Dietary support information

Dietary support
A dietitian will provide you with nutritional and dietary counseling as part of the work up to having your banding operation and as part of your regular follow-up following surgery.

Make a commitment to your health
Severe obesity is associated with a shorter lifespan, increased risks of other health problems and social impairments. Management of severe obesity must be considered a long term commitment to your health. Obesity surgery involves life-time changes – what you eat, the way you eat, when you eat and how you eat. You can only enter into this with a serious commitment to change your lifestyle and to focus on health, nutrition, exercise and the long term welfare of your body and mind. Lifelong behavior modification creating an ongoing lifestyle change is vitally important in maintaining long-term weight loss. The surgery provides the first step and then it’s up to you to climb the stairs.

What about your surgery?
Gastric banding is a major operation and should only be done by surgeons that are properly trained in this procedure. The surgery requires a general anaesthetic and you may require some further tests prior to having the anaesthetic. The band is inserted via laparoscopic surgery or “keyhole” surgery and forms a ring around the stomach. It divides the stomach into two pouches communicating via a narrow passage, somewhat like an asymmetrical hourglass (smaller section on top). The surgery involves making 5 small incisions on your abdomen through which the surgeon passes a telescope, long instruments and the band.

The tail of the band is then brought out through one of the skin incisions and it is fastened to the injection reservoir. The reservoir is then placed quite superficially under the skin. The incisions are then glued and dressings applied. The band itself is not sutured to the stomach so therefore reduces the potential of any bleeding and or infection.

There is always a very slight chance that the surgeon may need to place the band via open abdominal surgery.

The bands balloon will not be inflated or adjusted for at least 2 months following surgery – this allows the body time to heal and scarring to form around the band.

You will wake up in the recovery area and remain there until completely awake before going back to your ward.

You are encouraged to mobilise as soon as possible after returning to your bed. Normally you can go home the following day if there are no complications.

What you can expect following surgery?
Some nausea and vomiting is normal and should settle within 24 to 48 hours. The surgeon will arrange your first post operative visit to her in her rooms however the band will not be adjusted for 8 weeks. Initially you may feel some constriction and this is fine. If you are having problems swallowing fluids or persistent vomiting, pain or fever then you need to contact your surgeon.

Can normally shower the next day, bath or swim after 15 days. Wait at least 4 weeks before any sport or gym activities.

Dietary advice following surgery
(This is a guide and your surgeon and dietitian will provide more extensive information.)

After surgery:
The evening and day one after surgery – clear fluid only. (water, tea, coffee, clear soup). Commencing with sips only.
Day 2,3,4 – free liquids.
Day 5-13 (9 days in total) - Pureed food
Day 13-19 (1 week)- Soft Food
DO NOT START ON THE SOFT DIET UNTIL CONSULTATION WITH RHIANNON BARNES
Day 20 and beyond - Full diet

Try other foods once you have adjusted to eating the easier to eat foods. Food tolerances will vary greatly from one person to another. Test different foods – type, quantity and size of pieces. You will soon become aware of your limits and learn to adjust.

8 golden rules

1. Must eat very, very slowly – avoids overfilling the pouch. Allow a few minutes between mouthfuls and make sure the food had is in the pouch before taking another mouthful.
2. Chew thoroughly – chew until pulpy, eat in small mouthfuls and is mixed thoroughly with saliva.
3. Carbonated (fizzy) drinks and effervescent medications are strictly prohibited. The gas bubbles in these liquids will expand your small stomach “pouch”, which will transform it into a second large pouch – making your gastric band useless.
4. Do not drink with your meals - must drink in between meals only – otherwise the volume of food and fluid will be too great for the small pouch and you could vomit.
5. Cut your food into very small pieces before putting in your mouth.
6. Chew your food thoroughly and swallow slowly.
7. STOP eating as soon as you detect the first sign of fullness – one spoonful more and you may vomit.
8. Exercise. At least twice a week include some form of physical activity appropriate to your ability.

If you are incapable of swallowing anything, even water – call your surgeon immediately.