Dietary modification is the first-line treatment for all stages of gastroparesis. The "Gastroparesis Diet" focuses on small, frequent meals (6–8 per day) to avoid overdistending the non-functioning stomach. Patients are advised to prioritize liquid or pureed calories, as liquids typically empty from the stomach even when solid motility is impaired. Fat and fiber intake are restricted, as both naturally slow gastric emptying and increase the risk of bezoar formation.

Nutritional counseling often involves the supplementation of fat-soluble vitamins and minerals that may be poorly absorbed. In diabetic gastroparesis, coordinating insulin delivery with delayed meal absorption is a significant challenge, often requiring the use of continuous glucose monitors (CGM) and insulin pumps. Documentation on the clinical guidelines for nutritional support and the role of specialized medical foods can be found in the Gastroparesis Treatment Market analysis.

For patients who experience "volume intolerance," a liquid-only diet may be necessary during symptomatic flares. The goal is to maintain a Body Mass Index (BMI) within a healthy range and prevent the "vicious cycle" of dehydration and hospital readmission. By integrating dietary discipline with prokinetic therapy, many patients can achieve a stable quality of life and avoid the need for more invasive surgical permanent feeding tubes.