Lap band surgery, also known as adjustable gastric banding, is a weight-loss procedure involving the placement of an adjustable band around the upper part of the stomach. This band restricts the amount of food the stomach can hold, leading to reduced hunger and promoting weight loss. The success of lap band surgery is heavily reliant on adhering to specific dietary guidelines, both before and after the procedure. These guidelines are designed to ensure proper nutrition, prevent complications, and maximize weight loss outcomes. This article provides a detailed overview of the lap band diet, encompassing pre-operative preparations, post-operative stages, and long-term lifestyle changes.
Pre-Operative Diet
Before undergoing lap band surgery, patients typically follow a pre-op diet plan tailored by their physician. This diet aims to reduce liver size, making the stomach more accessible during surgery, and initiate weight loss.
Post-Operative Diet: A Phased Approach
The post-operative diet after lap band surgery is structured in phases to allow the body to heal and adjust to the changes in the digestive system. The progression through these phases is gradual, ensuring the stomach pouch is not stretched and complications are minimized.
Phase 1: Clear Liquid Diet (Day 1 in the Hospital)
Immediately following surgery, patients begin with a clear liquid diet. This phase is crucial for keeping you hydrated. Acceptable liquids include:
- Water
- Clear broth
- Caffeine-free tea
- Sugar-free JELL-O
Phase 2: Full Liquid Diet (Days 2 to 14)
The full liquid diet starts 2 days after your surgery and lasts for 2 weeks. Full liquids are foods that are normally liquid and foods that turn into liquid when they are at room temperature.
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During this phase, the diet expands to include thicker liquids that are high in protein and low in fat and sugar. The goal is to consume small portions that will empty easily from the pouch. Examples of suitable options include:
- Sugar-free pudding (made with Fairlife milk or with added collagen protein powder or non-fat dry milk powder for extra protein)
- Cream soups (celery, mushroom, chicken, broccoli, etc.)
- Homemade blended liquid soups (e.g., butternut squash soup, carrot ginger soup)
- Sugar-free popsicles (limit 1 per day)
- Lite yogurt (no fruit chunks)
- Double Milk Snack Choices - choose 3 per day
- 1 cup fat free Fairlife milk
- 5 to 6 oz Greek yogurt (100 kcal or less)
- 1 cup fat free Fairlife or regular skim milk + 2 tbsp Peanut Butter powder
- 1/2 cup Cottage cheese (fat free or 1%)
- 1 cup skim milk + 1/3 cup non-fat dry milk powder
- 1 cup skim milk + Carnation Instant Breakfast (Light Start or No-Sugar-Added)
- 1/2 protein shake
Recipes:
- Roasted Carrot Ginger Soup: This soup combines carrots, parsnips, onion, and ginger for a flavorful and nutritious option.
- Cream Soup: A simple recipe using nonfat dry milk powder and chicken or beef bouillon.
- Butternut Squash Soup: This soup features butternut squash, sweet potato, apples, and spices blended into a creamy texture.
Guidelines:
- Drink six 8 oz glasses of water each day.
- Take 5 to 15 minutes to drink 1 oz.
- Do not wait 30 minutes before or after meal to drink fluids.
- Sip throughout the day.
- Stop eating when you are full!
- Start taking vitamin and mineral supplements after your 1 week follow-up visit, as ordered.
- Follow all of the "Lifestyle Changes."
Begin with 1 tablespoon portion sizes and increase to 2 tablespoons as tolerated. Begin drinking 1/4 cup of liquid at a time and increase to a 1/2 cup as tolerated. It is also very important to stay well hydrated.
Phase 3: Pureed Diet (Days 15 to 30)
During weeks three and four post-surgery, the diet progresses to pureed foods, which have a consistency similar to baby food. Nutritional emphasis should be on protein rather than carbohydrates. You will be on a pureed diet days 15 to 30 after your surgery.
Examples of foods to puree:
- Low-sugar, low-fat items like smooth applesauce
- Pureed cooked carrots
- Eggs
- Canned tuna
- Other pureed fruits and vegetables
Phase 4: Soft Diet (Days 31 to 60)
Soft foods are introduced five to six weeks after surgery. While these foods don't need to be pureed, they must be carefully chewed before swallowing. You will be on a soft diet days 31 to 60 after your surgery. You will start this diet after your 1 month follow-up visit.
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Guidelines:
- Chew foods to a pureed consistency (chew 20 to 30 times before swallowing).
- Slowly add soft foods to your meals and snacks.
- Take 30 minutes to eat.
- Eat 3 milk snacks per day and 3 soft food meals.
- Drink six 8 oz glasses of water each day, working up to eight 8oz glasses.
- Stop eating when you are full!
- Take vitamin and mineral supplements as ordered.
- Start doing strength-building exercise in your daily routine, such as strength and aerobics for 60 minutes each day.
