Because the opening from the upper stomach to the lower stomach is smaller than the pylorus, this stoma can easily become blocked with partially chewed food. All food should be chewed to a semi-solid liquid (the consistency of pudding) before swallowing it. Gulping down food will not work with this weight loss surgery. You cannot eat like Bert. Bert is my dog. Bert used to leave food in his dish, which my other dog, Ernie, would eat. Then we had Bert castrated—no more testicles, but a great appetite (who says obesity isn’t hormonal?). When you give Bert anything to eat, he takes three quick chews and swallows. If Bert were to have VBG weight loss surgery, he would have to learn to eat much more slowly.

If you do not chew well and a large piece of meat or vegetable blocks the stoma, you will start to vomit (the bodies reaction to the blockage). There are a several tricks for getting food through the stoma. One way is to vomit it up. There are better ways, however, such as drinking a few sips of a highly carbonated beverage. This will sometimes force the food through the stoma. (When things get stuck in the esophagus, weight loss surgeons sometimes use “fizzies” to force them down into the stomach.) If some meat has stuck in there, you can try some meat tenderizer (1/3 teaspoon of tenderizer in two teaspoons of water—retry in a half an hour). If this does not work, a gastroenterologist will probably have to remove it.

If you go to the emergency room and they try the fizzies—please do not let them also give you contrast. The gastroenterologist will want to scope you first and if your gut is full of contrast, it will obscure the view. The gastroenterologist can remove those food bolus products and, if necessary, can enlarge the stoma.

If you develop an ulcer in the stoma, you may need to be on some medicine to decrease the ulcer,such as Pepcid®, Prevacid®, or some such acid blocking agent. Generally you will be on these medicines for at least six weeks, sometimes longer.

With VBG weight loss surgery you can eat a balanced diet—just less of it

The VBG bariatric operation is a simple tool that will allow you to eat a normal diet. There is nothing difficult here, just simple eating. While you need to have a diet high in protein after some weight loss surgeries, this procedure allows you to eat a diverse diet—but you will be able to eat less and be satisfied.

The pouch depends on solid food to distend it. If you are eating foods that are not solid, you are not using your new tool. Foods that we allow early post op do not work later. For example, yogurt is a good food, but it will not keep you satisfied and full for long. Mashed potatoes have a lot of nutritional value, go down easily, but also go through the stoma easily. Again, there are no bad foods, just bad quantities of foods. This is the time to learn how to eat a balanced meal. Your pouch will enlarge, and that is a good thing. You will still be able enjoy eating more food, but the key staying healthy and losing weight is in having a balanced diet.

Once again, the key to successful weight loss with the VBG bariatric operation is to have a balanced diet with low glycemic index carbohydrates and high-quality protein. Enjoy a balanced meal, feel full, and lose some pounds.

The VBG has stood the test of time. It works because it combines a simple restrictive component. It works best when bariatric patients are informed, learn what foods to eat, and what foods will not work. The VBG bariatric operation provides a sense of satiety and control over food that you couldn’t enjoy before.