Question:
Diet differences depending on type of surgery
Are there any major diet differences for those having an open RNY v/s the other types of bariatric surgery? I read about some people dumping on sugar, but somebody posted that they can eat hershey's kisses in moderation. I wondered if there was a difference in what you could tolerate depending on the type of surgery? — Carolyn M. (posted on February 4, 2003)
February 4, 2003
hi there :) yes there is a difference as to what youll be able to tolerate,
not only depending on which surgery you have but also the indvidual as
well. everyone is different. some may tolerate sugar while others wont,
same thing applies for pretty much anything. ie, meats, fatty
food,fried,etc. best of luck to you! :)
— carrie M.
February 4, 2003
I don't know how many differences there are but I can speak
from experience. Had open RNY on Nov. 13, '02. I have little desire to eat
most of the time. I avoid sugar, try to get "no sugar added"
products when we shop (as a spaphetti sauce, Hunt's canned, no sugar
added). I have not tried any chocolate except 0 fat, 0 sugar pies my
husband makes. A little goes a long way and I haven't really wanted
chocolate....amazing as I used to crave it.
I've had trouble with chicken and pretty much avoid it. I
had some problems with it before surgery though. I am still drinking
Carnation no sugar added mixed with my liquid vitamins and that gives me
the chocolate taste too... and the extra protein. I have to remember not
to
drink fluids at meals. Hope this helps.
Cheryl Laird
— Cheryl L.
February 4, 2003
Carolyn, most people who are not in the very earliest stages of RNY *can*
eat Hershey's kisses in moderation, meaning a few pieces. For some, that
means one or two. Others can have more, though the days of mowing through
the entire bag are over for most of us. Some people who have RNY surgery
never dump; others dump for a few months, but then stop dumping; still
others find they can re-set their "dump-o-meter" by cutting out
all sugars, thus making their pouches sensitive to too much sugar again.
(Dumping is a sick feeling, sometimes with heart palpatations, sweating,
and just general yuckiness.) It depends on the individual, and on just how
much sugar you're talking about eating in one sitting.<P>As far as
other surgeries go, I have no personal experience with them, but my
impression is that "banders" can eat sweets without fear of
"dumping" because their surgery is about volume restriction, not
malabsorption. (Again, though, the whole bag of kisses would be too much
for them, I think). I don't know about the duodenal switch folks, but I'm
sure one of them will chime in on this one.
— Suzy C.
February 4, 2003
Hi Carolyn.. YES! If you have Adjustable Gastric Banding (AKA AGB or Lap
band), a Duodenal Switch (DS), or A Biliopancreatic Diversion (BPD) you
WILL be able to eat things that many who had an RNY cannot eat (notice I
say many and not ALL, because not all who have had the RNY have the
aversion to sugars/fats/carbs known as 'dumping') Also with A DS or BPD you
would not have the severe restriction that you see in the RNY and the AGB,
weight loss for the DS and BPD are acheived by SOME restriction and a WHOLE
LOT of malabsorption. This is a good question and I'm so glad to see it
asked, so many people assume the the RNY is the only way to go because it
is the most widely publicized form of WLS, there are MANY options out there
and it's important to do the research and know what is best for you. I'm 8
months post op lap BPD and I've lost 97 pounds.. this was the way to go for
me, though it may not be the way to go for others. Please feel free to
email me if I can be of any help in answering questions for you. My email
address is in my profile. Best of luck! ~Peace
— Joscelin
February 4, 2003
Hi, I'm 9wks open RNY and I at first was vomiting even if I smelled food.
But now I can eat anything. sweets don't bother me well I should say things
like drinks spegetti sauce, I really haven't tryed candy or cakes. but any
foods that have sugar add has not bothered me to the point of dumping. I
only dumped once since this wls and that was when I took a tums on a empty
stomach, yes it was awful, I thought I was dieing lol anyways I so far eat
what I please but uses my head to know if it is good for my diet or not.
when I get cravings I did eat what ever I craved and that was the end of
it. NOW I see I have no more cravings and I'm back eating for my diet.
