Vertical Sleeve Gastrectomy Patients
Postoperative Weight Loss Guide
Important Tips to Remember for Successful Weight Loss:
Now that you’ve taken your decision for gastric sleeve surgery in Mexico here are some important guidelines to follow. The greatest weight loss will occur within the first six months. It will start to slow after that, but can continue for a total of 12-18 months. You may intermittently have plateaus in your weight loss for up to a month. This is usually an indication that you are eating too many carbohydrates or calories and/or not exercising enough. Take this as a sign to re-examine your eating and exercise habits. Most patients' weight will plateau after 8-12 months. After this time, additional weight loss may be difficult. Weight regain may also occur if too many calories are consumed, exercise is discontinued or old habits, such as grazing, snacking, or poor eating habits return.
1. Consumption of an adequate amount of liquid, preferably water, is crucial
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Patients should consume a minimum of 2- 2½ quarts (64-80 fluid ounces) of liquids per day. This should be done slowly and throughout the day. The easiest way to keep track of this is to purchase a 32-ounce water bottle and finish at least 2 bottles of liquids a day. Sip, Sip, sip..
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This amount should be increased by 10-20% when the weather is very hot and humid to prevent dehydration.
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In the first 30-45 days after surgery, avoid drinking more than 3-4 ounces of liquids (1/3 of a cup) in a 10 minute period to avoid vomiting. Avoid gulping any more than 1 ounce (shot glass size) at a time. Eventually, you may be able to drink more at a time.
2. Solid foods should generally only be eaten 3 times per day. (This should correspond to mealtimes.) Some patients need to eat more often 5-6 small mini-meals to get their protein in, you will just need to adjust according to your own needs.
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Snacking between meals or "grazing" on small amounts of food throughout the day will sabotage your attempts at successful weight loss.
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If you "graze," you will not lose an adequate amount of weight because you may consume too many calories.
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You will need to be the judge of your meals and snacks. Some patients need to have 5 mini-meals per day and that works for them. Since everyone is individual, there is no hard fast rule.
3. The primary source of nutrition should be protein.
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70%-75% of all calories consumed should be protein based (eggs, fish, lean meats, etc.; bacon is not a lean meat).
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Carbohydrates (bread, rice, pasta, potatoes, beans, etc.) should be only about 10%-20%, and fats (butter, cheese, etc.) only 5%-15% of the calories that you eat. If you must eat the carbs, opt for quality whole grains.
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A diet consisting of 600-800 calories and about 70 grams of protein should be your goal for at least the first 6-8 months. Caloric intake can increase as your stomach stretches.
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Swollen ankles, fatigue, hair loss, cracked nails, and defective healing and immunity are just some of the side effects of inadequate protein consumption (not to mention difficulty losing weight). Hair loss may also be due to hormonal changes but protein levels can be checked to be sure you are not developing a protein deficiency.
4. NEVER drink liquids when eating solid foods.
5. Avoid foods that contain sugar, especially simple sugars, such as in most sodas, fruit juice drinks and candy bars.
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You must focus on eating enough protein to prevent malnutrition and hair loss. If you eat protein rich foods first at each meal, you will have little room left in your stomach for simple sugars.
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Sugar and other carbohydrates may slow your weight loss because they are so easily digested and absorbed. Vertical Gastroplasty/Gastrectomy patients who have early plateaus are most always consuming too many carbohydrates. Because the negative biofeedback of Dumping syndrome is not present with this operation, it is all too easy to start eating too much sugar and other carbohydrates. Eating protein first and when hungry will help to minimize the chance of consuming too many carbohydrates.
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Sugar, sugar alcohols and artificial sweeteners cause gas, bloating and diarrhea. VSG patients usually do not get dumping; however they may if they eat significant amounts of fat or sugar. If too much sugar is consumed, it may enter the intestines rapidly and travel through quickly. This may lead to gas, bloating and a mad dash for the bathroom.
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Avoid starchy foods such as rice, pasta, cereals, and mashed potatoes. Again, if you must eat them, opt for better choices of whole grains.
6. Stop eating/drinking when you begin to feel full. Do not "stuff" yourself. This may cause your stomach pouch to stretch.
7. You should begin an exercise program. You will accelerate your weight loss and have a better chance of reaching your goal weight by establishing a good aerobic exercise program and making healthy dietary choices. In addition and more importantly, aerobic exercise strengthens the heart and makes you feel better. It can also help to suppress hunger.
8. As mentioned above, patients whose weight loss has hit a plateau are usually eating too many carbohydrates. Lack of exercise may also limit the amount of weight loss. Occasionally, patients who exercise a great deal can experience a weight plateau due to increased muscle and lean body mass (like body-builders). Remember - muscle is denser than fat and thus weighs more. These patients often notice that they are losing inches and clothing sizes and should keep up the good work! Weight loss through exercise is the healthiest way to lose! Do not let the scale dictate your progress for you, how do your clothes feel, are you losing inches? These are the questions you should ask yourself.
Tips for eating
The most difficult (and most important) time after surgery is the first 3-6 months. This is also the most important time because the habits that you develop in this period will be the ones that you will probably adopt for the rest of your life. In the first months after surgery, you are relearning how much you can eat (portion size as well as "bite" size), how well you have to chew, and what you can eat without developing problems. Although everyone is different, usually by the sixth month patients are eating most regular (healthy) foods - but in much smaller portions than they did before surgery. There will definitely be foods that you will never want to eat again because they will cause some type of "intestinal distress."
