Question:
After gastric by-pass surgery, what do you eat

I'm considering a gastric by-pass but afraid of eating the wrong foods and having dumping. What does one eat and how do you know if it will agree with you. [email protected]    — flashygal1 (posted on June 5, 2008)

June 5, 2008
You truly never know which foods may affect you. That is why it's strongly recommended you try one new food per day AT HOME. This way you can determine which food negatively may affect you. Higher sugar content tends to be problematic for most RNY patients, but not all. Sugar doesn't bother me. Others have difficulty with beef, rice, pasta, fast foods, bread, etc. Some even have difficult with chicken. You won't know for sure until you try that specific food. Greasy or fatty foods can cause dumping for some patients too. Seasonings can play a part in this also, as well as cooking mediumes--spray non stick coatings, butter, oils, etc. RNY tends to have a high success rate of weight loss compared to other forms, with only minimal adjustments--portion control, daily exercise, vitamin and calcium citrate supplements. Most RNY patients gladly trade these life adjustments for the health issues caused by obesity. DAVE
   — Dave Chambers

June 5, 2008
I only dumped a few times...After it happens once, you really don't want to go thru again...but you do. I have close calls and once in a while (4 years later) I still push my limits occasionally. I cannot eat say, rice and then sugar or I will be in sever pain for 2 hours. Milk too...One day I like something...The next I find it just doesn't taste good. I can't eat greasy food the taste of potaote chips or french fries actually makes my throat feel really coated and yuck! I hate that feeling and the taste. I used to LOVE those things. I never liked milk...but now the feeling is mutual. It wreaks havoc on my belly. I can eat sugar...but no more than about 24 g per serving. Fake sugar or SF stuff tends to bother me more than sugar lately. You just never know. But I enjoy cooking healthy natural meals gourmet style! I like to make recipes WLS friendly. I eat bread only once a week or month...I still get in whole grains and fiber...I eat fruit and totally love it much better than sugary desserts. You just become accustomed to healthy food and it makes you feel good to know that you don't have to give up flavor. Yesterday I wanted some Doritos... I measured out a portion and they tasted pretty good...Left me a mild belly ache and now I don't want any chips for a really long time. I don't deprive all my cravings, but I do keep them under control. If I hadn't measured out a portion...and ate outta the bag...I don't even want to know what would have happened...You can do this...Start looking at labels on the food you enjoy. Then look for alternatives of similar items and try to get the protein and fiber high...Low sugar and carbs and no trans fat....The lower fat the better. But you don't have to do all non fat. You will not absorb all fat...That's a fact! It's so easy once you get an idea what you are looking for. Then try new things and see what you can do to make with the lighter versions of your old food in recipes and dishes. Try making a wrap and grill it rather than a snadwich on bread. Use mustard instead of mayo...Little things make a HUGE difference...Play around with it...Even if you don't have the surgery...do it anyway! It will help.
   — .Anita R.