— Naes Wls J.
February 5, 2003
I had the DS almost 9 months ago and can eat anything. There are no
restrictions. I've never vomited. I don't have dirreah. I eat steak,
sandwiches, chicken, chocolate. I don't feel like i miss out on anything
because if I want something I eat it. But everything is in moderation. If
I want a cookie, i eat it. I don't want or feel like eating 5 cookies. The
desire is not there. I've eaten 6 oz steaks at one sitting and loved it.
With the DS you have to take a few more supplements. But, let's face it, we
should all be taking vitamins regardless of ever having surgery. If taking
calcium, multivitamins and ADEK's the rest of my life means that I will
probably maintain my weight loss, so be it. My stomach functions like a
normal stomach, but just smaller therefore I can eat like a normal person.
I've lost 115 pounds in 9 months. Life is good!
— mckdevin
February 5, 2003
Hi Carolyn! Yes, there are differences in a lot of WLS surgeries that
allow you to eat differently. I have friends who've gotten the RNY, and
they cannot tolerate sugars at all (they get dumping syndrome) whereas
others can tolerate in small doses. Another friend had a Lap Band, and he
can pretty much eat anything he wants, however in very small portions. His
rate of weight loss is a little slower. You can "cheat" very
easily with a Lap Band, too, so make sure that option would be good for you
based on your eating habits if you seek it (research research research!).
I personally had the BPD/DS (Biliopancreatic Diversion with Duondenal
Switch) and I'm nearly a year out. I've lost 120lbs and I've had no
dietary restrictions at all. It's *reccommended* that you don't eat sugars
and carbs simply because it can slow down your weight loss (our bodies
don't absorb fats, but we do absorb sugar). You really can't regain with
eating sugars (unless that's all you eat 24/7), but it can slow things
down. I happily enjoy pastries, cookies, cake, etc... with no negative
reaction. Granted, I don't eat half a cake like pre-op! HAHA! I am
completely satisfied with a small slice. :) The BPD/DS is probably one of
the few surgeries where you can eat anything you want without ill effects
(I actually am not sure what is comparible). Also, your tummy is a little
bigger than with some other forms of WLS, so you don't have to settle for
tiny portions. I can eat a relatively normal sized meal with no worries
(and your body simply doesn't absorb all of what's going in). That's the
beauty of this option. If you have any questions, please email me and I'd
be glad to giver you additional info! If you visit my website, you can get
more info as well as some great links to check out for more in-depth
studies. Good luck to you! Continue doing your research, and you are
bound to find the surgery that best works for you!
— Amber S.
February 5, 2003
It's true that even among individuals who have had the same surgery,
diffrent people will be able to tolerate different types of foods. However,
there are also some general differences between the surgeries. I had the
Dudodenal Switch (BPD-DS). The deciding factor for me was that the
Dudodenal Switch offers a higher percentage of excess weight loss with a
much lower risk of late regain. A secondary reason, however, was that I'm a
vegetarian, and I wanted to be able to eat a wide variety of fibrous fruits
and veggies after surgery without any worries of "plugging" my
pouch. Because the Duodenal Switch leaves the pylorus intact, your stomach
continues to function very normally -- it's just a smaller version of its
pre-op self. My experience with the DS has been that I have no problems
with any food. My body handles sugar, fat, and dairy just fine (some people
with the DS do develop lactose intolerance, so I was lucky). I can also
drink with my meals without worrying about "washing" food out of
my stomach too quickly. Basically, I can eat anything I want in moderation,
without fear of getting sick OR of compromising my weight loss (because of
the high degree of malabsorption the DS offers). The only real adjustments
in diet have been that my meals are smaller now and that I have to be very
careful to eat enough protein every day. My surgeon requires at least 70
grams a day, but I aim for 100 grams by including daily protein shakes.
I'm very happy with the Duodenal Switch -- it was definitely the right
choice for me. Good luck with your own decision!
