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Member
Join Date: Apr 2004 |
Location: Pahrump Nv. |
Surgeon: Dr. Callery |
Age: 56 |
Posts: 131 |
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Tips & Pitfalls of Gastric Bypass Surgery
Knowing how much to eat
This issue is understandably a source of significant concern for gastric bypass patients. There is not a single answer that fits all patients at all times following surgery, so guidelines are going to be laid out instead of a list of amounts and types of food.
First, during the recovery phase from surgery (first 4-6 weeks) it is normal to have no appetite. During this time you are likely to consume far less food than you would need over the long haul to stay healthy, but in this limited time period it is OK. Your surgeons want you to be sure you consume adequate fluids (zero-calorie) to stay well hydrated, but they do not want you to force food.
At this stage, food should be used to begin to teach yourself new eating habits that will help you feel well and lose weight over the following year.
Next, a few teaching points about knowing when you have eaten enough:
a. Don’t eat until you feel full – we are absolutely serious. The reason has to do with the fact that the nerves of satiety (feeling of stomach fullness and eating satisfaction) are "slow" nerves. There is a delay of around five minutes from the time your stomach pouch gets comfortably filled to the time that your brain becomes aware of that fact. If you swallow even one additional bite then the pouch will be overfilled and you will experience painful nausea. Realistically, every patient will experience this overfilled feeling at least once or twice, and it will not damage your stomach if it does not become a pattern. The goal is to learn from the experience – remember how much was consumed and what kind of food it was. Next time, use your memory and your eyes to know when to stop eating, before you fell full.
b. An irritated stomach stays irritated for a day or so. If you overeat or if you eat something that does not agree with you, the stomach pouch will be irritated or "pissed off" for 12-24 hours. While it is pissed off it will be less tolerant of food and liquid than usual, and even small amounts of food can cause the overfull feeling to recur. The lesson here is that if you have an overeating episode, give the stomach pouch a chance to recover by taking only clear liquids for the next meal or two. You can apply this principle to any situation where your stomach pouch is irritated – if medications or an illness makes you feel unable to eat, simply consume liquids alone to maintain your hydration.
c. Your capacity will increase over the first 6-9 months following surgery. The pouch and small intestine learn how to work together and become more pliable over a period of months after gastric bypass. Many patients notice a dramatic increase in the amount of food they can handle comfortably. This is normal in the vast majority of cases. THIS is the time that the good habits developed in the first few months will support further weight loss. If a patient has gotten away from the old habit of using fullness as a signal to stop eating, then they will comfortably continue to eat restricted amounts of food and will continue to lose weight. On the other hand, if a patient has depended on the physical limitation imposed by the pouch to tell them when to stop eating, this relaxation of restriction will come as an unpleasant surprise as their weight loss slows and then comes to a halt.
So the bottom line on how much is the right amount – make a habit out of the type and amount of food that works well about three months following gastric bypass. Stick with this amount over the next several years to obtain excellent weight loss and health.
Other tips:
High calorie liquids will defeat the operation. Sugared soft drinks, ice cream, whole milk, apple juice, and sweet tea (with sugar) can provide enough calories to prevent weight loss.
Avoiding sugar. If you read labels carefully you will find it is nearly impossible to avoid all sugar. A good rule of thumb is to stay away from products that list any of the following in the first three ingredients: sugar, maple syrup, honey, molasses, corn syrup, corn sweeteners, glucose, lactose, maltose, dextrose, fructose, sorghum, sorbitol, or mannitol.
Nutrasweet and other artificial sweeteners generally work OK with the gastric bypass.
Each meal should take between 20-30 minutes. Taking less time means the meal has been eaten too quickly, or is too small, and the patient will be hungry again soon. Taking more than 30 minutes to chew your meal means too much food will be eaten at one sitting.
Liquids must be taken before solids. If breakfast consists of a scrambled egg and coffee, drink the coffee, then eat the egg (or half of it). Trying to drink the coffee after eating will cause vomiting. Also, eating and drinking together is a no-no. This will convert the egg, for example, into a liquid. Consequently, this liquid will pass through your outlet faster, allowing greater food intake which you want to avoid.
A patient who is prone to nibbling should find a snack food which is solid, thereby preventing constant eating. Examples would be beef jerky rather than Cheetos or apple pie rather than cookies. Don't eat ice cream! It is even better to modify your main meals toward solid bulk protein so that you don’t feel the urge to nibble or snack between meals. Frequent small eating is the only way to "defeat" the operation and fail in the weight loss goal.
"Quit when you are full." Each patient will quickly discover the feeling of discomfort when the pouch has been stretched. It is important to stop eating at the first sign of fullness (or even before fullness – see the preceding page). You will discover the feeling by paying attention and looking for that "full feeling" – you should recognize it as a "Quit Eating" signal.
When in doubt about a new food, try it! Some patients can eat anything, whereas others may not be able to tolerate certain foods. You won't know for sure unless you try – just start off with tiny amounts of the new food.
If a food can not be eaten at all, wait a month and try it again.
Early Diet Rules
Diet Rules for the first 4-6 weeks after Gastric Bypass or Adjustable Gastric Band:
1. Eat food only if you are hungry. If you are not hungry, don’t eat.
2. Drink plenty of zero-calorie liquids.
3. If you are hungry, choose mushy proteins. Avoid carbohydrates. Aim for the smallest “meal” possible to relieve your hunger.
4. Don’t drink liquids with your food. Avoid drinking for at least 1 hour after eating.
5. Start your exercise program ASAP.
6. Begin taking Vitamins + Iron, and supplemental Calcium.
Longterm Diet Rules
Diet Rules for lifetime success after Gastric Bypass or Adjustable Gastric Band:
1. Exercise regularly.
2. Drink plenty of zero-calorie liquids.
3. Pre-fill your stomach pouch by “power drinking” just before meals.
4. Don’t drink liquids with your food. Avoid drinking for at least 1 hour after eating, and realize that you probably will not feel hungry after a meal until liquid “washes out” your stomach pouch.
5. Eat 2-3 meals per day, and avoid snacks between meals.
6. Solid proteins and vegetables are the best choices to provide nutrition and prevent hunger. Each meal should be based on these. Minimize carbohydrates.
7. Chew thoroughly, and take 20-30 minutes for each meal.
8. Continue taking Vitamins + Iron, and supplemental Calcium.
__________________
Woody
4-24-02
Open w/Dr Callery
350/At Goal
What the mind of man can perceive and believe, he can achieve.
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