Milk Snack Choices - choose 3 per day
- 1 cup skim Fairlife milk
- 5 to 6 oz Greek Yogurt (100 kcal or less)
- 1 cup skim milk
- 1/2 cup Cottage cheese (fat free or 1%)
- 1 lite mozzarella string cheese stick
- 1 cup unsweetened soy milk (or high protein pant-based milk)
- 1/2 cup Fat Free Chocolate Milk (mixed with 1/2 cup skim white milk)
- 1/2 protein shake
*Can flavor milks with Peanut Butter Powder, sugar-free chocolate syrup or sugar-free hot coco mix
Meal Portion Size:
- Protein: 1/4 to 1/3 cup or 2 to 3 oz
- Vegetable: 1 to 2 bites
- Carbohydrate (fruit & starches): 1 to 2 bites
Soft Food (Looking for crockpot tender):
- Chicken
- Sweet potato
- Banana
- Ground turkey or pork
- Carrots
- Oatmeal
- 90% lean ground beef
- Cauliflower
- Potato
- Salmon, Tilapia, Tuna
- Green Beans
- Cream of Wheat
- Eggs
- Black beans
- Peaches
- Refried Beans
- Broccoli
- Brown Rice
Soft Food Menu Items:
- Breakfast
- 1/2 slice of toast with low sugar fruit spread
- 2 scrambled eggs
- 1/4 cup turkey sausage
- Lunch
- 2 to 3 ounces shredded chicken
- 1/4 cup green beans
- 1 to 2 bites of fruit
- 1 to 2 ounces ground turkey
- 1-ounce light cheese
- 1/4 cup black beans
- Dinner
- 1-ounce light cheese
- 1/2 tortilla (6 inch)
- 2 to 3 ounces salmon
- 1/4 cup mixed vegetables
- 2 to 3 ounces baked fish
- 1/4 cup cooked carrots
- 1-2 bites of fruit
Phase 5: General Diet (Day 61 to Forever)
Starting approximately two months after surgery, patients transition to a general bariatric diet. This phase focuses on maintaining long-term weight loss and overall health. This phase is a lifelong commitment starting day 61 after your surgery.
Guidelines:
- Chew food to pureed consistency (chew 20 to 30 times before swallowing).
- Eat lean foods, such as baked, broiled, grilled, or steamed foods.
- Drink eight 8-oz glasses of water each day.
- Take vitamin and mineral supplements as ordered.
- Keep doing strength and aerobic exercise for 60 minutes or more each day.
Milk Snack Choices - choose 3 per day
- 1 cup skim Fairlife milk
- 5 to 6 oz Greek yogurt (100 kcal or less)
- 1 cup skim milk
- 1/2 cup Cottage cheese (fat free or 1%)
- 1 lite mozzarella string cheese stick
- 1 cup unsweetened soy milk (or high protein plant-based milk)
- 1/2 cup Fat Free Chocolate milk (mixed with 1/2 cup skim white milk)
- 1/2 protein shake
Key Dietary Recommendations
Throughout all post-operative phases, several key dietary recommendations must be followed:
- Eat slowly: Take at least 30 minutes to eat a meal.
- Chew thoroughly: Chew each bite 20 to 30 times until it reaches a pureed consistency.
- Eat small, frequent meals: Consume six small meals per day instead of three larger ones.
- Prioritize protein: Aim for a minimum of 65 to 75 grams of protein per day to preserve muscle tissue.
- Stay hydrated: Drink at least eight 8-oz glasses of water daily, but avoid drinking 30 minutes before, during, and after meals.
- Avoid certain foods and beverages:
- Carbonated drinks (pop, juice, alcohol)
- Foods high in fat, sugar, or calories
- Tough-to-digest foods (red meats, chicken, breads, high-fiber fruits and vegetables)
- Alcohol
- Take vitamin and mineral supplements: Essential supplements include a multivitamin with iron, vitamin B12, calcium, and vitamin D.
Lifelong Lifestyle Changes
Bariatric Diet and LifestyleLifelong lifestyle ChangesStarting today, you agree to:
- Eat 3 meals a day.
- Eat protein and a carbohydrate choice at each meal.
- Eat your protein first.
- Take 30 minutes to eat your meal.
- Chew your food to a pureed/mush consistency. This takes 20 to 30 chews.
- Eat nutrient-dense foods such as vegetables, whole grains, fruits, and lean meats.
- Do not eat calorie-dense foods such as chips, cookies, crackers, ice cream, fried food, candy, hot dogs, brats, and bologna.
- Do not eat non-nutrient-dense foods such as pretzels, rice cakes, and animal crackers.
- Eat 3 milk snacks each day.
- Do not drink carbonated fluids such as pop, juice, or alcohol. Carbonation can cause stomach pain. These rinks have extra calories and sugar that is not needed.
- Drink 6 or more cups of plain water a day. You may drink 8oz of unsweetened coffee or tea per day. Do not drink anything with citric acid.
- Do not drink fluids 30 minutes before meals, with meals, or for 30 minutes after meals.
- Do not use tobacco or nicotine products. It slows down healing and can lead to complications.
- Exercise 30 minutes or more a day.
- Keep detailed food and activity records (bubble sheets). Bring them to each dietitian appointment.
- Do not use straws. Air bubbles form in your new pouch and can cause pain.
- The first 3 months after surgery, do not eat acidic or citrus foods such as tomatoes, lemon, orange, or lime.
Common Challenges and How to Overcome Them
- Nausea and Vomiting: Eating too quickly or not chewing food thoroughly can lead to nausea and vomiting. Slow down and focus on proper chewing.
- Dumping Syndrome: This occurs when food moves too quickly from the stomach into the small intestine. Symptoms include nausea, vomiting, dizziness, and diarrhea. Avoid high-sugar and high-fat foods.
- Dehydration: Sip fluids throughout the day, but avoid drinking with meals.
- Constipation: Increase fiber intake through soft, easily digestible fruits and vegetables.
- Weight Gain or Stalled Weight Loss: Re-evaluate food choices and portion sizes. Ensure adherence to dietary guidelines and increase physical activity.
Long-Term Monitoring and Follow-Up
Regular follow-up visits with a bariatric specialist are crucial for long-term success. These visits allow for monitoring of weight loss progress, assessment of any complications, and adjustments to the lap band as needed.
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