After surgery, you'll need a new nutrition plan. Dr. Farid Zarif, Director of Bariatric Nutrition / Dietetics can assist you in attaining the best plan suitable for your lifestyle. You'll learn about the healthy changes you can and need to make in your food selections and daily diet. Along with daily physical activity. It's very important to follow your new eating and drinking instructions beginning immediately after the surgery.
"THE LAP BAND CAN!"TM
"The Lap Band Can!" TM (if used correctly), be the most effective tool for safe and healthy weight loss in the history of weight loss programs, diets and surgery. The Lap Band is a tool. A tool that, when applied with healthy food selections, moderate physical activities, and adequate sleep, can assist in reducing caloric intake, sustaining the unfed state, and increasing purposeful eating while minimizing impulsive food selecting.
"The Lap Band Can!" TM be a very pleasant experience when committing to and qualifying for the Lap Band procedure. The following are a few easy steps to insure a successful and most effective experience before surgery.
Allow at least 7 days to "Prepare" for your new Lap Band Lifestyle.
Then, After Surgery
Week 1: a 7 days Liquid Diet is required.
Week 2: a 7 days Pureed Diet is required
Week 3: a 7 days Solid Food Diet is required.
"The Lap Band Can!" be most effective in weight loss by eating whole solid foods.
Pre and Post-Surgery Diet and Physical Activity Instructions
Progression to solid food will vary w/ each individual.
Eat smaller portions two hours between meals.
2 Weeks Before Surgery
Progression to solid food will vary with each individual. Your band will not have any fluid in it until after your first adjustment.
Partial-Liquid Diet
Time Frame
2 weeks
Purpose
Preparation for surgery helps to reduce possible complications during surgery. Also to prepare the patient for the first 2 weeks of post surgery.
Do
THIS IS FOR ALL PATIENTS
Purchase Liquid or Powdered Protein (Ex: Opti-Fast, Iso Pure, Myoplex, Whey Protein Powder)
Available at local vitamins and health foods store. Any liquid high protein drinks (20-30 grams/serving plus with low-no fat and no sugar) are acceptable, including the popular "ready to drink" products
Drink 2 times per day
The shake should be taken for breakfast and lunch for two weeks
Drink plenty of liquids with the protein+
Water, diet juices, liquid soup
Carbonated and sweet beverages should be limited daily. Moderate 6-8 ounces pre day, then progressively discontinue.
Salads (no fatty dressings, just basics – lettuce, tomato, cauliflower, etc, lemon juice, vinegar , no olive oil, no creamy dressings)
and
Broth (thin clear broth, no creamy soups, no high caloric fattening soups)
THIS REGIMEN MUST BE ADHERED TO OR THE CASE MAY BE CANCELLED.
LAP-BAND DIETARY INSTRUCTIONS POST HOSPITAL DISCHARGE
Amount of food The surgery reduces the size of the stomach which limits the amount of food consumed to about 1 to 2 ounces (2 to 4 tablespoons). The diameter of this new stomach pouch's exit is also small which delays emptying. Overeating results in distressing pain and/or vomiting.
Frequency and duration of meals Because volume is limited and stomach emptying is delayed, it is important to eat and drink slowly patients start with an ounce of food (1 tablespoonful) over about 10 to 15 minutes. Eventually, each meal should take no less than 20 to 30 minutes. In the long run, eating about 6 small "meals" allows for a more nutritionally balanced diet.
Food texture Initially liquid meals are recommended until the stomach heals. The diet is progressed to puree foods to avoid blocking the small opening. Texture is advanced according to how well foods can be chewed. Taking small bites and chewing foods to a pureed consistency is essential.
Liquids Only small amounts of liquids should be consumed with meals. This prevents fullness and allows necessary foods to be eaten. However, liquids are crucial to prevent dehydration. They should be sipped between meals.
Nutritious foods Because the quantity of food eaten is reduced, it is important to select food with the best nutritional value. This is not only important to ensure healing after surgery, but also to ensure that weight loss occurs and is maintained in the long run. The psychological urge to eat will test the capacity of the gastric pouch with increased amounts and varieties of foods. It can be stretched and the purpose of the surgery can be defeated. Food intolerances vary from individual to individual. Vitamin, mineral and other nutritional supplements may also be indicated. It is important to work with a dietitian to ensure that "nutrient rich and calorie poor" foods are eaten.
Follow-up after surgery is essential to monitor weight loss, for blood tests to assess hydration, presence of specific vitamin, mineral, or other nutrient deficiencies, and psychological adaptation to lost weight and lifestyle changes. With time, a gradual increase in types and amounts of foods may be eaten. Within 1 year, most people stop losing weight and attention is directed to diet and lifestyle changes that maintain the weight that has been lost and to prevent regain.
When you are discharged from the hospital, you must continue to follow very specific instructions for about three weeks. You will return to your surgeon about one week after your surgery, at which time you will begin specific diet instructions as to what types of food you can eat. It is important to follow the instructions below:
(progression to solid food will vary w/ each individual)
WATER: 64 oz. (8 glasses) of water / day
Water helps the body metabolize fat, eliminates fluid retention, suppresses the appetite, maintains proper muscle tone, prevents the sagging skin that usually follows weight loss, eliminates waste, and relieves constipation.
