10 Andover Road
Portland, Maine 04102
207-761-6642
www.cascobaysurgery.com

Bariatric Surgery Program
Post-Operative Nutrition Handbook (LAP-BAND)

Introduction

Lap-Band surgery is a “tool” for you to use to help you lose weight. Most people who use the “tool” correctly can expect to lose about 75% of their excess body weight over about 5 years after surgery. It can be an effective means of losing weight and keeping it off. But in order to make it successful, you must know how to use this tool.

The surgery works in several ways that make is easier for you to eat fewer Calories:

Because you will be eating very small amounts, it is important for you to focus on eating healthy foods so that you do not become malnourished or fall into habits that could cause you to later regain your lost weight. You will still need to choose foods low in sugar and fat in order to lose weight.

Unlike gastric bypass surgery, there is no intolerance to sugar or malabsorption with Lap-Band surgery. Weight loss occurs more slowly compared to gastric bypass, but can occur over a longer period of time. Another difference between the two surgeries is that the Lap-Band is adjustable. A port placed under the skin makes it possible to adjust the amount of fluid in the band, which can make it tighter or looser as needed. It is necessary to return to Maine Medical Center ’s Bariatric Surgery Center for Lap-Band adjustments, which can only be performed by our surgeons and nurses.

The First Month

In order for your lap-band to become set in place on your stomach, you will need to follow a diet of smooth, blended foods for the first month after your surgery.  Eating solid food with more texture can cause the band to move out of position.

It is important to drink enough fluid. You need 6-8 cups of liquid per day, which is normal before and after surgery. You may need more in hot weather or when you exercise. You may need to drink slowly to prevent discomfort. Bring liquids with you wherever you go so that you do not forget to drink. 

Avoid high Calorie beverages. These include alcohol, cream in your coffee, milkshakes, frappes, juice cocktails, fruit drinks, fruit punch, and other sugar-sweetened beverages.

In order to avoid taking in excess air, you should avoid carbonated beverages.

Avoid sweets or added sugar due to their Caloric content. It is okay to use sucralose (Splenda), aspartame (Equal or Nutra-Sweet), or saccharin (Sweet ‘N Low).

The normal stomach holds about 5 cups of food. After Lap-Band surgery, the upper part of your stomach will hold much less. Eating too much will cause pain and discomfort and may cause vomiting or regurgitation. Eating the wrong foods or eating too much during the first month can cause the band to dislocate. 

You are likely to feel full with a small amount of food. Stop eating when you feel full, or limit your meals to one-half hour. Typically you will eat less than one-half cup of food at a meal. Eat three meals daily and avoid snacking or “grazing” between meals. Drink liquids between meals, waiting one-half hour after drinking before eating, and one hour after eating before you resume drinking.

Food Suggestions & Examples for the First Month (by food group)

Meat group and vegetarian protein sources

blended meats such as chicken, turkey, or beef
strained baby food meats
blended beans (e.g. navy, pinto, chickpeas, lentils)
fat-free refried beans
hummus
blended tofu

Dairy group

plain or lite yogurt
skim or Lactaid milk
fat-free or low-fat cottage cheese, small curd

Vegetable group

vegetable juice (e.g. tomato, carrot, V-8)
blended cooked vegetables

Fruit group

blended unsweetened fruit
100% fruit juice (limit to ½ cup per day)
applesauce
baby food fruit

Starch group

Hot cereal (e.g. oat bran, cream of wheat, cream of rice)
Blended low-fat soups

It is okay to blend foods together. Casseroles or stews often blend well. You may need to add liquids to foods before blending. For example, add milk or broth to foods before blending. All foods must be smooth during the first month.

You may use the following beverages:

water
skim milk
100% fruit juice, ½ cup limit per day
V-8 or tomato juice
Fruit 2-0 or other flavored non-carbonated, no-calorie water
Crystal Lite
Tea, coffee, iced tea without cream or sugar
Yogurt or fruit smoothies made without sugar or cream

You may use any of the following complete nutrition products or protein supplements as needed to meet your protein needs. 

Your Protein Diet

You will eat fewer Calories than your body needs while you are losing weight, but you still require the same amount of protein as usual. Consequences of a low protein intake include hair loss, poor healing, depressed immune system, weakness, and fatigue.  You should choose high protein foods first and add other foods later as your intake improves.

Most women should take in at least 50 to 60 grams of protein daily. Men usually need 60 to 75 grams daily. Some people may need more. You can keep food records and check your protein intake to make sure you are getting enough.  Use the “Nutrition Facts” section of the food label to find out how many grams of protein are in the food you are eating. Be sure to compare the portion you eat to the portion listed as a serving.

Foods highest in protein are in the Meat and Dairy groups. You can also obtain significant amounts of protein from liquid nutritional products. Here is a listing of various foods and supplements and the average amount of protein they contain:

After the First Month

You may start to return solid foods to your diet after the first month. Some foods may not pass easily through your band, causing discomfort and regurgitation (vomiting). Foods most likely to cause problems are stringy foods and foods that may swell. You should avoid the following foods:

Celery
Asparagus stalks
Broccoli stalks
Artichokes
Popcorn
Coconut
Pineapple
Rhubarb
Dried fruits
White bread
Pasta
Some meats, unless ground

Remember that your goal is weight loss, so you should avoid high Calorie foods such as sweets, cream, creamed foods, fried foods, fatty meats, alcohol, or large amounts of added fats. Especially to be avoided are liquids that are high in Calories, as they may pass easily through the band while adding more Calories to your diet. 

Other Considerations  

Because you are eating less and may not obtain all the vitamins and minerals you need, it is recommended that you take a multivitamin/mineral supplement. A chewable vitamin such as Chewable Centrum or Chewable Viactiv Multivitamin is recommended for the first month. After that, you can continue with the same product or switch to a vitamin in pill form.

You should eat slowly and chew thoroughly. Stop eating when you feel full. Continue to eat 3 small meals per day. Avoid snacking between meals to keep your Calories low. Continue to separate liquids from solids.

Your band can be adjusted to make it tighter or looser as needed. This must be done by one of our surgeons or nurses and cannot be done elsewhere.

Don’t forget to exercise. Best of luck with your weight loss!