Diet

Diet before surgery:

Every body should go on a liquid diet of about 800 calories for about 1 – 2 weeks before the operation. This should include skimmed milk, yoghurts, soups, pureed vegetables/meat/fish,& juice. This is a very important preparation to reduce the size of the liver to facilitate the operation and to make one fit for the operation

Diet after surgery:

This is exactly the same as before the operation. This is to help prevent disruption of stitches holding the band or breakdown of the staple lines resulting in anastamotic (join) leak. Every body should go on a liquid diet of about 800 calories. One needs at least 6 – 8 glasses of liquid a day.

Day of surgery and next 24 hours:

sips of water only (room temperature).

Day 2 – 6:

Introduce clear fluids i.e., fruit juice (unsweetened), clear soup, tea (no sugar), yoghurts, skimmed milk, sugar-free drinks. Sip very slowly; this is important so as not to create pressure on the anastamosis (join).

Day 6 – 4 weeks after the operation:

thick liquid diet as before the operation. It should include skimmed milk/yoghurts, soups, pureed vegetables/meat/fish, and juice

Resuming a solid diet :

There are 5 golden rules in eating:

1. Eat slowly
2. Chew well
3. Stop eating once you feel full
4. Do not drink liquids along with food; wait for 1/2 an hour before you drink
5. Eat nutritious diet.

After the first month post-op you can resume a solid diet. Start with soft diet first before you move to solids. Because you can still only tolerate small amounts (of well-chewed food) you will need to make sure that the food you eat is nutrient high in protein but not calorie dense. This means avoiding concentrated sources of calories, which contain few other nutrients, i.e. fat, sugar and alcohol. You should also continue to take your multivitamin / mineral preparation.

Try to include the following foods in your diet to ensure you meet your requirements for protein and micronutrients:

1. Growth and repair group i.e. protein foods:

Meat, fish, eggs, low fat milk products and beans. Include 2-3 small portions per day e.g. 60-90grams, (2-3oz) meat, 30-60g (1-2oz) low fat cheese.

2. Protective foods, containing vitamins and minerals:

All fruit and vegetables. Include 4-5 portions per day (unsweetened fruit juice counts as one portion).

3. Avoid or Restrict Energy foods, includes carbohydrates, fat and alcohol:

This is the group you most need to restrict. Choose one small portion (60-90g/2-3oz) of starchy foods at each meal, e.g. bread, potatoes, rice or pasta (choose the wholemeal or high fibre varieties where possible). Minimise fat cooking, avoid alcohol, sugar and puddings, except fruit or low fat yoghurts.

How to prepare pureed food

All foods must be smooth and not contain lumps. A liquidiser or food processor to puree foods is best. A potato masher can be used to puree soft vegetables and potatoes. A sieve and spoon can be used to remove lumps, pips and skin. When liquidising food use extra fluid to thin it to the required consistency.

Meat, chicken, and fish: Remove any skin, bones, fat or gristle. Puree to a paste, and then gradually add liquid.
Potato: Can be mashed with low fat milk. Liquidise if they are still lumpy. Instant mashed potato is useful and can be used without being liquidised.
Pasta: Soft pasta dishes liquidise well if extra sauce is added. Keep to low fat versions of spaghetti bolognaise, lasagne, or ravioli.
Vegetables: Cook until tender, drain and puree. The cooking liquid can be used to thin down the puree.
Fruit: Puree tinned, fresh or stewed fruit and extra fruit juice to the desired consistency.
Vitamins: A chewable or liquid mixture containing multivitamins, in particular the B complex, iron, Zinc and calcium are recommended.

General Dietary Guidelines following Obesity surgery

Vomiting will result if you eat too quickly, if you eat too much or if you do not chew your food properly. Once your body has adjusted, after the first few months following surgery, the frequency of vomiting should reduce.

1. For the first month following surgery, you should puree all food to ensure it passes through the narrow opening between the upper and lower stomach.
2. After the first month solid foods can be resumed but these must be chewed thoroughly, otherwise vomiting may result.
3. Eat 3 meals only per day and do not have extra snacks. Keep to small meals, as your stomach cannot manage large quantities.
4. Stop eating at the first feeling of fullness. Even one or two extra bites may cause vomiting.
5. Ensure an adequate fibre intake to prevent constipation.
6. If vomiting is persistent, rather than occasional, after the first few months, revert to a liquid diet for 1 – 2 days before resuming solids.
7. Do not try to induce vomiting to relieve symptoms of bloating or fullness, this will not help you to adapt to the banding.