REALIZE Lap Band vs Gastric Bypass: Differences in Nutritional Needs

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Patients trying to choose which surgical weight loss method - gastric bypass, LAP-BAND or REALIZE Band - is most appropriate for them have important nutritional issues to consider, according to the experts at a New Jersey medical center which specializes in the treatments.

The three procedures have differing nutritional implications for life after surgery, which doctors and patients need to discuss. Ajay Goyal, M.D., and Karen Kelly, R.D., of the New Jersey Bariatric Center (Hoboken and Union), offer counseling and free educational seminars to help prospective patients make informed choices based on their medical history, weight-loss goals, and diet.

Certain post-surgical requirements are the same among all three choices. In all cases, patients will be placed on a high protein diet with supplemental calcium and multi-vitamins. There are differences, however, in the amount and duration of supplementation required.

Gastric Bypass - Nutritional Needs

Gastric bypass leads to almost complete loss of the body’s access to a number of vital nutrients that are usually absorbed in the stomach, including protein and various vitamins and minerals. Patients who opt for this approach will need to take those supplements permanently--including a daily B12 lozenge put under the tongue to dissolve. Gastric bypass patients will also require annual blood tests to ensure they are maintaining adequate levels of all these elements, since outward symptoms of deprivation may not become apparent until significant damage is done.

Lab Band - Nutritional Needs

Following LAP-BAND or REALIZE Band surgery patients also need supplemental calcium, vitamins and protein, but only so long as they are on a totally liquid diet. This appears to be a significant advantage over gastric bypass. However, the less intrusive nature of these procedures can lead to a different kind of problem, as patients may have a harder time keeping to the nutritional regime needed to maintain their weight loss.

After any weight loss surgery, it is important for patients to make significant adjustments to their diet, in particular to minimize their consumption of highly caloric liquids such as juice, soda and sugary coffee drinks.

The gastric bypass patient who disregards this is likely to suffer an intense physical reaction called dumping. Symptoms include a cold clammy sweating, nausea, palpitations, and anxiety, followed by cramps and diarrhea; episodes can last for as long as an hour. This extremely unpleasant experience can be highly motivating for gastric bypass patients to learn to control their consumption of the trigger foods.

In contrast, patients who have chosen REALIZE Band or LAP-BAND procedures don’t experience dumping. However, they actually have the same need to restrict certain foods, and without the strong physical deterrent of the dumping syndrome, it can be significantly more difficult for them to modify their behavior and habits.

Whichever procedure is chosen, patients are going to need to make a number of challenging dietary and life changes. Before deciding among gastric bypass, REALIZE Band and LAP-BAND, each person should review with his or her doctor the consequences of each and make a realistic assessment of which kind of future restrictions will be most sustainable and lead them to the most satisfactory outcome.

Dr. Goyal and the New Jersey Bariatric Center have one of New Jersey’s best medical records for weight loss surgery, with zero mortality to date and a complication rate below the national average. For more information about weight loss surgery and educational counseling, their website is

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