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. This means eating smaller meals more often, usually 6 small meals daily.

It takes about 4 weeks after the surgery before you can eat solid food again. You'll likely 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

After surgery, you may have problems eating certain foods. This is called food intolerance. It can make it hard to stick to your new diet and keep the pounds off.

The opening through the band is adjustable. If the opening is too small, some nutritious foods you once enjoyed may get stuck there. You might have an uncomfortable full feeling in your lower chest that takes some time to go away. Or you may vomit up the food that you had swallowed. 

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 above the band. Eating bread or popcorn may cause a blockage. 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 and pork chops. Unfortunately, the skins of fruits and vegetables are often the most nutritious part. If you put 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. The band may need to be adjusted and opened slightly to allow you to eat enough protein-rich foods.

• Salad greens. This may be because of the high fiber content of greens, which may make it hard to pass through the band.

• Fresh fruits and vegetables. These foods are also high in fiber and typically have a skin, which makes them harder to digest and pass through the band.

• Breads. Swallowing bread, even after chewing, can block the opening at the band.

Having to skip nutritious fruits and vegetables like oranges and sweet potatoes makes it hard to get the nutrients your body needs.

Nutritional problems linked to food intolerance

Because food intolerance makes it harder to get enough protein and vitamins, people with the gastric band are at risk for nutritional problems and complications. These problems include anemia, a lack of protein, and malnutrition.

For this reason, it's important to stick to your new diet and get help dealing with food intolerance. Call your healthcare provider if 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 healthcare provider might advise tests such as an upper gastrointestinal X-ray or endoscopy.

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 healthcare provider 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 fewer calories than before, you'll also need to take daily vitamin and mineral supplements. To prevent complications and still lose weight, you will need to change your diet.

You may have eaten high-calorie foods, such as pastries and ice cream, before your surgery. After surgery, 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, small stomach can handle, you'll either have upper abdominal pain until it passes or until you vomit it up. You will also need to stay away from soda, beer, and other carbonated drinks. They can cause bloating.

Preventing problems

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. It's important to follow up with your bariatric surgeon and nutritionist so weight loss can be optimized, and problems can be prevented.

If the band is too tight, your healthcare provider can take some fluid out, and open the band up a bit. This can reduce food intolerance. Sometimes you may have food intolerance even if the band seems to be correctly adjusted. Unfortunately, healthcare providers don't always know why some people have food intolerance after adjustable gastric band surgery and others don't. 

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.

• Eat slowly. Take 20 to 30 minutes for each meal. It's important to stop eating as soon as you feel full.

• Check that all meat is very tender. Cut it into tiny pieces or blend it before you eat it. White meats are better tolerated than red meats. Hamburger is better tolerated than steak.

• 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 healthcare provider has prescribed. Forgetting to take them or purposely not taking them puts you at risk of 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 healthcare provider might have you add a protein supplement for a while. They 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 opening is bigger and you have more space in your stomach for digestion. 

In some cases, your healthcare provider may suggest that you have your band totally deflated or removed if you have persistent vomiting.