LAP-BAND Forum

Post Weight Loss Surgery Diet, Nutrition, and Exercise
After weight loss surgery, you will need a new nutrition plan. Discuss this in detail with your surgeon and/or dietitian as they can help you learn about and get used to the changes in lifestyle and eating habits you need to make.

It is very important to follow the eating and drinking instructions starting right after the operation to allow the new stomach structure to heal completely and in the right position. This may take a month or more. It is also important, especially in the early weeks, not to stretch the small stomach pouch above the band. Vomiting can stretch it, so it is important not to vomit. Vomiting can increase the chance of stomach tissue slipping through the band.

The First Few Days Post-Surgery
Right after the operation you can take an occasional sip of water or suck on an ice cube. You shouldn?t drink more than this. The day after the operation, you can take a little more fluid but only a small amount at a time. Besides water, you should also choose clear liquids that have an adequate number of calories. To prevent nausea and vomiting, do not drink too much.

Liquid Diet (1-2 weeks post-op)
The goal during this early post-operative period is to protect the small stomach pouch. Only thin liquids can be tolerated at this time. It is also important to keep hydrated with lots of water. Other liquids recommended during this phase include:

• clear broth or soup (with no vegetables or meat and not creamy)
• skim milk
• fruit juice
• no-sugar-added popsicles

Pureed Foods (3-4 weeks post-op)
During this phase you may start having slightly textured foods. Aim for the consistency of baby foods. This will help you transition to more solid foods later. Because protein is so important to help you maintain muscle while you are losing weight, eat protein-rich foods first, and then move on to fruits and vegetables. Foods in this stage may include:

• pureed skinless chicken or fish
• mashed potatoes
• peas
• low-fat yogurt or pudding

In the first few weeks you may be able to eat foods that might not be allowed in your diet later as these foods may contain too many calories. It is more important in the first few weeks to let your stomach adjust to the LAP-BAND ® System than it is to lose weight. Also, your timing and progression into each dietary phase may vary. In general, you should follow the advice of your surgeon and/or dietitian about nutrition.

Soft Foods (5 weeks post-op)
Your meals can now include tender cooked foods like fish and ground turkey. Now that you can chew, make it a habit to chew foods well. If you have dentures, be sure to cut your food into small pieces and chew it thoroughly. If you don?t follow these precautions, you may experience vomiting, stomach irritation and swelling. You could also have stoma obstruction.

If solid foods cause nausea and vomiting,go back to the liquid diet you had earlier. Then you can slowly add soft foods and eventually transition to solid foods. Always ask for advice from your doctor or dietitian that is specific to your situation. Vomiting may increase the incidence of band slippage, stomach slippage, or stretching of the small stomach pouch above the band.

Your New Nutrition Plan
When you can eat solid foods without problems you will need to pay close attention to your diet. Liquids will pass through the reduced stomach pouch quickly and will not make you feel full. The LAP-BAND ® System was designed to restrict solids, not liquids. Drinking liquids during or immediately after meals tends to flush food through the pouch and you will not get the prolonged feeling of satiety needed to help you eat less.

Staying hydrated throughout the day is important. Drink at least 6-8 cups of water per day and make sure you consume them between meals.

Many patients have a difficult time with solid foods during the morning hours. If this is the case for you, you can open up your LAP-BAND ® System by starting with a couple of glasses of liquids before your first meal.

Too much food or big chunks of food can block the stomach pouch outlet. You can avoid this problem by chewing food welland eating small bits at a time. It is important to remember that your new stoma opening is approximately the size of a dime. Chew your food adequately so that it can easily fit through the opening.

Eat only three small meals a day and make sure that these meals contain adequate nutrients. Your stomach can only hold about1/4 cup of food or 2 oz. at a time. Stop eating when your hunger is gone or when you feel comfortable.

You may find that the small stomach pouch makes digestion of high-fiber, high-fat and dry foods more difficult. Tolerance will vary from person to person. Ask your surgeon and/or dietitian about your food choices. The general guide below can help you create good and healthy meals that contain adequate nutrients but little sugar and fat.

Good Food Choices

1. Fruits and vegetables

• 1 to 2 servings of fresh fruit daily
• 2 to 3 servings of fresh vegetables daily

2. Breads and cereals

• 1 small portion of low-sugar cold or hot cereal
• 1/2 to 1 slice of toasted whole wheat or rye bread each day.

Note: some patients have difficulty eating bread.

3. Meat, fish, poultry, eggs
1 oz. to 2 oz. of meat, fish, or poultry or one egg each day. (Remove all visible fat from the meat. Remove the skin from poultry. Prepare the meat in ways that need very little fat. Grilling, steaming, microwaving, or boiling are all good ways to do this.) Note: some patients have difficulty eating meat.

4. Dairy products
Milk and yogurt are calories in liquid form. However, these types of food have calcium, which makes them an important part of a healthy daily diet, so choose a maximum of 2 cups of skimmed milk or low-fat yogurt and 1 oz. of cheese a day.

5. Fats
Restrict the use of fat to 3 to 4 teaspoons of margarine, butter, or oil per day. You can have low-fat salad dressings and mayonnaise in moderation.

6. Drinks
Drink as many calorie-free liquids per day as you wish (though not with meals).Suitable drinks are:

• tea or coffee (black) with low-calorie sweetener
• water
• non-carbonated beverages containing few or no calories

Some doctors have reported that carbonated beverages may contribute to enlargement of the small pouch and recommend they be avoided.

Foods to Avoid
Some foods have a concentrated supply of calories with little nutritional value and should be avoided as much as possible. They include foods such as:

• syrups
• cakes
• biscuits
• jam
• honey
• pies
• chips
• pastries

Alcoholic drinks should also be consumed in moderation, for example a glass of wine per day.

Common Problem Foods
Some foods have difficulty passing through the opening of the stoma and may cause blockage. These include foods such as:

• dry meat
• shrimp
• untoasted or doughy bread
• pasta
• rice
• peanut butter
• dried fruit
• fibrous vegetables like corn,asparagus and celery
• nuts
• coconut
• popcorn
• greasy or fried food
• seeds and skins of fruits and vegetables
• membrane of citrus fruits

Introduce these foods slowly and individually to see if they are tolerated. Always be careful, chew well, and follow your surgeon?s or dietitian?s advice.

Exercise Guidelines
Incorporating regular physical activity into your daily routine is as important as your nutrition plan. Often patients have been sedentary due to decreased activity tolerance, psychological constraints, and in some cases, physical disabilities. After LAP-BAND ® System surgery, aerobic activities?particularly walking and swimming?are generally best tolerated. Consult your surgeon and weight management team to find out which activity is right for you.

Next: Living with the LAP-BAND ® System >>