Adjustable Gastric Band Surgery: 9 Month Follow-Up

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Adjustable Gastric Band Podcast

Hi, I’m Debbie Petitpain, one of the Bariatric Surgery Program Dietitians here to talk to you today about your diet after the having a gastric band placed!

Yes, it’s true that after surgery, you still need to “diet” for life. While many people consider the four letter word diet to mean the act of restricting food intake or the intake of particular foods, it really means “the usual or habitual food and drink consumed by a person”, not necessarily a controlled regimen. So to say you have to follow a healthy diet for the rest of your life simply acknowledges the fact that you will have to eat for the rest of your life. But if you get in the habit of making healthy food choices, you will also be successful at losing weight!

So what foods and how much should you be choosing after the gastric banding surgery?  Well, how much you should eat depends in part on how restricted you are. Each person will get to their “sweet spot” of optimal restriction at a different time point out from surgery and after a differing number of adjustments. As you get adjusted, your portions will continuously get smaller. But what you eat is something you can control since post-op day one!

You want to include a lean source of protein at each of your meals. For our men, you are looking at 6-7 servings per day and our women would need 5-6 servings per day where one serving is one ounce of cooked meat, 1 egg or ½ cup of cooked beans, for example. If you take those servings and divide them equally amongst your three meals, that is only about 2 ounces of protein per meal. Healthy meat choices include skinless turkey or chicken breast, ground turkey breast or 96% lean beef, fish fillets, shrimp, clams, oysters, tuna or salmon canned in water, pork tenderloin and game meats like venison.  One ounce is approximately the size of your finger but it is more accurate to weigh your cooked meat in a kitchen scale. There are other foods that fall in this “protein” category. One egg, 2 egg whites or ¼ cup of egg substitutes is one serving. One-half cup of cooked beans like black beans, white beans, lima beans, pinto beans, black-eyed peas, split peas or lentils is one serving. ¼ cup of low fat or fat free cottage cheese or ricotta cheese or 1 ounce of reduced fat or fat free cheese is also considered a serving. So here are some examples of how to use your two ounces of protein at each meal: try 2 egg whites with 1 oz of fat free cheese melted on top for breakfast, 2 oz or ¼ cup of tuna mixed with fat-free mayo for lunch, and 2 oz of grilled chicken or pork tenderloin for dinner. Now while we recommend only 3 meals per day with no snacking, if you do have a planned snack that includes a protein, you would cut back on your meat at mealtime. For example, you could skip the cheese on the egg whites at breakfast and have a low-fat cheese stick or ¼ cup of cottage cheese for snack.

At all calorie levels, for both men and woman, you can include up to 3 servings of dairy per day where one serving is a cup of skim or 1% milk or a container of non-fat, light yogurt. Just be sure you are choosing low-fat varieties to keep the calories low, and if you aren’t a dairy person, you can substitute with some extra servings from the protein choices we already discussed.

Foods of color are important as well! Fruits and veggies provide fiber and bulk – two things that are important for promoting satiety with the band – and they are low in calories. Strive for at least 4 servings of veggies per day. One serving of vegetable is ½ cup of cooked or 1 cup of leafy. So if you have 2 cups of salad at lunch, perhaps topped with your tuna, and 1 cup of cooked broccoli at dinner with your grilled chicken or pork or other meat, you have included your veggies for the day. Just avoid topping those low-calorie choices with added fats like salad dressing or butter!

You may have 2-3 servings of fruit per day, where one serving is a small 4 oz piece of fruit or ½ cup of canned fruit. Most pieces of fruit weigh in at more than 4 oz. That jumbo apple from the grocery store, for example, may be both your fruit servings for the day. And also note that juice is not a good choice. The calories from that juice will just slide through your band without promoting any sense of fullness so stick to the fruit you have to bite and chew and avoid the kind that must travel through a straw. Try putting one serving of fruit with your breakfast and one at lunch or save it for your planned snack, if you are having one.

Starches may or may not be well tolerated with the band. Even if you do tolerate them, you want to consume them in moderation and choose high fiber choices when possible. Our men can have 7-8 servings per day and our women 5-6 but consuming even less will help you cut calories. Divided up equally throughout the day, that is 1-2 servings at breakfast, two at lunch and two at dinner. Let’s talk serving size. ½ cup cooked cereal like oatmeal or grits or cream of wheat would be your starch at breakfast. One serving is one slice of bread - and we encourage the low calorie light wheat at only 40 calories per slice – so a sandwich with two slices of bread would be both of your servings at lunch. Tortillas, buns, English muffins, bagels and rolls also fall in this category where one ounce is one serving.  ½ cup of cooked rice, pasta, or potato are each one serving. Again, gummy, sticky carbs like bread rice or pasta may not go down well after surgery. It is easy to consume too many starches per day if you are using starchy snacks like crackers, chips, and pretzels in your diet.

Finally, watch your added fats like salad dressing, butter, margarine, olive oil, sour cream, mayo, etc. While they are yummy, they quickly add calories and they slide right through the band without promoting fullness. Be sure to cook your foods using non-stick cookware and spray like Pam or by baking, broiling, grilling or stewing. Don’t fry!

You will have your own individual list of foods that you do and do not tolerate. We can work with you on your food choices and meal patterns during your clinic visits so be sure to come in regularly. While band adjustments will help you manage portion sizes, you can start adjusting your food choices, meal patterns and timing right away!

 Your MUSC Bariatric Surgery Team wants you to be successful and stay in touch. If you need an appointment, call us at (843) 792-7929 or visit us at www.muschealth.com/weightlosssurgery


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