surgery. Don’t forget to clean your navel. You may wash your hair with regular shampoo. Do not use any body lotion after showering.
• Remove piercings, jewellery, makeup, and nail polish. Gel or acrylic nails are allowed.
• For men, it is important to shave the beard around the mouth.

Packing list

• Personal hygiene items.
• Your own indoor shoes.
• A change of clothes, comfortable attire.
• The medications that we prescribed, as well as the stockings, and any other regular medication.
• There may be some waiting time, so you may want to bring something to occupy yourself with.
• Leave jewellery and valuables at home.
• If you have a long journey home, an empty thermos can be useful for preparing broth that you can drink on the way back.

Fasting

How to find us

Admission and preparation

• When you arrive on the day of the surgery, you will change into hospital attire. You should also wear your support stockings.
• You will be able to keep your belongings in a locker.
• You will meet with the anesthesist and the surgeon who will perform the surgery.
• An anaesthetic nurse will prepare you for surgery. You will receive intravenous fluids, antibiotics, pain relief, and sedative tablets.

After the surgery

• You will be asked to blow into a “PEP” (Positive Expiratory Pressure) once every hour to help restart lung and blood circulation.
• In order to reduce the risk of blood clots and restart bowel movements, you will be asked to get up and start moving as soon as you can after the surgery. Moving around is also a way to alleviate pain.
• The staff will demonstrate how to administer your blood-thinning injection.
• You will spend the night at our clinic in a shared hospital unit.

The morning after surgery

• You will be awakened at 6:00 a.m. for blood tests and checks-ups.
• You may change into your own clothes.
• At around 7:00 a.m, we will be serving breakfast (coffee, tea, rose hip soup and/or yogurt).

Discharge

• The book Ett liv med sleeve eller gastric bypass (only available in Swedish).
• Surgical tape that can be used to reinforce your dressings (more details further down) .
• Painkillers (Alvedon®, Oxynorm®).
• Stock cubes.
• A medical certificate, blood test referral, and a summary of the procedures performed (epicrisis).

For those staying at the hotel on the second night

• When checking in at the hotel, you can request a can of yogurt to bring to your room.
• You can find tea and a kettle in the room as well.
• Between 5:00 p.m. and 9:00 p.m, a smooth soup is served in the hotel’s dining room.
• The following day, you can check out from the hotel and travel home in the morning. If you are feeling well, no further contact with the clinic is necessary this day.

Follow-up

Wounds and dressings

Your surgical wounds are closed with dissolvable stitches. Dressings should remain in place for 10–14 days. You may shower with them, but avoid bathing and saunas. If the outer plastic film loosens, reinforce it with surgical tape. If water gets under the dressings, remove them, but leave the small tape closest to the skin for 10-14 days and cover it with surgical tape.

After removing the dressings, allow the skin to air, e.g. during the night. Then, use the surgical tape on the scars. Change the tape and allow the skin to air for one day a week. Tape for at least three months. Protect the scars from sunlight exposure.

Medications and support stockings

• Take Innohep® / Fragmin® for 10 days after the surgery. The first injection is administered at the clinic; you will receive instructions on how to administer it at home.
• Take Esomeprazol® for three months after surgery, even if you have no symptoms. Take one tablet morning and evening for the first month, then one tablet daily for two more months.
• If you have pain or discomfort, take paracetamol (Alvedon® or Panodil®). For pain radiating towards the shoulders, adding Ipren® 400 mg can be effective. Always follow the recommended dosage on the packaging. Oxynorm® 5 mg can be taken if needed for severe pain.
• Wear the support stockings during the day for 10 days.

Exercise

Sick leave

Vitamins and minerals

If you develop a fever or acute abdominal pain

A slightly elevated body temperature, up to 38°C, may occur on the second day due to the healing process. If this persists, or is higher, you should either contact us, call 1177, or go to the nearest emergency room.

In the case of acute abdominal pain, contact 1177 or go to the nearest emergency room.

Constipation

• Drink enough fluids and keep moving.
• Prune juice or linseed oil (1-3 teaspoons per day) may help.
• Dulcolax® can be taken for temporary constipation. Movicol® or OXYtarm® can be taken daily.
• Contact us if the problem persists.

After the surgery, your stomach needs time to heal. Start with a liquid diet for the first week, then gradually introduce more solid textures over the next three weeks. After one month, you can begin to reintroduce regular food. These timeframes are guidelines — you may need more time before increasing food consistency or returning to solid food.

