Food Intolerance After Gastric Band Surgery

Laparoscopic adjustable gastric banding (LAGB) is a type of weight-loss surgery meant to help severely obese people lose at least half of their extra weight. During the surgery, a band is placed around the top section of the stomach to reduce the size of the part of the stomach where the food goes. This makes you feel full more quickly, and it helps you not eat too much food.

Illustration of a restrictive surgical procedure for weight loss

After this surgery, you won't eat as much as you used to. This helps you lose a lot of weight. By losing weight, you also cut your risk for obesity-related diseases. But the surgery may lead to a number of side effects, including food intolerance.

Food intolerance means that your body can't digest certain foods the way it should. These foods include meat, fruits, and vegetables. Because of this, you may have unpleasant symptoms such as nausea and vomiting. You may also become lacking in certain nutrients.

A problem that gets missed

Doctors may not always notice food intolerance after weight-loss surgery. In the past, doctors thought that people who had LAGB surgery wouldn't have nutritional problems. That's because LAGB cuts down on the amount of food you eat, but not the amount of nutrients you get. Everything you can eat will get absorbed normally. Other weight-loss surgeries like gastric bypass are meant to interfere with how the body gets nutrients from what is eaten. These operations can affect normal absorption of ingested food by bypassing certain regions of the stomach and small intestine where nutrients are absorbed. But nutritional problems can happen after LAGB if you don't eat a diet that's nutritious. It can also happen if you don't take the daily vitamin and mineral supplements your doctor gives you, or if you experience frequent vomiting. If you can't digest meat, for example, you might develop anemia. That's because meat contains a lot of iron, which prevents anemia.

Sometimes food intolerance is caused by a condition called parosmia. This condition makes the smell of foods seem unpleasant. Parosmia can trigger nausea and vomiting. Because of this, you don't want to eat and so don't get the nutrients you need. Parosmia tends to be more common in people who have had gastric bypass surgery, but it can also happen after gastric banding.

Left untreated, nutritional problems can damage the nervous system.

Symptoms of food intolerance

These are signs of food intolerance:

  • Excessive gas and abdominal cramping

  • Nausea

  • Repeat vomiting

  • Gastroesophageal reflux disease, or GERD

  • Bloating or an overly full feeling in the abdomen

Diagnosis and treatment

Your doctor will order regular blood tests to check for any nutritional problems. He or she will do this at six months after surgery, or sooner if needed, and then every year after that. This is important because nutritional problems may develop over time, even years after LAGB. But talk with your doctor right away if you notice symptoms of food intolerance or any unusual symptoms. These include fatigue, inability to exercise, abdominal pain, swelling, persistent vomiting, neurologic problems (such as double vision or confusion), or other signs of diet-related diseases or malnutrition. Together, you and your doctor can develop a plan for a nutrient-rich diet.

Be sure to take the daily vitamin and mineral supplements (calcium and iron) that your doctor gives you. If you can't eat high-protein foods such as meat, your doctor may have you add a liquid protein supplement for a while. Other ideas include cutting food, especially meat, into tiny bites or blending it, cooking food until it is tender, chewing well, and eating slowly. Try to avoid baby food meats. 

It's extremely important to address any signs of malnutrition as early as possible because it can become difficult to treat and even life-threatening in advanced stages. Know that if you have severe food intolerance, you may need to have your gastric band deflated or removed.