Nutrition Care For Patients Undergoing Laparoscopic Sleeve Gastrectomy For Weight Loss

The vertical sleeve gastrectomy involves surgical removal of a large part of the stomach. The stomach is reduced to about the size of a banana and as such, patients feel full after a very small amount of food, losing weight because they eat less. Compared with the traditional gastric bypass, in which the stomach is completely removed from the path of food, this procedure has lower rates of side effects. According to Dr. Dennis Smith of Wellstar Comprehensive Bariatric Services, this procedure does not cause the malabsorption of essential nutrients and does not involve the placement of foreign objects to bind the stomach. Weight loss is expected to be 55 to 70 percent of body weight.

Nutrition Requirements

As with any weight loss surgery, your diet will need to significantly change your diet after the procedure. Cornell University recommends progression from a liquid, to soft, then a modified solid diet over a period of 6 to 8 weeks. It is important to monitor portions and adhere to the nutritional plan your physician recommends. Overeating can lead to vomiting and malnutrition.

The First Days and Weeks

The first day following the procedure is a rest day for your bowels; you consume no food. On days 2 and 3, you advance to clear liquids -- about 3 to 4 oz. every hour when awake. Day 3 to week 3 mark a soft, pureed diet that is high in protein. Food is pureed for ease of consumption. This diet should include 550 to 700 calories with 50 to 70 g of protein and 4 to 6 oz. of fluids every hour.

Week 3 and On

Weeks 3 to 6 involve re-introducing solid foods one at a time to ensure you can tolerate them. The food should be easy to chew such as lunch meats, slices of low fat cheese, toast and crackers. It is important to focus on lean protein, fruits, vegetables, and whole grains with a low sugar and low fat content. Weeks 6 to 8 involve increasing the variety and texture of solid foods. Diced meats, veggie burgers, soft fruits, and well-cooked pasta can increase diet variety. During month 3, you can add rice, bread, and meats to your diet. Month 4 can include crunchy fruits, vegetables and include salads with low fat dressing. Six months after surgery, you can incorporate lean meats and pork.

Supplement Requirements

Due to the drastic changes in your food intake, you will need vitamin supplementation. Cornell University recommends a chewable children's vitamin twice a day, chewable calcium, and protein shakes during the first three weeks after surgery. Following this initial period, you should take an adult multivitamin and 1200 mg of calcium citrate each day. In addition to these vitamins, your physician may recommend vitamin D and iron replacement if your levels are low, protein shakes if the daily requirement is not met by food alone, and gallbladder medicines. Ursodiol is a medication that acts on the gallbladder to prevent formation of gallstones during rapid weight loss; you may take this medication for six months.