Adjustable Gastric Banding surgery was developed to induce weight loss. In order to achieve and maintain the desired weight loss, some behavior patterns must be modified.
After Lap Band Surgery Care
After surgery, you will find that you need to make changes in your eating patterns, not only to prevent pain and vomiting, but also to produce the desired weight loss. Perhaps even more important is development of appropriate eating habits to prevent band slippage and obstruction of the stoma (the opening for foods leaving the upper stomach). Changes considered to be important are outlined in the following paragraphs.
Eat slowly and chew foods until they reach a mushy consistency. Swallowing food in chunks may block the opening and prevent the passage of food. The following are hints to help you eat more slowly:
- Set aside 30 to 45 minutes to eat each meal.
- Actually count the number of times you chew each bite. Aim for 30.
- Make an EAT SLOWLY sign and place it on the table in front of you.
- Explain to family members why you must eat slowly so they will not urge you to eat faster.
- Take small bites of food. You may want to try eating with a baby spoon.
- Pay attention to taste. Learn to savor each bite, noticing its flavor, texture, and consistency.
- Chew well. Ground or very soft foods may be necessary if you have dentures.
Stop eating as soon as you are full.
Besides causing you to vomit, extra food over a period of time may stretch your stomach. Indications of fullness may be:
- A feeling of pressure or fullness in the center of your abdomen just below the rib cage.
- Feelings of nausea.
- Pain in your shoulder area or upper chest.
If you start vomiting, and it continues throughout the day, stop eating solid foods and just sip clear liquids (gelatin, clear juice, broth, and tea). The vomiting may indicate that your outlet is blocked. If intermittent vomiting continues for more than 24 hours, contact your doctor. Most vomiting episodes can be prevented. The causes of vomiting are:
- Eating too fast and not chewing food properly.
- Eating too much at a meal.
- Drinking liquids right after eating.
- Lying down after a meal.
- Eating foods that don't with agree you.
Important Lap Band Rules
Eat three small meals a day only. The LAP-BAND System creates a small stomach that can only hold an amount of food roughly equivalent to half a mug. If you try to eat more than this quantity at one time, there is a risk you will become nauseated or vomit. If you regularly eat too much, the small stomach may stretch, canceling out the effect of the operation. In addition, certain complications can then occur, such as stomach slippage, as a result of frequent vomiting. Therefore, it is sensible to learn how much you stomach can hold comfortably and then not exceed this amount.
Eat slowly and thoroughly. Food can only pass through the stoma of the new stomach if it has been “chopped” into very small pieces. That is why you have to chew very well. Moreover, you have to take more time for your meals.
Stop eating as soon as you feel full. Once the stomach is full, the body receives a signal that enough has been eaten. In other words, you have a feeling of satiety (fullness). But it takes a little while to become aware of these signals. So you may eat more than is good for you. This can lead to nausea and vomiting. Take you time over your meal and try to recognize the feeling of fullness in yourself. Then stop eating immediately.
Don’t drink while you are eating. The operation only has results with solid food. If you drink at mealtimes, the food becomes more liquid and the effect of the LAP-BAND System is greatly weakened. It is preferable for you not to drink anything until one to two hours after the meal. In this way, you retain the feeling of fullness for as long as possible.
Don’t eat between meals. After you have had a meal, don’t eat anything else until the next meal. Eating snacks in between meals is one of the main reasons for failure to lose weight. It is extremely important for you to try to break this habit.
Only eat fresh food. With the LAP-BAND System is place, you can only eat a little. Therefore, it is important for the food you eat to be as healthy as possible and for you not to fill your stomach with food deficient in important nutrients such as vitamins. Food high in protein and vitamins, such as fresh vegetables, fruit, meat and cereals is recommended. Food high in fat and sugar is not good for you. You can eat apples and oranges, but try to avoid, as far as possible, orange juice and apple juice in cartons and bottles. Consult your doctor or dietician about whether you need to take vitamin supplements. Note: Solid food is more important than liquid food. The operation will have little or no effect if you only eat liquid food. Liquids are transported directly through the stoma and do not make you feel full.
