What Can I Eat After Swedish Adjustable Gatsric Band Surgery?

The Swedish Adjustable Gastric Band (SAGB) procedure will have a major impact on your life and can help you lead a healthier life style with less risk of obesity-related secondary diseases. However, you will have to change your eating habits as well. Although the SAGB will help you to induce sustainable weight loss it is not a self-acting slimming device and your postoperative dietary and behavioural compliance is of essential importance for successful weight loss as well as in avoiding complications.

Each individual surgeon will have specific diet requirements for their patients, but the following are general recommended guidelines following SAGB surgery. Please consult your surgeon and dietitian on your personal diet requirements.

Weeks 1 & 2: Fluid Diet Plan

Day 1 after surgery: CLEAR FLUIDS

Drink small amounts (about 50 ml) slowly in small sips
Wait in between the sips for a minute or two
Have a drink (about 50 ml) at least every 20-30 minutes
Suitable clear fluids include:
- water, still not sparkling
- black tea or coffee
- cordial
- strained fruit and vegetable juices
- broth, Bovril, Bonox, stock
- jelly
- clear high protein nutritional supplement drinks, as suggested by your surgeon or dietitian.

Day 2 to Day 14: FULL FLUIDS

Continue to drink slowly in small sips
Wait in between the sips for a minute or two
Gradually increase the volume of drinks from 50 ml to 120 ml over the first week. Then increase as tolerated to no more than 200 ml per drink
Choose liquids that are thin enough to pass through a standard siping straw. Suitable fluids include:
- all fluids on the clear fluid list (above)
- milk, thin milk shakes and thin smoothies
- thin, strained soups (these do not need to be clear)
- milky high protein, nutritional supplement drinks as suggested by your surgeon or dietitian

Weeks 3, 4 & 5: Pureed Diet Plan

The following is a guide only. It is important to follow the recommendations given to you by your surgeon or dietitian. Their recommendations may vary slightly.

Introduce puree/mushy consistency foods – much like baby's first foods.
Use a blender or bar mix to achieve a smooth consistency.
Your portion size should start at around ? cup. This may increase over the next three weeks, but should not exceed 1 cup (200ml).
Include at least 3 regularly spaced meals ie; breakfast, lunch and dinner.
If you are getting hungry
- add a small snack between meals
- choose thicker blends
try to include a source of protein (blended meat, chicken, fish, eggs, legumes or lentils), with each meal
Eat slowly, using small spoonfuls and practice your chewing.
Concentrate on your meal. Do not do anything else while eating.
Suitable pureed foods include:
- Yoghurt (no lumps) – low fat preferred
- Reduced fat ricotta or cottage cheese
- Reduced fat/ reduced sugar mousses, diary desserts, custards and ice-cream
- Fruit puree – fresh or canned.
- Mushy breakfast cereals eg; Weetbix soaked with milk
- Thin porridge
- Mashed potato
- Mashed baked beans
- Pureed vegetables
- Blended casseroles containing meat, chicken, fish, lentils, legumes, vegetables and rice/pasta
- Very soft white fish may be mashed with a fork, rather than pureed.

NOTE FOR WEEK 5

If you experience hunger, you may be ready to increase the consistency of your food at week 5 post surgery. Try introducing the following:

A small piece of soft, white fish wish sauce, eg white sauce
A scrambled or poached egg
Soft cooked vegetables, fork mashed
Minced meat or minced chicken in gravy or sauce

Fluids

It is important to separate fluids from foods. Stop drinking 10 minutes before you are due to eat and wait 30 minutes after eating, before drinking again.
Drinking fluids with foods may ‘flush’ the food through your band before your brain is able to register that you are full.
Continue to drink adequate fluids between your meals (about 2 litres per day).
Stick to 200 ml as the maximum volume of fluid taken at once.

Week 6 onwards : Introduction of solids

The timing of the introduction to solid foods will vary between surgeons.

Most commonly this occurs at week 5 or 6 post surgery. Ensure you follow the recommendations given to you by your surgeon or detitian.

Starting solids is a return to healty 'normal' consistency foods, much the same as you would have had prior to surgery. However, the amount you will be able to eat will be much smaller.
Use a small plate (entr?e sized) to ensure your meals are appropriately sized.
Eat slowly, taking small mouthfuls.
Chew your food well - much longer than you have been used to prior to the operation.
Enjoy what you are eating and concentrate on your meal. Do not do anything else while eating.
Be aware of your eating habits.
Stop eating immediately when you feel full, even if it means leaving some food on your plate.
Avoid "grazing" - it is better to stick to regular meal times.
Include one or two snacks to avoid getting overly hungry. This can cause you to eat too fast and not chew your food enough.
Suitable food choices cover the main food groups
- Vegetables – start with soft cooked, and progress to firmer options, including salads. Some stringy, fibrous vegetables may need to be eaten with caution eg; raw carrot, asparagus, leaf spinach, cauliflower and broccoli stalks, green beans with the string, leeks and cabbage. Chew well.
- Fruit – start with peeled fruit, cut into small pieces. Progress to fruit with the skin as tolerated. Chew well.
- Meat and alternatives : Choose tender, lean meat, chicken and fish. Minced meat and poultry, tender casseroles and wet dishes as well as juicy cuts are better tolerated eg; chicken thighs. Caution will need to be paid to stringy and dry meats such as steak and chicken breasts. Chew well. Eggs, legumes and lentils are usually well tolerated.
- Bread and cereal products: Doughy or fresh bread (especially white, tends to get stuck in the gastric band. Choose less doughy options such as crackers (low fat) and well toasted wholegrain breads or flat breads. Breakfast cereals, grains, rice and pasta dishes are usually well tolerated.
- Dairy foods are generally well tolerated. Choose reduced fat options.
- Fats and oils –use sparingly to assist with weight loss.
In the long term, you should try to eat as normally as possible (like the rest of your family and freinds) but in smaller quantities.

FLUIDS
- Continue with the fluid recommendations given in the above section.
- Make sure you drink enough (at least 2-3 litres per day) of low-calorie or calorie-free liquids
- Drink mainly between meals rather than during a meal.
- Please have on you mind that liquids pass freely and very quickly through the narrow area created by the band on your stomach. It is easy to take more calories than intended by this
- High-calorie drinks (sugar sweetened, alcohol etc) as well as ice creams may prevent weight loss or even make you gain weight, so try to avoid them
- If feelings of faint and dizziness occur it is often due to insufficient fluid intake. Keep your fluids up.
- Inadequate fluid intake may lead to constipation.

Adjusting the gastric Band

After about 4-6 weeks, the gastric band will have healed into place sufficiently for the system to have its first filling. Again the timing of this will vary with the surgeon.

Following are some considerations for band fills.

After each band adjustment, make sure you try a drink of water before you leave the surgeon’s rooms. This is to check you can get fluids through the gastric band with no problems
After fillings, you may find that the reduction of the amount you can manage causes you some eating difficulties at first. This is generally due additional restriction caused by theswelling/inflammation of the stomach wall.
This makes it particularly important to eat slowly, chew well and drink enough fluids between meals.
If you experience difficulties, you can go back choose foods that are mushy until the swelling has reduced.

For more dietary information talk to your bariatric surgeon or dietitian.

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