NUTRITION GUIDELINES FOR LAP-BAND ® PATIENTS

New Ways of Eating and Living.

Eat slowly and chew foods until they reach a mushy consistency. Swallowing food in chunks may block the opening and prevent the passage of food. The following are hints to help you eat more slowly:

• Set aside 30 to 45 minutes to eat each meal,
• Actually count the number of times you chew each bite. Aim for 30.
• Make an EAT SLOWLY sign and place it on the table in front of you.
• Explain to family members why you must eat slowly so they will not urge you to eat faster.
• Take small bites of food. You may want to try eating with a baby spoon.
• Pay attention to taste. Learn to savor each bite, noticing its flavor, texture, and consistency.
• Chew well. Ground or very soft foods may be necessary if you have dentures.

Stop eating as soon as you are "satisfied". Once your stomach is full, your body receives a signal that you have eaten enough. It takes time, though for you to become aware of this signal. If you hurry your meal, you may eat more than you need. Besides causing you to vomit, extra food over a period of time may stretch your stomach. Try to recognize the feeling of fullness. Then stop eating at once. Indications of fullness may be:

• A feeling of pressure or fullness in the center of your abdomen just below the rib cage.
• Feelings of nausea.
• Pain in your shoulder area or upper chest.

If you start vomiting, and it continues throughout the day, stop eating solid foods and just sip clear liquids (gelatin, clear juice, broth, and tea). The vomiting may indicate that your outlet is blocked. If intermittent vomiting continues for more than 24 hours, contact your doctor. Most vomiting episodes can be prevented. The causes of vomiting are:

• Eating too fast and not chewing food properly.
• Eating too much at a meal.
• Drinking liquids right after eating.
• Lying down after a meal. Eating foods that don't agree with you.

Set aside three mealtimes per day and eat solid foods only at these times. The LAP-BAND® system creates a small stomach pouch that can hold only about half a cup (3 to 4 oz.) of food. If you try to eat more than this at one time you may become nauseous. You may also vomit. If you routinely eat too much, the small stomach pouch may stretch. Frequent vomiting can also cause certain complications, such as stomach slippage. You need to learn how much your stomach pouch can hold comfortably and then not exceed this amount. It is important to eat nourishing foods and to avoid the habit of snacking. Eating often throughout the day may keep you from losing weight because you will be able to eat enough calories to maintain that weight. Individuals who continuously munch on crackers, potato chips or other foods have not only failed to lose but have even gained weight.

Drink four to six cups of liquids per day between meals. Liquids are needed to replace normal body water losses and thus prevent dehydration. Recommended beverages are skim milk, water, tea, coffee, and low-calorie drinks. Individual need will vary, but you should drink at least 6-8 glasses of water a day.

Do not drink while you are eating. If you drink at mealtimes, the food you have eaten becomes liquid. Then the effectiveness of the LAP-BAND® system is greatly reduced. You should not drink anything for at least one hour after a meal. That way you can keep the feeling of fullness as long as possible.

Sip beverages slowly. One way to begin is by taking sips of beverages from a medicine cup or shot glass instead of drinking from a regular glass.

Eliminate high-calorie drinks. Milkshakes, soda pop, beer, and other alcoholic beverages are very high in calories. By sipping on high-calorie liquids throughout the day, many calories are absorbed without creating the effect of fullness. This will result in a poor weight loss record. Avoid carbonated liquids because they could increase the size of the pouch creating discomfort.

Do not eat between meals. Eating snacks between meals is one of the major reasons for weight-loss failure. It is very important to break this habit. Eat a balanced diet. Because the quantity of food you can consume at a meal is reduced, it is important that what you do eat be of good nutritional value. Do not fill your small stomach pouch with "junk" food that lacks vitamins and other important nutrients. Eating foods from each of the four food groups will provide adequate amounts of protein, vitamins, and minerals for your needs.

Exercise at least 30 minutes a day. Since physical activity consumes energy and burns calories, it is very important to successful weight loss. Exercise can help improve your general health. Start with simple activities such as walking and swimming. Gradually expand your program to include more vigorous forms of exercise such as cycling. Jogging and aerobics. Increase your activity level in the course of daily living. For example — stand rather than sit, walk rather than stand, be outside rather than inside, walk rather than drive, climb the stairs rather than use the elevator, etc.