NO VITAMINS FOR THE FIRST 2 WEEKS AFTER SURGERY

For the first 2 weeks after surgery you will be on a thin liquid diet. Anything that is thin enough to be sipped through a straw is fine. For example, choose beverages like Gatorade diet or regular ice teas, crystal lite, broth, skim milk, juice, vegetable juice, tomato soup, water, coffee, tea, ices. No Jello. Avoid carbonated drinks as they may stretch your new pouch and cause gas. Drinking straws may cause gas too, and should be avoided. You are permitted to have high calorie drinks during the first 2 weeks only. After 2 weeks you will switch to sugar free/no calorie beverages.

Include 2 protein shakes per day. You may have a premade shake such as Ensure Lite, Slim Fast, Glucerna, Ultra Pure Protein or prepare your own. To prepare your own, blend one scoop of a protein powder such as Designer Protein or GNC Challenge into 4 oz of liquid (preferably milk) with some ice. Carnation Instant Breakfast, ALBA mix, Weight Watcher shake mix can be used as well.

Limit fluid intake to sips at a time. Sip your fluid slowly. Do not gulp. HINT: Drink fluid as if you were drinking hot tea. This will prevent your pouch from stretching, and prevent nausea/vomiting. Reminder: No vomiting in the 1^st 6 weeks as it can cause the band to slip.

Adequate hydration prevents dehydration and constipation. Have a goal of consuming 6-8, eight oz glasses of fluid per day.

Medications (if large) will be chewed or crushed for the first 2 weeks after surgery. NO VITAMINS FOR THE FIRST 2 WEEKS AFTER SURGERY

Pureed foods will be started 2 weeks after surgery. Focus on a balanced healthy diet with an emphasis on protein and nutrient rich foods. Sample food ideas are included in this packet.

A long-term goal is to eat 2-3 meals a day. Start this habit while on pureed diet. Eat only when you are hungry. Avoid snacking, which will slow down weight loss.

Note: You can stop taking the protein shakes once you are started on the pureed diet. You may wish to replace a meal (i.e. breakfast) with a shake.

Remember to take your time at meals. Chew food thoroughly otherwise vomiting will occur. Limit yourself to one teaspoonful, or less, of food at a time to allow yourself to chew thoroughly.

Stop eating when full. The new small pouch can only hold about half a cup to one cup of food per meal. You may regurgitate your food, become nauseous or experience pain if you overeat. Learn to listen to your body.

Vitamins – It is suggested that you take a daily multivitamin at this time. PREFERABLY THE DOUBLE X VITAMINS. It is also recommended that you take a calcium supplement.

Medications – you may swallow your medications at this time.

Fats and Oils Limit 2-4 tsp.

Beverages 6-8, 8 oz / day

Shakes (i.e. Slim Fast) may be used as a meal replacement.

Blended soups can also be a meal. Blend any soup in blender/food processor and serve.

You will advance to a regular diet in 4 weeks. There will be certain foods to avoid such as red meat, doughy bread, dry white meat poultry and fibrous foods (such as asparagus and spinach). The white parts of citrus fruits (the membranes) will not be digested and should be removed before eating these fruits.

Texture is your friend! Soft foods and crunchy foods will go through your stomach smoothly. Foods that tend to “glob up” are more likely to get stuck such as dry white meat chicken, steak and pizza. You can have toasted bread, crackers, dark meat poultry and ground meat.

Do not drink with your meals. The operation works only if you eat solid food. If you drink at mealtimes, the food becomes liquid and the effectiveness of the Lap-Band is greatly reduced. Wait 5 minutes before and 2 hours after meals before taking liquids.

Increase your activity!  Exercise can help burn calories, preserve lean muscles mass and will help you lose weight. Check with your Doctor before you begin any exercise program.

High calorie, high fat and high sugar foods or drinks will sabotage weight loss efforts and should be avoided.

Include 1-2 shakes (Slim Fast, Ensure Lite, Ultra Pure Protein, Myoplex Lite, etc.) every day!  They will help give you energy and protein.  It will help promote with healing and help preserve muscle.

Shake idea:  take 4 oz milk, crushed ice, and blend with 1 scoop protein powder (i.e. Designer Whey) to make a protein smoothie.

HINT: The first two weeks are the most challenging! It is suggested that you avoid watching TV during this time due to the large number of food commercials.  Choose other activities such as reading books, knitting, writing, using the Internet, talking on the telephone, etc., to help keep your mind off of food.

Each MEAL SHOULD BE CENTERED AROUND A PROTEIN RICH FOOD (I.E. EGG, CHICKEN, FISH).  Always eat your protein first, then vegetable and fruits.  Save your starches (rice, cereal, bread, pasta, potatoes) for last.  You should limit starches.

If you experience increased hunger in the first 2 weeks, drink more calorie rich drinks (i.e. slim fast, milk).  Do NOT advance your diet prematurely as you will increase your chances of band slippage.  You are on a liquid diet to help promote healing.

If you experience excess gas make sure you are not using drinking straws as it promotes swallowing excessive gas.  Other possible causes of gas include Lactose Intolerance, high consumption of sugar free foods, excess dietary fiber, and calcium carbonate.  Make the appropriate changes if needed.  For example, try Dairy Care, lactaid milk or soy milk if you are lactose intolerant.  Talk to the MD or RN about products such as GasX, Mylanta or Beano to help reduce gas.

If you experience constipation, increase fluid, dietary fiber and physical activity as medically feasible.  Fiber rich food include beans, oatmeal, fruits, whole grain breads and high fiber cereals.  Add fiber slowly into your diet to avoid stomach upset.  Increase your fluid intake as you increase your fiber intake.

It is recommended that you keep a food journal.  This will help you keep track of your eating habits.  Bring the food journal to your nutrition follow up visits to review your progress with the nutritionist.

It is very common to hit a weight loss plateau (weight loss stops for a period of time).  Most people will experience one or more plateaus during their weight loss journey.  This is NORMAL!!!  Your body is becoming more adjusted to consuming fewer calories.  At this time review your diet and eating behaviors.  Are you consuming “soft calorie” foods (i.e. ice cream)?  Are you drinking at your meals?  Review the original guidelines in this packet and adhere to them.  Meet with you nutritionist to review your diet.

When you come in for an adjustment (a “fill”) you will be placed on a FULL LIQUID DIET for the first 2 days.  The following 2 days (day 3 and 4) you must be on a mushy/pureed diet.  You may resume regular foods on the 5^th day after your fill.