— Tally
February 5, 2003
Carolyn, One of the things to consider carefully is how you feel about the
diet restrictions with the RNY and variations thereof. Some RNY post-ops
eat with nearly the abandon that DS post-ops do - with no dumping issues at
all. Some RNY post-ops dump on fresh fruit and are not able to consume it
at all. Other restrictions that some RNY surgeons recommend for their
patients include not eating items that include raw veggies such as carrott
and celery - because of the potential of stoma blockage.
It seems that nearly ALL WLS post-ops go through a honeymoon period when
all foods that are bad for you seem simply repulsive and think - "Wow
- this is it! I'm never going to want that stuff again!" For me,
after having my DS 7 months ago - totally true. I couldn't stomach the
thought of consuming anything but foods that were ultra good for you items.
(Fresh fruits, veggies, salads, whole grains, high protein, low fat.)
Well - time goes on, and eventually, those things that made you feel better
- say when you're PMS (think chocolate in my case!) sound just as good as
they ever did. Some people feel they deserve and/or NEED the negative
reinforcement that dumping provides (however - keep in mind, some RNY
post-ops simply do not dump - there's no way to tell if you will or won't
until you've been there) and the fear of it keeps them from going there.
For me, I'm thankful for my DS because it means if I'm PMS and wanting a
chocolate covered almond, well, I'm gonna eat one, and not feel guilty
about it. Blessings, dina. (7 months post-op BPD/DS - down 115 lbs)
— Dina McBride
February 5, 2003
Hi Carolyn,
There are some major post-op diet differences between surgeries. If your
surgeon does several different types, it would be a good question to ask
him. In my research into WLS, I've learned that there are several distinct
differences, but many people vary in what they perceive as good, bad,
necessary or tolerable. I had the DS one year ago and I can only tell you
my experience and observations from my support group. The long-term volume
restrictions don't apply to DS patients, since the stomach expands in the
months after surgery. Dumping does not apply to DS patients, either.
Immediately after surgery, weight loss is a result of the severe
restriction of the newly miniaturized stomach combined with malabsorption
of whatever food does get in. Over time, DS patients can eat more in terms
of volume, but never reach pre-op volume levels. Long term weight loss is
maintained by this continued malabsorption. This is different than the
primarily restrictive procedures like the RNY and lap-band, which rely on
restricting the aamount of calories that get in and have little if any
malabsorption component (the exception being a distal RNY, which has as
much malabsorption as a DS combined with the restricted stomach of the
RNY). Immediately after surgery, a meal for me was two crackers with tuna
salad. Now, a year later, I can eat a regular sized meal or most of one if
given enough time. The other day, I went to dinner with a friend at
Outback steakhouse and had 1/4 of a blooming onion, 1/2 of a caesar salad
and the entire rack of baby back ribs, bbq sauce and all, while drinking
two diet cokes. I took the fries home to share with hubby and the dogs. ;)
I was really hungry that day and hadn't eaten much of anything else since
I knew I was going out to dinner. Most of my lunches consist of at least
half a sandwich with all the trimmings: lettuce, tomato, onion, peppers,
regular mayo and mustard...and double meat to boot. This is considerably
less than I was able to eat before surgery and with the DS, I don't absorb
all of the calories I do get in. I'm always drinking diet coke (in a
glass, with ice because of the bubbles) and coffee, as well as a lot of
water. I do avoid candy and high sugars, but not because of dumping. I
have to avoid sugars, especially simple sugars, because the DS does not
hinder the absorption of sugar calories, only fat, protein and to a lesser
extent complex carbs. I know that bbq sauce and mayonnaise have
"hidden" sugars, but I don't ban them from my diet...I just
exercise moderation. I was always semi-lactose-intolerant and have never
been able to drink milk and that got worse after surgery, so I had to avoid
high amounts of dairy. Now I can tolerate cheese in sandwiches and
parmesan on pasta with no problem. If I'm going to have more, like when I
attacked the brie the other night, I take a Lactaid. Some post-op DS
patients report problems with bread or pasta. It doesn't make them sick,
but it fills them up so fast they can't eat anything else. I have that
problem with rice: three spoonfuls of rice and I can't eat anything else
for at least a hour, including protein, so I avoid rice or rice products.
