Gastric bands… putting the squeeze on obesity?

I’m in the process of setting up a support website for gastric band wearers and would love to hear your experience – contact me if you’d like to share your story.
Obesity rates continue to soar… by 2015, it is predicted that 41% of adults and nearly 24% of children will be obese ie with a body mass index of more than 30.
An increasingly popular solution to obesity and more recently type 2 diabetes is gastric banding, which involves keyhole surgery to fit a small silicon ring around the upper part of the stomach, creating a small pouch.  The pouch fills quickly with food as the band restricts movement of food to the lower stomach.  The tighter the band, the more restricted the passage and the slower the speed of gastric emptying.  The purpose of the band is to help the patient feel hungry less often, to feel full more quickly and for longer and to eat smaller portions.
Banding reportedly minimally affects vitamin and mineral absorption, however research shows a real risk of micronutrient deficiencies, particularly iron, vitamin B12, folate, calcium, vitamin D and vitamin A.  There’s a reported iron deficiency in 72% of patients just 18 months after band placement, probably due to low intake as eating iron-rich meat and vegetables is difficult.  Changes in eating habits (such as less carbohydrate from cereals, bread, pasta and green veg) can result in low folic acid intake. Over 44% decline in folic acid levels was found within two years in banded patients. Homocysteine is an amino acid produced in the body and recycled harmlessly with the aid of folic acid, B6 and B12.  High homocysteine levels have been linked with dementia and Alzheimer’s disease, strokes and heart attacks, osteoporosis, diabetes, pregnancy complications and poor concentration.
Also, due to the small capacity of the stomach it can be difficult to drink enough water and patients may be at risk of dehydration, with its resulting symptoms of constipation and fatigue.
Therefore, in addition to nutrient status, banded patients should be monitored for high homocysteine, secondary hyperparathyroidism, osteoporosis and anaemia.
Giving specific advice regarding foods is difficult as everyone is different but generally the foods would need to be nutrient dense, low in saturated fat and sugar and be easy to swallow.
It is vital to eat slowly, chew well and eat small meals at regular intervals with snacks between meals to help balance blood sugar levels and maintain energy.  In light of the nutritional deficiencies reported, it would be advisable for the gastric band patient to follow a supplement plan in chewable, liquid or powder form to prevent obstruction of the band.
Support for gastric band wearers is an area I’m particularly interested in.  I’m aware how difficult it can be to eat properly with a band; eating can become a chore and you can become disheartened and bored… and having a band fitted does not reduce the cravings you may have had before the op.

Written by

Claudia Williamson Registered Nutritional Therapist DipION, FdSc, mBANT, mCHNC Tunbridge Wells, Kent