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What will my long-term diet be like after bariatric surgery?
Patients who undergo bariatric surgery usually must completely transform the diet and activity habits they have spent a lifetime developing. Because this change can be difficult for many people, those interested in a surgical weight-loss procedure should carefully consider the postoperative and exercise recommendations.
Patients who undergo the two most commonly performed bariatric surgeries must adhere to the following long-term dietary restrictions:
Roux-en-Y gastric bypass
Postoperative patients will always eat more frequently than they did prior to surgery. The number of small "meals" consumed daily will vary among patients, from three to eight. Patients must not only adjust the frequency of meals and quantity of foods they eat but also learn to eat slowly and chew thoroughly.
In general, patients should eat only when they are hungry and stop eating when they feel full. In addition:
• Patients should drink fluids 30 minutes to an hour after meals. Taking fluids before or at mealtimes may cause bloating, inadequate food intake, vomiting, or dumping syndrome, a phenomenon caused by food passing too quickly through the digestive tract. Dumping syndrome causes patients to temporarily experience symptoms such as diarrhea, vomiting, dizziness, nausea, and heartburn.
• Highly refined foods and sweets of any kind—including sweetened chewing gum, candy, and sodas—are prohibited, as they, too, can cause dumping syndrome. Alcohol intake should be very limited.
• Foods high in fat are off limits because they can cause dumping syndrome and also because consuming high-fat foods is unhealthful as well as counterproductive for patients who have taken a dramatic step to lose weight.
• The consumption of high-protein foods is a must. Adequate protein promotes continued healing of the pouch and staple line, as well as overall good health.
In addition, patients typically must take three vitamin supplements for the rest of their lives after undergoing Roux-en-Y gastric bypass surgery:
• A multivitamin containing the full complement of water- and fat-soluble vitamins, iron, and zinc
• Calcium. Because the gastric pouch does not produce the acid necessary for the body to absorb calcium, a supplement—often calcium citrate, which is already acidified—is usually advised to prevent calcium deficiency.
• Vitamin B-12. The stomach pouch does not produce the protein necessary for the body to absorb dietary B-12, which helps prevent problems with spinal cord nerve function and progressive anemia. Vitamin B-12 supplements may be taken orally or via injection.
For the first three post-surgery weeks, the supplements should be chewable; after that, a pill form is preferred.
Lap-Band® procedure
Following discharge from the hospital, most patients who have undergone the Lap-Band procedure are instructed to gradually add soft, easily chewable foods as they are able to tolerate them. While some physicians may recommend vitamin supplements for certain patients, there are usually no restrictions on dietary intake except to avoid hard-to-digest foods and overeating.
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