Adjustable Gastric Band: What Happens If You Don't Follow Your New Diet
Adjustable gastric band surgery restricts the size of the opening to your stomach. This decreases the amount of food you can take in. After this surgery, you are likely to lose a lot of weight, as long as you follow instructions. At the same time, you will need to get used to a totally new way of eating. You may lose a lot of weight in the first few months because you can only eat a small amount of food at any one time.
It takes about 4 to 6 weeks after the surgery before you can eat solid food again. You'll probably have a high-protein, liquid-only diet for 2 weeks. Then you'll have only pureed foods for 2 to 4 more weeks. Solid food may have never before seemed so tempting. But when you're finally ready for it, you may face a new problem called food intolerance.
Food intolerance after gastric band surgery
Food intolerance means that after surgery you may have problems eating certain foods that you once ate or that are an important part of your new diet. This can make it hard to stick to your new diet and keep the pounds off.
The opening through the band is called a stoma. One problem is that the diameter of the stoma may be as small as a quarter of an inch across. This means that some nutritious foods you once enjoyed may get stuck there. This raises your risk for food intolerance.
Experts suggest that people who have this surgery not eat foods rich in fiber. These foods include celery, corn, oranges, pineapples, asparagus, and sweet potatoes. These kinds of foods can get caught in the stoma. Other foods you may not be able to eat include the skins of fruits and vegetables, and protein-rich nuts and meats such as steak, hamburger, and pork chops. Unfortunately, the skins of fruits and vegetables are often the most nutritious part. If you putt them in the blender before you eat them, you may still be able to eat this nutritious part of the food.
Common food intolerances include:
Meat and dairy. Food intolerance is one of the main reasons that people who have gastric band surgery often don't get enough protein in their diet. Many eat less than half of the recommended amount of protein because they can't tolerate foods rich in protein.
Salad greens. This may be because of the high fiber content of greens, which may make it difficult to pass through the stoma.
Fresh fruits and vegetables. These foods are also high in fiber and typically have a skin, which makes them more difficult to digest and pass through the stoma.
Having to skip nutritious fruits and vegetables like oranges and sweet potatoes makes it hard to get the nutrients your body needs. Food intolerances make it even harder.
Nutritional problems linked to food intolerance
Food intolerance after gastric band surgery may be more widespread than doctors thought. Because food intolerance makes it harder to get enough protein and vitamins, severe nutritional problems and complications have been seen among people who have gastric band. These problems include anemia, a lack of protein, and life-threatening malnutrition.
For this reason, it's important to stick to your new diet and get help dealing with food intolerance. Call your doctor as soon as you notice any symptoms of food intolerance. These symptoms include gastroesophageal reflux (GERD or heartburn) or regurgitation, stomach pain and discomfort, and especially repeated vomiting. Your doctor might advise tests such as an upper gastrointestinal X-ray or endoscopy to check on your situation.
You should also seek medical help right away if you have any unusual symptoms, such as severe exhaustion, confusion, a feeling of being cold when others are not, and unexplained bruising. These are signs that your body is starved for nutrients.
Sticking with your new diet
Before you have gastric band surgery, your doctor and a dietitian or nutritionist will talk with you about the changes in diet you'll need to follow for the rest of your life. Because you'll be taking in many fewer calories than before, you'll also need to take daily vitamin and mineral supplements. To avoid complications and still lose weight, you will need to overhaul your diet.
You may have eaten high-calorie foods, like pastries and ice cream, before your surgery. Now you'll need to eat a diet that's high in protein and lower in calories.
Because your stomach can only hold a small amount of food, you need to eat much smaller amounts. Any time you eat more than your new, tiny stomach can handle, you'll either have upper abdominal pain until it passes or until you vomit it up. You will also need to avoid soda, beer, and other carbonated drinks. They can cause bloating.
Food intolerance can make it hard to stick with your diet. So, your weight loss may slow or even reverse. If you don't eat certain foods or food groups, you may not get key nutrients.
Unfortunately, health care providers don't know why some people have food intolerance after adjustable gastric band surgery and others do not.
These tips may help you to better adjust to your new way of eating:
Chew your food slowly, up to 20 times per bite, so that it's a liquid when you swallow it.
Make sure all meat is extremely tender and cut into tiny pieces or blended before you eat it. White meats are better tolerated than red meats.
Meet with a dietitian regularly to talk about your eating issues.
Get regular health checkups and blood tests for the rest of your life to look for nutritional problems. Some of these problems can show up years after your surgery.
It's also important to take the daily vitamin and mineral supplements your doctor has prescribed. Forgetting to take them or deliberately not taking them puts you at risk of developing serious nutritional problems. Some problems can develop in a matter of weeks. Certain vitamin shortfalls, especially of thiamine, can also cause permanent neurological symptoms, including permanent nerve damage and other problems if they're not treated early.
If symptoms don't go away and you are having trouble getting the nutrition you need, your doctor might have you add a protein supplement for a while. He or she might also suggest that you make other changes in your diet or the way you prepare your food. Your band may also need to be adjusted so that the stoma is bigger and you have more space in your stomach for digestion.
In some cases, even if you follow your new diet and take your supplements, you may still not get enough nutrients. Your doctor may then suggest that you have your band totally deflated or removed.
- Grantham, Paula, RN, BSN
- MMI board-certified, academically affiliated clinician