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Complications from advancing diet too soon



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No matter how many people get this surgery there are always people who are going to want to do it the softer easier way and that's why they will probably gain back their weight in about five years.

Over the years I've seen too many people from being gung-ho in the beginning with great weight loss that gained back weight in the end anyway.

However, I understand the need to think "this won't be happening to me because I will be the perfect patient following everything to the letter and more" - I'd like to have a guarantee that this whole WLS thing will be the end of obesity as well. Unfortunately there is no guarantee as it seems. Look at the long term studies. Ask any real old timer who is 6, 8, 10 or more years out and is still active on boards or in RL self-help groups.

Many people who were quite smug during their first months or even years have become much more modest after some years, even though they didn't gain back weight or only a bit.

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But then you have people like me who got a diet plan, went in one week post op and was told that they weren't to worried about the diet just try each phase and if it worked out ok if not back up a step. So I'm like totally lost and pretty much just eating the same thing every day.

Wow. As a nurse, that makes me suspect some very unclear communication, either on the part of the surgeon/staff or on the part of what you understood.

My surgeon has one of the most liberal diet progression plans I've seen, and she knew from our conversations that she could give me the written lists and some general guidelines and I'd know what to do with them because I'm an RN.

She started me on full liquids - which on her plan includes Jello, pudding, and greek yogurt and a couple of other pudding consistency items - on day 2 after I kept Clear Liquids down fine on day 1 coming out from surgery. There was no negotiation on that for the first 2 weeks until my first checkup. Protein Shakes, and the things on the full liquids list, period.

She entirely skips the puree phase, as she says it's not functionally much different from the soft/mushy foods phase if your teeth work well, and most people hate it and aren't compliant. So I had a list of soft foods that I could START introducing after my 2 week checkup. One food at a time, from the softest and moistest foods first working my way to firmer consistencies. One new food at a time, tested a couple of times before adding another new food. This was for no less than another 2 weeks.

At my 4 week checkup, she allowed me to start adding in "normal" foods, except for a list of problematic foods such as raw veggies and things with seeds or small hard particles. Those were allowed after 6 or 8 weeks, I forget. I didn't actually try any of them until well after 2 months. But again, it was adding ONE food at a time, trying it several times before adding another.

So if your surgeon really said just "try foods as tolerated" then s/he failed to clearly communicate what the goal of the progressive diet is, and what you're trying to accomplish. That sounds like you can try all the foods in each phase for a day or two and if nothing causes a problem, go on to the next and you're on solids in under a week. Even if that's what s/he *said*, it is very doubtful to me that is what s/he *meant*. Doctors are not the greatest at patient education, it's not generally in their training. A surgeon who is truly advocating progressing the diet that rapidly has very likely not been doing it long enough to lose a patient to a leak or abscess.

That is REALLY good stuff. Well done, well communicated. If gives you a why as well as the what. May I suggest you copy that and put it in the pre-op section with, the horrible warning from the OP? Between the two, this is 90% of your first six weeks post op.

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