Why do some foods get stuck in the lap-band? One of the vagaries of the LAP-BAND is that some foods appear to lodge in, or above the band, resulting in patient discomfort, productive burps, and vomiting. This is not a desired effect, and can lead to a band slip, or even to band erosion. There are several types of foods that become stuck.
Gluten style foods
Doughy white bread, white crackers (like goldfish), sticky white rice, sticky white pasta are all foods that sit above the lapband and can cause discomfort, and a number of times have caused the patient to have a band slip. None of those foods are on a list of any food that a person concerned about losing weight or their health would be eating. The mechanism for these foods is clear- much like adding water to flour and making paste- these foods appear to form a ball that sits above the band- and the body works hard to expel them.
The human does not have the digestive enzymes to break down methylcellulose. Hence most vegetables and fruits that are high in this fiber will get stuck. Classic examples include skins from grapes and apples – pulpy fruits like some grapefruits or pineapple. Vegetables that are problematic include asparagus or broccoli.
Apples may need to be peeled. Grapes frozen. By freezing the grape the skin is fractured when you eat it, and goes through the lapband easily.
Vegetables should be cooked. There are many who assume that raw vegetables are better than cooked—and that is not the case (We have an entire video about this on yourdoctorsorders.com). Cooking the vegetables allows a break down of the methylcellulose that would otherwise become stuck in the band.
The best method of cooking vegetables is Sous Vide style. Consider that the opening of the stoma (the middle of the band as it compresses the stomach) is typically about the diameter of a pencil lead. Eating anything larger than that will result in it being stuck- especially if it is stringy. So mechanically cutting food to small pieces is a start.
Another method of breaking down the fiber is to dry it out, dried vegetables are easily tolerated. The methylcellulose fiber is dried out- so when you crunch it, the vegetable goes down easily.
Proteins are a different matter as to how they are cooked. Meats are like a sponge- when they are cooked they first soak up the protein like a sponge soaking up fluid. Technically, the proteins, when cooked below 200 degrees F unravel a bit – and the amino acids that unravel are called hydrophilic – meaning they are friendly to water. This is why the center of medium rare is so juicy.
You can imagine taking a bite size piece of sponge – that is soaked with water- and pushing it easily through a small funnel. Cooking above 200 degrees causes the proteins to dry out. The amino acids that unravel in this range of cooking are hydrophobic, meaning they repel water. This is why meats become dry the more they are cooked at higher temperatures.
Take that soaked sponge, and put it in the oven at 350 degrees for an hour. It is dried out. Now cut off a bite size piece of the sponge and try to push it through a small funnel – -it won’t work. Your body tries to do this- and to help push it through your body creates a lot of “slime” to push the protein through (also called sliming).
The best method to cook meat is to use a Sous Vide method of cooking. Cooking chicken at 147 degrees F in a sealed bag in a water oven allows you to cook it through without getting rid of the juices. Chicken will get done in about 45 minutes.
Other methods of cooking can be used for chicken- such as how supermarkets sell it (roasted) – which is the meat is cooked slowly- and is typically retaining its juices. Pressure cooking can dry a chicken out, as can a crock pot if left on too long.
Dr Terry Simpson
Dr. Terry Simpson is a Phoenix weight loss surgeon. He encourages his lap-band surgery patients to learn to cook and adopt healthier lifestyles. His goal is to use culinary medicine to keep patients out of his operating room. in 2017, Dr. Simpson became a Certified Culinary Medicine Specialist.