The Effect of Practical Dietary Counselling on Food Variety and Regurgitation Frequency after Gastroplasty for Obesity

After obesity surgery, the primary measurement of success is the amount of weight lost. There has, however, been little assessment of how patients cope with the dietary constraints imposed by gastroplasty. Similarly, dietary patterns adopted to cope with these constraints have not been studied fully. These factors are of great importance in terms of nutritional adequacy, patient acceptability and long-term success. A study involving 32 patients was conducted to ascertain whether practical nutritional intervention and extensive follow-up would improve the overall outcome of the gastroplasty operation with respect to the type of foods tolerated and the incidence of regurgitation or vomiting experienced. To quantitate success in terms of frequency of regurgitation and variety of food intake a vomiting/eating (V/E) score was devised. The results showed that the group of patients with more intensive practical education and counselling had a more varied intake of food and coped better with a wider variety of solid foods in the long term. Despite a more solid diet they did not regurgitate food as frequently as patients with less education, and over half the study group of patients reported no regurgitation at all. From this study, it is proposed that patients can be assessed and categorized postoperatively using a V/E scale. This scale numerically scores success with diet after gastroplasty, which, when recorded in conjunction with subsequent weight loss, can give a better quantification of success after obesity surgery.