Your Diet Before Surgery
Before your surgery you will be required to go onto a Very Low Calorie Diet (VLCD) to help shrink your liver. You will lose weight by following this diet before surgery and reducing the size of your liver will help to decrease your risk of complications during surgery. At your preoperative appointment your Dietitian will advise you on the best meal plan for you to follow, appropriate meal replacements to use and the length of time required. A potential side effect is constipation. It is important to consume adequate fluids and fibre supplements may be required.
Your Diet After Surgery (Adjustable Gastric Band, Sleeve Gastrectomy, Gastric Bypass)
Initially after surgery you will be on fluids for two weeks. During this phase your body needs nutrients to heal and to maintain your energy levels and general health. Your dietitian will provide you with appropriate fluid choices to help meet your body’s requirements. When on the fluids phase it is important that you sip fluids slowly over the first week and gradually increase them to a rate and volume that is comfortable.
It is important that you follow these guidelines carefully – if you were to eat solid food or drink large amounts of liquids quickly you could cause damage to the surgery that has just been done.
Following the fluid phase, your dietitian will guide you onto either a puree or a soft diet depending on which surgery you have had. Do not commence either the puree or soft diet until two weeks after surgery and ONLY after you have seen your dietitian and/ or doctor. Commencing sooner can cause unnecessary complications. If you have tolerated a soft diet with limited discomfort you will be progressed onto normal diet textures and variety. Portions tolerated will vary depending on the surgery you have had.
Dehydration and constipation can occur in the diet phases after surgery. It is important that you monitor your fluid intake to stay hydrated. If you are having problems with the regularity of your bowels you can try prune juice or a fibre supplement.
As a result of your surgery your stomach is now reduced in size. Because of this it will be necessary to make changes to your diet and eating patterns. It is important that you discuss your dietary management with your dietitian as you progress throughout the different dietary phases to ensure your new smaller stomach does not get damaged. Your dietitian will also guide you on achieving the best outcomes for your long term weight management.
Your Diet After Surgery (VBLOC)
Recovery after VBLOC surgery is quite rapid and does not require any special dietary restrictions as there has been no interference to the stomach. So other than remaining on fluids immediately post-surgery until the hospital staff allows you to eat, you can then start eating normal foods as you feel comfortable. After VBLOC surgery it is common to have an extremely small appetite initially so your portions will certainly be very small. This settles as time progresses but you will always feel more satisfied hence eat smaller portions.
Dietary Guidelines for Long Term Success
Each of the weight loss surgeries are a tool to help you achieve long term weight loss with healthy eating behaviours and food choices. Your dietitian will help you achieve a positive relationship with food through dietary changes and improved eating awareness skills. It is very important to adopt the behaviours and changes your dietitian suggests to you as they will go a long way to ensuring longer term success.
Your surgery will have reduced your portion size nicely, but the quality of the foods you are eating and the fluids you are drinking will be critical to ongoing weight loss and then weight maintenance. The surgery can only do so much – it is up to you to make sure your diet is not ‘letting the team down’ in your weight loss journey.
Some basic dietary guidelines that your dietitian will be reinforcing include ;
- Reduce food portions -: If you have had a band your portion will be similar to a cupful of food when it is a wet dish or bread and butter plateful if the meal is more solid. For sleeve and bypass patients your portions may be smaller and your dietitian will guide you to what would be suitable. For VBlock your reduced appetite will determine portion size – your dietitian and nurse will help you with recognising ideal portion sizes. It is important to follow the recommended portions with each procedure to minimise the risk of stretching the stomach.
- Limit your fluid intake at meal times -: Be very careful to drink only small amounts of fluid with meals. Too much fluid can ‘overfill’ and increase the risk of vomiting or contribute to stretching your stomach size. Small sips during a meal should be OK but larger volumes should be avoided. There is no need to avoid fluid intake with food with VBLOC.
- Consume low calorie fluids -: As fluids are easy to consume with all of our surgical options, a mistake some patients make is drinking high calorie fluids such as soft drinks, alcohol, fruit juices, flavoured milks etc. Your dietitian will give you advice regarding how much of these high calorie fluids can be included in your diet.
- Choose low fat -: In general, meals need to be as low in fat as possible as fats are a significant source of calories. It is important to use low fat dairy products and lean meats in your daily intake to reduce your calories and intake of saturated fats. Minimising the use of oils, cream, butter, coconut milk and other high fat products when cooking also helps to control calories. Your dietitian will assess your current diet and make suggestions how to reduce fat intake and improve cooking methods.
- Increase your fluids -: It is important to drink at least 1.5L or more/day of no or low calorie fluids, preferably between meals. Good low or no calorie fluids include water, tea, coffee, diet soft drinks and diet cordials.
- Eat slowly and chew your food thoroughly -: It is very important in all surgical procedures to allow foods to safely pass through the stomach. Discomfort and vomiting can occur when food is poorly chewed or rushed – take your time !Try and avoid foods that tend to ‘stick’ -: If you have a band then foods can stick at the band junction or get stuck passing through a sleeve or bypass. Some foods that tend to trouble patients include fresh bread, dry meat or chicken, stringy fruits or vegetables (eg. pineapple, orange, stalks etc.). Your dietitian will discuss this with you in more detail.
- Learn to savour food and be mindful -: It is important that you learn to enjoy good quality, tasty foods but in small portions. When eating, focus of engaging all of your senses to get good satisfaction. Think about what the food looks like, how it smells and tastes. Limit meal time distractions such as watching TV to help manage your intake and concentrate on the enjoyment of the meal and chewing it thoroughly.
- Minimise non-hungry eating -: It is not uncommon to eat for reasons other than hunger. Reasons for non-hungry eating include boredom, stress, emotions etc. Your dietitian will help you learn to identify and manage physical hunger, fullness and non-hungry eating behaviours.
- Vitamin Supplements -: You will have had a full nutritional blood test analysis done pre-surgery and any nutritional deficiencies will have been identified and appropriate supplements prescribed. It is recommended all patients take a multivitamin to cover any potential nutritional deficiencies that could arise from eating reduced food portions post-surgery. Tablet multivitamins are appropriate but if swallowing these becomes difficult, then there are some good liquid and chewable multivitamins available which can be discussed with your dietitian.
- Dietitian Reviews -: It is important that you continue to see your dietitian to achieve the best long term outcomes and to ensure you are achieving weight loss in a healthy way. Your dietitian will continue to work with you to develop healthy eating patterns and behaviours with a wide variety of healthy food choices.