Chapter 5
The gastric balloon is an endoscopic weight loss procedure that includes inserting a balloon inside the stomach and inflating it with saline solution or air. Afterward, a gastric balloon diet to achieve desired results is required. This diet includes three steps: a liquid diet, a puree diet, and a solid diet. After these stages are done, patients will switch to a solid food diet. From then on, they will continue their journey with their dietitian, even after their ballon is removed on the 6th or 12th month.
Sometimes following a diet might seem difficult, or too monotone. That is totally not the case. There are numerous delicious and healthy recipes that can replace comfort foods. As long as you follow your gastric balloon diet guidelines and keep yourself physically active, you will start enjoying your new lifestyle.
Do I need a diet prior to the surgery?
A pre gastric balloon diet is not a necessity. However, if you wish to get used to your new calorie intake and start your adjustment early, you can go through a gastric balloon pre op diet.
For gastric sleeve and gastric bypass, a pre-op diet might be deemed necessary. That is only if their BMI is way above the limit or they have fatty liver disease. However, these procedures require the liver to be lifted. For the gastric balloon, that is not the case.
The gastric balloon is an endoscopically performed procedure. So it does not require the liver to be lifted. Also, the balloon sometimes is used to shrink the liver and lower the BMI in some cases to make other bariatric surgeries safer to perform.
This pre-op diet only requires the patient to consume clear liquids a few days before the intra-gastric balloon procedure to ensure the stomach is empty when its time for gastric balloon insertion. Sometimes, your surgeon might prescribe you PPI (proton pump inhibitor) to reduce stomach acid levels.
Does gastric balloon surgery require a post-op diet?
Yes, a gastric balloon post op diet is absolutely necessary to achieve weight loss. The patient should lower their calorie intake and get the necessary nutrients their body needs. With a gastric balloon diet plan tailored to meet your need by your dietitian, you will achieve the best optimal results.
To maintain your long-term weight loss, you should stick to your diet wholeheartedly. Not following the steps of your diet might result in weight gain. And that regain can even be more than your starting weight.
You might also experience certain side effects and other risks. Some side effects can still show themselves during the adjustment phase, but that is absolutely normal. Post gastric balloon diet will help you manage and/or avoid them.
Here is the post-op diet guide in 3 stages
The 3 stages of this post gastric balloon diet are tailored for the adjustment phase of the patient. Going from clear liquids to solid food gradually will help your stomach get used to the balloon. During that phase, you might experience some side effects, such as abdominal pain and cramping. The diet can help you manage, and even avoid them.
Let’s dive into more detail on these three stages and what awaits afterward.
Stage 1: Liquid and heavy liquid diet
The first stage has 3 other stages in it where you are required to consume only liquids. This stage lasts a week. For the first day, you will be asked to only drink clear liquids. Such as water and herbal or green or black tea.
On your second day, you will continue with the liquid diet. However, you can now have protein shakes, fresh juice, lactose-free or fat-free, or plant-based milk, chicken or bone or vegetable broth, and compote. While making broth, you should avoid vegetables that can make you gassy, such as cauliflower or onions. And make sure your liquids are at room temperature. Avoid drinking liquids too hot or too cold.
On your 3rd day, you will switch to a heavier liquid diet. You can have yogurt, decaffeinated coffee, kefir, etc. Until your 7th day, your diet will continue like this.
Stage 2: Pureed food
On your second stage, on your 7th day, you will switch to soft foods. Meaning you will be having pureed food. This can be veggies, lean meats, and fruits. You will go on with this diet until your 15th day. Make sure you blend or mash your food. If it has any grains left, make sure to chew thoroughly. You should keep avoiding vegetables that can make you gassy. And continue consuming your food when they are at room temperature.
For the first 2 days, you can start trying eggs in this stage. It can be boiled, scrambled, or omelet. Make sure you mash or blend it enough. After 2 days, try soft low-fat cheese for another 2 days. After that, try eating the egg and the cheese together. You can eat them separately or mixed.
Since now you are consuming purees, you should wait 30 minutes between meals to drink water. Drink your water or other liquids 30 minutes before your meal. And wait 30 minutes after your meal to drink water and other liquids. Because eating and drinking at the same time can make you feel fuller and you may not be able to get the nutrients you need. It can also cause your stomach to stretch and consume more calories.
Stage 3: Solid food
After 2 stages are done, you will now switch to solid food. Your dietitian will provide you with a daily diet and various recipes to try. You will still be learning about the limits of your stomach. Most of your restrictions will be lifted. Don’t rush your process. If a food you tried brings discomfort, stop eating them for a week. And try them again then. Your stomach wall is sensitive because of the presence of the balloon, so it will need some time to regain strength and tolerate most foods.
There are two golden rules you need to apply for the rest of your life after this procedure. One of them is avoiding carbonated drinks at all times as they can largen the stomach. Also, do not drink anything with your meals. Not only can it enlarges your stomach, but it can also prevent you from getting the nutrients you need as you will start to feel full faster with your gastric balloon.
Can I drink alcohol after the balloon operation?
You should avoid alcoholic beverages after a gastric balloon operation, either surgical or pill operation, for at least 3 months. Because alcohol is high in calories and has little to no nutritional value. We aim to reduce calorie intake and alcohol can do more harm than good in the early stages of your weight loss journey.
