Why aren't there dietary standards for this?

[Cleo's Mom 257]

From reading all the posts it has become obvious to me that there does not exist a standard set of dietary guidelines in the medical community for pre and post surgery patients across this country. Some have to do full liquids only 2 weeks before surgery - others get to eat one solid meal a day. Others only have to do a prep the day before. And then after the surgery the diet varies widely. I am 9 days post-op and am on the clear liquid only diet until I see my doctor next week - then it will be the creamy liquid only diet for 2 more weeks. Many at my point are already on the mushies. By next week some will have advanced to foods like scrambled eggs, etc. This is definitely something I will ask my surgeon about. I bought that book about banding written by a doctor who does them and by 2 weeks post-op he has already added fruits, vegetables and starting to add fish and some meat. Any thoughts?

[luluc 6]

No, clue - it is just amazing the "rules" out there and the range of each dr. good luck with your new banding!!!!

[heartfire 4]

I agree with both of you. It is amazing. And it's so confusing too! I just wonder if that has anything to do with increased slip rates. I only needed to do 2 weeks of liquids after surgery before going to soft foods. I'm 5 1/2 weeks out and now on regular foods after slowly introducing new Proteins every week. Hopefully I'll be okay but if I ever have a slip, I'll probably wonder if it wasn't the quickness of the food stages from my surgeon.

[Hollie519 1]

The surgery is too new and there are too many different types of bands you can have. Also, every person's body is different. Don't get mad, just follow YOUR doctors orders.

[eyespy 1]

I agree. I was on liquids for 4 weeks post op: 2 weeks clear, and 2 weeks, full liquids. My surgeon actually cleared me for full liquids at my first post op visit one week later. I have never been so happy in all of my life. So, actually I was on liquids for three weeks, and then on to soft foods.

I tried my best to follow my doctors orders, but I did start the soft foods a little earlier. Since I knew other doctors had their patients eating soft foods the first week, I wasn't too worried. I didn't go crazy. I added something really easy like sandwhich meat and chewed it to a pulp.

Now I'm wondering about the post fill diet. I just had my third fill, and it's back to liquids for 4 days. I've lost 22.5 pounds so far, but no thanks to the band! So far, I haven't felt any restriction. I think the real reason you lose weight with the band is because you have to be on liquids so darn much! I am now at 7 cc. I think this one will make the difference. It already feels differently drinking fluids than before. What is your post fill diet like?

[Jachut 487]

It is a bit confusing. I'm all for no rules and go by feel but that's me, and there's a lot of people out there that would really not be able to handle that.

Obviously people's bodies are all different, but the way people talk on here, as if their rules are black and white and the ONLY rules, annoys me a bit, as obviously, that's NOT the case.

I mean, I've done no pre op diet, eaten carbs all the way through and never ever been told to focus on Protein. I'm OK, and I've lost weight, so patently, the American way is not the only way. On the other hand, people here lose weight fantastically well so obviously Protein first and half cup servings work darn well too.

I think there's a few "rules" that have become apparent here over the years though:

the pre op diet is for a REASON. Stick to it. Its worth your while. Yes, you will probably cheat. Just get back on the wagon when you do.

Most unbanded people way overdo the carbs. You do not need six slices of bread, two cups of Cereal, Pasta and Cookies all in one day. Most people really do need to change their protein/carb ratio.

You should not be eating a whole roast chicken three days out from surgery. Follow your routine and take it slowly. It will not kill you.

Somewhere around 1000 to 1200 calories a day appears to be ball park for most women. Running an hour a day or going to the gym and lifting does not turn you into an athlete who needs five Protein shakes on top of that.

Eat less, move more. It usually works.

[IndioGirl55 32]

It is a bit confusing. I'm all for no rules and go by feel but that's me, and there's a lot of people out there that would really not be able to handle that.

Obviously people's bodies are all different, but the way people talk on here, as if their rules are black and white and the ONLY rules, annoys me a bit, as obviously, that's NOT the case.

I mean, I've done no pre op diet, eaten carbs all the way through and never ever been told to focus on Protein. I'm OK, and I've lost weight, so patently, the American way is not the only way. On the other hand, people here lose weight fantastically well so obviously Protein first and half cup servings work darn well too.

I think there's a few "rules" that have become apparent here over the years though:

the pre op diet is for a REASON. Stick to it. Its worth your while. Yes, you will probably cheat. Just get back on the wagon when you do.

Most unbanded people way overdo the carbs. You do not need six slices of bread, two cups of Cereal, Pasta and Cookies all in one day. Most people really do need to change their protein/carb ratio.

You should not be eating a whole roast chicken three days out from surgery. Follow your routine and take it slowly. It will not kill you.

Somewhere around 1000 to 1200 calories a day appears to be ball park for most women. Running an hour a day or going to the gym and lifting does not turn you into an athlete who needs five protein shakes on top of that.

Eat less, move more. It usually works.

Jachut

Question for you - I'm just curious - what was your post op diet - since they have been banding in your country along time before here in the USA

What was your doc's instructions??? How long on each stage..

[Jachut 487]

Gosh, it was so long ago........I think it was as follows

2 days Clear Liquids (surgery day and day after)

three weeks liquids, gradually thickening up

2 weeks mushies

then onto solids

DH got banded in June and only did 2 weeks liquids, same doctor.