I have to take a multi-vitamin and supplemental calcium every day. I am
allowed to take NSAIDs (ibuprofen, etc.). I did have vomiting episodes
early on when I overate my stomach volume (boy, you learn to avoid that one
real quick!) and while I have had episodes of diarrhea, they have always
been directly related to what I ate...just like everybody else. I even had
an episode of food poisoning which was very unpleasant and probably more
pronounced because of my DS, but since when is food poisoning ever
pleasant? I also have to exercise to maximize my weight loss and develop
muscle tone, just like everybody else. I've lost 90% of my excess weight
(267-149 @ 5'2") in 12 months and I'll probably lose another 20 or so
over the next year depending on how often I get my butt into the gym. My
doc says I'll probably stay or end up here, and I'm not going to complain
about that! I always harp on research, research, research, but as a
librarian it is an occupational hazard. Please investigate ALL surgeries
and decide what will fit you best. I have several friends who have had the
RNY and are happy with their lives and weight loss and I have no reason to
question that...if they're happy, I'm happy. One doesn't experience
dumping and another can eat almost as much as I do and has still lost
weight, so everyone is different. I realize that the RNY is the most
popular of WLS types, but it just irks me when people go into something
like this without having explored all of what's available (not pointing
fingers at you, just a general statement). There are legitimate medical
and personal reasons for choosing any surgery over another, but much of it
rests on how you want to live the rest of your life, which has to be an
informed decision. My email address is in my profile if you have any other
questions! Best of luck to you in whatever surgery you choose!!
— Maria K.
February 5, 2003
Carolyn, I had an open RNY/Distal procedure almost 3 months ago and am
down 50 pounds. I can eat surgar with no problems. My doctor explained
that distal surgery prevents dumping from surgar and has a very high
success rate at keeping weight off long term. The trade off is that you
have to watch your protien intake. Some people have to add protien
supplements to their food. I have been very lucky in that all my blood
tests have been normal. Good luck to you
— debbie11092002
February 5, 2003
I am 4 months post-op. I had the duodenal switch and so I am able to eat
all foods in every catagory. I can drink soda and any other beverage I wish
with or apart from a meal..............................................
The quanity is limited but not as severely as with the other
procedures......................................
Weight loss is primarily one of malabsorption so fats are acceptable in my
diet. I like that I can take vitamins and other medications in pill form
just as I could before
surgery.............................................
I find that the DS does not "punish" me for being fat.
— Pat H.
February 5, 2003
I had the lap rny and I definitely don't feel "punished." I eat
pretty much what I want--yes even sweets. It does make me conscious of what
I am eating. I eat far healthier than most people I know but I still enjoy
great food. For lunch today I went to a spanish restaurant and had a
beefsteak tomatoe salad with bleu cheese and balsamic vinaigrette, serrano
ham, manchego cheese, and olives, and some shrimp and corn chowder. I
didn't have dessert then because I was stuffed but later had some Dove milk
chocolate because I wanted it. Come on . . . Punish me some more! LOL
— ctyst
February 5, 2003
With the lap band, I can eat basically anything I want. I avoid bread,
because it gets so gummy and causes trouble. But anything else in
moderation is fine. We eat our protein first, though and make it our main
goal to get enough protein.
Millie
— M. B.
February 6, 2003
Not everyone who gets the RnY will dump.. some who do dump may even dump
after eating rice, pasta, or fruit. There is no way to know until you've
had surgery. You don't dump with the AGB and the VBG, but you might
experience vomiting if your food isn't well-chewed enough. The good things
bout the AGB is that it has a very short recovery period, and because of
the fills, your pouch size can be adjusted based on your needs. If you have
a duodenal switch, you do not dump, ever, because it preserves the pyloric
sphincter in the stomach, so there is more "normal" digestion.
Postop DS patients also can eat steak, celery, and other fibrous foods
without having to worry that they will get a blocked stoma and throw up.
Check out all forms of wls- you may find one that "fits" you
perfectly!
Best,
Liane French
— Liane F.
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