Week 1: The liquid phase

During the first week, you should only consume a liquid diet. The consistency should be such that you could easily ingest the food through a straw. Avoid anything containing solid pieces or seeds, as your stomach needs to recover after the surgery.

Eat slowly, preferably with a teaspoon, to avoid eating too much or too quickly. Do not eat more than 200 ml per meal. At first, it may be difficult to consume this amount, as the stomach is still swollen after the surgery. It may be helpful to use a measuring cup to monitor your intake.

In the beginning, you may need to eat more than six meals a day to get the nutrition you need. Listen to your body and take it at your own pace.

Start separating foods and liquids immediately after the operation (read more about this in the ‘Fluids’ section).

Do eat/drink during the first week:

• Soups (Kelda soups or homemade pureed soups, sprinkle some parmesan or mozzarella for added protein)
• Filmjölk, yogurt, drinking quark
• Smoothies without seeds and chunks
• Juice
• Broth
• Nutritional drinks from the pharmacy

Avoid during the first week:

• Seeds and chunks
• Acidic foods (e.g., orange juice, lemon water, vinegar, tomato soup)
• Blueberries (constipating)
• Very fatty or creamy foods
• Spicy seasonings such as chili, cayenne, garlic
• Alcohol
• Carbonated drinks

Week 2-4: The soft diet phase

You can now start eating foods that are soft and can be mashed into a purée. The goal is to slowly get your stomach used to regular food again over about three weeks. Take it step by step and add one food at a time to see how your body reacts. During this period, you will also begin taking your supplements.

Do eat/drink week 2-4:

• Fish fillet, tuna in water, fish balls
• Eggs, omelet
• Minced meat
• Boiled potatoes, cooked vegetables
• Oatmeal
• Cottage cheese, quark, skyr
• Banana, pear, avocado, berries
• Crispbread without seeds

Avoid week 2-4:

• Stringy and hard-to-digest foods, such as asparagus, pineapple, rhubarb, nuts, mushrooms, and shrimp
• Doughy foods like soft bread and pasta
• Fried food (oven-baked or boiled is fine)
• Rice and other grains/seeds like couscous, quinoa, and bulgur
• Still avoid anything too acidic/spicy/fatty

Week 5: Transition to regular diet

Eating frequently and regularly

To ensure you receive all the necessary nutrients, aim to have 5–6 meals a day, including breakfast, lunch, dinner, and 2–3 light meals. Try to eat every three hours, and do not skip the light meals — they are important for meeting your nutritional needs.

Eating small portions and stopping when you feel full

For main meals, a portion size of 1.5–2 decilitres is appropriate. Snacks can be 1–1.5 decilitres and may be in liquid form.

It can be helpful to serve your food on a small plate or in a smaller bowl, which can make it easier to visually monitor and manage your portion sizes. Occasio­nally measuring your food to ensure it aligns with the recom­mendations can also be beneficial.

Always stop eating as soon as you feel full; never force yourself to eat a specific amount of food. If you’re unable to meet the recommended intake, consider adding light meals throughout the day to ensure your nutritional needs are met.

Chewing thoroughly and eating slowly

After obesity surgery, your stomach is no longer as efficient at processing food before it moves into the intestine. Therefore, it is essential to chew your food thoroughly before swallowing. Choose calm, stress-free environments that allow you to eat mindfully. Aim for each meal to last 20–30 minutes.

Planning your meals

It’s important to plan ahead so that you can meet your daily nutritional needs. Plan your grocery shopping with lists and prepare your meals in advance, ideally using a weekly schedule.

To successfully create and follow a healthy diet, you should avoid grocery shopping when hungry, decide what to eat before you get hungry, surround yourself with healthy food both at home and on the go, and always keep a healthy snack in your bag.

Great tips and recipes for healthy meals and snacks can be found in the book Ett liv med sleeve eller gastric bypass (available in Swedish only).

Meeting your nutritional needs

In the next section, you can read about how to structure a balanced meal to ensure you get the neces­sary nutrition.

The plate model

By following the plate model when planning your meals, you’ll achieve a good balance of the nutrients your body needs. You’ve probably heard of the plate model before, but after bariatric surgery, it looks a little different than before. Fill half of your plate with a good source of protein, and one quarter with carbohydrates (preferably complex). Fill the remaining quarter with vegetables, which provide fiber, vitamins, and minerals.

