FIRST TWO WEEKS:

• Liquids� (anything that easily passes through a straw without using a straw).
• Start the first 2-3 days with clear liquids like 100% juice diluted with water, low-fat broth, water, and non-caloric fluids.
• After the first 2-3 days drink 1-2 ounces of a protein shake every 3-4 hours and sip on 48 ounces of non-calorie fluids between protein shakes to ensure ample protein intake and to prevent dehydration. Do this for 11-12 days.
• Cold beverages cause the pouch to spasm, start with warm fluids or fluids at room temperature.
• Introduce one new liquid item at a time to insure tolerance.

ITEMS TO BUY:

• Low-fat broth/bouillon
• Low-fat cream soups without solid pieces
• Vegetable or tomato juice
• 100% fruit juice without pulp (limit 1/2 cup a day)
• Skim, 1%, rice, soy milk
• Decaffeinated coffee/tea
• Decaffeinated, sugar-free drinks that are non-carbonated
• All sugar substitutes
• A Protein shake (see recommended products section)

SECOND TWO WEEKS:

• Soft foods� (foods that do not require chewing or can be mashed with a fork). These foods should have no chunks and be soft and moist.
• Eat 1-2 ounces of soft foods every 3 hours, emphasizing protein foods to ensure 50 grams of protein a day for women and 63 grams a day for men.
• Take baby spoon bites and chew up until a liquid consistency.
• Sip non-calorie fluids between 1-2 ounce meals. Stop sipping non-calorie fluids � hour before each meal and do not resume sipping fluid for 1 hour after each meal. You must get in 48 ounces of clear, non-calorie fluids a day to prevent dehydration.
• Clear fluids are fluids you can see through that have no food particles in them like pulp. Examples of clear fluids are grape/apple juices, broth�s, sugar free jello/Popsicle�s, decaffeinated tea/coffee.
• Introduce one new food item at a time to ensure tolerance.

ITEMS TO BUY:

• Low-fat, low-sugar pudding
• C ooked cereal (Oatmeal, Grits, Cream of Wheat, Farina)
• Dry cereal with fat free milk-soggy 
• Dannon Lite and Fit creamy yogurt
• Low-fat cottage cheese (small curd)
• Chicken, Tuna, salmon, crab, Egg, salads made with (low-fat mayo)
• Mashed potatoes
• Unsweetened applesauce
• Soft cooked/scrambled eggs
• Canned fruit in its own juice
• Sugar-free Jell-O
• Soft cooked vegetables

Protein Amounts In Foods:

NOTE: Eat these foods first to get the 50 grams for women and 63 grams for men in every day.

Egg=6 grams
3 tbsp. meat, fish, seafood=14 grams
3 ounces or 1 small deck of cards size of lean; meats, fish, seafood=21 grams
Dannon Lite and Fit Creamy yogurt=8 grams
Hard block cheese (1 inch by inch cube)=7 grams
Low fat cottage cheese � cup=13 grams
Skim/1%/lactaid free milk (8 ounce cup)=8 grams

Once Protein Requirement Is Met For The Day These Other Foods May Be Consumed On the Pureed Stage

• Soups should be non-chunky. Low-fat cream soups or pureed low-fat soups like Healthy Choice.
• Add tasteless protein powder to boost protein in soups.
• Oatmeal, grits, instant mashed potatoes.
• Unsweetened applesauce and canned fruit in their own juice (no pineapple) and baby fruit, V-8 juice.
  

Week five:

• Advance to regular consistency food as tolerated. Tolerance varies from person to person. Add regular foods slowly back into diet. Soft breads and thick meats won�t be tolerated if adjusted properly.
• All foods should be low fat, low-sugar or sugar free and have high fiber.
• Avoid broccoli, asparagus, dried fruit, corn, celery, artichokes, rhubarb, pineapple, and dry/overcooked foods. These foods could obstruct the band if not overcooked and cut into tiny pieces.
• Coconut, chips, and popcorn can also obstruct the band and are best left alone.
• Nuts are difficult to digest.
• Eat 2-3 ounce of protein, 2 ounces of carbohydrate (1/4-1/2 cup of food) 3-4 times daily.
• Introduce one new food item at a time.
• Chew until food is a liquid to prevent vomiting.
  