June 5, 2008
You dont know. You lsiten to your dr, first find a truly good dr in this field. If your in Ct I know the best. it is a lot of trial and error at first. I couldnt eat cereal and really still cant eat a lot of it. i couldnt eat pasta, now I can, i couldnt eat steak now I can, Carbs and sugar will make you dump. When I dump i fell crappy for about 30-45 minutes. deepending on how much I have eaten that I shouldnt ahve eaten. I did everything I should for the first 2years. I didnt even drink alcohol. I am still not a big drinker but I was scared to drink. Let me tell you, you get drunk a lot faster and it lasts longer too so be careful . Basically its stay away from whites. bread, flour sugar. It worked for me. It is one of the best decisons I ever made in my life. I was 274LBS and wore a size 24 clothes I am now 135-140 and wear a size 6 clothes. Love it love it love it. Good luck
   — Joanc

June 5, 2008
yes...i have to agree with the first answer that was posted...you will need to try a new food each week....see if it agrees with you....like a baby trying new foods...works that way...but you'll do just fine...we all did...and you can too...*smilling* The surgeon will give you a book that you can follow....he follows you all through the process......God bless you in your decision....Linda
   — LindaA

June 5, 2008
There is a weight loss surgery that is statistically nearly as effective as the Gastric Bypass and does not have ANY of the side effects like Dumping and Mal-absorption. It is the Vertical Sleeve Gastrectomy. The biggest problem with this surgery is that it is considered "Experimental" by many insurance companies because it has not been done for more than 5 years in the United States, so there is no long term data HERE on the procedure. The procedure has been done in Central and South America and Europe for quite some time but the US medical institutions will not take the data obtained from those places since they do not consider them as reliable sources (as if the US sources are above corruption). The short of it is that many insurance companies will not pay for the Vertical Sleeve Gastrectomy to be done and will only pay for the Gastric Bypass or the LapBand surgery. Take this for what it's worth. I am telling you up front that I am NOT an "Expert" on Weight Loss Surgery. I am just a PATIENT that has done some research. I encourage EVERYONE to RESEARCH EACH surgical option FOR THEMSELVES! THIS is the information that I have found in MY research. I have posted it here for you in an effort to help GUIDE and you help you START your OWN journey into your OWN research. There are a LOT of differences in the different types of surgical procedures. There are a LOT of differences in different SURGEONS. Some surgeons require more of their patients than others. Some PROCEDURES require more of the patient than others. You need to do some research and find the BEST fit for YOU. I just had a Vertical Sleeve Gastrectomy on March 1, 2008. My surgeon did NOT require me to lose weight. I had a BMI of 43.6. Now that isn't NEARLY as bad as many people. Had I been HEAVIER, he may HAVE required it. I don't know. What I CAN tell you is that I was having problems with arthritis in my knees and my shoulder. That was almost three months ago. Now it is GONE. There is just a TWINGE every now and again but NOTHING NEAR the constant agony that I was in before! I was also a Diabetic 3 months ago. I have had to DROP all of my diabetes medications on Easter Day because the ONE glucovance pill that I was taking caused me to have my blood sugar to DROP to 53 POINTS! My sugars are still a LITTLE high, but under 150 (usually between 114 to 140 after a meal) and WITHOUT medication! In a FEW weeks with some MORE weight loss, I figure that my diabetes will be in COMPLETE remission! I have lost 59 pounds in a little over 2 MONTHS with my surgery (the VSG) and it was done WITHOUT feeling HUNGRY! From what I have learned, your MAIN options are the Lap Band, the Vertical Banded Gastroplasty, the Gastric Bypass, The Duodenal Switch and the Vertical Sleeve Gastrectomy. There are other options, I am sure, but these are the most common that I have found. There are also combinations of these options ALSO available such as the Banded Duodenal Switch, the Banded Gastric Bypass, and the Banded Sleeve Gastrectomy. The Banded options are basically the same as the Regular surgeries but they have a Lap Band added as additional insurance in case of future need. The Lap Band: (http://www.obesityhelp.com/content/wlsurgery.html#LapBand) is well known. It basically squeezes the stomach to make it smaller and creates a pouch with a restriction at the top of the stomach which fills quickly and empties slowly. The advantages of this surgery are that it is reversible if needed and it is adjustable if needed. It is a HIGHLY flexible procedure. This surgery is well known and accepted by many insurance companies. It may be best for people who have a history of cancer either themselves