Protein

After bariatric surgery, it is crucial that you consume an adequate amount of protein. During weight loss, your body may otherwise begin to use muscle protein as an energy source, leading to a loss of muscle mass. This can in turn affect your metabolism and potentially slow down your weight loss progress.

After bariatric surgery, you will need to consume 1 to 1.5 grams of protein per kilogram of body weight. For example, a person weighing 80 kg should aim for about 80 to 120 grams of protein per day. To meet the recommended daily intake, be sure to include a source of protein in each meal.

From time to time, it’s a good idea to calculate how much protein you’re getting in a day to make sure you’re meeting your needs.

Good sources of protein include fish, seafood, ground beef or lamb, chicken, eggs, quorn, quark, cottage cheese, seeds and nuts, soy products, and legumes.

Plant-based protein sources for vegans include soybeans, chickpeas, sunflower seeds, kale, almonds, red lentils, beans, quinoa, broccoli, and tofu.

Carbohydrates

Carbohydrates are often categorised as either slow or fast. Slow carbohydrates, also known as complex carbohydrates, have a slower impact on your blood sugar, while fast ones cause a rapid spike, leading to more fluctuations throughout the day. Good sources of slow carbohydrates include root vegetables, whole grains, fruits, and vegetables. Consume these in larger quantities and minimise your intake of fast carbohydrates (white bread, sweet beverages, candy, cookies, etc).

Fats

After bariatric surgery, you need to consume at least 20 grams of fat per day, preferably in the form of mono- and polyunsaturated fatty acids. Good sources of healthy fats include fatty fish (such as salmon, mackerel, sardines), plant-based oils, nuts, seeds, avocado, and olives.

Limit your intake of saturated fats, which are found in full-fat dairy products, sauces, cheese, processed meats, meat, chips, and cookies.

How much water should I drink?

You should consume at least one litre of water per day, preferably 1.5 litres per day. At first, it might be challenging to reach this amount due to post-operative stomach swelling. Nausea and pain can also make it difficult to stay hydrated. Try to drink small amounts frequently, listen to your body, and take it at your own pace.

Ensure that you urinate frequently and that your urine is light in colour, which indicates adequate hydration. If your urines turns dark yellow or brown, it means that you have not had enough to drink.

After bariatric surgery, you can only drink water in small sips, so you’ll need to plan your fluid intake just as carefully as your meals. Drink regularly, throughout the day, and even when you don’t feel thirsty.

Always carry a water bottle with you. Consider measu­ring your intake by setting a time during the day by which you aim to have finished the water in your bottle.

Separate food and drink

After your surgery, your stomach is too small to handle food and fluids at the same time. To ensure you get the nutrition you need, you should let your stomach rest from fluids for a while before and after meals. Ideally, you should avoid drinking any fluids for 30 minutes before and 30 minutes after eating.

If water doesn’t taste good

Some patients find that water has a strange or unpleasant taste after bariatric surgery. You can try flavouring it with berries, apple, or cucumber. After the first month, you may also add lemon or lime for flavour.

If drinking feels uncomfortable

After bariatric surgery, some may experience cramping in the stomach or chest pain when drinking cold water. In that case, it may help to drink water at room temperature or to have a warm beverage, such as tea.

FitForMe

After your surgery, the risk of deficiencies in certain vitamins, minerals, and trace elements increases. You will therefore need to take nutritional supplements daily for the rest of your life.

We primarily recommend FitForMe®, a supplement specifically developed for bariatric patients. It contains everything you need in one single product. You take one multivitamin tablet per day (WLS Optimum® or WLS Forte®, depending on whether you had a sleeve or gastric bypass), along with one chewable calcium tablet (Calcium Soft Chew®).

Order FitForMe here: https://fitforme.com/sv-se/.

Alternative supplements

For those who do not wish to take FitForMe®, the following supplements are recommended:

• Mitt Val Kvinna, 2 tablets once daily
• Betolvex® (Vitamin B12) 1 mg, 1 tablet daily
• Folsyra® 500 µg (0,5 mg), 2 tablets once daily
• Calcitugg® (Calcium) 1 g, once daily
• D-vitamin 800 - 1000 IU = 20 - 25 µg, once daily
• Duroferon® 100 mg (iron) for women only, 1 tablet twice daily for one week during menstruation.

We do not issue prescriptions for these supplements; they are available over the counter at the pharmacy.

We understand that there may be many questions before undergoing bariatric surgery. We take the time to listen and support you — from the first consultation to postoperative care. You are always welcome to contact us. Every question matters.