POST-BAND FILLS:

If a patient receives an adjustment:

• Follow Liquids� stage listed above for 48 hours.
• Advance back slowly to regular consistency foods.

TIPS ONCE EATING:

• Avoid overeating/vomiting at all costs. Both may cause slippage of the band and send you back to the operating room.
• Eat slowly and chew foods until they are a mushy/thin consistency.
• Work your way slowly up to �-1/2 cup of food meals.
• Do not eat pieces of food that are too large and can block the stomach opening (avoid thick meats and soft breads).
• Stop eating when satisfied and comfortable not when overly full. Overeating can cause the pouch to stretch prematurely and may cause vomiting. This may also cause a slip of the band and require surgery.
• Eat three meals a day and consume protein with each meal.
• Consume one protein shake a day.
• Always read food labels for low fat, the sugar rule, and high fiber.
  

VITAMINS:

• All patients must take one chewable Bariatric Advantage multivitamin.
• You may swallow a One A Day multivitamin after the first month.
• Additionally patients must take 3 Bariatric Advantage calcium chews a day for calcium.
• You may swallow 2 calcium citrate vitamins with vitamin D to provide 1200-1500 mg/day after the first month.
  

VITAMIN SCHEDULE:
Start immediately post operation

• Take 1 multivitamin and 1 Calcium Chew
• Wait 2 hours
• Take 1 multivitamin and 1 Calcium Chew
• Wait 2 hours
• Take last calcium chew
  

INCORPORATE EXERCISE INTO YOUR LIFESTYLE:

Start off with 10-15 minutes of some form of exercise 2-3 days a week and increase as able. Do something you�ll enjoy at a moderate level.

IDEAS FOR EXERCISE:

• Stationary bike
• Walking
• Water walking
• Swimming
• Exercise tapes at home
• Curves Gym
• Arm weights and floor exercises

PREVENT DEHYDRATION:

• Do not drink fluids with calories.
• No carbonation, caffeine, or straws. Caffeine is a diuretic, which causes fluid loss. Carbonation is air bubbles, which cause gas/ bloating, and take up space where fluid could go. When drinking with straws you�re taking in air as well.
• Drink fluids between meals.
• Consume a minimum of 48 ounces a day.
• Sip fluids continuously between meals to meet the 48 ounces a day goal.
• Do not eat and drink together, it will stretch the pouch.
• Simultaneous eating and drinking may cause expansion/swelling of the food with resultant overfilling of the pouch leading to vomiting and possible slippage of the band requiring surgery.
• Stop sipping 30 minutes before the meal and resume sipping 60 minutes after each meal.

RECOMMENDED PROTEIN SUPPLEMENT PRODUCTS:

1. Bariatric Advantage.com Anywhey protein powder 17 grams of protein. This is a tasteless protein powder.

2. Wildberry, pineapple orange, peach mango, lemon, grape, orange, grapefruit protein powder mixed in water with ice. Provides 15 grams of protein.

3. After the 5th week post-op there are various protein bars (see Nancy Lum for details)

RECIPE: protein powder � cup skim or 1% milk 3-ice cubes 1 packet of Splenda a few drops of flavor and few pieces of fruit and puree.
This powder may also be added to foods.

GENERAL INFORMATION ON LAP-BAND SURGERY:

• Goal is to lose 1-2 # a week.
• After two years goal to lose ~50-60% of excess body weight.
• First post-op follow-up appointment is 2 weeks after surgery.
• First assessment for adjustment is on week 6. Patient will be re-assessed for adjustment every 6 weeks until the 6-month appointment and then every 3-6 months.
• Keep a weekly weight diary to show Dr. Li at every follow up appointment .