Pretty standard, I think.

[IndioGirl55 32]

Gosh, it was so long ago........I think it was as follows

2 days Clear Liquids (surgery day and day after)

three weeks liquids, gradually thickening up

2 weeks mushies

then onto solids

DH got banded in June and only did 2 weeks liquids, same doctor.

Pretty standard, I think.

Thanks I was just wondering cuz you guy were banding way before us..

I had 1 1/2 days clear - full liquids 10 days - mushies 10 day - soft 10 day then regular..

How sweet you both are banded :tongue: - I just did a commercial for my Doc yesterday and there were a husband & wife who had their surgery a week a apart (bypass) they have lost a total of 240 ... I think that would be the way to go - then everyone eats healthy :tongue:

[*slim* 2]

I think that would be the way to go - then everyone eats healthy :tongue:

I agree. I just went grocery shopping tonight for my family. It was so odd buying things to make different meals for me and my DH. My son is will try most anything once, so I could feed him whatever I ate. My DH will not eat things like baked fish or any baked meat other than meatloaf.

My post diet is 1 week clear liquids, 1 week full liquids (she said I could puree anything I wanted as far as Soups and such, but I could only have whatever goes through the strainer), 1 week soft (mushies) foods, and then regular foods. There really should be some standard guide book on what the stages should be and what exactly is allowed in those stages. I have two different books, one is from my required nutritionist visit and one from my pre-op class. They were written specifically for my surgeon, yet they allow different foods during some of the stages. For example, during the full liquid stage, one book says thin mashed potatoes, but the other book says thin mashed potatoes and thin grits.

[MacMadame 81]

The reason it's not more standardized, IMO, is that nutrition is an area with not that much research behind it and so there is not a lot of clinical data to go on. So each doctor is interpreting some general guidelines in their own way.

The general guidelines are:

1) Losing weight before the operation can make the liver less slimy, which makes the surgeon's job easier, plus

2) Weighing less at the time of surgery makes the surgery safer

3) You need to eat very lightly in the first 2-4 weeks while everything is healing up, but particularly lightly in the first 2 weeks

So some surgeons ask all their patients to lose weight -- even though there is no correlation between weight loss pre-op and success post-op. Some only ask the heavier patients to lose weight. Some require it, some just suggest it. Some are very specific about how they want their patients to lose weight and some leave it up to the patients.

As far as the diet is concerned, there has been a trend in the US to let patients progress from liquids to mushy to regular food very quickly and there has also been a rise in slip rates. The doctors I investigated who had good slip stats all required *at least* two weeks of liquids of some kind, sometimes more and no regular food until at least 4 weeks, but usually more like 6 weeks. I would have trouble having any faith in a surgeon who progressed his patients faster than that without any clinical data to back it up.

But some surgeons are very conservative, putting their patients on 1-2 weeks of Clear Liquids and 1-2 of full liquids when this article I read about bariatric nutrition published by the ASMBS says that that there may not be clinic evidence to support being on a clear diet more than a day or two.

I was on clears at the hospital and then "thin" liquids for 2-3 weeks. Thin liquids are clears plus Protein drinks and milk (basically). They don't include everything on "full" liquids like oatmeal and applesauce. Those come with "softs" which is anything you can get through a straw the beginning, followed by anything you can mush up -- like tuna fish -- for 2-3 weeks. Then progressing to regular food "as tolerated".

You don't move to each stage based on the clock, but based on what you are tolerating. So at two weeks out, if I'm still having issues with thin liquids, I'm not supposed to go to softs. Likewise, some people don't get to regular food until as much as 3 months out because they aren't tolerating anything but soft food.

The basic diet doesn't change based on surgery type, but I bet most bandsters progress faster than the rest of us with cut stomachs. I would be surprised if I started doing soft food as early as 2 weeks. We'll see but my sleeve is kind of swollen right now and I'm having a horrible time *slowing down* so I still get pain when I drink my shakes too fast. Until I can go a whole day without that kind of pain, I won't go to softs.

Edited October 3, 2008 by MacMadame

[heartfire 4]

Mac, you always have such great, concise information.

I was on a 10 day pre-op of shakes only.

Weeks 1 & 2 post-op of shakes only. Stop shakes at end of week 2.

Week 3 soft foods - yogurt, milk, cheese, eggs, Peanut Butter.

Week 4 add Beans, nuts (!) and seafood

Week 5 add chicken and turkey

Week 6 add beef and pork

I'm in week 6 and have had no problems other than Week 3, first day had a scrambled egg and it didn't sit so well. Felt like a lump in my stomach. Stayed away for about a week and tried again, no problems since.

He also requires ONLY Protein for the first 3 months (he wants to make sure you're getting at least 35g of protein). After that you can start to add, gradually and in VERY small amounts veggies and fruit, BUT I've already done that. I don't eat much but I miss my fresh organics (we get a box from a local farm every week!). Tonight was a black bean lasagna and a small salad.

[Weas123 0]

I think the reason we go on a post op diet is to make things easier for the surgeon. If we go on a low fat diet, the fat around our livers is shrunk and it is easier to retract it during surgery.

I didn't have a pre op diet. Whopee.