or in their family and may need to take chemo-therapy and for women in childbearing years who may become pregnant. There are also other reasons for wanting this type of surgery, but I don't want to spend ALL day writing this. There is an effective Excess body weight loss over 3 to 5 years of 50% to 60% noted in some studies. The PROBLEM with this option is that there are sometimes complications with this device. Some people have a reaction to the foreign object in their body. People with immune issues should NOT have this device. Lupus and MS patients for example, can have a reaction to the foreign body and it may trigger an immune system response. Other issues with the Lap Band are that it is common for the band to "Slip" on the stomach and cause the pouch to enlarge thus causing the person with the device to eat more and negating the purpose of the surgery. Some surgeons have started stitching the band to the stomach to prevent this from happening. It would be wise to ask your surgeon if you are considering this option if he does this. Other times people have learned to "Eat around the Band" and force the food PAST the band to fill up the rest of the stomach and thus defeat the purpose of the band. Actually, this is an issue with ALL weight loss surgeries. All can be defeated by a patient who is either ignorant or intent on doing so. It seems to be MORE common with the Banded options, however. Another issue with Banded options is that occasionally the bands will erode the outside lining of the stomach causing damage to the stomach that often needs repairs and calls for a removal of the band and or a revision to some other type of weight loss option. This happens in about less than 1% of the Lap Band Surgeries but it IS something that needs to be taken into consideration. In the Vertical Banded Gastroplasty: (http://www.obesityhelp.com/content/wlsurgery.html#VBG) (commonly known as stomach stapling) the surgeon makes a cut into the stomach to create a pouch. He sews the pouch and places a band at the bottom of the pouch. This banded option has less chance of the band slipping since the cut in the stomach holds it into place. It also has the advantage of being somewhat reversible but is not as easily reversible as the Lap Band. It is NOT as well known as it's more famous banded cousin, the Lap Band. There may be difficulties in getting this option with some insurance companies. It has many of the advantages and disadvantages of the Lap Band surgery with the exception that the Band does not tend to slip and let the pouch expand. The Gastric Bypass: ( http://www.obesityhelp.com/content/wlsurgery.html#RNY) is made when the surgeon cuts the TOP of the stomach off and creates a pouch. An OLDER version of this surgery left the stomach intact but had a line of staples that was used to create the pouch. This method is no longer in use much, if at all. The surgeon then takes a length of intestine and BYPASSES it. He takes the LOOSE end that is still attached to the intestines and sews it to the SIDE of the pouch that was created from the TOP of the stomach. The BYPASSED intestine is then attached to the side of the intestine that was connected to the pouch so that BILE from the bile duct can empty bile from the liver into the intestine. This option is often the DARLING of insurance companies. Many companies that won't pay for any OTHER Weight Loss Surgeries will pay for THIS one. THAT makes THIS surgery quite popular for many surgeons! This surgery has the advantage of being a HIGHLY effective tool in the arsenal of weapons against the foe obesity! It has an effective rate of weight loss and maintenance of 60 to 80% in some studies at 1 to 2 years. The DOWNSIDE of this weight loss option is that there issues of malabsorption of minerals and vitamins due to the bypassed intestine. This often leaves the patient reliant on his doctor for the special supplements required to maintain his or her health. Other issues are dumping, nausea, and vomiting. Dumping is basically when you have diarrhea that is caused by the intestine's inability to absorb the food that was eaten. Along with the diarrhea can come intestinal cramping, sweating, palpitations and other unpleasant side effects. Some people experience dumping with sweets. Others experience it with fats. Each person seems to have their own issues but whatever they are, they cause them to excrete the food that they ate before it was fully digested. Nausea and vomiting, while experienced by many in ALL weight loss surgeries is NOT experienced by ALL. It does seem to be MORE PREVALENT in the GASTRIC BYPASS and DUODENAL SWITCH patients according to the research that I have seen. The gas and foul smelling stool are also a result of the shortened digestive process due to the bypassed intestine in both the Gastric Bypass and the Duodenal Switch. There is also something called the "Mini Gastric Bypass" This was quite popular a while back but there where problems that were soon discovered that KEPT the procedure