Avoid extremely fibrous foods. Food that contains many fibers such as asparagus might block the stoma. You are unable to sufficiently chew this food into small pieces and your saliva cannot break the food down either. That is why you have to avoid fibrous food. If you would like to eat asparagus or other very fibrous foods once in a while, cut the food into very small pieces beforehand.
Drink enough during the day. If you lose weight, your fat content will drop as well. Waste products are a result of this process of breaking down fat. In order to excrete these waste products, it is necessary to urinate a lot. That is why you need to drink large quantities of liquids a day. Remember, only water (or sparkling water), tea or coffee (without milk/cream and sugar) or diet soft drinks are allowed! Remember, you have to keep the food and drinks completely separated during the day.
Only drink low calorie drinks. Liquids simply run through the narrow area created by the band. If you drink liquids that are high in calories, you will hardly lose any weight, even if you keep to your diet otherwise.
Lap Band Diet and Nutrition
There are two diets ordered post-operatively for Gastric Banding patients. When you are ready to begin eating, a clear liquid diet is ordered. You will be on the clear diet for usually one day.
The Clear Diet
Breakfast, lunch and dinner
1/3 cup broth
1/3 cup clear jello
1/3 cup clear juice
You won't be able to eat all of the items sent on your trays. At first you will probably only be able to eat two teaspoons of each item. Eat only until you are full. Between meal liquids on the clear diet will consist of clear juice. If you tolerate clear liquids, you will be advanced to pureed food. You will be on this diet for approximately four weeks.
A Sample Pureed Food Diet
Breakfast
Soft egg
Hot cereal
Margarine (optional)
Skim milk (for cereal)
Salt/pepper/sugar
Lunch and dinner
Pureed meat and blended casseroles
Pureed vegetable
Pureed fruit or custard
Margarine (optional)
salt/pepper
Between meals, liquids for the pureed diet will be skim or 2% lowfat milk, juice, or low-calorie beverages. It is very important that you eat food high in protein at each of your three meals and drink 1-2 cups of milk between meals. Protein is needed for wound healing and to renew body cells.
Recommended Daily Dietary Allowance
(RDA) for Protein
56 Gms/day for men
46 Gms/day for women
You wont be able to eat the amount listed above, but you should try to eat 25-30 Gms of protein each day.
| Protein and Calories in Common Foods | ||
| Protein | Calories | |
| 8 ounces of skim milk | 7 g | 80 |
| 1 medium egg | 7g | 80 |
| 1 ounce sliced cheese | 7g | 120 |
| 1/4 cup creamed cottage cheese | 7g | 80 |
| 1 ounce lean meat or fish | 7g | 75 |
| 1/2 cup low-fat plain yogurt | 6g | 72 |
| 1/4 cup strained baby food meat | 3g | 100 |
| 1/4 cup low-calorie custard | 4g | 40 |
| 1/4 cup vegetables | 1g | 13 |
| 1/4 cup cereal | 1g | 35 |
| 1/4 cup toast | .5g | 18 |
| 1/4 cup potato | 1g | 35 |
| 1/4 cup fruit | 0g | 40 |
Lap Band Surgery and Exercise
Exercise at least 30 minutes a day. This rule is just as important as the rules for dieting. In addition to a good low-calorie diet, physical exercise, which consumes energy and, thus, calories, has been shown to be very important to successful weight loss. Physical exercise can also help you to improve your general health. You size may make it hard for you to exercise as much as you should, but usually the more weight you lose, the easier it gets. Start with simple exercise such as walking or swimming, and gradually increase your program to include more intensive forms of exercise such as cycling, jogging and aerobics. Important: you should always check with your doctor regarding the amount and type of exercise you should do.