What are the 5 stages of the bariatric diet?
In order, the 5 stages are clear liquids, then protein shakes and full liquids, pureed foods, soft foods, and regular healthy eating. Dr. Serrano's team sets the timing of each stage for you, so move ahead only when they say you're ready.
Your surgeon's team tells you when to move to each stage, usually over several weeks. Each stage below shows what to eat and how much at a time.
Stage 1: Clear liquids
This stage usually starts in the hospital. Take tiny sips, about 1 oz (30 mL) at a time.
Stage 1: Clear liquids| Type | Options |
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| Water | Plain, or with sugar-free flavor drops |
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| Electrolyte drinks | Sugar-free kinds, such as Gatorade Zero or Powerade Zero |
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| Broth | Clear broth (bone, vegetable, chicken, or beef) |
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| Tea | Herbal (ginger, chamomile, peppermint) or decaf |
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| Treats | Sugar-free gelatin or ice pops |
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| Protein | Clear protein drinks or protein water, if Dr. Serrano's team allows them |
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Skip anything fizzy, sweet, caffeinated, or alcoholic.
Stage 2: Protein shakes and full liquids
Aim for 2 to 4 oz at a time. Protein shakes are your main food in this stage.
Stage 2: Protein shakes and full liquids| Type | Options |
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| Shakes | Ready-made or powder shakes, low in sugar (whey isolate or plant-based) |
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| Milk | Skim, 1%, ultra-filtered (such as Fairlife), or unsweetened soy or almond milk. Choose lactose-free if milk upsets you. Soy milk has more protein. |
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| Yogurt | Plain Greek yogurt or unsweetened kefir, thinned until you can drink it |
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| Soups | Broth-based soups or low-fat cream soups, strained smooth (for example tomato, mushroom, broccoli, or chicken) |
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| Protein broth | Broth with unflavored protein powder stirred in |
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| Treats | Sugar-free pudding made with milk and protein powder, or sugar-free cocoa made with milk or a protein shake |
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Stage 3: Pureed foods
Blend everything until smooth, like baby food, with no lumps. Have 2 to 4 tablespoons per meal, 3 meals a day, plus protein shakes.
Stage 3: Pureed foods| Food group | Options |
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| Protein, eaten first | Chicken, turkey, or tuna blended with broth, plain Greek yogurt, or low-fat mayo · pureed salmon, tilapia, or other white fish · soft-scrambled eggs or egg whites · ricotta or cottage cheese · plain Greek yogurt · hummus or pureed lentils · low-fat refried beans · silken tofu |
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| Vegetables, cooked soft and pureed | Carrots, zucchini, squash, pumpkin · sweet potato · mashed cauliflower · green beans or spinach |
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| Fruit, in small amounts | Unsweetened applesauce · mashed ripe banana · pureed pears or peaches canned in juice, not syrup · mashed avocado |
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Meal ideas
- Soft-scrambled egg with a spoon of cottage cheese
- Pureed chicken with mashed cauliflower
- Tuna blended with Greek yogurt
- Low-fat refried beans topped with melted low-fat cheese
Keep seasoning mild. Spicy food can bother a healing stomach.
Stage 4: Soft foods
Food should be moist and tender enough to mash with a fork. Have ¼ to ½ cup per meal. Try new foods one by one, so you can see how each one agrees with you.
Stage 4: Soft foods| Food group | Options |
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| Protein, eaten first | Moist ground chicken, turkey, or lean beef · soft meatballs made with lean meat · flaky fish like cod, sole, tilapia, or salmon · canned tuna, salmon, or chicken · chopped cooked shrimp · eggs, scrambled, poached, soft-boiled, or in an omelet with soft vegetables · low-fat cheeses like panela, mozzarella, string cheese, or cottage cheese · soft tofu · well-cooked beans and lentils |
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| Vegetables, cooked soft, no skins | Carrots, zucchini, squash · spinach and other cooked greens · broccoli and cauliflower tops · well-cooked green beans · peeled tomatoes |
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| Fruit, soft, peeled, no seeds | Banana · cantaloupe, honeydew, watermelon · ripe mango, peaches, or pears · fruit canned in juice |
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| Soft starches, in small amounts | Oatmeal · sweet potato · mashed potato made with milk |
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Meal ideas
- Spinach and panela omelet
- Baked flaky fish with soft carrots
- Turkey meatballs with zucchini
- Tuna salad with a little sliced avocado
Not yet: salads and raw vegetables · fruit skins, seeds, and nuts · bread, rice, pasta, and tortillas · tough, dry meats like steak or pork chops · fried, greasy, or spicy food
Stage 5: Regular healthy eating
Start this stage only after your surgeon's team clears you. Keep portions small. About 1 cup per meal is a common long-term size.
Stage 5: Regular healthy eating| Food group | Options |
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| Protein, eaten first | Chicken breast, turkey, lean beef, pork tenderloin · cooked fish and seafood · eggs and egg whites · cottage cheese, Greek yogurt, low-fat cheese · lentils, beans, chickpeas, edamame, tofu |
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| Vegetables | Any cooked vegetable · salads and raw vegetables, added slowly and chewed well |
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| Fruit | Most fresh fruit, such as berries, apples, oranges, and grapes, starting with small servings |
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| Healthy fats, a little | Avocado · olive oil · a small handful of nuts or seeds, chewed well |
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| Whole grains, a little | Oatmeal · quinoa · a few whole wheat crackers or a small corn tortilla |
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Meal ideas
- Grilled chicken and roasted vegetables
- Salmon with a little quinoa
- Cooked shrimp salad with avocado
- Turkey in lettuce wraps
- Greek yogurt with berries and a few chopped nuts
Go slow with bread, rice, pasta, tough red meat, and stringy raw vegetables. Many people find these hard to tolerate.