from becoming a popular option. You can read MORE about this procedure at this location: http://ezinearticles.com/?Mini-Gastric-Bypass---The-Ideal-Weight-Loss-Solution&id=361143 . This is a direct copy of the entry for the post on the Mini Gastric Bypass in the section defining the procedure under the Variations of the Gastric Bypass in WikiPedia. The quote begins here: "Loop Gastric bypass ("Mini-gastric bypass"): The first use of the gastric bypass, in 1967, used a loop of small bowel for re-construction, rather than a Y-construction as is prevalent today. Although simpler to create, this approach allowed bile and pancreatic enzymes from the small bowel to enter the esophagus, sometimes causing severe inflammation and ulceration of either the stomach or the lower esophagus. If a leak into the abdomen occurs, this corrosive fluid can cause severe consequences. Numerous studies show the loop reconstruction (Billroth II gastrojejunostomy) works more safely when placed low on the stomach, but can be a disaster when placed adjacent to the esophagus. Thus even today thousands of "loops" are used for general surgical procedures such as ulcer surgery, stomach cancer and injury to the stomach, but bariatric surgeons abandoned use of the construction in the 1970s, when it was recognized that its risk is not justified for weight management. The Mini-Gastric Bypass, which uses the loop reconstruction, has been suggested as an alternative to the Roux en-Y procedure, due to the simplicity of its construction, which reduced the challenge of laparoscopic surgery. It is claimed that construction of a long tubular gastric pouch reduces the risk of inflammatory complications, and renders it as safe as the RNY technique." While it has been CLAIMED that the change to a longer tubular Gastric pouch reduces the risk of inflammatory complications, there is little research that PROVES it. If you are interested in having this procedure done, keep this in mind. The entry for Gastric Bypass in WikiPedia can be found here: http://en.wikipedia.org/wiki/Gastric_bypass_surgery . Here is a short animation that shows what is done for the Mini Gastric Bypass: http://www.youtube.com/watch?v=OFQPLF9IjtI . The Duodenal Switch: (http://www.obesityhelp.com/content/wlsurgery.html#DS ) is the STRONGEST tool in this arsenal of weapons! Many surgeons think it shouldn't be used lightly and often only recommend the procedure for people with a body mass index OVER 50! In the Duodenal Switch, the surgeon REMOVES approximately 85% of the stomach including MOST of the region of the stomach that produces the hormone grehlin. Grehlin is one of the hormones that create HUNGER. Removing the section of the stomach that creates hunger is a HUGE feature of this procedure. The surgeons then sew the rest of the stomach back together and create a tube shaped stomach that resists stretching. The stomach varies in size depending on the surgeon and the patient but can be anywhere from 2 ounces to 6 ounces, perhaps more. The next step of this procedure involves bypassing the intestine just like in the Gastric Bypass. Instead of attaching the intestine to the SIDE of the stomach, it is attached to the BOTTOM of the stomach where the intestine used to exit. The bypassed intestine is then sewn at one end near the liver and the far end of the intestine is sewn to the intestine that was attached to the stomach to pass bile to the intestines as it does in the gastric bypass. This procedure is MORE efficient than the Gastric Bypass in losing weight. This option has an effective rate of weight loss and maintenance of 70 to 90% in those same studies. The downside when compared to the Gastric Bypass is that Insurance companies often do not know of this option and are often reluctant to pay for it. This option has many of the same issues as the Gastric Bypass. There are some severe malabsorption issues. There are often issues with dumping, nausea, vomiting, GERD (acid reflux), gas and foul smelling stools. Many surgeons have been reluctant to perform this surgery due to the severity of the complications that can arise. This is why it is often reserved for those who are considered severely morbidly obese. Many surgeons had looked for an alternative to this surgery which lead to what was initially considered a "Half Duodenal Switch" or as it later became known, the "Vertical Sleeve Gastrectomy." The Vertical Sleeve Gastrectomy: (http://www.obesityhelp.com/content/wlsurgery.html#VSG) (if you get the same picture as the Vertical Banded Gastroplasty, just scroll UP) is a GREAT tool to use in the fight against obesity. While not QUITE as effective as the Duodenal Switch, it is often JUST as effective as the Gastric Bypass without the severity of the side effects of EITHER of those two options. The Vertical Sleeve Gastrectomy initially started as an attempt to create a safer Duodenal Switch alternative. While early attempts were not as successful in weight loss reduction, this was mainly due to the fact that the surgeons