What will my post-surgical diet be like after gastric banding?

It is essential that you have ongoing surgical reviews in the initial 12 months of having gastric banding, not only for band adjustments but to also make sure everything is going as planned.

Post surgery your total food and fluid intake should be between 5000 kilojoules - 6000 kilojoules (1200 - 1500 calories) per day. A daily multi-vitamin is essential.

Generally:
week 1-2 after surgery will be fluids only - ALL FLUIDS MUST BE ABLE TO BE PASSED THROUGH A STRAW.  After surgery when you return to your ward you will be encouraged to drink small amounts of clear fluids (20mls ONLY every 10-15 minutes). This will increase to 1/2 cup (125mls) each hour after 2 days. Fluids may include: thin liquids, water, coffee, tea, diet cordial, clear soups, milk, optifast, protein drinks, sustagen or resource.

Week 3-4 after sugery: a Puree Diet progressing to a soft diet - this while you are still healing from sugery. All meals should be 1/2 cups serves. Eg, scrambled egg, mashed or pureed vegetables, pureed meat, low fat yoghurt, stewed fruit pureed, diet jelly, pureed casseroles etc

Week 5 onwards solid foods (normal diet) - reintroduce foods SLOWLY. Take your time eating, always chew your foods. The aim is to eat your meal from a bread & butter sized plate. Always eat protein and vegetables first at meal time to ensure you don't fill up on less nutritious foods. As your stomach size is now smaller it's essential that the food you do eat is nutritous. Try not to consume beverages and food together to prevent filling up. Meals are around 1/2 cup in size.

Things to buy before surgery which you will find helpful:
1. 50ml medicine cup
2. kitchen measuring cups (especially the 1/2 cup one)
3. A soluble or chewable multi-vitamin
4. A soluble fibre drink (such as metamucil or benefibre)
5. Bariatric Plate to guide portion sizes (you can buy one from www.greatideas.net.au)

For more information from individuals who have had gastric banding visit:
www.obesityhelp.com
www.obesityguidelines.gov.au

As Samantha has already explained in detail, you will progress back to normal food after a fluid and puree diet.

I find many clients still believe that once you are back on a normal diet, the role of the band is to ‘stop’ you eating or to deter you from eating by making eating uncomfortable. This is NOT the case. The role of a gastric band is to help you feel satisfied on a smaller amount of food, not stop you from eating.  

Some people experience difficulty with tough, dry or stringy foods. This can be overcome by changes in food preparation techniques and your dietitian can help you with this.

The technique of eating is also important to ensure you can eat comfortably and enjoy a variety of foods.

The following eating technique is important after all forms of weight loss surgery, including gastric band surgery:
- Cut food into small pieces, the size of a 5 cent piece
- Chew, chew, chew
- Wait on minute after you swallow before taking the next mouthful
- Put cutlery down between mouthfuls to help slow down
- Allow 20-30 minutes for a meal - discard any food left after this time

By ensuring a good eating technique you will tolerate a wider variety of foods.

Sally Johnston
www.yourbariatricdietitian.com.au

Great responses thus far. To add to the discussion it is important to also understand the daily variabilities which will affect whether a food is tolerated or not, these include:
1. Portion of food taken per mouthful
2. Degree of chewing
3. Waiting adequate time between mouthfuls 
4. Time of the day. 
5. Stress levels
6. Previous blockage experienced during the day
7. Type of food eaten
8. Tightness of the gastric band
9. Position of the band

Become your own gastric band doctor by understanding the impact of the above 9 points

Helen Bauzon
www.GlobalGastricBandSolutions.com.au

For two weeks after gastric banding, we keep the patients on liquids only, so water, tea, coffee, juice, soup without the vegetables, and Optifast. Then following that week three and four, we have them on baby food, so mashed potato with gravy, etc. And at week five, they will begin on a solid diet. Three common complaints on a solid diet is dry bread on its own, over cooked rice and dry, tough meat. Those were the three things most patients said they would have difficulty with, with a gastric band.

There is a period of 4 weeks after surgery where you move through phases of liquid, puree and then onto solid food as described by my colleagues.   Longterm, you can eat most things you usually would have, however, the typical calorie intake is around 900 Calories per day (3780kJ), so it becomes more important to choose foods of high nutritional quality. Despite choosing well, you will need to take a multivitamin daily, and you may need other specific supplements if your diet is not well balanced.  Eating behaviour is the key to being physically able to eat most foods longterm. Your dietitian will help train you in the ideal eating behaviours to get the best tolerance of foods with a gastric band.     You may find you speak to other band owners who describe regular “vomiting”or regurgitation. This is a sign that they are not eating correctly and this can easily be addressed with a change in eating behaviour.         

Every surgical practice has a different protocol for dietary requirements after lap band placement.

In my practice, I advise patients to stay on clear fluids and optifast for the first two weeks.

I advise patients to drink / sip slowly and be in an upright postion when drinking.I ask people not to lie down for two hours after drinking. This is to avoid reflux and vomiting.

In weeks 3 to 4, we go to puree diet. At this stage, I would have done the first lap band adjustment.

Depending on how this goes,  in weeks five to 6, we progress to a solid diet. Fizzy drinks, hard meats and bread are not usually well tolerated. 

As a principle I advise cutting food up into small pieces and eat very slowly. Gradually the band is inflated until a comfortable state of satiety is reached. If reflux and epigastric discomfort are experienced, it is important to go for a band adjustment.

It is important to keep close liason with our practice dietitian throughout the whole weight loss surgery process.

Ken Wong
http://www.centralcoastsurgery.com.au