After Surgery
Week 1 - Liquids, No Solid Foods
Time Frame
1 Week
Purpose
Drinking water helps the body metabolize fat, eliminates fluid retention, suppresses the appetite, maintains proper muscle tone, prevents the sagging skin that usually follows weight loss, eliminates waste, and relieves constipation. Liquids prevent dehydration, constipation, improves skin retract ability and helps the healing process
Do
Drink slowly (sips) and avoid gulping
Don’t
drink extreme hot/cold liquids
Examples
Water, liquid protein, meal replacement drinks, low-salted chicken or beef broth, bouillon, crystal light, unsweetened or diluted fruit juices, tea/coffee, sugar-free gelatin, popsicles, Italian ices.
Progression toward solid food, prevent discomfort/pain that may be experienced if the patient forgoes this phase.
Do
Drink slowly (sips) and avoid gulping, blend/chew food very well, eat/drink slowly, sit up straight when eating, use a baby spoon or teaspoon, stop eating before you feel full, put spoon down between bites.
Don’t
Drink while eating
Examples
Baby food, oatmeal, farina, mashed potato, tofu, soups (Without chunky vegetables and meat), creamed soups, etc.
Week 4 - 6 - Soft Food Phase
Time Frame
4 - 6 weeks
Purpose
Help to slow emptying of proximal pouch (New stomach) and sustain the unfed (without eating) state.
Do
Eat natural whole foods versus commercially processed foods. Include all food groups, eat dairy products sparingly.
Grocery
Choices
Select foods that will benefit your weight loss goal. Again, Eat natural whole foods versus commercially processed foods. Include all food groups, eat dairy products sparingly.
Your first adjustment should be at 6 weeks (If you need it). Make sure you have an appointment 6 weeks after surgery. Just call the office and make an appointment.
How do you know if you need an adjustment? The way the band works is that you will eat 4 ounces of solid foods and not be hungry for 2-3 hours. If you become hungry very quickly (within one hour or so you need an adjustment)
So, what is 4 ounces? The size of the palm of your hand is about 4 ounces. A smart phone, Blackberry, or iPhone is another way to estimate 4 ounces. So, you only want to eat a handful of food.
But you have to wait. You have to wait 20 minutes after a meal to see if you are still hungry. If you are not, then stop eating. If you are hungry, then you most likely need an adjustment. You do not have to feel full. We just do not want you to feel hungry.
Remember 4 ounces of liquid will not make you stop feeling full. So, soups alone may not satisfy you.
After an adjustment, you may have some swelling at your stomach. So, take liquids for 2 days. You can take in healthy protein shakes, sugar-free popsicles, or sugar-free jello. Then, purees (mushy foods) for another 2 days, and again introduce solid foods staying away from what you vomited. Why do we recommend that? You have swelling in your stomach after you vomit. Your stomach needs to rest so that the swelling can go away.
Do not eat too fast
Chew your solid food well
Swallow liquids slowly. Sip, do not gulp.
Wait between bites. You should wait at least 1 minute between bites
Avoid eating and drinking at the same time
No carbonated beverages
Stay away from doughy breads(other flour enriched foods) and well done steak
Stay away from starchy food (i.e. bread, pasta, noodles, cake)
Post-Operative Bariatric Medication and Supplements
Take supplements in the form of, an elixir (liquid) or chewable.
Supplements
Specially formulated for Bariatric concerns
Building Blocks- Essential Bariatric Supplements
Tylenol with codeine elixir
1 tablespoonful every 6 hours for pain when needed.
Dietary Tips
Remember: the new stomach can hold 1/8 cup to 1 cup
Drink at least 6-8 (8 oz.) glasses/day of water to improve retract ability of skin while losing weight, prevent dehydration and constipation.
Stop drinking water up to 5 minutes before meals and resume drinking, wait approximately 60 minutes after meals.
Consume small meals with 2 hours between each meal.
Chew food thoroughly until mushy and eat slowly.
Medications that may irritate the stomach: Aspirin, Advil, Aleve, Naproxen, Motrin, Celebrex, Vioxx
Pain Medication allowed: Tylenol, Tylenol with Codeine
Physical Activity After Surgery (Allow 3-5 days before returning to work)
Physical activity is a key component to being healthy and losing weight. Walking is allowed when you get home. Walk around at home but don’t overdo it. Once you feel tired, rest. Refrain from lifting over 5lbs.
Week 1- Walking (Very important, reduces the complications of blood clot)
Week 2- Treadmill, elliptical, or semi-recumbent bike (Program for slow movement)
Week 3- Jogging or repeat Week 2 with light resistance
Week 4- Light weight lighting (Up to 15 lbs for females and 25 lbs for males)
Important Fat Loss Helper
Pedometer- One of the most effective ways to track your daily physical activity is to wear a pedometer (A lightweight step counting device). On average, each person takes 5,000 steps each day. Each 2,000 steps is equivalent to 1 mile. Use a pedometer daily with your personal goal of 7,000 to 10,000 steps per day. Purchase a pedometer at Fitness Supply stores and Fitness Departments.
Call Nutrition Department at 310-273-8885, exts. 148, 149 and 157 for more information about the Lap Band Dietary Guidelines.