were relying on the larger size stomach often used for the Duodenal Switch patients who often rely on the "Switch" part of the surgery for some of the weight loss. Once the surgeons started reducing the size of the STOMACH, the Vertical Sleeve Gastrectomy became a much more effective tool at helping the patient loose weight. In the Vertical Sleeve Gastrectomy, the stomach is cut and approximately 85% of it is removed. Just like the Duodenal Switch, most of the cells that produce the hormone grehlin are removed. This eliminates most of the hunger that the patient used to have, if not all of it. The stomach that is made from what is left is turned into a tube that is resistant to stretching. This tube is often designed to hold from 2 to 4 ounces of food or liquid. At this point the surgery is complete. The surgeons just need to close up and the patient needs to recover. The upside to this surgery is that it is simple and has one of the LOWEST rates of complications of all the weight loss surgeries. It also has one of the HIGHEST rates of excess weight loss with one study in California coming in starting at 58% to 77.9% loss in a ONE to TWO year study and one doctor in England reporting that 100% of his patients had a weight loss and maintenance OVER 70% at 6 YEARS of living with the Sleeve. He also reported that patients with hypertension, diabetes, impaired glucose tolerance, obstructive sleep apnea, asthma, or arthritis were all cured or improved after surgery. It has also been said that this is the ONLY recommended option for people with immune system problems. People with diseases like Lupus or MS can have this procedure because there is NO foreign object placed in their body. This also is one of the few recommended options for people with organ transplants. People with transplants need their intestines to metabolize their anti rejection medications. There are possible issues with GERD in this surgery as there are with the Duodenal Switch There are NO malabsorption issues with this surgery. There are NO additional foul odors. There is NO additional intestinal gas. While nausea and vomiting is common in ALL weight loss surgeries, it is NO MORE PREVALENT in the Vertical Sleeve Gastrectomy than in most of the other options. If needed, the Vertical Sleeve Gastrectomy can be easily converted to a Duodenal Switch should additional Weight Loss measures need to be taken at a later date. This act is called a "Revision." Having your Vertical Sleeve Gastrectomy converted to a Duodenal Switch would be said to be having a, "Revision of your Vertical Sleeve Gastrectomy to a Duodenal Switch." The Biggest DOWNSIDE to the Vertical Sleeve Gastrectomy is that it is considered "Experimental" by many insurance companies. While it has not been practiced HERE in the US as a weight loss option for very long (about 5 years or so) it has been done for QUITE a while in Central and South America and in Europe for quite some time. The surgery has been used HERE in the US for OTHER reasons for QUITE a while. It has been used QUITE effectively to treat stomach cancers and ulcers with good effect. These treatments have been done in the US for quite some time. There is a NEW option that is being explored for people that have had the RNY that may be expanded to include OTHER weight loss surgical options and possibly be used to REPLACE them in the future if it becomes approved for that use. This new option is called stomaphyX. The stomaphyX surgery basically takes a post down the INSIDE of the stomach and then FOLDS the stomach in upon ITSELF and makes the available volume INSIDE the stomach SMALLER. There is NO CUTTING on the abdomen or anywhere ELSE. All of the surgery is done through the esophagus. None of the stomach is removed or cut. At the moment, from what I have been able to find according to MY research, the device is only approved for use with Gastric Bypass patients to help make their existing pouches smaller. Permission is being sought to expand the device's use to other types of weight loss surgeries and for use on patients that have NOT had weight loss surgery but to be used in PLACE of traditional weight loss surgery. From what I have been able to find, this device has not been approved for this use yet. To find out MORE about this option go to this link: http://www.themorbidme.com/2007/09/stomaphyx-incis.html . Options for getting surgeries that are not paid for by insurance can be found if you are persistent. You can sometimes petition the company and get them to reconsider with a doctor's explanation. You can also self pay or take out a loan. Many times, the surgeries are cheaper in Mexico or other central or South American countries. Do some research to find your options. Not every surgery is going to be right for every person. Frankly, for ME, if I were an obese male with a BMI under 50 (which I am) or an obese woman NOT of child bearing age, I would choose the Vertical Sleeve Gastrectomy (which I DID). If I were an obese male with a BMI OVER 50, I