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Preparing for Lap-Band® Surgery:

Nutritional Information to Know


By Felicia Cordier, RD, LD

Laparoscopic Adjustable Gastric Banding, a restrictive surgical access to the site.


procedure using the Lap-Band®, is gaining popularity and ac- An enlarged, fatty
ceptance in the United States healthcare industry as a safe and liver is common in
effective procedure for the treatment of obesity.1 With this ac- the morbidly obese patient and can cause the surgeon
ceptance comes a multitude of considerations. These include difficulty during the procedure by obstructing the view
dietary, behavioral and lifestyle modifications that patients or preventing completion of the procedure due to the
must be willing to adopt for life to promote successful, long increased risk of damage upon repositioning.2
term weight-loss and improved nutritional status, health and
well being. A common preoperative goal is to emphasize the im-
portance of reducing the size of the liver prior to sur-
Diet Modifications Prior to Surgery gery. Other important goals address improvement of
overall nutritional status, setting the stage for weight-
The procedure and related dietary protocols are relatively new loss, implementing healthier nutrition and dietary life-
to registered dietitians in the U.S. Several preoperative weight- style habits and strategies that will ensure long-term
loss strategies and dietary protocols exist and their use varies success.
among bariatric surgeons. One surgeon may require a 10 per-
cent weight-loss or more from their patients before surgical Dietitians provide a framework of guidelines to help
placement of the band and another may require their patients patients understand, learn and embrace how these goals
not to gain weight during the preoperative screening process, may be accomplished by initiating sound nutritional
using their initial weight as the baseline value. and dietary lifestyle behavior modifications. These
guidelines are explored below:
While one dietary protocol may promote the use of a total liq-
uid, very low calorie diet for two weeks prior to surgery, an-
other may choose to use a controlled carbohydrate, low calorie Nutrition and Lifestyle
diet with the use of total liquids a minimum of 24 hours prior
to surgery. Goals to Achieve
The nutritional status of the patient prior to surgery and the
Prior to Surgery
safety of the patient during the surgical procedure are primary We encourage patients to make proper
concerns of the surgeon, registered dietitian and weight-loss food choices from these categories:
team. No matter which one is chosen, both of the above-
mentioned preoperative dietary choices are designed to support • Protein foods to include very lean cuts
these primary concerns, and both have proven to be effective of beef, game, lamb, pork, poultry,
in producing positive results.
seafood, eggs and soy foods
The size and condition of the patient’s liver prior to surgical • Fresh vegetables and fruits (frozen,
placement of the band is the primary safety concern of the sur- canned, low sodium, without sugar)
geon. The left lobe of the liver is positioned over the site of the
band placement and must be repositioned to allow the surgeon • Low-fat or fat-free dairy products
The human body will experience uncomfortable symp- Certain rules must be
toms such as fatigue and headaches when certain foods, practiced prior to surgery
such as bread and desserts, are eliminated from the diet, to ensure success and to
but those symptoms last only a few days. Eliminating prevent possible compli-
some foods decreases the physical dependency on these cations, however more
foods. This results in an increase in the patient’s energy rules apply postopera-
level, an improvement in nutritional status and most tively: 3
importantly, a smaller liver. The following foods
should be eliminated immediately after the first preop- • Cut food into small
erative screening visit and continuing on through com- pieces and chew thor-
pletion of surgery: oughly
• Eat slowly and pay
• Bread, rice, pasta and potatoes attention to signs of
• Crackers, chips, pretzels, or any other high- fullness
carbohydrate snack food • Eliminate distractions
• Cookies, cakes, pies, candy or any sugar- while eating
sweetened food • Stop drinking 30 min-
• Sweetened drinks and full-strength juices utes before a meal
• Processed, fast, fried, breaded and saucy foods and wait 30 minutes
to drink after a meal

Tips to Help Initiate New It is noteworthy to reiterate that preoperative dietary protocols
will vary among practitioners, and these protocols are effec-
Eating Habits tive in producing a positive result. The bariatric patient will
• Plan meals to ensure proper food benefit from explicitly following the dietary plan prescribed
choices by their weight-loss team. Pre and postoperatively, if the pa-
tient embraces healthier dietary and lifestyle behaviors and
• Eat three meals a day at consistent they are empowered by a strong motivation and commitment
times - no snacks to succeed, this indeed is the recipe for positive results and
long term weight-loss success.
• Include protein foods with each meal
• Include unlimited non-starchy vegeta- Please Note: The information contained in this article is for
bles with at least two meals educational purposes only and should not be substituted for
medical advice or treatment from a healthcare professional.
• Include fruit once per day The OAC recommends consultation with your doctor or
• Limit starchy vegetables healthcare professional before initiating any dietary plans.

• Limit overall carbohydrate intake to 20- About the Author:


30 grams per day (including dairy, fruit, Felicia Cordier, RD, LD, is currently in private practice and
and starchy vegetables) owner of River City Nutrition in Jacksonville, FL. She is also
a bariatric nutritionist for Jacksonville Weight-Loss Center.
• Drink at least 64 ounces of water daily
(sugar-free beverages are allowed) References:
• Avoid the use of alcohol 1. Ponce, J., Paynter, S., and Fromm, R. Laparoscopic Ad-
justable Gastric Banding: 1,014 Consecutive Cases. J.
• Begin taking a multivitamin and mineral Am. Coll. Surg., 2005; Vol. 201, No. 4, 529-535.
and calcium supplement 2. Fris, R.J. Preoperative Low Energy Diet Diminishes
Liver Size. 2004, Obesity Surgery, Vol. 14, 1165-1170.
• Keep a detailed record of all foods and 3. Inamed Corporation. Taking the Next Step, The Preferred
drinks Choice for the Surgical Treatment of Morbid Obesity
• Initiate a minimum of 10 minutes of daily booklet. 2004, page 10.
activity
The mission of the Obesity Action Coalition is to
elevate and empower those affected by obesity through
education, advocacy and support.

About the OAC


The Obesity Action Coalition is a non profit patient organization dedicated to educating and advocating on behalf
of the millions of Americans affected by obesity. By strictly representing the interests and concerns of obese patients,
the OAC is a unique organization with a patient-focused approach to obesity. To learn more about the OAC, visit
www.obesityaction.org or contact the National Office at (800) 717-3117.

OAC Resources
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OAC provides several beneficial resources for patients, as well as professionals.

• OAC Introductory Brochure • Your Voice Makes a Difference. A Guide on How


• Obesity Action Alert You Can Help Fellow Patients Affected by Obesity
• OAC News • Weight-loss Surgery Coverage Fact Sheet
• State-specific Guides to Advocating for Improved • The OAC Web site: www.obesityaction.org
Access to Obesity Treatments
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contact the OAC National Office at (800) 717-3117 or send an email to info@obesityaction.org.