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Endoscopic Sleeve Gastroplasty (ESG) is a procedure that decreases the size of your stomach. Along with diet and lifestyle changes, this procedure is a great tool for weight loss. Naturally like with any tool, it works best when it’s used correctly. After the ESG procedure, your stomach will be shaped more like a tube, which can easily pass liquids and soft foods. Initially, after the ESG you will transition through a liquids-only and soft foods-only phase to allow time for your stomach to heal. But once it is healed, it will be vital to put this tool to work for you by being prepared to make some dietary changes. You can start to make some of those dietary and lifestyle changes now, which will help make the transition easier and maximize your weight loss after ESG. To maximize weight loss after the ESG, it’s important to avoid drinking calories and avoid eating high-carb and snack foods. Instead, the focus shifts to choosing dense, quality proteins, limiting carbohydrates, putting yourself on a set meal schedule, and creating an exercise habit.

How to Change Your Diet Before The ESG Procedure:


If you haven’t already, the first thing to do is to eliminate sugar-sweetened, carbonated, and caffeinated beverages. This includes beverages such as soda, sports drinks, lemonade, fruit juice, milk, coffee, tea, smoothies, and alcohol. Because the ESG procedure changes the shape of your stomach into a tube, fluid intake will not be drastically restricted. Therefore, it is vital to eliminate intake of these liquid calories if you wish to maximize your weight loss goals.

All beverages should be 10 calories or less per 8-ounce serving. Once you’ve found some sugar-free, non-carbonated beverages that you like (water, Powerade Zero, Propel, Crystal Light, just to name a few), the minimum is to aim for 64 fluid ounces per day. Start to practice drinking these fluids in between your mealtimes because after the ESG procedure there won’t be enough room to drink liquids and eat protein at the same time.


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The next dietary modification is to prioritize protein in your meals and snacks. Protein is the most satiating macronutrient; for this reason, it is recommended that you always eat protein first! The goal is to take in 60-90 grams (or more!) of quality protein daily; this is the minimum amount to maintain your lean body mass. Lean body mass is important to maintain because it helps your metabolism work its best. To meet these 60 – 90 grams of protein per day, a good portion size is about the size of the palm of your hand of protein at each meal. If you’re trying to gain muscle mass, protein intake would need to be a bit higher. Some great protein sources are chicken, turkey, beef, pork loin, fish, seafood, tofu, eggs, plain or light Greek yogurt, and cottage cheese.

A good way to know if your protein choice is of great quality is to ask yourself “Could I grow this in my backyard or see where this came from if I took a field trip to a farm?” For example, a hamburger patty comes from a cow, which could be seen grazing in a field on a farm, or salmon could be caught in a stream. Whereas, we do not see hot dogs or bologna walking around on a farm, or fields of protein cookies growing on a farm. Therefore, salmon or a hamburger patty are better quality protein sources than hot dogs, bologna, or protein cookies for example.



Good news: as you start to make quality protein the priority of your meals, you will start to feel fuller faster. This will make it easier to start avoiding starchy, processed, and empty-calorie foods. These are things like sweets (cakes, candies, cookies, pastries, etc.), bread/rice/pasta, breakfast cereal/oatmeal/grits, and snack foods like chips, crackers, pretzels, and popcorn. Though these foods are tasty, they lack protein. If you choose to eat these types of foods after the ESG procedure when your stomach is smaller, you will not have enough room to get adequate protein. Additionally, because of how some of these foods digest, when the stomach is shaped more like a tube after the ESG surgery these foods can slide through too easily and therefore make it harder to lose weight if they are consumed on a regular basis.

So, in preparation for the ESG procedure, limit your daily carbohydrate intake to 120 grams or less per day. Your carbs should mostly be coming from vegetables or fruits. (Hint: if you are consistently choosing dense, quality protein, you won’t be hungry enough to eat much more than 120 grams of carbohydrates per day anyway). A good way to know if you’re hitting your protein and carbohydrate goals is to download an app to track your food intake by measuring it and logging it. Baritastic is a great free app to keep track of your food and beverage intake, no code is required.




As you begin to track your food, you’ll notice how your food choices help (or hinder) your daily protein and carbohydrate goals. One way to help meet your goals is to be intentional about when you are eating. Plan for 3 meals (about 4-5 hours apart) and 1 snack daily, start to practice eating only 4x/day and not skipping meals. We want to avoid developing grazing or mindless snacking behaviors; if you are in the habit of eating small snacks every few hours it will be more difficult to lose weight after your procedure. More good news: when you’re eating a protein-dense meal 3 times per day, you’re less likely to feel hungry and therefore less likely to have the urge to snack. We also want to avoid skipping meals because after your procedure you will not be able to eat as much volume of food at 1 time. So, it will be very important to plan out 3 meals and 1 snack in order to consume adequate protein to maintain your lean body mass and metabolism.

While you’re eating your protein-dense meals, start to practice chewing your food well and limit your meal duration to 15-20 minutes. Set a timer if you need to. During mealtime, avoid distractions such as watching TV, checking e-mails, or browsing your social media accounts. Avoiding distractions will help you pay more attention to your fullness cues, which will be extremely important after your procedure.



And last but certainly not least, begin an exercise habit. I know, we are all busy. However, if you wish to maximize weight loss after your procedure it will be vital that you carve out 30-60 minutes per day of moderate-vigorous exercise. Start first by putting yourself on a schedule where you can consistently dedicate time to exercise. For example, if you are not a morning person, it would probably be unwise to think you’re going to consistently exercise in the morning; instead, pack a gym bag so you can swing by the gym on your way home after work. Once you have a dedicated and consistent time set aside, find an activity that you actually enjoy. If walking hurts your ankles or knees, that’s probably not going to be a sustainable activity for you for the time being. But perhaps a YouTube yoga session will feel better on your body! Any movement is better than none. So find something that you enjoy, that challenges you, and that helps you break a little bit of a sweat. To keep yourself accountable, find someone to join you in this activity!

Start making these changes prior to the ESG procedure. It will provide a chance for you to practice the diet and lifestyle modifications that will be the key to your long-term success. These changes will help you reach, and maybe even exceed, your full weight loss potential with the ESG!

If you would like us to help you with weight management, check out our nutrition counseling packages, or contact us so we find the best way to help you achieve your goals.


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