Saturday, August 18, 2012

5 Tips For Success after Bariatric Surgery

All bariatric surgery patients can benefit from these tips but especially those who have a gastric band. 

This week I had several adjustable gastric band patients who complained of occasionally vomiting after eating their meals but seemed to have no idea why this was occurring.

 Remember, for those of you who have had a gastric band, you have asked your bariatric surgeon to place a band around the upper part of your stomach to create a gastric pouch and adjust this band so the outlet is only about the size of the end of your ring finger. This is what gives you the resistance to eating too fast and too much at any one time.

 Consistently applying these principles will help.

 1). Liquid calories are not your friend
 Your pouch and narrowed outlet from the band is like a funnel. The purpose is to hold solid food in your pouch for a time, allowing the solid food to slowly leave the pouch and therefore suppress your appetite by releasing a small amount of the food over the next couple of hours. I call this “auto-snacking”; giving you the effect of snacking to suppress your appetite with out eating. Them after a few hours the pouch is empty and the person becomes hungry in about 3 hours when it is time for another meal.

 I often hear, “but liquids go down so easily!” but that is exactly the point; too easily! Your band is not made to hold back liquid food. All liquids will run straight through the narrow outlet. So take your calories as solid food not liquids.

 Avoid milk, (even skim since it has too many sugar calories), ice cream, cream soup, soda and fruit juices. Get your protein in solid food and only use protein shakes if you cannot get enough protein in your solid foods.

 Instead drink water, tea with sweetener, and Crystal lite or other non caloric beverages. This is an easy way to reduce your overall calorie intake and help you lose weight.

By the way, be careful of too much fruit since many fruits like watermelon are really sugar water in disguise.

 2). Minimize crunchy foods
 Crunchy foods like chips, crackers, pretzels and cookies, after saliva is added, go to mush and will go into the pouch and pass through the narrowed outlet too quickly. These types of foods can be your downfall. I am not saying you should never eat them but when you see them train your brain to flash “DANGER”. It is a question of portion size. One of my patients did a video on this blog sharing how she deals with this problem. She swore off ever eating out of a bag or box again. Now when she brings home the groceries she breaks down the crunchy foods into small zip lock bags for portion sizes. She no longer takes the large bag to the TV for her snack but goes to the pantry to get a zip lock portion size for her snack.

 3). Apply the “rule of 30s” consistently

 Chew 30 times before swallowing

 Wait 30 seconds before your next bite

 Wait 30 minutes before drinking

 4). Avoid foods that are likely to be difficult; steak, chicken and bread
 Steak will not pass through the narrowed outlet of your pouch if the particle sizes are larger than the tip of your ring finger. The stringy fibers you see when breaking open a grilled chicken breast can be chewed all day long but will probably ball into a “twine ball” in your pouch causing blockage of the outlet of the pouch. Doughy bread will become a “dough ball” in your pouch and block the small outlet of your pouch.

 This is a frequent cause of vomiting after a band is placed.

 If one of my patients tells me they can eat these things without difficulty it tells me their band probably needs adjustment. Usually they are gaining wait as well.

 5). Establish a “No Fly Zone”
 I want to my patients to establish good boundaries for what comes on their property and tell their friends and family, “Certain foods just don’t fly here.” We all have what I would call trigger foods; that is foods that comfort us and when these are around we have difficulty staying away from them. For me it is cookies, so guess what? My wife only buys one type of cookies to bring home from the grocery; Fig Newtons. That is because I really don’t like Fig Newtons much and they will stay around along time. If she brought chocolate chip cooking they would be gone in a flash because I have difficulty staying away from most other cookies. Without fully realizing it my wife has established a “No Fly Zone” at our home. Cookies just don’t fly at our house.

 Maybe your food trigger is pizza or soda or ice cream. Whatever it is you should establish a no fly zone at your house. You don’t bring these things into your house and family or friends and not welcome to bring these things as well. Let them know they are welcome to go out for these things but these foods just don’t fly at your house.

 Applying these principles consistently is the key to understanding what is going on with your body after having an adjustable gastric band or any other bariatric operation as well. If you are doing these things you are more likely to understand what is going on if you are having difficulty.