Hello! I'm Butterflygon!

So after a gastrectomy, the stomach (or lack thereof) won’t be able to hold as much as it used to. A food quantity that’s normal to him would’ve been too much. So instead of 3 large meals, Toshinori needs to eat 6 or more small meals a day. That way he still gets the correct amount. (Ideally)

Directly after surgery, he might have only been able to eat 1/2 to 1 cup of food at a time. It is possible to eat larger portions less often, but it would take several months, and it may never be something his body can do.

Chewing food well is key. The stomach typically does the digesting for you, but since his is missing, the body has a harder time doing so with large chunks of food. Chewing every bite thoroughly will aid in digestion. 

Eating slowly helps getting too full at once, feeling uncomfortable, and Dumping.  (I’ll go over that farther down)

Toshinori should sit upright at meals, not snacking while lounging on the couch. It helps food go in the right direction. And he shouldn’t lay flat for 2-3 hours afterwards.

The last meal should be at least 2 hours before bedtime.

He can’t drink much of anything during a meal, no more than 4 ounces (or half a cup), and no excess drinking 1 hour before and 1 hour after meals. Drinking may fill him up faster, and make him not be able to eat as much as he needs. It also helps prevent a Dumping episode. It’s not that he can’t drink, he just has to do so in moderation.

Protein is needed every meal. Good sources are eggs, meat, poultry, fish, nuts, milk, yogurt, cottage cheese, cheese, peanut butter, and tofu.

Stay away from alcohol.

NOW THAT BEING SAID

There may be food intolerances that he can no longer “stomach” har-har see what I did there

Some people find their bodies cannot handle certain foods. Eating or drinking such foods or drinks can cause Dumping. Sometimes the initial intolerance is at first, and then eventually goes away with time. But other times, it’s permanent. So these are some things he may not be able to eat anymore:

Sugar intolerance: candy, cane sugar, honey, syrups, cakes, cookies, etc.

Lactose intolerance: milk, yogurt, cottage cheese, cheese, ice cream, butter, etc.

Fat intolerance: butter, margarine, oils, mayonnaise, creamy salad dressings, cream cheese, gravies, potato and corn chips, rich desserts, fried foods, fatty meats, etc.

Carbonated drinks

Dumping:

Dumping Syndrome occurs when food moves too quickly in your small intestine, eating or drinking something high in sugar, or by eating too much at once. Symptoms typically start 10-30 mins after eating, but late Dumping Syndrome can start 1-3 hours later. Some people may go through both.

This isn’t something that only occurs right after surgery, it can happen years later. It can be a reoccurring issue if trying to experiment with diet. Or if the body decides it doesn’t like something or becomes intolerant to whatever was eaten.

Symptoms of early Dumping include: feeling bloated or too full after eating, flushing, rapid heart rate, dizziness, lightheadedness, cramping, stomach pain, nausea, vomiting, and diarrhea.

Symptoms of late Dumping include: rapid heart rate, sweating, flushing, dizziness, lightheadedness, anxiousness, shaky, weakness, nausea, vomiting, and diarrhea.

As far as what Toshinori may or may not be intolerant to, I’d say a large possibility is lactose. Here in Vigilantes Toshinori is hesitant but still accepting dairy products from the recent dairy farm he saved. He can’t turn away a thank you gift. He sweats nervously as he downs a whole mug of milk, and then eats a single slice of cheese cake and a butter cookie at the person’s request. But has to decline any more, saying that he’s had way too much dairy already (and will probably be reaping the consequences later).

I feel it’s highly possibly he has other things he can’t tolerate anymore as well, hard to say what all for certain. Personally, given his emaciated appearance, I think it’s safe to say things with a lot of sugar don’t agree with him, and certain if not all fats are probably in the same boat. He probably relies on a lot of protein to keep up his muscular body, but he’s even slimmed down in hero form as well. Easy to say his diet is very strict. This doesn’t mean he doesn’t go outside it now and then, but you can bet he pays for it later.

Losing weight unintentionally is something people with gastrectomies can face. This can be corrected by changing diet along with a Dietitian’s help. However, given how extraordinarily busy All Might was, the man had no time to sleep let alone worry about food. I believe time was a big factor in his severe weight loss. Trying to figure out a diet he can tolerate that will still give him the energy he needs, while also being fast to bring along if necessary. And then enough small meals to make it through the day. Yeah. That doesn’t sound like it happened most of the time. And Vigilantes again shows us how he really did never have time to eat, but at least he had a cafe downstairs to rely on from time to time. (Honestly, he’s probably a regular).

There’s also the factor of Toshinori’s other injuries as well. His stomach wasn’t the only organ damaged in the fight. There are no doubt other complications with multiple organs and their function, most likely also contributing to his malnourishment.

And then, of course, there’s the Depression. I’m sure All Might tried to eat to keep his strength up enough to work. But I also know he’s been depressed for several years (evident of even the little backstory we have of him). Not wanting to eat is a common symptom of depression. The feeling of not being worthy to even eat and fuel your body. This most likely increased in the later years after his injury. It could have started then, who knows for sure, but it also doesn’t seem out of his character to skip a meal or two when someone’s in danger. And who would know that All Might wasn’t eating?