Alcohol has a numbing effect. If it affects the stomach, it can interfere with the feeling of fullness, causing you to eat more. However, it can also disturb your stomach. The gastric balloon can make the stomach more sensitive. And alcohol can irritate the stomach lining. This can indirectly cause abdominal pain and cramping, along with other risks and complications.
8 tips to maintain your diet
Talking about the diet is easy. Maintaining the diet is the key point of it all. Sometimes it may get boring or you simply might not know what to do. That is why we compiled tips on how you can maintain your diet with ease. Let’s review.
Satisfy your eyes before your stomach
Even after surgery, you might feel like your plate looks empty. And that might drive you to fill your plate more than necessary. For this reason, you can use smaller plates—either a bariatric plate or a bowl, or a 9 or 10-inch dessert plate.
A smaller plate will help satisfy your eyes. Because the smaller the plate is, the bigger the amount of food will look like.
Balance your plate
Your plate after gastric balloon should be high in protein, moderate in carbs, and low in fat. Let’s make it clear how this diet works:
- If you eat fewer calories, you will lose weight.
- If you eat fewer calories and increase your protein intake, you will lose body fat.
- If you eat fewer calories with lots of protein and exercise regularly, you will lose body fat and gain muscle mass.
Your plate should consist of 50% protein, 30% complex carbohydrate fruits and vegetables, and 20% healthy fats. If you place your meals on a 9 or 10-inch plate, you should be able to get the right amount of nutrients. Nothing less, nothing more.
3 meals 3 snacks
Your gastric balloon diet plan will consist of 3 meals and 2+1 snacks. Normally, people opt for 2 snacks a day. So the additional snack time is optional.
If you divide your meals this way, you will not feel hungry throughout the day. And since you have a gastric balloon, you will feel full faster and longer as it also slows stomach emptying.
Stop eating once you feel full
You should stop eating once you start feeling full. It is okay that you leave some food on your plate. Do not feel like you have an obligation to finish them all. Because if you do try to finish your plate, you might experience stomach pain and cramps. It can even lead to nausea and vomiting. And that can compromise your health.
Additionally, if you continue eating while you are feeling full, your stomach can stretch to be able to fit all the food you are consuming in one meal. And during a weight loss journey, that is the last thing anyone would want, as it may delay you feeling full after eating.
Balance your macros throughout the day
Your daily calorie intake should be 800-1200. In order to lose body fat and gain muscle, your daily intake should look like this: 60-100 grams of protein, 26-42 grams of fat, and 50-100 grams of carbs.
If your diet plan requires you to consume 1200 calories, you should get 100 grams of protein, 42 grams of fat, and 100 grams of carbs. You can split these nutrients among your 3 meals and 2 or 3 snack times. To help you balance your macros, your dietitian will give you a few exemplary daily diet lists. You can mix and switch some of the things in order not to get bored of a routine and be able to enjoy various delicious, healthy food and snacks.
Make a meal prep plan
You can prepare your food weekly. Storing them in the refrigerator will help keep them fresh. You can heat them up and eat them whenever you need them. Some foods, like salads, do not even need to be heated.
To start making a meal prep plan, you need to see what you have and what you don’t have in your fridge or pantry. If you need to, you can go grocery shopping. After getting everything you need, check your diet list. You can also contact your dietitian to be sure. Look for recipes or revise some of the existing recipes with other ingredients. Make sure both ingredients have the same nutritional value.
You can change your weekly plan to your liking as you don’t have to eat the same things every week. Just make sure you confirm your ingredients with your dietitian.
Always stay hydrated
Water is life. It is highly crucial for both survival and weight loss. It can aid weight loss by promoting a feeling of fullness and curbing the appetite. Water can also help break down food and helps the absorption of necessary nutrients, vitamins, and minerals. Water is a great helper to avoid irregular bowel movements. During your adjustment phase, drinking water will help prevent constipation and diarrhea.
Another thing, sometimes hunger can be mistaken for thirst. And you might think your body needs nutrients. That is not always the case. To determine whether your body needs nutrients or needs hydration, you should drink water first. If you feel your hunger going away, that should be the case. If not, prepare and eat your food 30 minutes after you drank your water.
Make sure you stay active during the day
Being physically active is very important during a weight loss journey. Gastric balloons alone can only help to an extent. Yes, you will lose body fat, but you can also lose muscle mass. That can weaken you and might cause you to procrastinate in your daily life. Approximately walking 10.000 steps a day is recommended to be able to stay physically active, which lasts around 40 minutes to an hour.
Being physically active does not necessarily mean spending hours and hours in a gym 5 days a week. Of course, you can do that if you wish to do so. However, you can start with exercising 1 hour a day 3 times a week. As your strength increases and you feel more energetic, you can do that 4 days a week. And also it does not have to be going to the gym. You can dance, go on a run, do pilates or yoga, ride a bike, swim… Anything you enjoy doing that keeps you physically active, you can do it!
Genco A, Maselli R, Frangella F, et al. Effect of Consecutive Intragastric Balloon (BIB®) Plus Diet Versus Single BIB® Plus Diet on Eating Disorders Not Otherwise Specified (EDNOS) in Obese Patients. 2013;23(12):2075-2079.
Crossan K, Sheer AJ. Intragastric Balloon. PubMed. Published 2022.