would get the Duodenal Switch. If my insurance company would not COVER it, I would get the Sleeve. If not THAT, then the Gastric Bypass. I would keep working my way down the list until I found SOMETHING that I could get. If the insurance company wouldn't pay, I would try to take out a LOAN (this is actually what my wife did for me). If I were a WOMAN of child bearing years or a person facing the possibility of chemotherapy or some other health issues that would require periods when I would NEED more sustenance, I would want the flexibility of the Lap Band. The short of it is, Do YOUR RESEARCH and CHOOSE the right surgical option for YOU! If you can't get ONE option for a reason, at least get another! For the sake of yourself and the ones you love, do SOMETHING to fix the problem before it is too late. If you die due to health problems caused by obesity, it is TOO LATE! Whatever surgical option you choose, for whatever REASON you choose, we are ALL here for the same reason. We are here to HELP and BE HELPED. Please, let's respect each other. There are those on the OH boards that consider themselves to be "Experts." Most of these folks do not have any medical experience. They are patients just like me. It is best to take any advice you get on the OH boards with a grain of salt (if not the whole cellar). Some folks have a severe bias towards or against certain surgeries. There are folks who will TELL you that the surgery you are considering is WRONG and is BOUND to fail! IGNORE these people. Not every surgery is right for every person! DO YOUR OWN RESEARCH and and CONSULT with your PHYSICIAN or your SURGEON! I cannot stress the importance of doing your own research enough. There is a revised version of this post at my profile page. I have added some links to some web sites that have some interviews with some surgeons that perform weight loss surgeries and have videos that actually SHOW the surgeries. You can watch the surgeries being performed and get many of your questions answered by the surgeons as they explain what they are doing. They explain the positives and negatives of each procedure. My Profile page can be found HERE: http://www.obesityhelp.com/member/hubarlow/ . Look for a post called Surgical Comparisons. If you can't find the post on the profile page, look for the post in the March Archives. I hope this helps Hugh.
   — hubarlow

June 6, 2008
It is a step by step learning process. I am 4 yrs. post-op and still never try anything new unless I am at home. You cannot foresee which foods you will and will not tolerate. Consider all the benefits that you will be able to experience after surgery, the food issues take care of themselves. Good luck on your decision.
   — bariatricdivalatina

June 6, 2008
Simply, eat foods you know are good for you - meats/protein, veggies, fruit and limit other things. You can still eat any food, but do it in moderation. Some people have problems with certain foods, and others can eat anything. Keep sugars and fat to a minimum, and limit intake of process foods. Always try picking nutritious/healthy foods and drinks (no soda). If you decide on the bypass or any other surgery, it's best to get nutritional guidance from a professional. My surgeon's office has several nutritionists, and I see one each visit. As for agreeing or not, you'll know. Each person gets their own clues (runny nose was mine early out), and recently, it's just a feeling in my chest. I haven't dumped, but there are things that just don't work for me... milk, eggs, chicken. I will continue to try these things, and eventually, they might be OK. My body is still healing. (6 months post-RNY) I did have a stricture which caused 'feedback', so it put me behind on food progression.
   — gonnadoit

June 6, 2008
Beverly ... the trick is, you DON'T know what will disagree with you until you eat it (the old "learn by doing" routine) -- which, in the early days post-op, can be a little discouraging. I used to wail, "When will I EVER stop throwing up?" Eight years and change out from a VBG I still haven't stopped, because there's things that just don't agree with me. Most meat. Bread. Anything with mayonnaise in it or on it (makes it taste like it's gone bad). Fried stuff. I can eat sugar, but don't as a rule because I'm diabetic. Eggs, unless they're very sloppily scrambled. In a perverse way, I'm almost glad food can still make me sick -- tells me that even after all this time I haven't stretched my pouch beyond all redemption. Truth be told, you have to try stuff to see what "sets you off" and what doesn't. I still have a "three strikes and it's out" rule -- if I try a food and it makes me sick, I'll try it two more times before dropping it from the menu. I might try it again in six months or so (because your taste and tolerance does change over time), but only once or twice more. As well, sometimes it's just worth it -- sometimes that bite of cheeseburger that hurts for two hours is just what the doctor ordered. Best of luck --
   — Cheryl Denomy